B4Stage4: Get Informed | Mental Health America

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B4Stage4: Get Informed

When you or someone close to you starts to experience the early warning signs of mental illness, knowing what the risk factors and symptoms are will help to catch them early. Often times, family and friends are the first to support a person through these early stages. Like other health conditions, we need to address the symptoms early, identify the underlying illness, and plan an appropriate course of action on a path towards overall health.

Risk Factors


17-28% of risk for mental illnesses can be accounted for by variations in common genes.

Much stronger links were found in twin and family studies. Estimates for total heritability, or how much a disease is tied to genetics, are(1):

  • Schizophrenia: 81%
  • Bipolar disorder: 75%
  • ADHD: 75%
  • Depression: 37%


In one study, head injury between the ages of
11-15 was the strongest predictor for development of schizophrenia, depression, and bipolar disorder.(2)

Brain changes like building a “tolerance” or reward response to stress, or abnormalities in the prefrontal and frontal cortex, and irregularities in the function of the
neurotransmitter glutamate are also risk factors for mental illness and substance use.(4)



People who are exposed to adverse childhood events including abuse, neglect, divorce, witnessing domestic violence and having parents who have substance use issues, mental illnesses or are in jail are(3):

  • 2.6 times more likely to have depression
  • 5 times more likely to have serious alcohol problems
  • 17 times more likely to have learning or behavioral problems.
  • 3 times more likely to have serious job problems.



Substance use can increase chances of developing a mental illness and having a mental illness can increase risk of using substances.

People with any mental illness are(5):

  • 2.3 times as likely to develop nicotine dependence
  • 3 times more likely to develop alcohol dependence
  • 30 times more likely to develop illicit drug dependence.

Early Warning Signs and Symptoms

Having a combination of symptoms (not just one symptom) indicates that someone might be showing signs of a mental health condition. Be aware of these symptoms when they last longer than a few weeks and start to affect school, work, relationships, or your everyday activities:

Memory Problems

Problems with concentration, memory, or ability to think clearly

Appetite Changes

Changes in eating such as loss of appetite or overeating

School or Work Tasks

Not being able to complete school or work tasks

Feeling Worried

Feeling overly worried

Feeling Sad

Feeling sad, empty, hopeless, or worthless

Sensitivity to sounds, sight, smell, or touch


Irritability and restlessness

Loss of Interest

Loss of interest in activities that are normally enjoyable, withdrawal from others, or disconnection

Brain Playing Tricks

Feeling like your brain is playing tricks on you. Hearing knocking, scratching sounds, voices, or your name being called. Seeing things that other people do not see, like shadows, changes in light, figures.

Changes in Sleep

Changes in energy level and sleep patterns. Often someone will sleep during the day and be up at night.

Signs And Symptoms That Require Immediate Attention

  • Thoughts or plans of killing or hurting one's self or another person
  • Hearing voices or seeing things that no one else can hear or see
  • Unexplainable changes in thinking, speech, or writing
  • Being overly suspicious or fearful
  • Serious drop in school or work performance
  • Sudden personality changes that are bizarre or out of character

If you or someone you know is in crisis, call 1-800-273-TALK (8255), go to your local Emergency Room or call 911.


1Cross-Disorder Group of the Psychiatric Genomics Consortium. Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nature Genetics, August 11, 2013. http://www.nimh.nih.gov/news/science-news/2013/new-data-reveal-extent-of-genetic-overlap-between-maj....
2Orlovska, S., Pedersen, M. S., Benros, M. E., Mortensen, P. B., Agerbo, E., & Nordentoft, M. (2014). Head injury as risk factor for psychiatric disorders: a nationwide register-based follow-up study of 113,906 persons with head injury.
3Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child abuse & neglect, 35(6), 408-413. http://acestudy.org/files/Review_of_ACE_Study_with_references_summary_table_2_.pdf
4Brady, K. T., & Sinha, R. (2014). Co-occurring mental and substance use disorders: the neurobiological effects of chronic stress.
5Swendsen, J., Conway, K. P., Degenhardt, L., Glantz, M., Jin, R., Merikangas, K. R., & Kessler, R. C. (2010). Mental disorders as risk factors for substance use, abuse and dependence: results from the 10‐year follow‐up of the National Comorbidity Survey. Addiction, 105(6), 1117-1128.

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