Facts & Tools

What is Mental Health?

Mental Health includes our emotional, psychological, and social well-being. Mental health affects how we think, feel, and act, as well as determines how we handle stress, make choices and relate to others. Mental Health is important all through a person’s life.

Mental Health Wellness Tips

Below are tips to assist someone working toward improving their mental health wellness:

  • Maintaining a healthy diet
  • Exercising regularly
  • Keeping regular medical appointments
  • Maintaining positive and healthy relationships
  • Setting realistic goals for yourself
  • Practicing meditation
  • Taking breaks throughout the day

What is Mental Illness?

A Mental Illness is a disorder that can cause psychological and/or behavioral disturbances. The good news is that Mental Illnesses are treatable…there is help and hope!

The impact is more than in statistics and factoids, it’s in feelings and emotions. It’s in our families, with our friends and in our communities. Having a mental disorder should not be any different than experiencing a physical illness. And it doesn’t have to be; you can help make a difference.

A mental illness makes the things you do in life hard, like: work, school and socializing with other people. If you think you (or someone you know) might have a mental disorder, it is best to consult a professional as soon as possible. Early identification and effective intervention is the key to successfully treating the disorder and preventing future disability. A health care professional (doctor, mental health specialist, etc) will connect the symptoms and experiences the patient is having with recognized diagnostic criteria (DSM or ICD) to help formulate a diagnosis.

Types of Mental Illness

Anxiety Disorders
When feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause. Anxiety disorders are the most common mental health concern in the United States, with an 40 million adults in the U.S. (19.1%) diagnosed with an anxiety disorder.

Attention-Deficit/Hyperactivity Disorder (ADHD)
Attention-deficit hyperactivity disorder (ADHD) is a condition characterized by inattention, hyperactivity and impulsivity. The most commonly diagnosed behavior disorder in young people, the Center for Disease Control and Prevention (CDC) reports that ADHD affects an estimated 9 percent of children aged 3-17 and 2-4 percent of adults. Although ADHD has its onset and is usually diagnosed in childhood, it is not a disorder limited to children—ADHD often persists into adolescence and adulthood and is frequently not diagnosed until later years.

Bipolar Disorder
Bipolar disorder is a chronic illness with recurring episodes of mania and depression that can last from one day to months. This mental illness causes unusual and dramatic shifts in mood, energy and the ability to think clearly. Cycles of high (manic) and low (depressive) moods may follow an irregular pattern that differs from the typical ups and downs experienced by most people.

Depression
Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. More than 17 million U.S. adults—over 7% of the population—had at least one major depressive episode in the past year. People of all ages and all racial, ethnic and socioeconomic backgrounds experience depression, but it does affect some groups more than others. Some will only experience one depressive episode in a lifetime, but for most, depressive disorder recurs. Without treatment, episodes may last a few months to several years.

Dual Diagnosis and Integrated Treatment of Mental Illness and Substance Abuse Disorder
Dual diagnosis (also referred to as co-occurring disorders) is a term for when someone experiences a mental illness and a substance use disorder simultaneously. Either disorder—substance use or mental illness—can develop first. People experiencing a mental health condition may turn to alcohol or other drugs as a form of self-medication to improve the mental health symptoms they experience. However, research shows that alcohol and other drugs worsen the symptoms of mental illnesses.

Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don’t make sense, they are often unable to stop them.

Post-Traumatic Stress Disorder (PTSD)
Traumatic events—such as an accident, assault, military combat or natural disaster—can have lasting effects on a person’s mental health. While many people will have short term responses to life-threatening events, some will develop longer term symptoms that can lead to a diagnosis of Post-Traumatic Stress Disorder (PTSD). PTSD symptoms often co-exist with other conditions such as substance use disorders, depression and anxiety.

If you are concerned you or a loved one has a mental health or substance use disorder, contact a behavioral health professional for further evaluation

Warning Signs of Mental Illness

It can be challenging to tell the difference between expected behaviors and potential signs of a mental health condition. There’s no easy test that can let someone know if there is mental illness or if actions and thoughts might be typical behaviors of a person or the result of a physical illness.

Each mental health condition has its own symptoms, but common signs of mental illness in adults and adolescents can include the following:

  • Excessive worrying or fear
  • Feeling excessively sad or low
  • Confused thinking or problems concentrating and learning
  • Extreme mood changes, including uncontrollable “highs” or feelings of euphoria
  • Prolonged or strong feelings of irritability or anger
  • Avoiding friends and social activities
  • Difficulties understanding or relating to other people
  • Changes in sleeping habits or feeling tired and low energy
  • Changes in eating habits such as increased hunger or lack of appetite
  • Changes in sex drive
  • Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don’t exist in objective reality)
  • Inability to perceive changes in one’s own feelings, behavior or personality (”lack of insight” or anosognosia)
  • Abuse of substances like alcohol or drugs
  • Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing “aches and pains”)
  • Thinking about suicide
  • Inability to carry out daily activities or handle daily problems and stress
  • An intense fear of weight gain or concern with appearance


Mental health conditions can also begin to develop in young children. Because they’re still learning how to identify and talk about thoughts and emotions, their most obvious symptoms are behavioral. Symptoms in children may include the following:

  • Changes in school performance
  • Excessive worry or anxiety, for instance fighting to avoid bed or school
  • Hyperactive behavior
  • Frequent nightmares
  • Frequent disobedience or aggression
  • Frequent temper tantrums

What is Depression?

Feeling down from time to time is a normal part of life, but when emotions such as hopelessness and despair take hold and just won’t go away, you may have depression. More than just sadness in response to life’s struggles and setbacks, depression changes how you think, feel, and function in daily activities. It can interfere with your ability to work, study, eat, sleep, and enjoy life. Just trying to get through the day can be overwhelming.

While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular can feel angry and restless. However, you experience depression, left untreated it can become a serious health condition. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation.

No matter how hopeless you feel, you can get better. By understanding the cause of your depression and recognizing the different symptoms and types of depression, you can take the first steps to feeling better and overcoming the problem.

Signs and Symptoms of depression
Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression.

10 common symptoms of depression:

  • Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
  • Loss of interest in daily activities. You don’t care anymore about former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
  • Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
  • Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping.
  • Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
  • Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
  • Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
  • Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
  • Concentration problems. Trouble focusing, making decisions, or remembering things.
  • Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Causes
Depression does not have a single cause. It can be triggered by a life crisis, physical illness or something else—but it can also occur spontaneously. Scientists believe several factors can contribute to depression:

  • Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These changes may lead to depression.
  • Genetics. Mood disorders, such as depression, tend to run in families.
  • Life circumstances. Marital status, relationship changes, financial standing and where a person lives influence whether a person develops depression.
  • Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
  • Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) can mimic depressive disorder. Some medications can also cause symptoms of depression.
  • Drug and alcohol misuse. 21% of adults with a substance use disorder also experienced a major depressive episode in 2018. Co-occurring disorders require coordinated treatment for both conditions, as alcohol can worsen depressive symptoms.

 

Treatments
Although depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After an assessment rules out medical and other possible causes, a patient-centered treatment plans can include any or a combination of the following:

  • Psychotherapy including cognitive behavioral therapy, family-focused therapy and interpersonal therapy.
  • Medications including antidepressants, mood stabilizers and antipsychotic medications.
  • Exercise can help with prevention and mild-to-moderate symptoms.
  • Brain stimulation therapies can be tried if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.
  • Light therapy, which uses a light box to expose a person to full spectrum light in an effort to regulate the hormone melatonin

Alternative approaches including acupuncture, meditation, faith and nutrition can be part of a comprehensive treatment plan.

What is Self-harm?

People often keep it a secret, but the urge to self-harm isn’t uncommon, especially in adolescents and young adults. Many overcome it with treatment.

Whether a person has recently started hurting themself or has been doing it for a while, there is an opportunity to improve health and reduce behaviors. Talking to a doctor or a trusted friend or family member is the first step towards understanding your behavior and finding relief.

Self-harm or self-injury means hurting yourself on purpose. One common method is cutting with a sharp object. But any time someone deliberately hurts themself is classified as self-harm. Some people feel an impulse to cause burns, pull out hair or pick at wounds to prevent healing. Extreme injuries can result in broken bones.

Hurting yourself—or thinking about hurting yourself—is a sign of emotional distress. These uncomfortable emotions may grow more intense if a person continues to use self-harm as a coping mechanism. Learning other ways to tolerate the mental pain will make you stronger in the long term.

Self-harm also causes feelings of shame. The scars caused by frequent cutting or burning can be permanent. Drinking alcohol or doing drugs while hurting yourself increases the risk of a more severe injury than intended. And it takes time and energy away from other things you value. Skipping classes to change bandages or avoiding social occasions to prevent people from seeing your scars is a sign that your habit is negatively affecting work and relationships.

Why People Self-harm

Self-harm is not a mental illness, but a behavior that indicates a need for better coping skills. Several illnesses are associated with it, including borderline personality disorder, depression, eating disorders, anxiety or posttraumatic distress disorder.

Self-harm occurs most often during the teenage and young adult years, though it can also happen later in life. Those at the most risk are people who have experienced trauma, neglect or abuse. For instance, if a person grew up in an unstable family, it might have become a coping mechanism. If a person binge drinks or uses illicit drugs, they are at greater risk of self-injury, because alcohol and drugs lower self-control.

The urge to hurt yourself may start with overwhelming anger, frustration or pain. When a person is not sure how to deal with emotions, or learned as a child to hide emotions, self-harm may feel like a release. Sometimes, injuring yourself stimulates the body’s endorphins or pain-killing hormones, thus raising their mood. Or if a person doesn’t feel many emotions, they might cause themself pain in order to feel something “real” to replace emotional numbness.

Once a person injures themself, they may experience shame and guilt. If the shame leads to intense negative feelings, that person may hurt themself again. The behavior can thus become a dangerous cycle and a long-time habit. Some people even create rituals around it.

Self-harm isn’t the same as attempting suicide. However, it is a symptom of emotional pain that should be taken seriously. If someone is hurting themself, they may be at an increased risk of feeling suicidal. It’s important to find treatment for the underlying emotions.

Treatment and Coping

There are effective treatments for self-harm that can allow a person to feel in control again. Psychotherapy is important to any treatment plan. Self-harm may feel necessary to manage emotions, so a person will need to learn new coping mechanisms.

The first step in getting help is talking to a trusted adult, friend or medical professional who is familiar with the subject, ideally a psychiatrist. A psychiatrist will ask that person questions about their health, life history and any injurious behaviors in the past and present. This conversation, called a diagnostic interview, may last an hour or more. Doctors can’t use blood tests or physical exams to diagnose mental illness, so they rely on detailed information from the individual. The more information that person can give, the better the treatment plan will be.

Depending on any underlying illness, a doctor may prescribe medication to help with difficult emotions. For someone with depression, for instance, an antidepressant may lessen harmful urges.

A doctor will also recommend therapy to help a person learn new behaviors, if self-injury has become a habit. Several different kinds of therapy can help, depending on the diagnosis.

– Psychodynamic therapy focuses on exploring past experiences and emotions
– Cognitive behavioral therapy focuses on recognizing negative thought patterns and increasing coping skills
– Dialectical behavioral therapy can help a person learn positive coping methods

If your symptoms are overwhelming or severe, your doctor may recommend a short stay in a psychiatric hospital. A hospital offers a safe environment where you can focus your energy on treatment.

What to Do When Someone Self-harms

Perhaps you have noticed a friend or family member with frequent bruises or bandages. If someone is wearing long sleeves and pants even in hot weather, they may be trying to hide injuries or scarring.

Keep in mind that this is a behavior that might be part of a larger condition and there may be additional signs of emotional distress. They might make statements that sound hopeless or worthless, have poor impulse control, or have difficulty getting along with others.

If you’re worried a family member or friend might be hurting themself, ask them how they’re doing and be prepared to listen to the answer, even if it makes you uncomfortable. This may be a hard subject to understand. One of the best things is to tell them that while you may not fully understand, you’ll be there to help. Don’t dismiss emotions or try to turn it into a joke.

Gently encourage someone to get treatment by stating that self-harm isn’t uncommon and doctors and therapists can help. If possible, offer to help find treatment. But don’t go on the offensive and don’t try to make the person promise to stop, as it takes more than willpower to quit.

Stigma – What is it and how does it hurt?

Stigma is when someone is viewed in a negative way because of having a mental illness. It causes people to feel ashamed for something that is out of their control. Worst of all, stigma prevents people from seeking the help they need. The Allegany County Local Behavioral Health Authority and the Consumer Advisory Board provide public education to help address stigma and to inform the community that recovery is possible!

10 Questions to Ask When Choosing a Therapist

  1. How much will treatment cost? This may include: do you accept (insert your insurance), co-pays, sliding scales, etc.
  2. Tell me about yourself. How many years have you worked in the field. Do you have a specialty area? What is your lived and/or professional experience?
  3. What days and hours are you available for services?
  4. What should I expect at my first therapy session? How long are the appointments usually?
  5. How do I prepare for therapy?
  6. After my first visit, how do appointments get scheduled?
  7. How often do I have to come to therapy? For how long?
  8. What types of treatment do you offer?
  9. How will we assess progress?
  10. lf you are unable to address my concerns, can you refer me elsewhere?

Types of Mental Health Professionals

Many types of mental health care professionals can help you achieve your recovery goals. These professionals work in inpatient facilities, such as general hospitals and psychiatric facilities, and outpatient facilities, such as community mental health clinics, schools and private practices.

Health care professional job titles and specialties can vary by state. The descriptions below give an overview of what to look for and what credentials to expect from a mental health professional. Finding the right professional is easier when you understand the different areas of expertise and training.

The NAMI HelpLine can provide information on how to find various mental health professionals and resources in your area. Please note that we are unable to provide specific recommendations to individual providers as we are unable to speak to the quality of their care.

Assessment and Therapy
Therapists can help someone better understand and cope with thoughts, feelings and behaviors. They can also offer guidance and help improve a person’s ability to achieve life goals. These mental health professionals may also help assess and diagnosis mental health conditions.

Psychologists
Psychologists hold a doctoral degree in clinical psychology or another specialty such as counseling or education. They are trained to evaluate a person’s mental health using clinical interviews, psychological evaluations and testing. They can make diagnoses and provide individual and group therapy. Some may have training in specific forms of therapy like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and other behavioral therapy interventions.

Degree requirements: Doctor of Philosophy (Ph.D.) in a field of psychology or Doctor of Psychology (Psy.D.).

Licensure & credentials: Psychologists are licensed by licensure boards in each state.

Counselors, Clinicians, Therapists
These masters-level health care professionals are trained to evaluate a person’s mental health and use therapeutic techniques based on specific training programs. They operate under a variety of job titles—including counselor, clinician, therapist or something else—based on the treatment setting. Working with one of these mental health professionals can lead not only to symptom reduction but to better ways of thinking, feeling and living.

Degree requirements: master’s degree (M.S. or M.A.) in a mental health-related field such as psychology, counseling psychology, marriage or family therapy, among others.

Licensure & Certification: Varies by specialty and state. Examples of licensure include:
LPC, Licensed Professional Counselor
LMFT, Licensed Marriage and Family Therapist
LCADAC, Licensed Clinical Alcohol & Drug Abuse Counselor

Clinical Social Workers
Clinical social workers are trained to evaluate a person’s mental health and use therapeutic techniques based on specific training programs. They are also trained in case management and advocacy services.

Degree requirements: master’s degree in social work (MSW).

Licensure & credentials: Examples of licensure include:
ICSW, Licensed Independent Social Workers
LCSW, Licensed Clinical Social Worker
ACSW, Academy of Certified Social Worker

Prescribe and Monitor Medication

The following health care professionals can prescribe medication. They may also offer assessments, diagnoses and therapy.

Psychiatrists
Psychiatrists are licensed medical doctors who have completed psychiatric training. They can diagnose mental health conditions, prescribe and monitor medications and provide therapy. Some have completed additional training in child and adolescent mental health, substance use disorders or geriatric psychiatry.

Psychiatric or Mental Health Nurse Practitioners
Psychiatric or mental health nurse practitioners can provide assessment, diagnosis and therapy for mental health conditions or substance use disorders. In some states, they are also qualified to prescribe and monitor medications. Requirements also vary by state as to the degree of supervision necessary by a licensed psychiatrist.

Primary Care Physicians
Primary care physicians and pediatricians can prescribe medication, but you might consider visiting someone who specializes in mental health care. Primary care and mental health professionals should work together to determine an individual’s best treatment plan.

Family Nurse Practitioners
Family nurse practitioners (FNP) can provide general medical services like those of a primary care physician, based on each state’s laws. Like primary care physicians, they can prescribe medication, but you might consider visiting someone who specializes in mental health care. Family nurse practitioners and mental health professionals should work together to determine an individual’s best treatment plan.

Psychiatric Pharmacists
Psychiatrist pharmacists are advanced-practice pharmacists who specialize in mental health care. They can prescribe or recommend appropriate medications if allowed in their state and practice setting. They are skilled at medication management—meaning they evaluate responses and modify treatment, manage medication reactions and drug interactions, and provide education about medications. Many have completed additional training in child/adolescent psychiatry, substance use disorders or geriatric psychiatry.

Other Professionals You May Encounter

Certified Peer Specialists
These specialists have lived experience with a mental health condition or substance use disorder. They are often trained, certified and prepared to assist with recovery by helping a person set goals and develop strengths. They provide support, mentoring and guidance.

Social Workers
Social workers (B.A. or B.S.) provide case management, inpatient discharge planning services, placement services and other services to support healthy living.

Pastoral Counselors
Pastoral counselors are clergy members with training in clinical pastoral education. They are trained to diagnose and provide counseling. Pastoral counselors are members of the Association of Pastoral Counselors (AAPC) and can have equivalents to a doctorate in counseling.