Reasons for becoming unwell

There is research evidence that physical, social, environmental and psychological factors can contribute to the development of severe distress that gets diagnosed as mental illness. For most people, their mental health problems result from many factors interacting with each other. This is similar to the way that physical health problems often develop. Frequently it is difficult to pinpoint one main cause. For example, the link between a person’s genetic make-up and mental health is complex, and not well understood.

The people we spoke to had received various psychiatric diagnoses at different life stages. Most people could not identify any special reason for becoming unwell. Many found it hard to attribute first starting to feel unwell to particular circumstances or events. For some, feeling unwell began after the culmination of many things. As Helen said, ‘certain things that have happened through my life have maybe, all combined, pushed me into depression’. While many people were first diagnosed with severe mental health problems in adulthood, some described themselves as being ‘different’ and experiencing anxiety or other problems from an early age. For Ann this was as early as the age of two. This fits with strong research evidence that most people who experience severe mental health problems as adults first have similar experiences as teenagers or young adults, even though they may not receive a diagnosis at that stage of life. Tanai said her mother had a virus during pregnancy, and that people thought Tanai experienced brain damage in utero which effected her mental health.

While some people did experience life events that were out of the ordinary or ‘traumatic’, these were not always identified as contributing directly to mental health problems. Rather, some people talked about such life events as difficult times that they had to deal with, occasionally in the context of an existing diagnosis of a severe mental health problem (see Negotiating daily life). For other people, it was the way they responded to these unusual or distressing events that alerted them or others to the fact they were unwell.

Nonetheless, many people spoke about the time when they first became unwell as being a time of particular pressure or stress in their lives which was often attributed to work, studies, relationships or parental pressure. Carlo was in a high powered job in the city when he experienced panic attacks and heart problems. Maria found the pressure from her parents to be ‘more Greek than Australian… reached boiling point’ when she was diagnosed with bipolar disorder at the age of 19. David experienced ‘a personal loss’ when his best friend died in a car accident and someone he was ‘in love with’ was dying of cancer at the same time. He was told he had post-traumatic stress.

Ann was sleeping a lot towards the end of her studies, and had moments of wishing her life ‘would end’. When she got a job she was bullied at work, which she said was ‘when things really went quite pear-shaped’.

Moving house was a time of stress for some. Vanessa moved to the city from a small community where she lived on a farm. The transition from a place where everyone was ‘warm’ to a city where people were ‘not very hospitable’ created a lot of stress and eventually she experienced ‘major depression’.

Brendan noticed the first signs of depression when he moved to a new state with his mother and stepfather when he was 15. He missed his brother, found it difficult to make friends, and felt isolated.

When Helen’s husband put pressure on her to move to his homeland, she found she had trouble sleeping. After the move, she said, she ‘started to get out of hand’.

Young adulthood could be a particular time of pressure and stress (you can read more about that here: Childhood and adolescence)

Luana became ‘really stressed out’ when a lecturer told the students that 70% of them would fail. Later, the stress of doing well at work led to a breakdown.

For Sarah, her early 20s were ‘a confusing age’. She was just out of school and still working things out when she went on a Buddhist retreat in South East Asia and began hallucinating.

Some people were distressed by experiencing vague and shifting mental health problems over long periods of time. This is a typical situation for young people with mental health problems who may or may not receive a psychiatric diagnosis later in life. A few people described how they had taken recreational drugs at some point in their lives. Some said this had helped them to cope with stress or anxiety, but others felt that it may have contributed to their distress.

Dealing with pain, physical illness, injuries or disabilities, was a critical time for some people (see Physical health and mental wellbeing). Bernadette said she ‘slipped into a psychosis’ when she was being treated for hepatitis C. She described this as the side effect of medication combined with ‘a whole lot of stressful stuff that happened to me while I was on it’. Cindy described how she ‘suffered depression’ after seeking medical help for a painful skin condition that resulted in ‘itchy burning sores on her hand’. She described becoming ‘worn out’ because doctors ‘weren’t listening’ and ‘didn’t want to believe’ her. One doctor told her she was ‘delusional’. Her skin problem was never resolved.

After Michelle had an operation for sciatica the pain returned and the doctors couldn’t find a cause. She said the pain was ‘slowly eating away at’ her mind.

Although David had experienced ‘mental health symptoms on and off’ from his pre-teens, he had never sought help. When he had surgery that left him with chronic pain he felt suicidal and asked to see a psychiatrist.