Friday, January 25, 2013

Mental health care: How to spot the warning signs of severe mental illness

Jan. 25, 2013

Severe mental illness is one of the most stigmatized and least understood areas of modern medicine.

The public often mistakenly believes people living with schizophrenia or bipolar disorder are dangerous or too crazy to prosper in society. Research has proven that with treatment, most people with severe mental illness can live well in their own communities, have jobs and families.

But most people don't get treatment until their illness has bottomed out. About 160 people present themselves to the Dauphin County Crisis Intervention Unit to receive their first mental health care, said county Mental Health Director Dan Eisenhauer. About a third of them need to be hospitalized.

That's like waiting until for a cold to worsen into pneumonia before thinking about taking medicine, Eisenhauer said. If people begin treatment earlier, when they were healthier, they would likely have better outcomes.

What warning signs of severe mental illness should a person look for in themselves or a loved one?

We asked Dr. Alan J. Gelenberg, the Chair of Psychiatry at Penn State Milton S. Hershey Medical Center.

What should people look for?

Is the person acting out of character?

"A person whose behavior, familiar patterns of acting, feeling, talking, thinking are outside of the ordinary should trigger in a family member the consideration of getting professional input," Gelenberg said.

Pay special attention if someone who has been outgoing and exuberant suddenly gets dark, reticent and quiet. Look for physical signs like a change in weight, eating and sleeping patterns, either more or less. See a person is fatigued, lacks energy or has abdominal pains.

"Another broad area is anything that makes people uncomfortable," Gelenberg said. "Let's say a young person of 20 -- has he always been a little odd all his life? He's always been a little quiet, has kept to himself, has never had many friends, is always gone his own way, but I'm getting more concerned because lately he's talking to himself and he's saying things that scare me."

Is it illness or age?

Severe mental illness often appears in a person's late teens or early 20s. The normal transitions of that age can make it hard to discern what is the beginnings of a mental illness and what is the awkwardness of reaching adulthood.

"It's a grey zone," Gelenberg said. "There aren't bright lines that separate the 20 year old who's going to have a break with reality and need to be hospitalized or do something violent to themselves or someone else from the normal kid who's going through the pains that we have leaving parents and making career choices, dealing with peers and sexuality and moving out of home."

Similarly, the physical symptoms could be a physical illness.

Often, there is not one moment when a mental illness becomes apparent.

"It's not a dramatic change, but it's a gradual change that's setting off alarm bells," Gelenberg said.

What if you are worried about yourself?



Not everyone can recognize if a severe mental illness is beginning to affect their brain.

Some can. If you aren't sure if something is happening to you, here's one way to think about it:

"Something is happening to me. I'm feeling feelings, I'm having thoughts, I'm experiencing impulses that I just don't like, I don't understand," Gelenberg said, it's a good idea to speak to a professional.


If you suspect a loved one might be living with a severe mental illness, there are ways you can help them receive the treatment they need to likely recover.

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