5 symptoms of mental illness that we don't talk about enough
WE’RE SHINING A LIGHT ON PARANOIA, PSYCHOSIS, DISSOCIATION, AND MORE.
By Jackie Menjivar
(Jeremy Thomas / Unsplash)
Most of us probably have an idea of what anxiety or depression looks like, but what about psychosis or dissociation? As conversations about mental health become more normalized, it can feel really isolating if your mental health symptoms or diagnosis are rarely talked about or understood.
That’s why we’re breaking down some of these lesser-known symptoms of mental illness, what to do if you experience them, and how you can support people who have them.
Do any of these symptoms feel familiar to you? It may be helpful to take a mental health screen and see if something bigger is going on.
Dissociation
Dissociation can make a person feel disconnected from their thoughts, memory, and sense of identity. They feel like they’re watching themself from outside of their body or like their surroundings aren’t real.
Dissociation can range from mild to severe. “Zoning out” could be considered a mild (and very common) type of dissociation, and it doesn’t always mean there’s something deeper going on. People with severe and chronic kinds of dissociation — like feeling completely detached from reality — may have a dissociative disorder.
WHAT TO DO IF YOU EXPERIENCE DISSOCIATION:
Know your triggers. Recognize the things that activate your fight-or-flight response, like certain sounds or smells. Tell your friends and family about them so they can help you steer clear of them.
Use your senses. When you’re actively dissociating, you can ground yourself in the moment using your five senses. Squeeze an ice cube, eat something spicy, or try to identify every sound you hear out your window.
Keep a journal. This can help you feel more in tune with your thoughts and memories. It can also be a tool to reference when talking to your therapist or trying to identify triggers.
HOW TO SUPPORT SOMEONE EXPERIENCING DISSOCIATION:
Be patient when you’re communicating. They may not be responsive in a dissociative state, so try not to ask too many questions or force conversation out of them. Lower your voice, speak calmly, and reassure them that they’re safe with you.
Make their space safe. Avoid things that trigger them to dissociate. If they’re having a dissociative episode, guide them away from stuff that could overwhelm them (loud sounds, bright lights, large groups of people, etc).
Try grounding techniques. Grounding techniques help bring someone back to the present moment, usually through their physical senses. Walk them through a quick exercise — just don’t expect them to “snap out of it” instantly.
Delusion/Paranoia
A delusion is an idea that a person thinks is true, even if evidence shows that it’s not. Paranoia is a kind of delusion where a person feels irrationally and extremely threatened or persecuted. People experiencing paranoia can be suspicious of other people and hypervigilant of their surroundings.
A person who has delusions or paranoia without any other symptoms might have a delusional disorder. Paired with other symptoms, paranoia or delusions could be a sign of a mental illness like schizophrenia or bipolar disorder.
WHAT TO DO IF YOU EXPERIENCE PARANOIA/DELUSIONS:
Challenge your thoughts. When you have paranoid thoughts, ask yourself some questions. What would [trusted person] say about this? Is there any evidence that this isn’t true? How could I view this a different way?
Don’t isolate yourself. Make an effort to stay connected with the people you care about (and who care about you!). If you’re struggling, talk about it with a person you trust.
Make some lifestyle changes. Drugs, alcohol, and a lack of sleep can all increase paranoid thinking. Instead, exercise, eat healthy, and get enough sleep to feel your best physically.
HOW TO SUPPORT SOMEONE EXPERIENCING PARANOIA/DELUSIONS:
Be transparent. Speak clearly so they don’t misinterpret you, and offer to clarify if they need it. Give them as much information as possible about situations that could be stressful to them.
Honor their feelings. If they’re telling you about a fear or anxiety, take it seriously. Even if you don’t agree with their beliefs, be respectful of their feelings. You can empathize with the way they feel without validating the reason behind it.
Encourage them to get help. If they struggle with trusting people, encouragement from people close to them can go a long way. Support them in getting treatment and sticking with it.
Psychosis
Psychosis is a condition that disrupts a person’s thoughts, feelings, behavior, and perception in abnormal ways. A person experiencing psychosis may see things that aren’t actually there, move their body in strange ways, or get intensely fixated on certain thoughts or ideas.
People describe psychosis as a very scary and confusing experience. It can drastically change a person’s thoughts and make them question what’s real or not. Psychosis is the main symptom of psychotic disorders like schizophrenia, and it can also be a symptom of other disorders like bipolar or major depressive disorder.
WHAT TO DO IF YOU EXPERIENCE PSYCHOSIS:
Seek medication. Antipsychotic medication is usually the first step to managing psychosis. Once you’ve been prescribed a medication, find a strategy that helps you remember to take it.
Manage stress. Find the things that make you feel better when you’re experiencing something uncomfortable or scary. That could be a breathing technique, a relaxing bath, your favorite song, or a chat with a friend.
Keep a journal. Writing it out can help you process the things you’re seeing or feeling. You can revisit your writing later and think more objectively about what you’ve experienced.
HOW TO SUPPORT SOMEONE EXPERIENCING PSYCHOSIS:
Be available for them. Talk to them privately, and let them know that you won’t judge them for what they’re going through. Give them space, and make sure they know you’re available whenever they’re ready to talk. If they open up, don’t laugh at them, act afraid, or be condescending.
Don’t argue. You may know that their thoughts aren’t grounded in reality, but you probably won’t have a lot of luck trying to prove that to them. Instead, ask questions to get to the bottom of what they’re experiencing. You don’t need to argue or play along with what they say. Just listen and focus on the way they’re feeling rather than the facts. Once you connect with their emotions, you can help get them to a calmer state (i.e. “That sounds really scary, and I’m sorry that you’re going through this. How can I help?”)
De-escalate. Keep your tone calm and non-threatening, and try to avoid acting nervous. Don’t raise your voice, threaten them, or limit their movement — it might make their fear worse. Instead, ask them what they usually do to feel safe and how you can help them feel in control of the situation.
Obsessions/Compulsions
Obsessions are repetitive, unwanted thoughts. The person experiencing them doesn’t want to have them, and they cause anxiety and discomfort. They may be irrational fears, aggressive urges, or taboo thoughts. A compulsion is a behavior or ritual done to get relief from an obsession, and it can feel outside of a person’s control.
Obsessions and compulsions can happen independently or together. For people with obsessive-compulsive disorder (OCD), these symptoms interfere with their day-to-day lives.
WHAT TO DO IF YOU EXPERIENCE OBSESSIONS/COMPULSIONS:
Identify and challenge your obsessions. List your obsessions (yes, write them down). Include the situation, fears, feelings, and thoughts behind them. Now you can start to challenge them. Is this based on certainties or possibilities? Is this realistic? Is there another way to look at the situation?
Face your fears (gradually!). A therapist can help you face and overcome your anxieties through exposure therapy. If that’s not accessible to you, you can still use those strategies by yourself.
Make a plan with your loved ones. Your first instinct may be to turn to your friends and family for reassurance or help with your rituals. As you work on overcoming them, make a plan for how they can respond instead. (“Hey, we agreed that this isn’t helpful to you, so I’m not going to [xyz]. Let’s talk about how you’re feeling instead.”)
HOW TO SUPPORT SOMEONE EXPERIENCING OBSESSIONS/COMPULSIONS:
Don’t judge their obsessions. They can’t help their intrusive thoughts, and they might feel ashamed or scared to talk about them. Know that these obsessions aren’t a reflection of them as a person. Make sure you always respond with empathy.
Help manage compulsions without enabling them. In the long term, helping them do their rituals doesn’t actually fix the source of their anxiety. Set expectations with them about how you’ll work through it together. That could mean offering a hug or emotional support instead.
Be patient. Recognize that they can’t “just stop” what they’re doing. If they’re struggling with an obsession or compulsion, do your best not to get frustrated. Focus on the positive, and tell them about the things you’re proud of them for doing.
Mania
Mania, or manic episodes, are periods where a person’s mood and energy are extremely high. It can last for a week or more, and symptoms include increased energy, lack of sleep, impulsive behavior, and rapid speech.
We all have days when we feel especially good or energized. What makes mania different is the extreme change in behavior, which can cause problems in a person’s work, school, or social life. Mania is a defining feature of bipolar disorder, and it can also be associated with schizoaffective disorder, postpartum psychosis, and drug use.
WHAT TO DO IF YOU EXPERIENCE MANIA:
Know the signs. Maybe early on you miss a few nights of sleep or get really into a new hobby. Recognizing these warning signs can help you manage your mania before it gets more severe. You can also tell your friends about them so they can look out for you too.
Make a plan. It’s good to have a plan in case things get difficult. Talk with your friends and family about who to call and what medications you’re taking. It might also be helpful to find someone to take your credit cards to avoid overspending or designate someone to water your plants or feed your pets.
Keep a routine. You’re less likely to get into a sticky situation if you keep up your regular routine during a manic episode. Wake up, eat, exercise, and sleep at the times you normally would — no big decisions or actions.
HOW TO SUPPORT SOMEONE EXPERIENCING MANIA:
Redirect harmful behavior. During mania, they may want to make some risky choices like overspending or drug use. Find a different activity to do together, or suggest they wait a bit before making a big decision.
Avoid overstimulation. Try to bring them to a quiet place where they won’t get overwhelmed or triggered to act impulsively. It’s also not a great time for intense conversations, so keep it light.
Help them meet their needs. If they have super high energy, they may have trouble sleeping or sitting down to eat meals. Remind them to sleep, eat, and drink water.
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Do any of these symptoms feel familiar to you? It may be helpful to take a mental health screen and see if something bigger is going on.