facts and figures

by Sally Burningham

Many of us will experience mental health problems at some time in our lives or be close to someone who does. These conditions, which may range from the mild to the severe, can occur at any age. For instance, about 10% of children and young people are thought to have mental health problems severe enough to need professional help.

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It can sometimes be a relief to put a name to a problem, to help make sense of puzzling or distressing feelings. However, these conditions rarely fit into neat categories. People vary widely as to the extent they are affected, and many have to cope with a mixture of problems. It is very common, for example, to experience both depression and anxiety.

All statistics about people with mental health problems should be treated with great caution. This is because:

• A large number of such problems are not reported. Rather than visiting their doctors, people simply struggle on alone.
• A significant number of problems are missed by GPs. This may be because some patients come to see them with physical problems and avoid talking about their feelings, or because the doctors are too rushed to ask.

This feature looks at the frequency of certain mental health problems and who is most affected. However, the figures given are based on the studies available at present, and before the full picture can be known, a great deal more research needs to be carried out. More details can be found in The Fundamental Facts, produced by the Mental Health Foundation (see help and info).

differences between men and women

Many studies state that more women than men experience certain mental health problems such as depression. However, there are a number of reasons why the statistics for men might be higher than these studies show:

• Men visit their doctors far less frequently than women so there is less opportunity for the doctors to pick up signs of problems.
• Many men are uncomfortable about talking about their feelings or even admitting them to themselves. It can be hard for those close to them to know just what is wrong or what help to suggest.
• Men are more likely to see such problems as signs of weakness. Rather than seeking help, they may try to deal with it themselves by throwing themselves into work, for example, or perhaps through drink or drugs. Compared with women, men are three times as likely to be dependent on alcohol and twice as likely to be dependent on drugs.

anxiety

Although there is no precise definition of anxiety, most people recognise when they are anxious because of one or more physical, emotional and mental changes, such as:

• rapid breathing
• accelerated heart rate
• dizziness
• stomach churning
• increased muscle tension
• feeling frightened, restless or irritable
• fears that something dreadful may happen.

Anxiety can also express itself through physical complaints such as skin rashes or migraine.

We all feel anxious from time to time. Sometimes this can serve a useful purpose such as helping us to focus our energies on particular problems or alerting us to the fact that things are not quite right. However, according to the Mental Health Foundation, at some stage in our lives more than 1 in 10 of us are likely to experience anxiety serious enough to prevent us from functioning properly.

First Steps to Freedom (see help and info), an organisation offering advice and support to people with anxiety, reports that more women than men contact them with anxiety-related problems. However, as FSF points out, men may be just as anxious but simply find it more difficult to talk about their feelings and ask for help.

If you usually feel anxious in specific situations – cooking a meal for friends, say, or speaking in public – there are self-help measures you can adopt to help you cope. These include practising a relaxation exercise or learning to take things one step at a time.

However, if your anxiety comes to dominate your life, either because your reactions are out of all proportion to the apparent cause or because you have a feeling of unease much of the time, you should see your GP. Among the treatments that may be suggested are relaxation techniques, counselling and cognitive therapy.

For more information see our feature on anxiety.

phobias

It is estimated that around 13% of adults in the UK are affected by a phobia at some time in their lives. A phobia, which is a specific form of anxiety, is an acute and quite disproportionate fear of an object or situation. There is a wide range of phobias, from fear of dogs to fear of eating in public. Even though you know such a fear is irrational, you cannot reason it away.

People with phobias are not only acutely distressed if they have to confront the focus of their fear, they also become anxious worrying about the possibility of such an occurrence. This can severely restrict their lives as they go to great lengths to avoid these situations. Most people with phobias can be helped by an approach known as behaviour therapy, provided they are well-motivated.

For more information see our feature on phobias.

obsessive-compulsive disorder (OCD)

Studies have suggested that about 2.5% of people are likely to experience OCD at some time. This is another specific form of anxiety that can severely restrict a person's life. In this case, obsessions – such as unwanted and intrusive thoughts – give rise to anxieties that the person attempts to alleviate through compulsions: seemingly purposeless behaviours ('rituals') carried out according to strict rules, such as excessive handwashing, constantly checking that the gas is turned off or touching objects in a specific order.

Treatment for OCD is usually based on a number of behaviour therapy techniques, sometimes in combination with medication.

For more information see our feature on obsessive-compulsive disorder.

depression

It is quite normal to feel unhappy or low from time to time. But this is not the same as experiencing depression, or 'clinical depression' as it is sometimes called. This is an illness in which a number of symptoms, varying from person to person, come to dominate life so that the person is no longer able to cope in the normal way. Such symptoms may include feelings of hopelessness or worthlessness, tiredness or agitation, loss of pleasure and interest in what is going on.

Clinical depression is very common. According to the Depression Alliance, about 1 in 5 people will experience it at some time in their lives. It should always be taken seriously: 15% of people with severe depression commit suicide.

Depression can occur at any age from childhood on, but it is most common in people aged 22-44. It is also diagnosed more often in women than men up to their mid-50s. Some of this gender difference may be due to the fact that:

• Hormonal types of depression such as post-natal depression and depression related to pre-menstrual syndrome (PMS) affect only women.
• Women visit their doctors more frequently than men. They are also generally more comfortable in talking about their feelings and what is going on in their lives, thus making it easier for their GPs to identify depression.

Depression is quite common in older people but is often ignored because many people think it is normal for them to be depressed. It is true that older people are more likely to experience bereavement, physical illness and social isolation, but depression is not a natural part of the process of growing old. It is important to persuade an older person who may be depressed to see their doctor.

It is vital to remember that depression is treatable. It has been estimated that more than 80% of those with this mental health problem can be helped with the appropriate support, medication and/or psychological treatment.

manic depression

Manic depression – sometimes referred to as bipolar disorder – is a condition in which people experience mood swings, either to mania (a state of abnormal elation and over-activity) or to severe depression or to both.

Manic depression rarely occurs in children, but it can start at any age from 14 on. About 1 in every 100 adults in the UK will experience manic depression at some point in their lives, and it affects approximately equal numbers of men and women. It is usually a recurring condition, although about 20% of those affected experience only one episode.

It is important that people get help at an early stage since prompt treatment with appropriate medication can usually limit the length or severity of an episode.

For more information see our feature on manic depression.

deliberate self-harm

The term 'deliberate self-harm' includes self-injury such as deliberately cutting, burning or bruising oneself, as well as taking drug overdoses. Accurate figures for self-harm are hard to come by as much of it is not reported. However, hospital figures suggest that it is three to four times more common among women than men and more common among young adults.

It is estimated that 2-3% of girls will make a serious attempt at self-harm at some time during their teenage years. The rate for men appears to be rising: between 1980 and 1998, self-harm among those aged 15-24 almost doubled and the rate for those aged 25-35 rose by 15%. During the same period, the rate in women has risen considerably less.

A small survey among women who had self-injured found that 90% had cut themselves and about 30% had inflicted blows or scalded themselves. The majority had begun to injure themselves during childhood or adolescence.

Although self-harm is not usually fatal, it should be taken very seriously as a sign that someone is very deeply distressed. If they cannot find appropriate help, people who self-harm are at great risk of committing suicide. It is important for both professionals and friends to listen to the person without judging or blaming and to make every effort to understand.

schizophrenia

Schizophrenia is the most common form of severe mental illness, affecting about 1 in every 100 of us at some time in our lives. In this condition, different parts of the mind fail to communicate with each other, so that thoughts, emotions, sensations and memories, for example, no longer function together but become confused and disordered. Treatment usually involves medication and various forms of support.

Schizophrenia is extremely rare before puberty, and most commonly occurs for the first time in the late teens or early 20s. It affects men and women equally but often starts at an earlier age in men.

Schizophrenia occurs among people of all races and backgrounds all over the world. Its causes are not yet fully understood, but it is clear that inheritance may play a part in some cases. This means that:

• you have a 10% risk of developing schizophrenia if one of your parents or a brother or sister is affected
• you have a 45% risk of developing schizophrenia if both your parents are affected.

About 25% of those with schizophrenia will experience only one episode and will make a good recovery with appropriate treatment. About 50% will experience a number of episodes but cope reasonably well in between, while the remaining 25% will have repetitive episodes and need considerable ongoing support.

People with schizophrenia are a danger to others only rarely, in times of acute crisis. But they are fairly frequently a danger to themselves: around 1 in 10 people with schizophrenia will commit suicide.

eating disorders

Many people with eating disorders do not see their doctors, so the numbers for both men and women may be much higher than studies show.

Anorexia nervosa is an extreme fear of weight gain that does not diminish even when the person becomes dangerously thin. The person with anorexia – who will have low self-esteem and a distorted body image – will eat only minimal amounts, and may also exercise vigorously or consume laxatives in an effort to lose weight. Once weight decreases beyond a certain point, it is very difficult to reason with the person about the importance of eating, and the anorexia can be then be life-threatening.

It is important to seek help – perhaps from a specialist in eating problems – while difficulties are still manageable. It is crucial that support is given for the underlying mental health problems that gave rise to the anorexia rather than simply focusing on getting the person back to an acceptable body weight.

Studies suggest that, in the UK, about 1 in every 100 women between the ages of 15 to 30 has anorexia and that half of all cases occur before the age of 20. It is also estimated that 12 times more women than men suffer from anorexia, but the figure for men may actually be higher.

Bulimia nervosa involves episodes of 'binge eating' – that is, consuming large quantities of food in a very short time. The person may then try to counter the effects of overeating by making themselves sick or consuming large quantities of laxatives, possibly followed by a period of strict dieting and vigorous exercise. Bulimia can damage health, and the earlier treatment is sought, the better. Treatment may involve counselling or group, behaviour or cognitive therapy.

It is estimated that between 1 and 2 in every 100 adult women in the UK are affected by bulimia. Men also develop it, but it is not clear how many.

Check out the food section for more information about eating disorders.

suicide

There are no cast-iron figures for attempted suicide, but it is thought that about 1.5 times as many women attempt suicide as men. Young women between the ages of 15 and 19 are at highest risk. In recent years, there has also been an increase in suicide attempts among men aged 55 and older. According to The Samaritans, about 80% of suicide attempts are through self-poisoning – for example, drug overdoses. Around 1% of people who attempt suicide go on to die through suicide within a year

Despite the fact that more women than men seem to experience mental health problems and more of them attempt suicide, far more men actually kill themselves. Three quarters of suicides in the UK are by men, and there are four times as many suicides among men under the age of 25 than in women of the same age.

The reasons for this gender difference are unclear. Some of the possibilities that have been put forward include:

• Men often choose more violent methods such as hanging, rather than drug overdoses, which may not be fatal.
• Men may be unwilling to admit they have a problem so they do not seek help.
• Men are more likely to abuse drugs or alcohol, which increase the risk of suicide.

Most at risk of suicide are men aged 25-34 years. Older people, too, have relatively high risks of suicide compared with the general public: it is estimated that around 16% of all suicides are committed by people over the age of 65. Men over the age of 80 are particularly at risk.

help and info

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

organisations

Depression Alliance
35 Westminster Bridge Road
London SE1 7JB
Tel: 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@first-steps.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
The Fundamental Facts publication: www.mentalhealth.org.uk/publications/fundamental-facts
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
Tel: 020 8519 2122
Mind Infoline: 0845 766 0163 (Mon-Fri 9.15am-4.15pm)
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)
130 East Claremont Street
Edinburgh EH7 4LB
Tel: 0131 557 8969
E-mail: info@nsfscot.org.uk
Website: www.nsfscot.org.uk
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.

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
Cityside House
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.

Eating Disorders Association
www.edauk.com
Information and help on all aspects of eating disorders including Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and related eating disorders.

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

OCD Online
www.ocdonline.com
A comprehensive site exclusively devoted to promoting a greater understanding of Obsessive Compulsive Disorder's (OCD) treatment and mental processes.

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.

Royal College of Psychiatrists
www.rcpsych.ac.uk/.../postnataldepression.aspx
Very helpful factsheet on Postnatal Depression and how it can be treated.

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.

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 (The Women's Press, 2001)
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 (Vida, 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 (Souvenir Press, 2004)
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 (Partners Publishing Group, 1998)
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

Surviving an Eating Disorder: New Perspectives and Strategies for Families by Michele Siegel (HarperCollins, 1997)
Case studies provide examples of the psychological components of eating disorders and how family members and friends can help.
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

(July 2001, resources updated December 2004)