For most peo­ple man­ag­ing men­tal ill­ness­es, an in­ter­ven­tion came dur­ing a pe­ri­od of cri­sis. Most­ly, it is the se­vere symp­toms that prompt peo­ple to look for help. And sever­i­ty is sub­jec­tive. In one in­stance, it may be be­cause of sui­ci­dal thoughts or feel­ings but a pro­longed pe­ri­od of sad­ness may al­so be sig­nif­i­cant enough to prompt an­oth­er to seek help.

On too many oc­ca­sions, stig­ma re­mains a present and force­ful de­ter­rent for peo­ple need­ing help. A lack of ed­u­ca­tion, aware­ness, and in­suf­fi­cient un­der­stand­ing, along with some long­stand­ing re­li­gious be­liefs and doc­trines, cul­tur­al un­der­pin­nings, and mis­in­for­ma­tion, cre­ate an un­holy al­liance of forces that de­ters peo­ple from get­ting pro­fes­sion­al in­put for men­tal ill­ness­es. Self-di­ag­no­sis and self-pre­scrip­tions are al­so bug­bears.

We are get­ting bet­ter, slow­ly, at ed­u­cat­ing and reach­ing out, but, to me, not at a rate that pro­motes the growth nec­es­sary to be con­sid­ered a so­ci­ety with a high pop­u­la­tion fo­cus on men­tal health and well-be­ing.

Maybe we could fo­cus on re­defin­ing men­tal health, teach­ing peo­ple that the brain is an­oth­er or­gan in the body that needs to be cared for, as we do with all oth­er phys­i­cal or­gans, and that brain health is men­tal health. And if we can some­how en­cour­age peo­ple to think of brain health as ur­gent as, say, heart health (car­dio­vas­cu­lar dis­eases), or en­docrine health is­sues like di­a­betes, we may have a fight­ing chance. Un­til then, we need to find ways to bring peo­ple to in­ter­ven­tions suf­fi­cient­ly ear­ly in or­der to pro­mote re­cov­ery.

Re­cov­ery is a re­al­is­tic out­come for men­tal ill­ness­es. It is not to be con­fused with heal­ing but more akin to Ja­cob’s (2015) de­f­i­n­i­tion, which says: “For many peo­ple with men­tal ill­ness, the con­cept of re­cov­ery is about stay­ing in con­trol of their life rather than the elu­sive state of re­turn to pre­mor­bid lev­el of func­tion­ing. Such an ap­proach, which does not fo­cus on full symp­tom res­o­lu­tion but em­pha­sis­es re­silience and con­trol over prob­lems and life, has been called the re­cov­ery mod­el. (pmc.ncbi.nlm.nih.gov).”

Ear­ly in­ter­ven­tion, then, re­mains one of the most ef­fec­tive ways of ex­pe­ri­enc­ing re­cov­ery from a con­di­tion or of stymy­ing a se­vere men­tal health cri­sis. Such a step would be ben­e­fi­cial to all but for all the rea­sons stat­ed be­fore, many peo­ple on­ly get to health­care pro­fes­sion­als in cri­sis.

The cri­sis signs are the more ob­vi­ous and acute ones but peo­ple must pay suf­fi­cient at­ten­tion to their men­tal well-be­ing in or­der to de­ci­pher when their emo­tion­al changes re­quire in­ter­ven­tions. Per­sis­tent sad­ness, anx­i­ety or pe­ri­ods of high stress (for two weeks or more) are times when we should recog­nise emo­tion­al im­bal­ance re­quir­ing help/guid­ance.

Peo­ple, how­ev­er, go through mul­ti­ple pe­ri­ods of break­downs with­out seek­ing as­sis­tance and gen­er­al­ly wait un­til there is se­ri­ous pathol­o­gy. But once your emo­tions are im­pact­ing your life: re­la­tion­ships, work, ap­petite/eat­ing, sleep pat­terns, and so on, that is the time to seek pro­fes­sion­al help. Shift­ing of moods, deep feel­ings of hope­less­ness, ir­ri­tabil­i­ty, ex­ces­sive guilt and shame, and anger are note­wor­thy mark­ers, too.

Then there are be­hav­iour­al changes that are sig­ni­fiers of a deep­er malaise. You or some­one in your cir­cle may be­gin to with­draw from the com­mu­ni­ty, show­ing no in­ter­est in things, places and peo­ple once cher­ished and be­gin­ning to have dif­fi­cul­ty at school or work. Some peo­ple be­gin to abuse al­co­hol or il­lic­it drugs and oth­ers may ex­hib­it strange be­hav­iour.

If this is you and you do not see it, hope­ful­ly some­one close to you will recog­nise the shifts and ap­proach you with the heart to help you to a res­o­lu­tion. If this is some­one else in your fam­i­ly or com­mu­ni­ty, con­sid­er reach­ing in to help, or, at the least, find some­one who may be able to as­sist.

In my own sit­u­a­tion, in the ear­li­er days of man­ag­ing de­pres­sion, anx­i­ety and then lat­er bipo­lar dis­or­der, the phys­i­cal as­pects of my health were the dead give­aways. I nev­er got suf­fi­cient sleep; most­ly I did not know how to go to or fall asleep and, when de­pres­sion would set in, I would then stay on the so­fa for dis­turbing­ly long pe­ri­ods. These ex­tremes are im­por­tant to mon­i­tor.

Eat­ing was not my strug­gle but buy­ing food, keep­ing the cup­board filled and hav­ing deep anx­i­eties about lack were per­sis­tent feel­ings that made me know I was un­well. Then, in my 30s and 40s, my body felt like it was in en­er­gy deficits for long pe­ri­ods. Those spells would be fol­lowed by hy­per en­er­gy lev­els and a feel­ing of in­sur­mount­abil­i­ty and then all would flop quick­ly. It took a while to get the di­ag­no­sis of bipo­lar­i­ty.

Cog­ni­tive­ly, I had al­ways had great con­cen­tra­tion, pris­tine mem­o­ry like an ele­phant and re­mained lu­cid and more or less log­i­cal. Though, mak­ing bad de­ci­sions be­came a hall­mark of my life un­til the fifth decade, when self-reg­u­la­tion helped sharp­en my in­tel­lec­tu­al acu­ity, help­ing me to de­ci­pher my mind from my mind when I am un­well. Learn­ing, too, that mis­man­age­ment of mon­ey is a ma­jor as­pect of men­tal ill health was cru­cial. Un­for­tu­nate­ly for me, by that time, lack of sup­port in work­places had sent me to plant­i­ng a flower gar­den.

Take a mo­ment and as­sess your­self based on this in­for­ma­tion.