Electroconvulsive Treatment

First becoming unwell

This summary is about when people first noticed they were unwell. You can read elsewhere about the different diagnoses people had and their general experience of mental illness (see ‘Diagnosis of a mental health condition’ and ‘Depression, psychosis and anxiety’).

Many (but not all) of the people we spoke to mentioned things that caused them a lot of stress leading up to their experience of mental health problems. These included difficult work environments, problems with family life, feeling socially isolated, feeling pressure to succeed (e.g. in studies), having a miscarriage or a traumatic birth, menopause, or the fallout from experiencing neglect or abuse as a child.

Sometimes events happened immediately before someone became unwell. For some, however, it was years later before they realised that difficult events they had experienced may have had a role to play. Some people felt that having a family history of mental health problems could also partly explain their problems (perhaps due to inherited genes and/or learned behaviour).

Some of those we spoke to didn’t notice they were experiencing problems at all. It was others – friends, family, employers – who first recognised that something was not quite right. Although they were struggling, at the time they were not aware of how serious it had become. Others (particularly those experiencing psychosis) were convinced that there was nothing wrong with them. So the change to being seen by others as unwell could feel sudden.
Gradually becoming unwell
It was hard for some to pinpoint the precise time when they first experienced mental health problems. With hindsight, many of the people we spoke to said they had been experiencing difficulties for most of their lives. Some people remembered feeling anxious or acting ‘strangely’ as a child (see ‘Childhood’), whilst others only experienced difficulties in their adult lives. Enid had had periods of depression throughout her life, but it was only in retirement that she became seriously depressed and needed to be admitted to hospital.
For some people it was only when their mental health led them to harm themselves or attempt suicide that they received help. Catherine Y found she couldn’t concentrate at school and was tired and apathetic. She remembers a school report when she was 14 saying that she was “in the midst of the doldrums.” It wasn’t until she took an overdose at 16 and was diagnosed with depression that she was admitted to hospital. Tristan thought at first that his wife was just physically exhausted after a long and traumatic labour, but she didn’t recover and in fact slowly got worse. She was very apathetic and eventually tried to harm herself.
Sudden realisation of being unwell
Many people recalled the moment when they noticed they or a loved one was unwell. For some a number of things happened at once and bought on intense feelings of anxiety and stress. Others described a key moment when they knew something had changed, or something had “triggered” them into illness, such as the death of a friend or pet, breakdown of a relationship or divorce.
While these could be difficult times for anyone, their reaction was unusual (e.g. “out of proportion”), and they didn’t recover from the initial shock or grief, and their feelings worsened. Several mentioned noticing the change when they went on holiday. Mandie had seen her cat run over and thought she was fine. But when she went on a family holiday two months later, she spent “the whole time” panicking and she said “it was like someone took the life out of me, and I couldn’t see the fun in it”.
For some, the change came without warning and for others there was a longer build up.
Many people spoke about experiencing mental illness after the birth of a child, either as the first experience of depression or one of several episodes. When this happened a long time ago, there was very little understanding of postnatal depression.

Last reviewed January 2018.

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