Know the Signs | NAMI: National Alliance on Mental Illness

Know the Signs

By Mindy Tsai

I should have been more careful and more aware of my mental health

At the beginning, I did not know what was happening to me. My stable and secure life had suddenly changed: I lost my job of five years; I broke up with my boyfriend of six years who I was living with.

I was very much alone suddenly. Chris and our couple friends were not around much with everyone making similar life change events: getting married, going back to school, and starting new jobs. I was not thinking about making new friends. I kept to my room, gym, and work, my Bermuda Triangle in East Cambridge, MA. I did not feel lonely. Quite the opposite. I felt determined. I wanted to control my life and give it order and purpose. I felt that I had so much to learn. Instead of eating out and hanging out with friends, I needed to take advantage of every free minute I had to be productive.

This mental rigidity meant that I was not expecting any new changes or surprises in my life. In the past, when facing a new stage in my life, I was always ready to draw on the connection with both old and new friends. However, at this time, when I was not at work, I preferred to be alone, even isolated. Without realizing it, I started living in a world of just me.

When I started working at my new job, I was in a very happy mood. I would listen to music and, not intentionally, sing out loud in my cubicle at work. I would chat with people in my group and laughed so loud that people down the hall could hear me. That was the me without any cover-up.

I was being me, from the inside out and not considering that I was surrounded by strangers I did not know. I believe this was the start of a sequence of small and large events altered and stressed my brain in a new way that it had not experienced before. Perhaps, being inside out made me more vulnerable.

Then the emotional spikes came. Then the uncharacteristic timidity showed. Then I heard my first voice. Still then, I did not worry about myself. It took about three months or so for me to finally have a mental breakdown and call for help.

Looking back, given my isolated and vulnerable mental state, I should have been more careful and more aware of my mental health. Here are some of the lessons I learned from my experience:

    1. Understand the genetic risk. My mother triggered her schizophrenia also late in her life, in her thirties. Given that, I should have read up more about this brain condition and keep in mind of the risk as my life changed.


    1. Be careful of major shift in personality. I became single-minded and hypersensitive to any surprises. I became emotionally more vulnerable than usual.


    1. Be mindful of major environmental change. Everything about my life changed within the same six months. Suddenly, I had to face new challenges and people all around me.


  1. Talk to a health professional. If I was aware of the signs, I should have talk to someone who could help me!

If I was able to spot early signs of problems and seek professional help, perhaps, I would not trigger and go through a full-on episode of psychosis with confused thinking and auditory hallucination. Learn about mental illness. Early education and detection might save you from triggering a lifelong condition.


Mindy Tsai is an aspiring writer working on her first memoir about her schizophrenia. She also started blogging about her real and messy life at During the day, she is a project manager at a digital health consulting firm. She lives in Brookline, MA.


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Note: This personal story was prepared by its author in his or her personal capacity. The opinions expressed are the author’s own and do not reflect the views of the National Alliance on Mental Illness.

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