Mental health conditions

Everyone experiences anxiety at some time in their life. Anxiety is felt as worry, nervousness or apprehension usually in response to a stressful event or situation such as exams, problems in relationships or work pressures. When the stressful situation or event ends, usually so does the anxiety.^{14 15}

For others, anxiety is more intense than just feeling worried or stressed. It is something they experience on an ongoing basis that really interferes with their life and is not easily controlled. Anxiety is a common experience for both men and women.^{16 17}

Signs and symptoms

The symptoms of anxiety are different for every person and may include a number of the following symptoms:

• a racing heart
• rapid breathing/breathlessness
• tight chest
• feelings of panic
• feeling restless or tense
• sweating
• trembling
• excessive and undue worrying
• feeling stressed
• anxious thoughts
• difficulty concentrating
• disturbed sleep
• tense muscles
• feeling faint
• headaches
• morbid thoughts
• upset stomach or nausea
• fear of losing control.^{18 19 20}

Types of anxiety

Anxiety is the most common type of mental health issue diagnosed in Australia.²¹ The different types of diagnosed anxiety conditions include:

• Generalised Anxiety Disorder – ongoing excessive worry about things someone experiences in everyday life such as work. ^{22 23} For more information go to beyondblue.

• Specific Phobias – extreme anxiety and fear of particular objects or situations such as fear of spiders, flying or injections. ^{24 25} For more information go beyondblue.

• Panic Disorder – repeated experiences of sudden feelings of overwhelming fear, anxiety, chest pain, heart palpitations, dizziness or breathlessness known as panic attacks.^{26 27} For more information go to beyondblue.

• Agoraphobia – fear or anxiety experienced in a variety of situations including being in places where escape is difficult such as on public transport, in crowds; or being outside of the home alone or in open spaces.²⁸ For more information go to Healthdirect.

• Social Phobia – Intense anxiety or fear of being criticised or negatively evaluated by others in performance situations or social interactions.^{29 30} For more information go to beyondblue.

What causes anxiety?

While there is no single cause of anxiety, there are a range of risk factors or triggers that may contribute to anxiety. These include:

• the genes you’ve inherited from your parents (some types of anxiety disorders run in families)
• poor physical health can increase symptoms of anxiety
• your personality type or thinking style such as anticipating the worst, ongoing negative self-talk, low self-esteem and poor coping strategies are linked to anxiety
• exposure to traumatic life experiences
• ongoing stressful situations and how you respond to stress
• alcohol or other drug use.^{31 32}

Help and support

Many people experience more than one type of anxiety and some also experience depression at the same time. Seeking support early can help you to recover more quickly.

For tips on overcoming anxiety go to the Tips and tools section.

If you have experienced a combination of the symptoms of anxiety (as described above) for a few months or more ³³ and this is affecting your ability to get on with everyday life, it may be useful to seek support from your GP, or a counsellor. If you need someone to talk to now, you can call beyondblue on 1300 22 4636. For information about anxiety go to beyondblue or Your Health in Mind.

How your GP can help

Your GP can help by talking to you about what you are experiencing and referring you to services that may be able to assist. Visit how your GP can help section or go to Support Services to find out what other help is available. 

Depression is not just having a bad day. Depression refers to a range of moods and symptoms that are longer lasting, more intense and distressing, and can affect everyday life and relationships.²

Like physical health we all experience ups and downs in our emotions, mental health and wellbeing. It is natural to feel sad, down, upset or angry in response to sad or disappointing news or circumstances. However, if these feelings are not going away, or if they exist for no reason at all, and are interfering with your day-to-day life, you may be experiencing depression.³

Depression can affect anyone, regardless of age, gender or social status. It is not a sign of weakness and any of us can experience depression at any stage in our lives.⁴

Depression can have a serious impact on your physical health, wellbeing, relationships and work. It is important to seek help as early as possible. Seeking help ensures that the correct approach to treatment and support is provided to assist you to recover more quickly.⁵

Signs and symptoms

People show symptoms of depression in different ways. Everyone feels down from time-to-time, but if these feelings are not going away and last for longer than two weeks, it may be useful to talk to someone you trust, visit your GP or contact a helpline.

Common signs and symptoms of depression can include:

• persistent feelings of sadness or hopelessness
• feelings of worthlessness, excessive guilt
• irritability, angry outbursts and negativity
• loss of energy or fatigue with no physical cause
• lack of interest in daily activities and in the things you normally enjoy
• withdrawing from family and friends
• difficulty concentrating, feeling restlessness or agitation
• marked anxiety and indecisiveness
• lack of motivation, loss of confidence and avoiding responsibilities
• sleep disruption and insomnia or having unrestful sleep
• comfort eating or a decrease in appetite, no enjoyment of food
• turning more to alcohol, cigarettes or other substances to cope
• thoughts of self-harm, thoughts of suicide, feeling life is not worth living.^{6 7 8}

What causes depression?

The cause of depression is not known. Depression usually develops from a combination of stressful life events and personal factors such as:

• long-term unemployment or job loss
• coping with a serious physical illness
• family or relationship problems
• traumatic experiences
• death of a loved one
• break-up of a close relationship
• a history of depression in the family
• a personality type may contribute to depression – people who tend to be negative about themselves, events of the world, are sensitive to criticism, worry excessively, or have low self-esteem
• alcohol and other drug use can lead to depression. However having depression can also result in increased alcohol and other drug use. Many people have problems with depression, alcohol and/or other drug use at the same time.^{9 10 11 12}

Help and support

Depression can usually be effectively prevented and treated.¹³ Being able to recognise the signs and symptoms of depression and getting the support you need early can make a difference.

There are lots of different support options available. These include:

• tips and tools for yourself
• getting support from people you trust
• accessing support services.

If you have experienced a combination of the symptoms of depression (as described above) for over two weeks and this is affecting your ability to get on with everyday life, it may be useful to seek support from your GP, or a counsellor. If you need someone to talk to now you can call beyondblue on 1300 22 4636 for information on depression go to beyondblue or Your Health in Mind.

How your GP can help

Your GP can help by talking to you about what you are experiencing and referring you to services that may be able to assist you. Visit how your GP can help section or go to Support Services on this website to find out what other help is available.

Obsessive-Compulsive Disorder (OCD) is a mental health condition that can affect anyone, at any age and it usually starts in childhood.³⁴

OCD - is characterised by:

• Obsessions - unwanted recurring irrational thoughts, images, impulses or fears such as fear of germs, or checking and rechecking that the oven has been turned off.
• Compulsions - repetitive behaviours or rituals, carried out to reduce anxiety such as excessive hand washing or repetitive behaviours. ^{35 36 37}

Signs and Symptoms

• repetitive behaviour such as frequent hand washing, tapping, repeating words, counting
• cleaning the house, clothes and belongings repeatedly
• doing things in a specific order. ³⁸

What causes Obsessive-Compulsive Disorder?

The cause of OCD is largely unknown although there is some evidence that it runs in families. ³⁹

Help and support

There are effective treatments available for OCD. For more information go to beyondblue or Your Health in Mind.

How your GP can help

Your GP can help by talking to you about what your are experiencing and referring you to services that may be able to assist you. Visit how your GP can help section or go to Support Services on this website to find out what other help is available.

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can occur following exposure to a frightening and traumatic event such as war, a natural disaster, a major car crash, a severe physical injury, an assault, seeing a murder or violence.⁴⁰

Signs and Symptoms

Some of the symptoms that may occur include:

• difficulty relaxing
• difficulty sleeping
• irritable
• lack of concentration
• feelings of distress when reminded of the traumatic event
• continually watching for signs of danger
• upsetting dreams or flashbacks
• avoiding anything to do with the related event.^{41 42}

What causes Post-Traumatic Stress Disorder?

It is not fully known what causes PTSD, it is thought to occur when the brain is overwhelmed and lays down memories in the part of the brain related to immediate action.

Help and support

Following a traumatic event it is normal to feel distress for a couple of weeks. However if these feelings continue, go to beyondblue or Your Health in Mind for more information.

How your GP can help

Your GP can help by talking to you about what you are experiencing and referring you to services that may be able to assist. Visit how your GP can help section or go to Support Services to find out what other help is available.

Eating disorders cover a range of problems related to food, eating and body image. When these problems are interfering with day-to-day quality of life they are considered to be a mental health condition.

Eating disorders are complex and can have serious medical complications. There are different types of eating disorders, and many different types of eating behaviours such as restricting food, overeating, purging, or over exercising.

No matter what type of eating disorder someone has, the underlying feelings will be similar. People experiencing an eating disorder use eating behaviours such as those described previously as a way of coping with extreme underlying emotional and psychological distress. In this way, an eating disorder can be thought of as a coping mechanism. A way to get through the day and manage feelings.⁴³

Types of eating disorders

Types of eating disorders include:

Anorexia nervosa is characterised by:

• A person’s intentional goal to lose weight to a dangerously low level and stay at that low body weight.
• An intense irrational fear of body fat and weight gain.
• A distorted image of their body weight and shape in that they see themselves as being fat when they are emaciated.⁴⁴

Bulimia nervosa

A cycle of eating a large amount of food quickly (binge eating) followed by actions to compensate for the binge.

Key features include:

• Feelings of loss of control over eating.
• Feelings of anger following a binge, physical discomfort and fear of weight gain.
• Behaviours to counteract the binge called ‘purging’ such as use of excessive exercise, fasting, dieting, induced vomiting or use of laxatives to get rid of the food.^{45 46}

Other eating related problems and eating disorders

When a person experiences issues related to body image, weight and eating behaviours that don’t fit with other eating disorders but can still severely affect a person’s day-to-day life. They may have several features of other eating disorders but not completely fit the criteria for these disorders and could include:

• Engage in purging behaviours but don’t binge (eat a large amount of food).
• Experience dramatic weight loss and persistent drive to be thin but don’t fit with the diagnosis for anorexia.⁴⁷

Binge eating disorder

This disorder is characterised by repeated episodes of binge eating (eating large amounts) without behaviours to compensate for the large amount eaten.

People can experience a feeling of losing control associated with low self esteem and weight gain.⁴⁸ For more information about each of these disorders visit headspace or Your Health in Mind.

Signs and symptoms

A person with an eating disorder may display some of the following signs and symptoms:

• self-starvation: by fasting and/or restricting food intake
• bingeing: by consuming quantities of food beyond what the body needs to satisfy hunger
• purging: by self-induced vomiting, over-exercising, or laxative use
• weight loss, frequent changes in weight or fear of gaining weight
• exercising a lot more than usual
• ongoing over-concern with body shape, weight and size
• obsessions regarding food – either avoiding places where food is the focus or spend a lot of time preparing food for others that they will not eat.
• low in energy, frequently feeling tired, faint or weak
• suffering visible deterioration in the condition of their teeth which can result from self-induced vomiting
• regularly leaving the table as soon as they have eaten or wanting to eat alone
• feeling depressed and isolated
• irritability and mood swings
• withdrawal from social interaction with family and friends; and a marked change in personality. ^{49 50 51}

What causes an eating disorder?

There are a number of factors that can lead to the development of an eating disorder. It is a complex set of interactions between culture, social environment, family and personal relationships, personality and physical factors including genetics. Some of these factors are:

• a culture that equates beauty and success with being thin
• a social environment that encourages dieting can increase the likelihood of someone developing an eating disorder
• problems with family and personal relationships
• feeling inadequate
• anxiety, loneliness and depression
• once the eating behaviours have commenced they can become self-perpetuating.⁵²

Help and support

It is important to remember that you can recover from an eating disorder. Taking the first steps towards treatment can be difficult. “Seeking help as early as possible reduces the severity, duration and impact of the eating disorder.”⁵³ 

A psychologist, a dietician and GP can help. You may also find the Butterfly Foundation helpful. They provide information, counselling and treatment for eating disorders, disordered eating, body image and related issues. Contact them on 1800 33 4673.

For self-help tips to use alongside professional help go to Headspace.

Understanding eating disorders - for family and friends go to Headspace.

Understanding eating disorders – for health professionals go to Headspace.

How your GP can help

Your GP can help by talking to you about what you are experiencing and referring you to services that may be able to assist. Visit how your GP can help section or go to Support Services to find out what other help is available.

Everyone develops their own unique personality which changes as you grow up and stabilises in adulthood. Your personality is formed by:

• the relationships you have with the people who raise you
• different life experiences
• your individual nature.⁵⁴

A personality disorder is characterised by behaviour and thinking that is different to the culture a person lives in. People with personality disorder are often distressed, find it hard to control their own behaviour, are inflexible, have difficulty with relationships and coping with everyday life.⁵⁵

Personality disorders are often experienced along with other conditions such as a physical condition or anxiety.⁵⁶

There are many types of personality disorders some of which include:

• Narcissistic Personality Disorder - a person displays a pattern of a need to be admired, increased self-importance and a lack of sympathy for others.⁵⁷
• Borderline Personality Disorder - a person is likely to have a poor image of themselves, extreme mood swings, impulsive behaviours and difficulties with relationships.58
• Antisocial Personality Disorder - likely to show disregard for other people with violent and aggressive behaviour.
• Schizotypal Personality Disorder - have unusual thoughts and beliefs that they can influence events or other people with their thoughts.⁵⁹

For more information on personality disorders go to ReachOut.com or Your Health in Mind.

Signs and symptoms

Many people are likely to show some of these behaviours described from time to time, it doesn't necessarily mean that you have personality disorder. In people with personality disorder these behaviours are much more extreme.

Some general symptoms of personality disorders include:

• impulsive behaviour
• regular mood swings
• difficulty making and maintaing relationships
• being socially isolated
• extreme vanity
• alcohol or other drug use.⁶⁰

What causes personality disorders?

What causes personality disorders isn't exactly clear. There are factors that are thought to contribute to the development of personality disorders including:

• A family history of personality disorders or other mental health conditions.
• Feel unsafe, powerless, afraid or were neglected during childhood.
• Disrupted family life while growing up.
• Experiencing a traumatic event during childhood such as death of parents or experiencing a distressing parental divorce.⁶¹

Help and support

Personality disorders are often hard to deal with on your own. There are a number of ways to manage personality disorders and it may be helpful to visit your GP to work out a treatment plan that is best for you.

How your GP can help

Your GP can help by talking to you about what you are experiencing and referring you to services that may be able to assist. Visit how your GP can help section or go to Support Services to find out what other help is available.

Everyone has mood changes, but for people who experience bipolar disorder these ups and downs in mood are more extreme. Bipolar is characterised by cycles of extreme low mood (depressive episodes) and high moods (manic or hypomanic episodes).

There are a number of bipolar and related disorders including:

• Bipolar 1 disorder – one or more manic episodes, lasting at least one week. A depressive episode or manic episode may happen before or after the manic phase. These symptoms can be severe and the person may need to be in hospital during these episodes.
• Bipolar 2 disorder – a person will experience hypomania (a milder form of mania) and depressive episodes but not manic episodes.
• Cyclothymic disorder – features persistent unpredictable mood swings but not the extremes of mood in bipolar 1 and bipolar 2.
• Symptoms of bipolar disorder – can also be caused by a medical condition such as a brain injury by substance use or some medications. ⁶²

For more information on the types of bipolar disorder visit the Your Health in Mind or the Australian Psychological Society

Bipolar symptoms during a low mood/depressive episode can include:

• feeling sad, despair, or hopeless
• loss of interest in things usually enjoyed such as food, work, sex and other people
• difficulty sleeping or sleeping too much
• low energy, feeling exhausted
• difficulty concentrating or managing small tasks, lack of motivation
• feelings of guilt, low self-esteem
• crying for no obvious reason
• suicidal thoughts.^{63 64}

Bipolar symptoms during a high mood/mania or hypomania episode can include:

• feelings of elation or euphoria
• rapid thoughts and/or speech, talking over people
• impaired judgement, easily distracted, poor concentration
• over-spending, buying unnecessary items on impulse
• unusually high levels of energy, creativity and activity
• increased risk taking
• increased sex drive
• little need for sleep
• reduced appetite and loss of weight
• unrealistic beliefs about one’s own abilities, delusions of elevated own importance, hallucinations
• higher than usual levels of irritability, aggression or impatience.^{65 66}

What causes bipolar?

The causes of bipolar disorder are not fully understood. The developing body of research indicates that bipolar disorder is caused by a combination of genetic and environmental factors.

These include:

• a family history of bipolar disorder
• environmental factors such as adverse life events and other types of stress
• having a medical condition such as a traumatic brain injury and use of some medications
• alcohol and drug use.⁶⁷

For more information on bipolar disorder go to Your Health in Mind or Black Dog Institute.

Help and support

Those diagnosed with bipolar disorder have their own unique experience, so it is important to know that your treatment and support may be different to someone else’s. Bipolar disorder needs to be diagnosed by a doctor so an effective management plan can be put in place. Most people with bipolar disorder can lead active and productive lives with the right treatment and support.

How your GP can help

Your GP can help by talking to you about what you are experiencing and referring you to services that may be able to assist. Visit how your GP can help section or go to Support Services to find out what other help is available.

Schizophrenia is a condition that affects the normal functioning of the brain, which results in a person having an altered experience of reality. It affects a person’s thoughts, perceptions, emotions and behaviour and interferes with their ability to function at work, school or relate to other people. ⁶⁸

Signs and symptoms

Schizophrenia has a large variety of symptoms, which are often displayed in a different way for each person.

Positive symptoms of schizophrenia:

These symptoms are called ‘positive’ but this doesn’t mean they are ‘good’ symptoms. It rather describes symptoms that are added to a person’s life experience:

• hallucinations (e.g. seeing, hearing or smelling things that are not there)
• delusions (thinking things are happening that are not, or that you or someone else, is someone they are not)
• disorganised thinking
• disorganised behaviour
• agitation.^{69 70}

Negative symptoms of schizophrenia

These symptoms can be negative but are described as abilities that have been lost from a person’s life experience:

• a loss of energy, enthusiasm and motivation
• withdrawal or not wanting to talk
• loss of interest in socialising and activities usually enjoyed
• flat mood
• lack of feelings
• concrete thinking
• poor self-care (not showering or preparing meals).^{71 72}

Disorganised schizophrenia symptoms

These symptoms are a result of confusion in the brain:

• difficulty understanding other people’s actions or emotions
• using jumbled words and jumping topic-to-topic
• words used out of context
• displaying inappropriate emotions such as laughing when something is sad
• difficulties with language such as using words out of context, jumbled speech.^{73 74}

A key misunderstanding about schizophrenia

A common misunderstanding about people experiencing symptoms of schizophrenia is ‘people with schizophrenia are violent’. In reality, “people being treated for schizophrenia are no more likely to be violent than anyone else, but they are more likely to be the victims of violence”.⁷⁵

As a community it is important that we provide support and understanding for people experiencing mental health issues such as schizophrenia to enable them to get the help they need as quickly as possible.

Causes of schizophrenia

There is no single cause of schizophrenia. The causes are complex and research suggests that schizophrenia develops due to an interaction between genetic factors/family history of schizophrenia and environmental risk factors. These can be triggered by:

• malnutrition of the baby while in the womb
• serious infections while pregnant
• complications during birth
• people who experience traumatic events, violence or severe stress
• alcohol and other drug use.⁷⁶

For more information on schizophrenia go to Your Health in Mind or SANE Australia.

Help and support

Schizophrenia is treatable and while many people recover completely others may experience episodes of schizophrenia periodically.⁷⁷

How your GP can help

Your GP can help by talking to you about what you are experiencing and referring you to the services you need. Visit how your GP can help section or go to Support Services to find out what other help is available.

Non-suicidal self-harm (also known as Non-suicidal self-injury)

Non-suicidal self-harm is a complex mental health condition that is not intended to result in suicide. It is not easy to tell the difference between suicidal behaviour and Non-suicidal self-harm. Self-harm is a coping strategy of causing non-fatal injuries to temporarily relieve emotional pain and negative feelings and thoughts. Although self-harm can often relieve a person’s short-term distress, it can also lead to longer-term negative emotional, social and physical consequences. ⁷⁸

Self-harm usually starts during the teenage years or as a young adult and may continue into adulthood. It can be a difficult behaviour to stop and seeking help early is important in preventing the behaviour becoming entrenched and persisting over many years.⁷⁹

While death is not the intention of self-harm, it is important to seek the help of a GP, a mental health professional or contact a support line to rule out that they are at risk of suicide and direct them to the best support for their needs.⁸⁰

It is important to acknowledge self-harm can lead to death even if this is not the intent. If a person has a serious physical injury and/or is at-risk of further harm or accidental death, seek emergency assistance by calling 000.

Risk factors

There are a number of risk factors that can lead to someone developing self-harming behaviour. Every person is different and may use self-harm as a way of coping with current problems. The following are some factors associated with self-harm:

• depression and anxiety
• difficult life events
• increased emotional reactions and suppression of unwanted thoughts
• negative self-esteem, hostile behaviour and anger
• history of sexual assault paired with a tendency to disconnect from thoughts, feelings, memories and sense of identity ⁸¹
• child abuse and neglect
• other diagnosed mental health conditions including borderline personality disorder and eating disorders.⁸²

Reasons why people engage in non-suicidal self-harm

As with other mental health issues, self-harming behaviour is often triggered when someone experiences a periodof overwhelming sadness, anxiety and a feeling of numbness. People use self-harm as a way of coping with emotional pain by changing it into physical pain.⁸³ The purpose of self-harming behaviour is to cope with life, not to end it.⁸⁴

Research suggests that people engage in self-harm to:

• avoid bad feeling
• feel something even if it is pain
• avoid doing something that they do not want to do
• get attention or help, or to fit in.⁸⁵

 Help and support

For yourself:

There are things you can do to help yourself with self-harming behaviour and professional support is available if you need it. Ways to help yourself include:

• visit your GP who can assist to find the right support services for you. ⁸⁶
• talk to someone you trust about your feelings and behaviours. Try to explain why you engage in self-harm. If you don’t feel comfortable talking to a family member or friend, you can try your doctor, health professional, counsellor, a psychologist or ring a support line.
• it can be helpful to recognise when you do and don’t engage in self-harm. Recognising the things that trigger the need to engage in self-harm can help you avoid those situations in the future.
• distract yourself if you feel the need to engage in self-harm. Try to focus on other things such as taking some deep breathes, taking a shower, going for a walk, reading a book or having something to eat or drink.
• writing in a diary to express your emotions can help you vent your feelings and cope better with negative thoughts. Writing it down can also help you to recognise the feelings that lead you to engage in self-harm.

 Helping someone who engages in Non-suicidal self-harm:

Supporting someone who engages in self-harming behaviour can be tough, particularly as many people find it difficult to understand why they do it. Here are a few tips for helping someone who has harmed themselves:

• try to remain calm, talk to them about the behaviour you’ve noticed and let them know that you are worried about them. Try to understand what they are going through from their point of view. Try not to be judgmental, shocked or take their behaviour personally.
• let them know that you care about them and are there to support and listen to them.
• help them come up with a plan to seek professional support.
• encourage them to get support from their GP or other mental health professional and offer to go with them to their appointments if they are scared or uncomfortable.
• don’t forget to take care of yourself, helping someone can be draining. Get support and look after your mental health and wellbeing too. ⁸⁷

For information on how to start the conversation click here.

How your GP can help

Your GP can help by talking to you about what you are experiencing and referring you to services that may be able to assist you. Visit how your GP can help section or go to Support Services on this website to find out what other help is available.

Last updated: 10 August 2019