Onset of mental health problems

Here, people talk about when their mental health problems first began. Some people first began to experience mental health problems as teenagers, a few when they were children, while others experienced them much later in life, in their 40s. One woman was diagnosed with an eating disorder and said she began ‘using food’ as a way of coping with family problems when she was a child. Some people were at university, college or school when their mental health problems began (see ‘Losses & gains: impact of mental health on everyday lives‘). And many people became unwell following a tough childhood.

When Tariq first began feeling unwell he didn’t know what it was, but said it felt “normal” like…

Age at interview 21

Gender Male

Age at diagnosis 18

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Circumstances leading up to the beginning of a mental health condition

Often people had experienced a whole series of difficulties in different areas of their lives before becoming unwell. These included problems at work and at home. People described conflicts with their family or partner, marriage breakdowns, and bereavement, as well as experiencing housing and financial problems. One woman described arguing with her husband about money. Many people had been separated from their parents (or surrogate parents) as children, including one woman who was placed in Local Authority care. Several had recently moved to the country from abroad, and often said they felt lonely and isolated. Some people had experienced abuse or rape or other kinds of physical harm. For some, this was at the hands of family members, while others were bullied at school or work. One woman felt that because she was being bullied at school and didn’t have a good relationship with her parents, she was ‘already in a vulnerable state’ when she started hearing voices. Some people also mentioned experiencing racism.

David’s mental health problems began when he was five years old and he was experiencing racism…

Age at interview 37

Gender Male

Age at diagnosis 37

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Sarah began having difficulty sleeping when gangsters were threatening her and her husband in…

Age at interview 48

Gender Female

Age at diagnosis 46

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A few people had experienced physical health problems and a few women described beginning to feel unwell during pregnancy or following the birth of a child, while others became unwell after having a miscarriage or having trouble getting pregnant. (See ‘Views about causes of mental health problems: individual factors‘.)

Shareen first became depressed after being told she couldn’t have any more children. (Played by…

Age at interview 39

Gender Female

Age at diagnosis 24

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Some people talked about members of their family having mental health problems, including one man who experienced his first episode of psychosis shortly after meeting his mother who also had schizophrenia.

Edward had his first experience of psychosis after the “shock” of migrating to Australia and…

Age at interview 59

Gender Male

Age at diagnosis 20

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Others mentioned drinking alcohol and using drugs just before they became unwell.

Noticing something was wrong

For some, their experience began merely as a feeling that something was ‘not quite right’ whilst others began hearing voices or experiencing hallucinations & delusions. For a few people, onset was very sudden [see Dolly below]. People responded to what was happening in different ways. Some didn’t realise anything was wrong or thought that what they were experiencing was ‘natural’ or ‘normal’ (see ‘Ways of describing mental health problems‘). [See Tariq above] Others said they were aware that something was definitely wrong. Some weren’t sure what was happening and felt confused, believing it might eventually go away, or thought it was something else, like a physical health problem.

Nelsy didn’t realise she was experiencing mental health problems and was shocked when she was…

Age at interview 56

Gender Female

Age at diagnosis 48

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Some said they didn’t tell anyone what was happening because they were embarrassed, scared, or in the case of one woman, felt they were seen by others as coping and ‘strong’. [See Tariq above] Some said they tried to carry on, and one man said he tried ‘to act normal’ to keep it secret, ‘but I wasn’t fooling anyone’.

People didn’t notice Imani was depressed because she gave them the impression that she was strong…

Age at interview 48

Gender Female

Age at diagnosis 47

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Many people described how parents, siblings and friends also started to notice that there may be something wrong, based on changes in behaviour or facial expressions or not seeing them for a while. For those who thought that there was nothing wrong, people’s responses were puzzling. One woman thought her mother ‘was making a fuss over nothing’, while one man began to think there must be something wrong because he trusted his mum [See Devon below].

Judy became sick when she couldn’t cope any more following the murder of her brother and her…

Age at interview 52

Gender Female

Age at diagnosis 22

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Others said that no-one noticed that anything was wrong, because they were seen as ‘strong’ [see Imani above].

What people did when they realised something was wrong

Once people realised something was wrong, most eventually went to see their doctor. People also made contact with social services or the hospital, or were referred to specialists, such as a child psychiatrist. Others were taken to see a health professional against their will by a concerned family member or by the police. One woman’s sister went to the GP who sent the early intervention team. One woman was so distressed by the voices she was hearing, she attempted suicide [see Dolly below].

When his symptoms got worse, Tariq told people he trusted and they went with him to the hospital;…

Age at interview 21

Gender Male

Age at diagnosis 18

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Dolly started to hear voices aged 14 and thought it would go away; she was referred to a child…

Age at interview 36

Gender Female

Age at diagnosis 21

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Devon’s mother called the doctor and then the police because she noticed that there was something…

Age at interview 49

Gender Male

Age at diagnosis 22

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One man says, on reflection, he was glad he was forced to see the doctor, as he was putting himself in danger.

Hanifs father forced him to see a psychiatrist and he thinks it was probably for the best…

Age at interview 49

Gender Male

Age at diagnosis 23

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Views about what people think caused their mental health problems are covered in ‘Views about causes of mental health problems: individual factors‘ and Views about causes of mental health problems: social & environmental factors).