May 03, 2021

By McKenna Schueler

According to the National Institute of Mental Health (NIMH), nearly one in five adults in the U.S. has mental illness. Despite how common mental health conditions are, not everyone knows how to identify them.

Early warning signs of mental illness are often missed. Family members, friends and even doctors can overlook lesser-known symptoms as a result of stigma, lack of mental health education and diagnostic bias. This is particularly true for people that don’t fit the textbook example of what having a mental illness looks like.

Early detection and intervention for mental illness is key to help a person get connected to a support system and improve long-term recovery outcomes. Especially considering that untreated mental illness can lead to both worsening symptoms and unhealthy coping mechanisms, such as substance use.

Early intervention starts with being able to recognize the warning signs, especially ones that can be mistaken for other health issues. Here are five symptoms of mental illness that are often overlooked.

1. Constant Fatigue
This shouldn’t come as a surprise, but living with mental illness can be exhausting.

Let’s say, for example, that a person has undiagnosed obsessive-compulsive disorder. It is likely they will be experiencing intrusive or obsessive thoughts that can be extremely draining and then acting on those thoughts (compulsions), which also takes a lot of energy.

Then, there is trying to keep up with work, school or other responsibilities on top of dealing with these symptoms. And maybe this person is trying to hide what they are going through so they don’t have to face judgment, shame or stigma from others, which takes even more of their energy to act “normal” as if none of this is going on in the background.

In other words, there are many biological, environmental and social factors that can explain why someone who has mental illness may feel tired a great deal of the time. If a person is exhausted for what seems like no reason, it might be worth asking questions to understand why.

2. Physical Pain
A key understanding in the integrated approach to mental health is that the body and the mind are inextricably connected. If your body is sick, this can affect your mental health. And vice versa.

Research shows that up to 50% of people with chronic pain conditions experience symptoms of depression. Conditions such as depression and anxiety can also cause upset stomach, changes in digestion, body aches, headaches, among other symptoms.

In addition, some research shows that people with certain mental health disorders, such as depression, may have increased sensitivity to pain, in part due to interactions between brain chemicals associated with these disorders and pain sensation. Pain sensitivity can be influenced by a variety of personal, physiological and biological factors and is an ongoing area of research in its connection with mental illness.

If someone is having random aches and pains that cannot be explained by their physical health, it may be worth exploring whether it’s related to their mental health.

3. Perfectionism
Some mental illnesses can distort how you perceive yourself, others and your surroundings. One of the ways that this can show in your life is in the expectations you set for yourself.

People with anxiety disorders or eating disorders, for instance, can become driven by a desire to achieve perfection in all or some areas of their lives: In school, at work, in their physical appearance or eating habits.

None of us are meant to be perfect. While self-improvement can be a commendable goal, we all need a balance between self-improvement and striving for standards that may be based on a distorted perception of our capabilities. This is one telling sign that there may be an underlying mental health issue if someone will accept nothing less than perfection.

4. Lack of Emotion
Lack of emotion is a common symptom of mental illness that isn’t always talked about. When we have conversations about mental illness, people often talk about how people may feel very depressed, anxious, upset or excitable.

None of these experiences are invalid. But there’s a need to acknowledge that people can also experience something of the exact opposite: Nothing, blankness, a blatant disregard for yourself, others and the world around you.

For example, if you’re depressed, you may find yourself less interested in activities you used to enjoy, or even the people around you.

In psychiatry, an inability to experience pleasure is referred to as “anhedonia.” And while we all have off days, it’s important to note if a person loses the ability to experience joy for an extended period of time.

5. Avoidance
Everyone has times where they might avoid a certain task, or even certain people, for a variety of reasons: Procrastination, stress or a lack of interest. Developing a pattern of avoidance, however, can sometimes be a sign of a deeper issue.

People with panic disorders, for instance, may repeatedly avoid certain situations that trigger their panic attacks. Avoidance can also be seen in people with schizophrenia who experience delusions. For example, someone experiencing a delusion may feel convinced to their core that a certain object, person or activity is “evil” or will cause harm to themselves or others.

For some people with mental illness, avoidance can become a coping strategy. If you avoid X, Y or Z, then you don’t have to face the challenges that might come with it. This usually leads to a person setting hard limits on what they can and can’t do, often making their symptoms even worse.


Understanding the Complexity of Mental Illness

All in all, what’s important to understand about mental illness is that it doesn’t look the same way for everyone. Mental illness affects people across cultural, racial, ethnic and socioeconomic lines. Our environments, our biology and our cultural understandings of mental health can shape our experiences of mental illness and how we might identify symptoms in others.

If you believe you or someone you know is living with undiagnosed mental illness, you’re not alone. Identifying signs of mental illness, and acknowledging there might be a problem, is the first step toward getting help.


McKenna Schueler works as a content specialist for the company Ark Behavioral Health, which owns a network of substance abuse treatment centers in Massachusetts. She holds a Bachelor of Arts degree in English with a minor in Psychology. McKenna also works as an independent journalist, covering topics of labor, news, politics and policing from where she lives in Tampa, FL.

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