Everyone has mental health, just as everyone has physical health. Think of the pain scale featured in doctors’ offices—the same type of scale can be used to consider mental health symptoms, physical pain, or other ailments and symptoms. Mental health includes how we think, feel, cope, relate to others, make decisions, and function on a day-to-day basis. Our mental health can be impacted and can change over time through both ordinary and extraordinary life circumstances. Stress, relationships, physical health, trauma, sleep, substance use, life transitions, genetics, and other factors play a crucial role in the development of a person’s mental health.
Most people go through periods of anxiety, sadness, grief, anger, or stress—that does not mean they have a mental health disorder. If these experiences are left unmanaged or unaddressed, they could develop into a disorder, and the factors listed above can influence how significantly that disorder develops.
Mental Health Isn’t “Healthy or Mentally Ill”
In the opening of this article, I mentioned that mental health exists on a continuum. A simple continuum may consist of:
Thriving → Managing → Struggling → Significant Symptoms → Mental Health Disorder → Crisis
People will move back and forth along this continuum throughout their lives. Many factors play a role in what causes someone to progress or regress along the continuum and what may help a person remain healthier or become more mentally ill.
When Does Something Become a Mental Health Disorder?
There are many things a professional will consider when determining whether something is developing into a mental health disorder.
- How long have the symptoms been present?
- How intense are the symptoms?
- How often are the symptoms occurring?
- Are the symptoms interfering with work, school, relationships, sleep, self-care, or daily responsibilities?
- Are the symptoms causing distress or impairment?
While the symptoms are important, their frequency, intensity, persistence, and impact on daily functioning are often what separate mental health symptoms from a mental health disorder. Many people live large portions of their lives in the managing stage with symptoms. The symptoms are present, perhaps even regularly, but they aren’t intense enough to prevent them from functioning at an optimal level. When a person’s symptoms begin causing distress that they or others notice, it is time to start a conversation about treatment options.
The Mental Health Spectrum Is Much Broader Than Depression and Anxiety
There are so many different categories and subcategories of mental health disorders that it would be impossible to discuss each one in a single article. Here are the main categories:
- Depressive disorders
- Anxiety disorders
- Trauma- and stressor-related disorders
- Obsessive-compulsive and related disorders
- Bipolar disorders
- Psychotic disorders
- Personality disorders
- Eating disorders
- Neurodevelopmental disorders
- Somatic symptom and related disorders
- Dissociative disorders
- Substance use and co-occurring disorders
Even within the same diagnosis or diagnostic category, two people can present differently. Each diagnosis has a set of criteria that must be met, typically requiring a person to meet a specific number of criteria. This leaves room for the particular criteria—or symptoms—a person experiences to vary from one person to another.
Mental Health Symptoms Don’t Always Look Like What We Expect
Often, people experiencing mental health symptoms—even when those symptoms are significant—can hide or mask them well. The symptoms may become more obvious as they grow more intense or frequent or when the person experiences a crisis. Mental illness doesn’t just show up as anxiety, hyperactivity, sadness, or distress. It can also look like irritability, isolation, difficulty concentrating, changes in sleep, physical complaints, perfectionism, anger, difficulty making decisions, needing constant reassurance, excessive worry, avoidance, appetite changes, feeling numb, and trouble maintaining relationships.
Just because a person appears stable doesn’t mean they are.
Mental Health and Substance Use Often Overlap
Individuals experiencing the symptoms discussed so far may be at risk of turning to alcohol or other drugs to cope with their symptoms. While certainly not everyone will develop a co-occurring disorder involving addiction and mental health, an estimated 21.2 million U.S. adults had both a mental health disorder and a substance use disorder in 2024.
On the surface, and for a short time while using the substance, a person may experience symptom relief. This can cause them to continue seeking out the substance so they do not feel the way they are feeling or can induce a feeling they are looking for. Over time, tolerance develops, causing a person to need more of the substance to get the same desired effect, and dependence may develop. Eventually, substance use can worsen psychiatric symptoms and cause further destabilization due to withdrawal and dependence.
If a person is experiencing both mental health and substance use problems, both need to be addressed. Leaving either one unaddressed will only perpetuate the cycle of mental health destabilization and substance use.
Do I Have a Disorder—or Am I Just Going Through Something?
An intensification of emotions and feelings can be an understandable response to typical life stressors—grief, divorce, job loss, caregiving, financial stress, physical illness, life transitions, and more. These symptoms could be short-lived and resolve over a brief period of time.
Other times, symptoms may persist or become significant enough that a person meets the criteria for a mental health disorder.
The reasons symptoms persist for some people and not others depend on many factors, including trauma history, coping skills, support systems, resilience, genetics, and the brain. It doesn’t mean one person is better than another because they handle stress differently. You shouldn’t think less of yourself, or anyone else, if you or they decide to seek help.
Both situations warrant therapy and support, and the section below outlines when to get help.
So…When Should Someone Get Help?
You don’t need to have a mental illness, be experiencing significant symptoms, or be in crisis to seek help. If you feel like you are managing but are starting to struggle, or if things are becoming difficult to manage on your own, consider reaching out.
Specifically, look for the following:
- Symptoms are lasting for longer periods or worsening.
- You’re avoiding things you enjoy doing.
- Normal activities and responsibilities are becoming harder to perform or accomplish.
- Sleep and appetite have changed significantly.
- Alcohol or substance use to cope is increasing.
- You are experiencing anxiety or panic attacks.
- You are experiencing mood swings, much lower moods, or more elevated moods.
- You are struggling to control your emotions.
- Negative self-talk is increasing, or your view of yourself is becoming more negative.
- People are expressing concern.
You don’t need to check each box—even checking one box is enough to consider seeking help. Waiting until life is unmanageable can make reaching out more difficult.
What Does “Getting Help” Actually Look Like?
There are various levels of care and treatment options. Help doesn’t automatically mean hospitalization, medication, or years of therapy.
Help can range from primary care conversations and maintenance to outpatient therapy, psychiatric consultation, medication, support groups, structured outpatient programs such as PHP or IOP, or hospitalization. Some of these can even be used in conjunction with one another.
There is no one-size-fits-all approach to treatment and therapy. It is important that you put in the effort when engaging in therapy so you get the most out of it. Therapy isn’t easy, but the work is meaningful and can lead to a healthier, more stable life.
The length of time a person spends in therapy will vary depending on the person, the situation, and the presenting problems. Some people may enter therapy briefly for a specific issue and never need to return, while others will. Some people may require more time in therapy and move through various levels of care.
What’s important is that you understand your needs and consider what professionals are recommending.
What About a Mental Health Crisis?
When a mental health crisis arises, seeking help immediately is important.
Urgent help is warranted when someone:
- Is thinking about suicide or harming themselves
- Is threatening or attempting to harm someone else
- Is experiencing severe psychosis or disorganization
- Cannot adequately care for their basic safety
- Is behaving in a way that creates immediate danger
You can always call 911 for assistance in these situations. You can also call or text the 988 Suicide & Crisis Lifeline at 988, 24 hours a day, seven days a week. If someone is in immediate danger, call 911.
Mental Health Care Is Health Care
Mental health care is as important as physical health care. We don’t tell someone with diabetes or a heart condition to wait to get help. Nor do we shame them for changing their lifestyle or taking prescribed medications.
We need to treat mental health the same way. Getting help early can prevent symptoms from escalating, improve functioning, and make treatment considerably easier. Treatment can help a person better understand themselves and where their symptoms are coming from, while also helping them monitor those symptoms to reduce the risk of future decompensation.
We don’t want to label every difficult symptom or emotion as an illness. We do want to recognize when emotional or behavioral changes occur, pay attention to them, and reach out early.
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