How do you know if you are mentally ill?

This thought occurred to me today and I thought maybe it was a good question to explore. In my profession as a mental health therapist, I have come across many people who have been described or even diagnosed as mentally ill that I felt may not qualify.

Let me explain:

You see there are times in all of our lives when we could be considered insane. Upon the death of a loved one, or during a horrifically painful situation where just staying alive will cause us to have quesionable behavior. Being in a strange country without speaking the language, getting lost and frustrated can cause us to be a bit unmanageable. Being poor and without food will cause us to do some pretty horrific things to feed ourselves or our families. Freeing ourselves from severely abusive situations by killing another person or disappearing for example can all be described as mental illness. During times of war and even times when our hormones are out of balance like after the birth of a child can cause us to be temporarily “out of our minds”. I have met and worked with people that were carrying the voice of a very temperamental and dangerous alter ego around that could snap at any time that were never diagnosed as mentally ill. I have had the kindest and most scared of men and women in my office crying because noone will help them with their “madness”. None of these describe mental illness necessarily. You see, mental illness isn’t situational. It can not be curried only managed.

This begs the question, when does it become illness?

According to the DSM 5 TR mental illness is when we are so sick that it disrupts our ability to function in society. I don’t know about you but I have met some really handy ”mentally ill” people that have managed to do pretty well for themselves. An example where mental illness is not only recognized but celebrated is Narcissistic personality disorder (NPD). The Diagnosis of Narcissistic Personality Disorder(NPD) is characterized by a general lack of empathy toward others and is one of the three most dangerous disorders a person can have as it relates to other people. There is a high correlation with some of the traits of NPD and what constitutes as the prototype CEO especially in American culture. You don’t have to look too far to see examples of this throughout history though and I doubt it would take long to identify several in your own memory. The funny thing is, this is not seen as mental illness because of the perception that they are contributing to society and living their best lives.

So how do you know?

Maybe the answer isn’t clear.

Here is a list of symptoms that may indicate it is time to get diagnosed by a professional:

1. Feeling sad or down

2. Confused thinking or reduced ability to concentrate

3. Excessive fears or worries, or extreme feelings of guilt

4. Extreme mood changes of highs and lows

5. Withdrawal from friends and activities

6. Significant tiredness, low energy or problems sleeping

7. Detachment from reality(delusions), paranoia hallucinations.

8. Inability to cope with daily problems or stress

9. Trouble understanding and relating to situations and people.

10. Problems with drugs or alcohol

11. Sex drive changes

12. Excessive anger or hostility

13. Suicidal thinking

    You can see how this can still be confusing. Every one of these things can be caused by some other physical ailment or social situation and it is confusing while self evaluating. Make sure that you do not self diagnose because it is not helpful.

    I think before I became a therapist I knew when someone I loved was acting so out of the norm that there must be an explanation other than they were “just making it up”or “ being stupid”. Many of my friends and even myself have had times when we needed to have help to sort out what was happening to us. Circumstances can make us very sick.

    The truth is, knowing if you are mentally ill is not something you should decide on your own.

    If you feel like you have several of these symptoms and want some support finding the right diagnosis, please contact a mental health therapist for help..

    And as always if you feel suicidal or are in crisis in the US please dial the lifeline at 988 on your cell phone.

    Many blessings

    Karen Van Acker LPC