Mental Health Diagnosis

What's normal, what's not

Understanding what's considered normal in mental health can be tricky. Feelings, thoughts and behaviors determine someone's mental health and observing these or asking about them can help you to recognize if you or a loved one has a mental health disorder.

What's the difference between mental health and mental illness? Sometimes the answer seems clear. For instance, a person who hears non-existent voices could have schizophrenia. A person who goes on a frenzied shopping spree or goes without sleeping for days at a time might be having a manic episode caused by bipolar disorder.

In some cases, however, the distinction between mental health and mental illness isn't so obvious. If you're afraid of giving a speech in public, does it mean you have a mental health condition or just normal anxiety? If you feel sad and discouraged, do you have the blues, or is it full-fledged depression?

It is difficult to distinguish normal mental health from mental illness because there's no easy test to show if something's wrong. There is no blood test or X-Ray that can diagnose a problem. Mental health conditions are diagnosed and treated based on signs and symptoms, as well as on how much the condition affects your daily life. Some signs and symptoms that can affect you are:

• Behavior. Obsessive hand-washing or drinking too much alcohol might be signs of a mental health condition.
• Feelings. Sometimes a mental health condition is characterized by a deep or ongoing sadness, euphoria or anger.
• Thinking. Delusions — such as thinking that the television is controlling your mind — or thoughts of suicide might be symptoms of a mental health condition.

How do mental health providers diagnose mental health conditions?

By asking about signs and symptoms: How you perceive your thoughts and behaviors and how much your signs and symptoms affect your daily activities can help determine what's normal for you. For instance, you might realize that you aren't coping well or that you don't want to do the things you used to enjoy. You might feel sad, hopeless or discouraged. If your sadness has a specific cause, such as divorce, your feelings could be a normal, temporary reaction. However, if you have signs and symptoms that are severe or don't go away, you could have depression. You might also need to have a physical exam to rule out any underlying health conditions.

By getting others' perceptions of you: Your perceptions alone might not give you an accurate picture of your behavior, thoughts or ability to function. Other people in your life can help you understand whether your behavior is normal or healthy. For example, if you have bipolar disorder, you might think your mood swings are just part of the normal ups and downs of life. But they might appear abnormal to others or cause problems at work, in relationships or in other areas of your life.

When is an evaluation or treatment needed?

Each mental health condition has its own set of signs and symptoms. In general, however, professional help may be warranted if you or a loved one experiences:

• Marked change in personality, eating or sleeping patterns
• Inability to cope with problems or daily activities
• Strange or grandiose ideas
• Excessive anxiety
• Prolonged depression or apathy
• Thinking or talking about suicide
• Substance abuse
• Extreme mood swings or excessive anger, hostility or violent behavior

Many people who have mental health conditions consider their signs and symptoms a normal part of life or avoid treatment out of shame or fear. If you're concerned about your mental health or a loved one's mental health, don't hesitate to seek advice from your family doctor, a counselor or psychologist. With appropriate support, you can identify mental health conditions and explore treatment options, such as medications or counseling.

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