Understanding The Early Warning Signs of Mental Illness

Early warning signs often emerge at the onset or worsening of mental illness symptoms. Simply, put these warning signs are any thoughts, feelings, or behaviors that significantly impair day-to-day functioning — such as feeling excessively sad or low — and they may indicate you need help.

Understandably, if you are experiencing unusual thoughts and feelings, you may prefer to ignore them or expect them to pass, but ultimately, it is in your best interest to address them as soon as possible. Otherwise, these feelings and behaviors could lead to worsening symptoms, an episode, relapse or even self-harm.

Here are a few considerations to help you address your own warning signs.

Consider Your Baseline and Past Experiences

To keep your mental health in check, you need to determine your baseline — how you are feeling and behaving on a good day, a normal day and a bad day. Early warning signs are typically deviations from your baseline, often starting with small changes, like minor sleep interruptions.

You’ll also want to recall any past experiences of mental health struggles or episodes. Were there any changes in your thoughts and behaviors prior to the episode? What did they signal? How did you address them? What were the outcomes? Knowing your past patterns can provide valuable insight into your current situation.

Experiencing early warning signs is not necessarily a cause for serious concern, but these signs may warrant monitoring or evaluation by a mental health provider.

Identify and Assess Your Current Warning Signs

If you experience what may be an early warning sign and have not been diagnosed with a mental health condition, consider your risk factors for mental illness. These include recent stressful life events (such as a job loss and relationship troubles), genetics and even age (75% of mental illnesses develop by the age of 24).

To identify your warning signs, pay close attention to your thoughts, moods, physical symptoms and behavior. They may occur independently or in combination. Warning signs could manifest as changes in emotions — including feelings of low self-esteem, uncertainty, worry, hopelessness, fear, irritability or anger. These can lead to withdrawal and isolation.

Warning signs could also manifest in physical changes, like a reduced need for sleep, increased activity and restlessness, sweating, rapid breathing, fatigue or back pain. When evaluating your situation, it’s important to note that these symptoms vary by condition. For example, a reduced need for sleep is often a warning sign for bipolar disorder and fatigue is a common warning sign for depression.

Once you determine what warning sign you are experiencing, it is important to note whether the symptom was triggered by something, such as a breakup, or appeared without a clear explanation. If it was triggered by a particular event, you may be able to address the situation through problem-solving or emotion-solving coping strategies.

Pay close attention to the impact of each early warning sign on your ability to function and perform daily tasks, grading each one from one to 10 in severity. Quickly progressing and sudden onset of symptoms may indicate that the situation is more concerning. Keep a daily record and be ready to share observations with a supporter or health care provider.

Make a Plan

Having a plan to address your symptoms and specific needs will allow you to move forward more effectively when warning signs emerge. Importantly, your plan should include alternate ways to perform daily activities that may be impacted; for example, you may need to secure work accommodations. You’ll want the plan to include:

1. Monitoring. Monitor for warning signs on a regular basis; this will allow you to quickly identify concerns before they escalate. Even if your situation improves, continue to closely monitor how you’re feeling.
2. Reaching out for help. You should have a sense of when you need to reach out for help, and what the help you need looks like. In some cases, you’ll need medical attention, and in others, you may be able to rely on self-care coping strategies.
3. Supporters. Identify key supporters. Let them know your warning signs in advance and explain how they can help. Supporters can often better detect deviations from your baseline than you can. Listen to them if they show concern. Know when you need to reach out to health care providers and have a plan in place with them as well.

Know Your Coping Strategies

There are various coping strategies to address symptoms and your reactions to them. It may help to ask friends, family members and health care providers for their recommendations (but note that each person will have different strategies and not every strategy will work for you). Also remember that you may have to apply coping strategies for the short-term or long-term. These strategies could include:  

• Getting eight hours of sleep and keeping to a regular schedule
• Taking medication as prescribed, following any adjustments your care team recommends when warning signs appear
• Maintaining a regular appointment schedule
• Speaking to a therapist to get an objective, professional opinion
• Limiting alcohol intake
• Avoiding social media
• Spending time with family
• Practicing mindfulness — a type of meditation in which you focus on being intensely aware of what you're sensing and feeling in the moment, without interpretation or judgment — and deep breathing.

Ultimately, early warning signs should not be ignored, downplayed or dismissed. They may not go away on their own. They are reminders that we all need to monitor our mental health, no matter how well we think we’re doing. And if they do arise, we can successfully address them if we treat them as the prevention tools that they are.

Katherine Ponte is happily living in recovery from severe bipolar I disorder. She’s the Founder of ForLikeMinds’ mental illness peer support community, BipolarThriving: Recovery Coaching and Psych Ward Greeting Cards. Katherine is also a faculty member of the Yale University Program for Recovery and Community Health and has authored ForLikeMinds: Mental Illness Recovery Insights. She is on the NAMI-NYC Board.