Onset of mental health problems

Introduction

Here, people talk about when their mental health problems first began. Views about what caused their mental health problems are covered elsewhere (see 'views about causes'). Some people first began to experience mental health problems as teenagers, a few when they were children, while others experienced them much later in life, in their 40s. One woman, diagnosed with an eating disorder, said she began “using food” as a way of coping with family problems when she was a child. Some people were at university, college or school when their mental health problems began (see 'Losses & gains: affects on everyday lives'). And many people became unwell following a tough childhood (see 'Views about causes: social & environmental factors'). 

When Tariq first began feeling unwell he didn't know what it was, but said it felt "normal" like having the 'flu. But he was still too embarrassed to tell people about it. (Read by an actor).

Circumstances leading up to onset

Often people had experienced a whole series of difficulties in different areas of their lives prior to becoming unwell. These included problems at work and at home. People described conflicts with their family or partner, marriage breakdowns, and bereavement, as well as experiencing housing and financial problems. One woman described arguing with her husband about financial matters. Many people had been separated from their parents (or surrogate parents) as children, including one woman who was placed in Local Authority care. Several had recently migrated, and loneliness and isolation were often mentioned. Some people had experienced abuse or rape or other kinds of physical harm. For some, this was at the hands of family members, while others were bullied at school or work. One woman felt that because she was being bullied at school and did not have a good relationship with her parents, she was “already in a vulnerable state” when she started hearing voices. Some people also mentioned experiencing racism.

Sarah began having difficulty sleeping when gangsters were threatening her and her husband in their business; at the time, she was also having financial problems. (Original interview in Cantonese, text in English).

David's mental health problems began when he was five years old and he was experiencing racism and bullying.

A few people had experienced physical health problems and a few women described beginning to feel unwell during pregnancy or following the birth of a child, while others became unwell after having a miscarriage or having trouble getting pregnant. (See 'Views about causes: individual factors'.) 

Shareen first became depressed after being told she couldn't have any more children. (Read by an actor).

Some people talked about members of their family having mental health problems, including one man who experienced his first episode of psychosis shortly after meeting his mother who also had schizophrenia. 

Edward had his first experience of psychosis after the "shock" of migrating to Australia and meeting his mother for the first time aged 20.

Others mentioned drinking alcohol and using drugs just before they became unwell.

Noticing something was wrong

For some, their experience began merely as a feeling that something was “not quite right” whilst others began hearing voices or experiencing delusions (see 'Hallucinations & delusions'). For a few people, onset was very sudden [see Dolly below]. People responded to what was happening in different ways. Some did not realise anything was wrong or thought that what they were experiencing was “natural” or “normal” (see 'Ways of describing mental health problems'). [See Tariq above] Others said they were aware that something was definitely wrong. Some weren't sure what was happening and felt confused, believing it might eventually go away, or thought it was something else, like a physical health problem.

Nelsy didn't realise she was experiencing mental health problems and was shocked when she was taken to a psychiatric hospital.

Some said they did not tell anyone what was happening because they were embarrassed, scared or in the case of one woman, felt they were perceived as coping and “strong”. [See Tariq above] Some said they tried to carry on, and one man said he tried “to act normal” to keep it secret, “but I wasn't fooling anyone”.

People didn't notice Imani was depressed because she gave them the impression that she was strong and coping; she didn't want to tell them or appear as if she couldn't cope.

Many people described how parents, siblings and friends also started to notice that there may be something wrong, based on changes in behaviour or facial expressions or not seeing them for a while. For those who thought that there was nothing wrong, people's responses were puzzling. One woman thought her mother “was making a fuss over nothing”, while one man began to think there must be something wrong because he trusted his mum [See Devon below].

Judy became sick when she couldn't cope any more following the murder of her brother and her mother's illness; other people noticed and she was taken to hospital by the crisis team.

Others said that no-one noticed that anything was wrong, because they were perceived to be “strong” [see Imani above].

What people did when they realised something was wrong

Once people realised something was wrong, most eventually went to see their doctor. People also made contact with social services or the hospital, or were referred to specialists, such as a child psychiatrist. Others were taken to see a health professional against their will by a concerned family member or by the police. One woman's sister went to the GP who sent the early intervention team. One woman was so distressed by the voices she was hearing, she attempted suicide [see Dolly below].

Tariq's story

Dolly started to hear voices aged 14 and thought it would go away; she was referred to a child psychiatrist after attempting suicide.

Devon's mother called the doctor and then the police because she noticed that there was something wrong - although he didn't think there was.

One man says, on reflection, he was glad he was forced to see the doctor, as he was putting himself in danger.

Hanif's father forced him to see a psychiatrist and he thinks it was probably for the best because his behaviour was putting him at risk and he wouldn't have accessed services otherwise.

Last reviewed November 2010.

Last updated November 2010.