How Different Mental Illnesses Are Diagnosed and Treated
Mental health conditions are disturbances in a person’s thinking, feeling, or behavior (or a combination of these) that reflect a problem in mental function. They cause distress or disability in social, work, or family activities. Just as the phrase “physical illness” is used to describe a range of physical health problems, the term “mental illness” encompasses a variety of mental health conditions.
Verywell / Jessica Olah
Mental illnesses are incredibly common in the United States. Each year:
- 1 in 5 U.S. adults experience mental illness
- 1 in 25 U.S. adults live with serious mental illness
- 1 in 6 U.S. youth aged 6 to 17 years experience a mental health illness
Serious mental illness (SMI) is a term used by health professionals to describe the most severe mental health conditions. These illnesses significantly interfere with or limit one or more major life activities. Two of the most common SMIs are bipolar disorder and schizophrenia.
There are hundreds of mental illnesses listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association’s diagnostic manual. The DSM-5 puts illnesses into categories based on their diagnostic criteria.
- Anxiety disorders: This group of mental illnesses is characterized by significant feelings of anxiety or fear accompanied by physical symptoms, such as shortness of breath, rapid heartbeat, and dizziness. Three major types of anxiety disorders are generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder (SAD).
- Bipolar and related disorders: Formerly known as manic depression, bipolar disorders are characterized by alternating episodes of mania, hypomania, and major depression. There are three broad types of bipolar disorder: bipolar I, bipolar II, and cyclothymia.
- Depressive disorders: The common feature of all depressive disorders is the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect a person’s capacity to function. Examples include major depressive disorder and premenstrual dysphoric disorder (PMDD).
- Disruptive, impulse-control, and conduct disorders: A group of psychiatric conditions that affect involving problems with the self-control of emotions and behaviors. Some disorders in this group are oppositional defiant disorder (ODD), intermittent explosive disorder, kleptomania, and pyromania.
- Dissociative disorders: This group of psychiatric syndromes is characterized by an involuntary disconnection between consciousness, memories, emotions, perceptions, and behaviors—even one’s own identity or sense of self.
- Elimination disorders: Children with elimination disorders repeatedly void urine or feces at inappropriate times and in inappropriate places, whether the action is involuntary or not.
- Feeding and eating disorders: Eating disturbances are characterized by a persistent disturbance of eating patterns that lead to poor physical and psychological health. Three major eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.
- Gender dysphoria: Formerly known as gender identity disorder, gender dysphoria occurs when a person feels extreme discomfort or distress because their gender identity is at odds with the gender they were assigned at birth.
- Neurocognitive disorders: These disorders are characterized by an acquired decrease in cognitive function. In addition to Alzheimer’s disease, other conditions in this category include Huntington’s disease, traumatic brain injury (TBI), and neurocognitive issues due to HIV infection.
- Neurodevelopmental disorders: These disorders typically manifest early in development, often before a child enters grade school. They are characterized by impairments of personal, social, academic, or occupational functioning. Examples include attention-deficit/hyperactivity disorder (ADHD), autism, and learning and intellectual disabilities.
- Obsessive-compulsive and related disorders: As the name suggests, these disorders are characterized by the presence of obsessions and/or compulsions. Examples include obsessive-compulsive disorder (OCD), hoarding, and body dysmorphic disorder.
- Paraphilic disorders: Describes intense or persistent sexual interests that cause distress or impairment. These may involve recurrent fantasies, urges, or behaviors involving atypical sexual interests.
- Personality disorders: These disorders are characterized by an enduring inflexible pattern of experience and behavior that causes distress or impairment. There are currently 10 recognized personality disorders.
- Schizophrenia spectrum and other psychotic disorders: These disorders are defined by abnormalities in one or more of the following areas: delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior (including catatonia), and negative symptoms.
- Sexual dysfunctions: This heterogeneous group of disorders is characterized by a person’s inability to fully engage in or experience sexual pleasure. Some of the most common sexual dysfunctions include female orgasmic disorder, erectile disorder, female sexual interest/arousal disorder, and delayed ejaculation.
- Sleep-wake disorders: There are several different types of sleep-wake disorders and all involve problems falling asleep or staying awake at desired or socially appropriate times. These disorders are characterized by misalignment of circadian rhythms with the surrounding environment or abnormalities of the circadian system itself. Common sleep-wake disorders include insomnia and narcolepsy.
- Somatic symptom and related disorders: People with these disorders feel extreme, exaggerated anxiety about physical symptoms—such as pain, weakness, or shortness of breath. This preoccupation is so intense that it disrupts the person’s daily life.
- Substance-related and addictive disorders: All substance-related disorders are characterized by a cluster of behavioral and physical symptoms, which can include withdrawal, tolerance, and craving. Substance-related disorders can result from the use of 10 separate classes of drugs.
- Trauma and stressor-related disorders: This group includes disorders in which exposure to a traumatic or stressful event is listed explicitly as a diagnostic criterion. The most common is post-traumatic stress disorder (PTSD).
Everyone experiences peaks and valleys in their mental health. A stressful experience, such as the loss of a loved one, might temporarily diminish your psychological well-being. In general, in order to meet the criteria for mental illness, your symptoms must cause significant distress or interfere with your social, occupational, or educational functioning and last for a defined period of time.
Each disorder has its own set of symptoms which can vary greatly in severity, but common signs of mental illness in adults and adolescents can include:
- Excessive fear or uneasiness: Feeling afraid, anxious, nervous, or panicked
- Mood changes: Deep sadness, inability to express joy, indifference to situations, feelings of hopelessness, laughter at inappropriate times for no apparent reason, or thoughts of suicide
- Problems thinking: Inability to concentrate or problems with memory or logical thoughts and speech that are hard to explain
- Sleep or appetite changes: Sleeping and eating dramatically more or less than usual, noticeable and rapid weight gain or loss
- Withdrawal: Sitting and doing nothing for long periods of time or dropping out of previously enjoyed activities
It’s important to note that the presence of one or two of these signs alone doesn’t mean that you have a mental illness. But it does indicate that you may need further evaluation. If you’re experiencing several of these symptoms at one time and they’re preventing you from going about your daily life, you should contact a physician or mental health professional.
There is no single cause of mental illness. Instead, it’s thought that they stem from a wide range of factors (sometimes in combination). The following are some factors that may influence whether someone develops a mental illness:
- Biology: Brain chemistry plays a major role in mental illnesses. Changes and imbalance in neurotransmitters, the chemical messengers within the brain, are often associated with mental disorders.
- Environmental exposures: Children exposed to certain substances in utero may be at higher risk of developing mental illness. For example, if your mother drank alcohol, used drugs, or was exposed to harmful chemicals or toxins when she was pregnant with you, you may be at increased risk.
- Genetics: Experts have long recognized that many mental illnesses tend to run in families, suggesting a genetic component. People who have a relative with a mental illness—such as autism, bipolar disorder, major depression, and schizophrenia—may be at a higher risk of developing it, for example.
- Life experiences: The stressful life events you’ve experienced may contribute to the development of mental illness. For example, enduring traumatic events might cause a condition like PTSD while repeated changes in primary caregivers in childhood may influence the development of an attachment disorder.
Diagnosis of a mental illness is a multi-step process that may include more than one healthcare provider, often starting with your primary care physician.
Before a diagnosis is made, you may need to undergo a physical exam to rule out a physical condition. Some mental illnesses, such as depression and anxiety, can have physical causes. Thyroid problems and other physical diseases can also sometimes be misdiagnosed as mental health disorders due to overlapping or similar symptoms; this is why a thorough physical exam is essential.
Your doctor will take a lengthy history and may order lab tests to rule out physical issues that could be causing your symptoms. If your doctor doesn’t find a physical cause for your symptoms, you’ll likely be referred to a mental health professional so you can be evaluated for mental illness.
Is There a Blood Test for Depression?
A mental health professional, such as a psychiatrist or psychologist, will ask you a series of questions related to your symptoms and family history. They may even ask one of your family members to participate in the interview so they can describe the symptoms they see.
Sometimes, the mental health professional will administer tests and other psychological evaluation tools to pinpoint your exact diagnosis or help determine the severity of your illness. Most psychiatrists and psychologists use the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose mental health illnesses.
This manual contains descriptions and symptoms for all of the different mental illnesses. It also lists criteria like what symptoms, how many must be present, and for how long (along with conditions that should not be present) in order to qualify for a particular diagnosis. This is known as the diagnostic criteria.
It’s not uncommon to be diagnosed with more than one mental illness. Some conditions increase the risk of other disorders. For instance, sometimes an anxiety disorder can develop into a depressive disorder.
The Difference Between Provisional and Differential Diagnoses
Most mental illnesses aren’t considered “curable,” but they are definitely treatable. Treatment for mental health disorders varies greatly depending on your individual diagnosis and the severity of your symptoms, and results can vary greatly on the individual level.
Some mental illnesses respond well to medications. Other conditions respond best to talk therapy. Some research also supports the use of complementary and alternative therapies for certain conditions. Often, treatment plans will include a combination of treatment options and will require some trial and error before finding what works best for you.
Living with mental illness, whether it affects you or a loved one, can be very hard—but help is available. If you suspect that you or a loved one may have a mental illness, talk to your doctor. They may make a referral to a mental health professional for further assessment, evaluation, and treatment.
If you or a loved one are struggling with mental health, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
How to Choose the Right Therapist for You