causes of mental distress

by Sally Burningham

'Why?' That's what most of us ask when someone we know experiences a mental health problem. However, in most cases, it is almost impossible to discover the exact reasons why a particular individual is distressed.

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Most mental health problems have a number of contributing causes that will vary from person to person. These can include an inherited vulnerability to certain problems, upsetting events in an individual's past or present, specific stresses and the person's own circumstances and personality.

genetic predisposition

If you have a genetic predisposition to a certain problem, it means that you have an inherited vulnerability in that area. It does not mean that you will necessarily develop the problem, simply that your risks of doing so are higher than normal.

The exact role that genetic vulnerability plays in a wide range of mental health conditions is not yet clear.

Research suggests that some people inherit a genetic predisposition to clinical depression and that it is also likely to play a part in some cases of manic depression.
Genetic predisposition is a contributing factor for some people who develop schizophrenia. Your chances of developing that illness increase 10 times if you have a parent with schizophrenia, whether or not that parent has brought you up.
It is thought that some people may inherit a genetic predisposition for some types of anxiety, but more research is needed.

One puzzle is why a particular person within a family develops a certain problem when brothers and sisters, who have been brought up in a very similar way, remain unaffected. We don't know all the reasons for this. However, we all differ in terms of physical constitution, temperament and the way we each interpret and make use of experience. It may be that some members of a family are born more vulnerable to certain types of stress or become so as the result of circumstances.

upsetting events in the past

People are more at risk of developing mental health problems if they have experienced certain upsetting events in the past, such as the loss of their mother before they reach the age of 11 or abuse, neglect or other difficulties within the family. Moreover, if children and young people with such problems are not given appropriate support at the time, their difficulties may persist into adult life.

If your problems have their roots in childhood experiences, they are likely to be quite complex. You may need professional help and support for quite a time to help you deal with them.

stress

Stress often contributes to mental health problems. Sometimes a particular stress or an accumulation of stresses may be the main cause. Or other factors may be more important and the stress simply acts as a trigger – the last straw.

While you may be unable to avoid some stresses, it is likely that there are others that you can control – for example, taking on too many responsibilities or working continually against the clock. It is important to sort out your priorities and say no to extra demands so that you give yourself time to relax and recover your energy.

Check out the stress section for more information and ways of reducing stress at home and work.

life events

Major events or changes in life can be very stressful. They are often associated with some kind of loss – bereavement, losing a job, relationship break-up. Even when the changes seem positive – such as having a baby, moving home or starting a new job – they, too, can prove stressful. This is because, in both types of events, the person involved has to adapt and find new ways to cope. This can be particularly difficult if a number of major changes have to be dealt with over a short period.

If you can, try to space out the important changes in your life. For example, it is a good idea to avoid moving home straight after a bereavement. And don't bottle up your feelings if you are feeling distressed. Talk to someone you trust about any worries.

You might like to visit our family site for information about ways of dealing with stress and the ups and downs of family life.

continuing stressful situations

Distressing situations that continue over time, such as bullying or racial harassment, may contribute to anxiety or depression. If you find yourself in such a situation, it is essential that you get advice and support for yourself rather than just letting it continue.

Feeling trapped in a situation over which you have no control or feeling unneeded or unappreciated, either at home or work, can also contribute to mental health problems. Try to find an activity where you are appreciated or have some control, such as voluntary work, a hobby or a sport.

Problems with a relationship, particularly with someone close, can be extremely upsetting and a cause of mental distress. When it is too difficult to talk things over with the person concerned, it may help to confide in a trusted friend to relieve your feelings and get things into perspective. You might also need professional support to help you understand what is happening and find a way of dealing with it.

Our sex section has a great deal of information about dealing with relationships – especially at difficult times.

illness

The mind and body are very closely linked, and physical illnesses can affect us psychologically. Therefore, it is not surprising that people sometimes feel more anxious or down because of a physical illness or because of the limitations it imposes on their lives.

However, depression can be a symptom of a number of physical conditions – including thyroid deficiency and other hormone imbalance. It can also follow certain illnesses, such as glandular fever and influenza, even when the person seems to have recovered. In addition, medication prescribed for certain illnesses – such as high blood pressure drugs and steroids – can produce depression or anxiety as a side-effect.

lifestyle

Your lifestyle can make you feel good physically and mentally, or it can produce the opposite effect.

Lack of exercise often increases tension and anxiety. Regular exercise will keep you fit, energetic and more able to cope.
Missing meals or eating a diet lacking in essential nutrients can increase anxiety or depression. It is important to eat regular balanced meals, however rushed you are.
Large quantities of caffeine can increase anxiety. If you are drinking more than a few cups of tea or coffee each day, you might consider cutting down and substituting other drinks such as fruit juice, herb teas or water.
You may drink alcohol because you think it will cheer you up, but in fact, alcohol acts as a depressant. Heavy drinking will increase anxiety and depression as well as leading to other problems. If you know you are drinking too much, try to cut down or ask your GP for help to do so.

help and info

You will find lots of useful advice and information in other articles in the mind section, especially am I losing my mind?, self-help strategies and family and friends.

organisations

Depression Alliance
35 Westminster Bridge Road
London SE1 7JB
Telephone: 0845 123 23 20
E-mail: information@depressionalliance.org
Website: www.depressionalliance.org
National network of self-help groups for people experiencing depression. Offers a quarterly newsletter, national pen friend scheme and correspondence service with advice, guidance, support and fellowship to people experiencing depression, and their carers. Produces booklets and leaflets on various aspects of depression.

First Steps to Freedom
1 Taylor Close
Kenilworth CV8 2LW
Helpline: 0845 120 2916 (every day 10am-10pm)
Info: 01926 864473
E-mail: info@firststeps.org
Website: www.first-steps.org
A confidential helpline for people suffering from general anxiety, panic attacks, phobias, obsessive compulsive disorder, anorexia and bulimia, and their carers. Offers counselling, listening, advice, support and information.

Mental Health Foundation
Sea Containers House
20 Upper Ground
London SE1 9QB
Tel: 020 7803 1100
E-mail: mhf@mhf.org.uk
Website: www.mentalhealth.org.uk
Working to improve the support available for people with mental health problems and people with learning disabilities. Offers information and literature on all aspects of mental health, including where to get help, information about specific mental health problems, treatments and rights.

Mind (National Association for Mental Health)
15-19 Broadway
London E15 4BQ
Mind Infoline: 0845 766 0163 (Mon-Fri 9.15am-4.15pm)
Tel: 020 8519 2122
E-mail: contact@mind.org.uk
Website: www.mind.org.uk
Campaigns for better mental health services in England and Wales, through its national office, regional offices and network of over 200 local branches, some of which also provide services. Publishes a range of helpful books and leaflets. Contact them for details of your nearest local group and for more information.

National Schizophrenia Fellowship (Scotland)
Claremont House
130 East Claremont Street
Edinburgh EH7 4LB
Tel: 0131 557 8969
E-mail: info@nsfscot.org.uk
Website: www.nsfscot.org.uk
NSF (Scotland) is a member led organisation that works to improve the well being and quality of life of those affected by schizophrenia and other mental illnesses, including families and carers. Provides community-based services, information/education and promotes greater understanding of schizophrenia.

Northern Ireland Association for Mental Health (NIAMH)
Central Office
80 University Street
Belfast BT7 1HE
Tel: 028 9032 8474
Website: www.niamh.co.uk
Northern Ireland equivalent of MIND. You can write in for general advice on mental health matters and details of local services, including self-help groups and you can download factsheets on a wide range of mental health topics from the website.

OCD Action
Aberdeen Centre
22-24 Highbury Grove
London N5 2EA
Tel: 020 7226 4000 (Tues and Wed 9am-5pm, Thurs 9am-12.30pm, answerphone available)
E-mail: info@ocdaction.org.uk
Website: www.ocdaction.org.uk
Offers advice and support for people experiencing obsessive-compulsive disorder and related disorders such as body dysmorphic disorder, compulsive skin picking and trichotillomania. Also provides information for carers and interested professionals. Can provide details of local support groups. For more information and a free leaflet on obsessive-compulsive disorders, please write to the above address.

Rethink
30 Tabernacle Street
London EC2A 4DD
Tel: 0845 456 0455 (general enquiries) (Mon-Fri 9am-5pm)
National Advice Line: 020 8974 6814 (Mon-Fri 10am-3pm)
E-mail: advice@rethink.org
Websites: www.rethink.org or www.rethink.org/at-ease (for young people)
Dedicated to improving the lives of anyone affected by severe mental illness, by providing information, advice and advocacy services, raising awareness of mental health issues, and challenging the attitudes that create stigma. Website has sections on employment, money, benefits and legal rights.

Samaritans
c/o Chris
PO Box 90 90
Stirling FK8 2SA
Helpline: 08457 90 90 90 (24 hours)
E-mail: jo@samaritans.org
Website: www.samaritans.org.uk
The Samaritans exists to provide confidential emotional support to any person, irrespective of race, creed, age or status who is in emotional distress or at risk of suicide; 24 hours a day. Can be contacted by e-mail, telephone, writing, or by visiting one of over 200 local branches (details are on the website).

SANE
40 Adler Street
London E1 1EE
SANELINE: 0845 767 8000 (every day 12pm-2am)
E-mail: london@sane.org.uk (admin queries only)
Website: www.sane.org.uk
SANELINE is a national mental health helpline providing information and support for people with mental health problems, and those who support them. They can provide information on illnesses and symptoms, local and national mental health services, medication, treatments and therapies.

Scottish Association for Mental Health (SAMH)
15 Carlton Court
Glasgow G5 9JP
Tel: 0141 568 7000 (information service)
E-mail: enquire@samh.org.uk
Website: www.samh.org.uk
Scottish equivalent of MIND offering information and advice on a wide range of mental health topics, including legal advice and publications. Campaigns for better services and provides some mental health services.

YoungMinds
102-108 Clerkenwell Road
London EC1M 5SA
Tel: 020 7336 8445 (for info and publications)
Parents Information Service: 0800 018 2138 (Mon and Fri 10am-1pm; Tues, Weds, Thurs 1-4pm)
E-mail: enquiries@youngminds.org.uk
Website: www.youngminds.org.uk
National charity committed to improving the mental health of all children and young people. Campaigns for better provision of child and adolescent mental health services. Provides information to anyone with concerns about the mental health or emotional well-being of a child or young person. Can give information on mental health issues, and details of local and national advice services. Leaflets for young people, and other helpful information are available on their award-winning mental health site.

websites

Anxiety Disorder Education Program
www.nimh.nih.gov/publicat/anxiety.cfm
Has information about panic attacks, phobias and other anxiety disorders and treatments, plus links and contacts. Part of US National Institutes of Health website.

Mental Help Net
www.mhnet.org
Website offering information on a wide range of mental health topics.

One in a Hundred
www.janssen-cilag.co.uk/1in100
A resource brought produced by Janssen-Cilag Ltd, aimed at people with schizophrenia and their friends and families. Offers information on support groups, facts, medication and causes of schizophrenia. An information pack can be applied for online. The pack provides facts about schizophrenia, details of a range of treatments, and a list of questions to help individuals and their families have a discussion with their doctor about the best treatment options for them.

Self-Harm: Look beyond the scars
www.nch.org.uk/selfharm
Frequently asked questions, information and resources about self-harm, especially for children and young people who are self-harming, or for their families and friends.

SpeakUp!
www.speak-up.org.uk
This interactive website will enable people aged 16-25 to share their experiences of mental health services with each other as well as professionals, carers and people involved in community projects. Participants will be able to express their views openly, ask questions and exchange ideas online. It is hoped that this site will help to improve mental health provision across the UK.

reading

	Anxiety, Phobias and Panic Attacks: Your questions answered by Elaine Sheehan (Vega Books, 2002) Information and advice on types of anxiety, treatments available, including self-help strategies, and what to expect. Get this book

	Dealing with Depression by Kathy Nairn and Gerrilyn Smith This is a practical guide for sufferers of depression and those who know someone who is depressed. It identifies the causes of depression and the many forms it may take, explores ways of coping and recovering, and evaluates the help available. Get this book

	I Am Not Sick I Don't Need Help! by Xavier Amador, Anna-Lica Johanson (Vida pr, 2000) This is a book addressed to carers of people with serious mental illness such as schizophrenia, with the purpose of helping them to understand why their loved ones refuse to acknowledge their illness and therefore refuse the medications they need, often as a matter of life and death. It is written in a simple and highly accessible style. Get this book

	Living with Mental Illness: A book for relatives and friends by Elizabeth Kuipers and Paul Bebbington Provides explanations and practical advice on matters such as coping day to day and in a crisis. Get this book

	Obsessive Compulsive Disorder: New help for the family by Herbert Gravitz and James Broatch A practical guide examining OCD's origins and nature, treatments, how it impacts on family members and how to break the disorder's negative effects. Get this book

	The Scarred Soul: Understanding and Ending Self-inflicted Violence by Tracy Alderman (New Harbinger Publications, 1997) Alderman's hope is that The Scarred Soul will help educate people on the topic of self-inflicted violence. There are numerous activities designed to help sufferers and their friends and families better understand and cope with this difficult issue. The book is also designed to be of benefit to therapists. Alderman says she wrote this book because the topic is so misunderstood and largely ignored. Get this book