About one in five American adults—that’s nearly 20 percent—suffer from mental illness each year, and these disabilities affect millions more, either directly or indirectly, through family, friends, and acquaintances. Despite the prevalence of mental illness, stigma and misunderstanding still exist. Mental Illness Awareness Week (MIAW) was established in 1990 to raise awareness, help fight the stigma, and provide support to those who are challenged by these illnesses that affect all races, sexes, and age groups. The National Alliance on Mental Illness (NAMI) has devoted 2020’s campaign to the theme of “You Are Not Alone” and the MIAW theme to “What People with Mental Illness Want You to Know.” (To hear real people talk about their experiences with mental illness, click on the NAMI Mental Illness Awareness Week site here.)
What, Exactly, Is Mental Illness?
Mental health involves effective functioning in daily activities, such as work, school, and family life. People with positive mental health have healthy relationships and an ability to adapt to change and cope with hardship.
Health conditions that involve changes in emotion, thinking, or behavior—or a combination of the three—are considered mental illnesses or mental health disorders. Although many people have mental health concerns at times, people with mental illnesses experience frequent distress and problems functioning in social, work, or personal relationships and activities. Just like heart disease, diabetes, or cancer, mental illness is a medical problem that is treatable.
With nearly 20 percent of the U.S. adult population having been diagnosed with a mental illness, it is quite a common disability. Of those 20 percent, 4.1 percent have a serious mental illness, characterized by a functional impairment that substantially limits or interferes with one or more major life activities. Examples include major depressive disorder, bipolar disorder, and schizophrenia. The most severe forms may require hospitalization.
Symptoms of Mental Illness
Signs and symptoms vary depending on the disorder, but some examples include:
- Feeling sad or down
- Confused thinking and lack of concentration
- Excessive fears, worries, or feelings of guilt
- Extreme changes in mood
- Withdrawal from friends and activities
- Feeling very tired, having low energy and sleep problems
- Detachment from reality (delusional thinking), paranoia, or hallucinations
- Inability to cope with daily problems and stress
- Trouble relating to people and situations
- Problems with alcohol or drug use
- Major changes in eating habits
- Changes in sex drive
- Excessive anger, hostility, or violence
- Suicidal thinking
Causes of Mental Illness 
Mental illness is a medical condition that can result from a variety of genetic or environmental factors, including:
- Genes and family history of mental illness
- Exposure to certain environmental factors in the womb, including alcohol and drugs, viruses, and toxins
- Traumatic brain injury
- Life experiences, such as stress or a history of abuse, especially when beginning in childhood
- Biological factors such as chemical imbalances in the brain
- Serious medical conditions like cancer
- Feeling lonely and isolated and lacking social interaction
- Use of alcohol or drugs
Facts About Mental Illness
Mental illness typically begins by the age of 24, but it affects people of all ages:
- 1 in 5 U.S. adults experience mental illness each year
- 1 in 25 U.S. adults experience serious mental illness each year
- 1 in 6 U.S. youth (ages 6–17) experience a mental health disorder each year
Mental illness occurs among all races and lifestyles in the United States:
- 37 percent of LGBTQ adults
- 27 percent of multiracial adults
- 22 percent if American Indian or Alaska Native
- 20 percent of white adults
- 17 percent of Latinx adults
- 16 percent of black adults
- 15 percent of Asian adults
The annual prevalence of major disorders among U.S. adults includes:
- Anxiety disorders: 19.1 percent, or 48 million people
- Major depressive disorder: 7.2 percent, or 17.7 million people
- Post-traumatic stress disorder: 3.6 percent, or 9 million people
- Bipolar disorder: 2.8 percent, or 7 million people
- Borderline personality disorder: 1.4 percent, or 3.5 million people
- Obsessive-compulsive disorder: 1.2 percent, or 3 million people
- Schizophrenia: less than 1 percent, or 1.5 million people
Breaking Down Some Types of Disorders
There are many types of mental disorders. Common disorders include the following:
- Anxiety disorders involve a lasting worry or fear that does not go away and gets worse over time. Types of anxiety disorders are generalized anxiety disorder, panic disorder, and phobia-related disorders.
- Bipolar disorder (formerly called manic-depressive illness or manic depression) causes people to have unusual mood shifts, changes in energy and activity levels, shifts in concentration, and a lack of ability to carry out daily tasks. The three types of bipolar disorder are:
- Bipolar I disorder: manic episodes that last at least seven days or manic symptoms requiring hospitalization because of their severity. Manic episodes alternate with depressive episodes, which typically last two weeks or more. Manic and depressive episodes also can occur at the same time.
- Bipolar II disorder: a pattern of depressive and hypomanic episodes, but not the full-blow episodes of Bipolar I disorder.
- Cyclothymic disorder: periods of hypomanic symptoms and periods of depressive symptoms lasting for at least two years (or one year in children and adolescents). Symptoms are less severe than hypomanic and depressive episodes.
- Borderline personality disorder is characterized by an ongoing pattern of varying moods, self-image, and behavior causing impulsive actions and difficulty in relationships. Episodes of intense anger, depression, and anxiety can last for hours or even days.
- Depression is accompanied by feelings of:
- sadness or emptiness
- loss of interest in activities
- overeating
- not being able to sleep or sleeping too much
- extreme fatigue
- feelings of hopelessness, irritability, anxiety, or guilt
- aches or pains, headaches, cramps, or digestive disorders
- thoughts of suicide
- Eating disorders are forms of serious mental health disorders because they involve irrational thoughts about food and eating behaviors that can lead to improper nutrition and even death. Common types of eating disorders are:
- Binge-eating—eating out of control until uncomfortable and then experiencing feelings of guilt, shame, and distress. People who binge eat tend to be overweight or obese.
- Bulimia nervosa—binge eating followed by purging by using laxatives or throwing up. People with bulimia may be slightly underweight, normal weight, or overweight.
- Anorexia nervosa—avoiding food, severely restricting food, or eating very small quantities of only certain foods. Anorexics may see themselves as overweight even when they are severely underweight. People with anorexia nervosa are extremely thin. Anorexia has the highest death rate of any mental disorder.
- Major depressive disorder (clinical depression) is a common, serious mood disorder causing severe symptoms that affect how one feels, thinks, and functions. Types include:
- Persistent depressive disorder (dysthymia) lasts for two or more years and includes episodes of major depression.
- Postpartum depression (PPD) is much more than the relatively mild depressive disorder occurring within two weeks of giving birth known as the “baby blues.” PPD is full-blown depression that occurs during pregnancy or after giving birth and is characterized by episodes of overwhelming sadness, anxiety, and exhaustion that interfere with daily activities, self-care, and care for the baby.
- Psychotic depression is severe depression mixed with psychosis that can include delusions or hallucinations.
- Seasonal affective disorder (SAD) is severe depression that occurs during the winter months, when sunlight is lacking. It tends to improve during the spring and summer and includes episodes of increased sleep, weight gain, and social withdrawal.
- Obsessive-compulsive disorder (OCD) is a common, chronic, and long-lasting disorder of uncontrollable, recurring thoughts (obsessions) or behaviors (compulsions) that need to be repeated over and over.
- Post-traumatic stress disorder (PTSD) occurs in some people who have experienced an event that is frightening, shocking, or dangerous and that continues to be a major problem long after the traumatic event.
- Schizophrenia is a serious, disabling mental illness in which people lose touch with reality. Symptoms of schizophrenia fall into three categories:
- Psychotic symptoms:
- Hallucinations—hearing voices or seeing things that are not there
- Delusions—firmly held beliefs not supported by facts
- Thought disorders—unusual thinking or disorganized speech
- Negative symptoms:
- Reduced motivation and difficulty planning, beginning, or continuing activities
- Diminished feelings of pleasure
- Reduced expression of emotions via facial expression or voice tone known as “flat affect”
- Cognitive symptoms:
- Difficulty processing information to make decisions
- Problems using information immediately after learning it
- Trouble focusing or paying attention
- Psychotic symptoms:
Diagnosis and Treatment
A diagnosis for a mental illness includes going over the person’s medical history, performing a physical exam with lab tests, and having a psychological evaluation performed to discuss thinking patterns, feelings, and behaviors.
Treatment for mental illness depends on the severity of the illness, but it typically involves therapy, medications, and outside social support, such as peer support groups.
Intensive treatment is usually reserved for people with major mental illnesses and may include hospitalization. Hospitalization may be recommended for people with a detachment to reality or who are a threat to themselves or others. Psychiatric stays include counseling, group discussions, and activities.
Seeking Help
See a mental health professional when you notice signs or symptoms of mental illness since mental illness does not improve on its own. Call your primary care doctor or your mental health provider for direction.
If you have suicidal thoughts: 
- Call 9-1-1 if you feel you must act on those thoughts immediately
- Call a suicide hotline at 800-273-TALK (8255) or 888-700-4889 en español
- Text HOME to 741741 to be connected to a crisis counselor
- Connect to Lifeline Chat
- Connect to the SD County Access and Crisis Line Live Chat in the evenings, 4 p.m. to 10 p.m.
- Visit the county’s East County walk-in crisis clinic at 1000 Broadway, Suite 210, El Cajon or call 619-401-5500
- Reach out to a friend or loved one
- Contact a clergyperson or someone in your faith community
Prevention
Mental illness cannot be prevented completely, but there are ways to keep symptoms under control. They include:
- Paying attention to warning signs: Work with mental health professionals to learn and avoid triggers and what to do when symptoms return.
- Getting routine medical care: Get regular checkups to keep track of any new symptoms or side effects of medications.
- Getting help when needed: Seek help early. Do not wait until symptoms get bad, which only prolongs treatment and suffering.
- Taking care of oneself: Get adequate sleep, a good diet, and regular physical fitness to improve overall health.
Herrick Library Resources
The following resources are available at Herrick Library to reserve and check out via curbside pickup or electronically via OverDrive , where indicated*:
- Anxiety: The Ultimate Teen Guide*, by Kate Frommer Cik (2020): This ebook provides valuable information for young adults struggling with all degrees of anxiety.
- Bipolar Disorder Survival Guide: What You and Your Family Need to Know, by David Miklowitz: The author shares proven strategies for managing bipolar disorder or supporting a loved one with the disorder.
- (Don’t) Call Me Crazy*, edited by Kelly Jensen (2018): In this ebook, 33 actors, athletes, writers, and artists offer essays, comics, and lists on a wide range of mental health issues.
- The Disturbed Girl’s Dictionary*, by NoNieqa Ramos (2019): This work of young adult fiction is told from the perspective of a teen dealing with a depressed mother, an imprisoned father, and a brother who is in the custody of Child Protective Services.
- Empty: A Memoir*, by Susan Burton: The author reveals the story of her binge-eating disorder and anorexia that started in her adolescence.
- The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness, by Susannah Cahalan (2020): The New York Times best-selling author of Brain on Fire investigates the story behind the experiment by a Stanford psychologist and eight others who entered asylums in the 1970s while undercover.
- Hidden Valley Road: Inside the Mind of an American Family*:, by Robert Kolker: This Oprah’s Book Club pick tells the story of one of the first families studied by the National Institute of Mental Health because six of the 12 children were diagnosed with schizophrenia.
- The Hilarious World of Depression, by John Moe (2020): Written by the creator of the podcast of the same name, this book is part memoir and partly a collection of funny stories about people suffering from depression.
- I Am Brian Wilson, by Brian Wilson (2016): From the creator of the Beach Boys hits “God Only Knows” and “Good Vibrations” comes this memoir of Wilson’s challenge with mental illness and drug use and how he returned to a life of mental stability.
- One Nation Under Stress: The effect stress has on mental and physical health is investigated in this 2019 HBO documentary.
- Prozac Monologues: A Voice from the Edge*, by Willa Goodfellow: Misdiagnosed and therefore prescribed the wrong medications, Goodfellow recounts her life with Bipolar 2 through edgy and funny essays.
- Robin Williams: Come Inside My Mind: This 2018 HBO film explores the life and times and mental ups and downs of the talented, one-of-a-kind comedian Robin Williams, who died by suicide in 2014.
- Shockaholic, by Carrie Fisher (2011): The former Star Wars star and author discusses everything from her career to her bipolar disorder and addiction, which may have contributed to her death in 2017.
- Silver Linings Playbook (review to come later in the week): Nominated for eight Academy Awards, this 2012 film is an entertaining yet realistic look at mental illness.
- Teen Depression: Signs, Symptoms, and Getting Help: This 2009 video explores depression from the point of view of teens.
- When Your Adult Child Breaks Your Heart: Coping with Mental Illness, Substance Abuse, and the Problems That Tear Families Apart, by Joel L. Young: The suffering that parents of the mentally ill and substance abusers endure is highlighted in this book, which offers anecdotes, advice from other parents, and practical information for those struggling to make tough decisions.
Sources: American Psychiatric Association, What Is Mental Illness?, https://www.psychiatry.org/patients-families/what-is-mental-illness; Mayo Clinic, Mental Illness, https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968; MedlinePlus, Depression, https://medlineplus.gov/depression.html; Medline Plus, Eating Disorders, https://medlineplus.gov/eatingdisorders.html; National Alliance on Mental Illness, Mental Illness Awareness Week, https://www.nami.org/Get-Involved/Awareness-Events/Mental-Illness-Awareness-Week; National Institutes of Health, Health Topics: Mental Disorders and Related Topics, https://www.nimh.nih.gov/health/topics/index.shtml;
Graphics: https://www.nami.org/Get-Involved/Awareness-Events/Awareness-Resources; https://choosework.ssa.gov/blog/25-years-of-mental-health-awareness-week; http://www.namispokane.org/may-is-mental-health-awareness-month/
