Mental illness

Depression a common mental illness affecting 1 in 16 people in Australia. Everyone feels down at times which is a normal response and people often mistakenly describe those feelings as being `depressed`. To define depression in a medical sense, it is a state of low mood or sadness in addition to other symptoms and signs lasting longer than two weeks according to some criteria that the person diagnosing you will go through. ¹⁰

There are several factors that can lead to depression:

• genetics
• stressful and traumatic events
• social isolation
• personality disorders
• chronic illness or injuries
• sudden changes in life circumstances
• experiencing discrimination, bullying and abuse.

People suffering from depression not only experience low mood but also show physical, emotional, or behavioural symptoms and signs of depression:

• sadness, anxiety or irritability
• hopelessness
• negativity about themselves and people surrounding them
• feeling alone and isolated
• feeling angry
• lack of motivation
• loss of enjoyment of activities they previously enjoyed
• loss of interest in sex or intimacy
• the need to excessively drink alcohol or use drugs
• exhaustion and loss of energy
• reduced concentration levels and memory
• disturbed sleep

If you experience any of these symptoms for a period lasting more than two weeks in a way that interferes with your day-to-day life, it is strongly recommended that you reach out to people you trust and seek professional help. See the resources in ‘When and where should I ask for help?’.

For information on depression related to the birth of a child, see the perinatal mental health section of our Men as Parents page.

Anxiety is a common mental health problem affecting 1 in 4 people in Australia. Everyone feels anxious sometimes, as this is the normal way our body responds to stress or pressure. However, if those anxious feelings don’t stop once a stressful situation has passed, or if they happen without a particular reason or affect your daily life, then it may be a sign that you are experiencing some sort of anxiety.

Anxiety as a mental illness is more than a feeling of nervousness that you sometimes experience. It can impact your life and have numerous physical and psychological symptoms which can be frequent or persistent. For instance, you may avoid attending social gatherings in crowded spaces where you think you may feel anxious, leading to limited interaction with other people and negatively affecting your life. ¹¹

There are five major types of anxiety disorders:

1. Generalised anxiety disorder: anxious on most days and excessively worrying for a period greater than six months.
2. Social anxiety: persistent fear of being criticised or embarrassed in social situations such as public speaking, eating in restaurants or using public bathrooms.
3. Panic disorder: intense anxiety and fear associated with physical symptoms such as sweating, shortness of breath, chest pain and shaking. People having a panic attack may think they’re having a heart attack or they’re about to die. Diagnosis is made when panic attacks are recurrent.
4. Obsessive compulsive disorder: unwanted thoughts (obsessions) that cause anxiety and are not relieved until specific actions are done to relieve the anxiety (compulsion). For example: counting, fear of germs.
5. Post-traumatic stress disorder

Anxiety symptoms are not always obvious and can develop over time. Some symptoms of anxiety are:

• panic attacks: a panic attack is a short episode of intense anxiety and causes a sensation of fear, shortness of breath or dizziness
• Feeling hot and cold (flushes)
• Sweating, shaking or trembling
• rapid, pounding heartbeats
• tightening of the chest, chest pain and shortness of breath
• excessive fear, worry or thinking obsessively about things
• avoiding normal situations that require socialising, which can stop you from having a normal life.

There may be a combination of reasons causing a person to feel anxious. The most important thing is to recognise the symptoms and signs and ask for help and support. ¹³

Post-traumatic stress disorder (PTSD) is a mental illness that can happen after someone has experienced a traumatic event that impacted and threatened their life or the lives of others around them.

Traumatic events can include:

• a serious accident, physical assault, war, torture, sexual assault or abuse, or natural disasters
• witnessing a traumatic event happening to another person
• the sudden death of a family member or a loved one
• knowing that a family member or someone you love has been involved in a life-threatening event or has been seriously injured.

Traumatic events are common, and most people will experience at least one traumatic event in their lives. The event may be overwhelming and difficult to get over, with feelings of sadness, anger and guilt lasting a few days to weeks and then resolving. These feelings are normal responses to trauma. However, if the psychological distress continues it may lead to mental illnesses like PTSD. ¹⁴

Every person responds differently to traumatic events, but these are some symptoms to recognise if someone is experiencing PTSD:

• hypervigilance: this is when a person is overly alert to their surroundings and is constantly assessing threats and ways that people and their environment may hurt them
• violent or angry outbursts
• distressing, intrusive or unwanted memories
• having vivid nightmares and problems with sleep (see also Sleep Disorders)
• flashbacks of the traumatic event
• avoiding things that remind them of the traumatic event
• feeling strong guilt or blaming themselves and others
• not enjoying the things they used to enjoy
• feeling horror and anger
• feeling isolated or apart from other people
• feeling numb, dissociated or unable to be present in the real world.

It is normal to experience these symptoms in the days and weeks following a traumatic event. However, if they continue and start to impact your day-to-day life, you should seek professional help. Sometimes the event may not have a large impact on you at the time, but later in life it becomes a problem that needs to be addressed. See the resources in ‘When and where should I ask for help?’.

It is also common for other mental illnesses such as depression or anxiety to be present with PTSD.

Note: if you are having suicidal thoughts, seek help immediately.

If you are in immediate danger, call 000 or visit your local emergency department. If you are experiencing personal crisis or thinking about suicide, call Lifeline 13 11 14. It is a confidential telephone service (available 7 days a week, 24 hours a day). All calls are free.

Visit

Suicide is the act of deliberately killing oneself. This means a person does not want to continue living and takes action to harm themselves with the intention to die. One million people take their lives across the globe every year, most of whom are from low-middle income countries. This can happen for a wide range of reasons and at any stage of their lives. ¹⁶

Self-harm is the act of deliberately hurting oneself but may not necessarily be done to cause injuries that result in death. People may self-harm for numerous reasons such as to cope with intense emotional pain, to distract themselves from past trauma or due to low self-esteem. The injuries may be visible on the body, like cuts, burns and bruises, or invisible, like refusing to eat or drink even when hungry. It also includes alcohol and drug abuse. Most of the time there may be no intention of dying however, accidental death can happen. ¹⁷

There are many myths and misconceptions that prevent people from speaking up about attempted suicide and self-harm. It is important to be aware of the reality of suicidal behaviour.

• Suicidal behaviour means deep unhappiness, but it is not always associated with mental illness. Not everyone affected by a mental illness will be affected by suicidal/self-harming behaviour.
• Some people who are experiencing suicidal/self-harming thoughts are afraid of judgment or being dismissed. This means they may not seek help.
• Sometimes a suicidal person may show warning signs before they end their life that are not definitive but may give a hint that a person is going through a grave situation. These include:
  • giving away sentimental or expensive possessions
  • engaging in uncharacteristically reckless behaviours
  • not wanting to maintain personal hygiene or appearance
  • saying they feel worthless or alone
  • expressing hopelessness
  • talking about their death or wanting to die.¹⁸
• Someone who is experiencing suicidal/self-harming thoughts may not want to die but may see no better solution at that moment to help them cope with what they’re feeling. Having access to emotional support can prevent suicide. ¹⁹

If this content has brought up any issues for you, you can contact:
MensLine Australia: 1300 78 99 78
Beyondblue support service: 1300 22 46 36
Lifeline: 13 11 14

Psychosis is defined as a disturbance in a person’s thoughts and perceptions leading to disconnection with reality. The main symptoms of psychosis include:

• thought disturbance: others may notice the person speaking differently than usual. It can include speaking very quickly (pressure speech) or slowly, racing from one idea onto the other, making up words, using the wrong word to describe things, or using unclear sentences (word salad)
• delusions: false, fixed beliefs that are generally not accepted by the person’s culture
• hallucinations: hearing, seeing, or tasting things that are not there.
• changed behaviours and feelings.²⁰

Psychosis can be an event that happens only once with an obvious cause, for example, substance misuse, or can last longer due to a mental illness such as schizophrenia and schizoaffective disorder.²¹

Schizophrenia is one of the most common psychotic disorders that includes persistent experiences of psychotic symptoms such as delusions, thought disorders and hallucinations, but it is not the only one. Other mental illnesses have psychosis as their core symptom, such as Brief psychotic disorder and schizoaffective disorder. People can also experience psychosis as part of another physical or mental illness, such as epilepsy or bipolar disorder, and others can have psychotic episodes caused by some drugs.

People who suffer from psychotic episodes often experience symptoms that affect how they think, feel, and behave. The most common symptoms are hallucinating or delusions, such as believing they are being spied on or hearing imaginary voices or messages. Violence is not a symptom of psychotic illnesses.²²

A sleep disorder is a condition that stops us from having a restful sleep. Signs that can indicate you have a sleep disorder are persistent difficulty going to sleep, difficulty staying asleep and feeling sleepy during the day.²³

People with depression often don’t sleep well but not everyone with depression will have a sleep disorder. The changes that a person can experience in their sleep can be not getting enough sleep, sleeping too much or interrupted sleep. ²⁴

Getting enough sleep can help us restore our body and organise our brain to help it function properly. This is also important to help keep our immune system, our heart and blood vessels healthy.²⁵

Insomnia and nightmares are some of the most common sleep disorders.

Insomnia

Insomnia happens when it is difficult to fall asleep or stay asleep for as long as necessary. It could mean that going to sleep is hard or that once you wake up in the middle of the night, you can’t go back to sleep.

The causes of insomnia can include:

• depression
• significant stress
• anxiety and worrying about sleep
• a loved one passing away
• experiencing chronic pain or a chronic illness
• having a distracting or unsafe sleeping environment, also known as 'bad sleep hygiene'
• unhealthy use of alcohol or other drugs
• it is possible that there is no clear cause.

Anxiety does not always affect sleep, but it can sometimes lead to insomnia. People with anxiety often find it hard to go to sleep and quiet their minds, and this increases the risk of having insomnia. Furthermore, a person with anxiety that is experiencing difficulties with sleep can start worrying about the lack of sleep so much that it creates a cycle of poor sleep and only makes things worse. Losing sleep often increases anxiety the next day.

Having insomnia can cause lack of concentration and make it harder for you to remember things, make you feel sleepy during the day, be more emotional, or increase symptoms of depression or anxiety.

If you are experiencing ongoing trouble sleeping, consistent problems with your mood or restlessness in bed, you should seek help from a healthcare practitioner to assess you and assist to manage your condition. ²⁶

Nightmares

Nightmares are not only a problem for children. Adults can also have nightmares. Nightmares are frightening dreams that tend to wake us up and make it harder to go back to sleep due to fear.

Nightmares can occur due to stress, trauma or from mental or physical illness. If the nightmares are linked to a traumatic event, they may involve vivid images from that particular event such as an incident of assault or abuse, natural disasters, or war.

Some common effects of nightmares are:

• waking you up suddenly, usually 90 minutes after you go to sleep. This is when the dreaming stage of sleep sets in, also known as the ‘Rapid Eye Movement’ stage.
• repeatedly waking up through the night with intervals of 90 minutes, leading to disruption of the normal sleep cycle
• physical symptoms such as sweating, rapid and pounding heartbeat, experiencing chest pains or shortness of breath
• seeing vivid images or scenes of a traumatic event or a bad memory.

People who have PTSD may have frequent nightmares. Other sleeping problems related to having PTSD include:

• sleep terrors: feelings of terror and panic during deep sleep that are usually short-lived (only lasting a few minutes). The person might make noises or sweat, but won’t remember much after they wake up ²⁷
• sleepwalking: moving around during deep sleep that occurs only for a few minutes and is associated with sleep terror ²⁸
• sleep talking: talking while asleep without knowing it
• upsetting dreams and night sweats
• REM sleep behaviour disorder: the person moves unusually and talks during sleep, as if they are living a dream. These movements can be violent and dangerous, especially for bed partners in some cases.²⁹

Good sleep habits and routines that reduce anxiety before going to sleep can help prevent nightmares. This includes:

• Relaxing in the hours before bedtime, such as meditating or taking a warm shower
• Reducing time on screens like TV and computers before bed
• Avoiding alcohol, sugar, caffeinated drinks, or heavy meals
• Make the bedroom dark, silent, and free of distractions