Mental health: What’s normal and what’s not

What is considered normal mental health? Patterns of thoughts, feelings, and behaviors can be pointers to seeking help for yourself or a loved one.


What is the difference between normal mental health and mental disorders?

Sometimes the answer is clear. But often the distinction is not so obvious. For example, if you are afraid to give a speech in public, does it mean that you have a mental health disorder or a case of normal nerves? At what point does shyness turn into a case of social phobia? Here we offer you help in understanding how mental health conditions are identified.

What is mental health?

Mental health is the general well-being of the way you think, regulate your feelings, and behave. Sometimes people experience a significant disturbance in this mental functioning. There may be a mental disorder when patterns or changes in thinking, feelings, or behavior cause distress or impair a person’s ability to function. A mental health disorder can affect your ability to:

  •  Maintain personal or family relationships
  • Function in social settings
  • Performing at work or school
  • Learn at a level according to your age and intelligence
  • Participate in other important activities.

Cultural norms and social expectations also play a role in defining mental health disorders. There is no standard measure across cultures for determining whether behavior is normal or when it becomes disruptive. What may be normal in one society may be cause for concern in another.

How are mental health disorders defined?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guide published by the American Psychiatric Association that explains the signs and symptoms of several hundred mental health conditions. These include anxiety, depression, eating disorders, post-traumatic stress disorder, and schizophrenia. The DSM provides criteria for making a diagnosis based on the nature, duration, and impact of signs and symptoms. It also describes the typical course of the disorder, risk factors, and common coexisting conditions. Another commonly used diagnostic guide is the World Health Organization’s International Classification of Diseases (ICD). Health insurance companies use the DSM and ICD diagnostic coding system to determine coverage and benefits and to reimburse mental health professionals.

How do mental health professionals diagnose disorders?

A psychiatrist, psychologist, or other mental health professional can make a diagnosis of a mental health condition. Your primary care physician may also participate in a diagnostic evaluation or refer you to a mental health specialist. The diagnosis can be based on the following:

  • Medical history of physical illness or mental health disorders in you or your family
  • A complete physical exam to identify or rule out a condition that may be causing the symptoms
  • Questions about your current concerns or why you are seeking help
  • Questions about how recent events or changes in your life (trauma, relationships, work, death of a friend or relative) have affected the way you think, feel, or behave·      Questionnaires or other formal tests that ask for your opinion about how you think, feel or behave in typical situations
  • Questions about past and present drug and alcohol use·
  • A history of trauma, abuse, family crisis, or other major life events
  • Questions about past or current thoughts regarding violence against yourself or others
  • Questionnaires or interviews completed by someone who knows you well, such as a parent or spouse

When is an evaluation or treatment needed?

Each mental health condition has its own signs and symptoms. But in general, professional help may be necessary if you have:

  • Changes in diet and sleep schedules
  • Inability to cope with problems or activities of daily living
  • Feeling of disconnection or withdrawal from normal activities
  • Unusual or “magical” thoughts
  • Excessive anxiety
  • Prolonged sadness, depression, or apathy
  • Thoughts or statements about suicide or harm to others
  • Substance abuse
  • Extreme mood swings
  • Excessive anger, hostility, or violent behavior

Many people with mental health disorders consider their signs and symptoms to be a normal part of life or avoid treatment out of embarrassment or fear. If you’re concerned about your mental health, don’t hesitate to ask for advice. See your primary care physician or make an appointment with a psychiatrist, psychologist, or other mental health professional. It may be important for you to find a professional who is familiar with your culture or who demonstrates an understanding of the cultural and social context that is relevant to your experiences and life stories. With the appropriate support, you can identify mental health conditions and receive appropriate treatment, such as medication or counseling. You can find an extensive list of English-speaking counsellors and therapists in the ESHA Spain business directory


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