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Is someone you know unwell?

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Something is not quite right about the way someone close to you is behaving. Is it serious, or are the changes in behaviour and mood just a phase? Are drugs involved? Should they see a doctor? There is probably not a serious problem. However, if there is a developing mental illness, then getting help early is very important.

If the illness is picked up early, then treatment can work earlier too, and help deal with the symptoms. It’s more likely that the person will keep up good relationships with family and friends, and there will be less disruption of school, work, and everyday activities.

Checklist 1

Behaviour which is considered normal although difficult.

People may be:

  • rude
  • irritable
  • over-sensitive
  • lazy
  • argumentative
  • weepy
  • over-emotional
  • withdrawn
  • thoughtless

These behaviours may also occur as a normal brief reaction to stressful events such as -

  • breakup of close relationship.
  • other family crisis.
  • exam failure.
  • moving house.
  • death of a loved one.
  • physical illness.
  • divorce.
  • other personal crisis.

In these cases, the person probably doesn’t need to see a doctor for assessment. Try not to over-react, and be as supportive as possible while waiting for the bad patch to pass. If the behaviour is disruptive or distressing for other people, or if the difficult behaviour persists, seek help from a counsellor, gp or other health worker, or Citizens Advice Bureau.

Checklist 2

Behaviours which are considered abnormal for that person.

People may -

  • withdraw completely from family, friends and others.
  • sleep poorly – for example, sleep during the day and stay awake all night.
  • become very preoccupied with a particular topic – for example, death, politics or religion.
  • uncharacteristically neglect responsibilities, personal hygiene or appearance; eat poorly.
  • deteriorate in performance at school or work.
  • have difficulty concentrating, following conversation or remembering things.
  • panic, become anxious, depressed, or talk about suicide.
  • have extreme changes in mood for no real reason.
  • hear voices that no-one else can hear.
  • believe, without reason, that others are plotting against or spying on them, and feel fearful or angry about this.
  • believe they are being harmed, or influenced to do things against their will – for example, by television, the Internet, aliens or the devil.
  • believe they have special powers or influence when this is not so.
  • believe their thoughts are being interfered with, or that they can influence the thoughts of others.
  • spend extravagant and unrealistic sums of money.

See a doctor as soon as possible

These behaviours are much stronger signs that something needs to be checked out by a doctor, particularly if they have been present for some weeks. There may only be a minor disturbance but a mental illness, such as a psychotic disorder, may be developing.

What about Drugs?

Some people who are developing a mental illness may use alcohol or street drugs to help feel better. While this may work for a short time, these drugs will, in fact, make symptoms worse, and make treatment more difficult.

Drugs such as cannabis can also produce psychotic symptoms like those listed in Checklist 2. This may be short-term (a drug- induced psychosis) or can lead to a long-term psychotic illness such as schizophrenia. If someone’s behaviour worries you – or drug use causes problems at home, school or work – then try to get help for the person. A doctor can make a medical assessment to see if there is a mental illness which needs treatment, or decide if referral to a drug and alcohol agency for treatment would help.

Encouraging a visit to the doctor

Sometimes people don’t want to see a doctor because they feel they are being criticised, that others are against them, or because they feel frightened, anxious or angry. Some may have trouble putting their thoughts together to explain their problems, or they may not realise they are ill.

  • Talk things over when you are both calm and when you feel the person is likely to be cooperative. For example: I’d like to talk something over with you that’s been worrying me – is this a good time or shall we talk later?
  • Focus on how the person is feeling and try to stand in their shoes. Ask someone else to talk to the person if you do not feel sympathetic or are not trusted by them. It is best at first to focus on problems the person feels comfortable talking about, for example:
  • I know you’ve been having trouble sleeping and concentrating lately – would you like to talk to someone about it?
  • You’ve been feeling very down in the dumps lately – shall we talk to the doctor and see if she can help?
  • Encourage everyone involved to think of the doctor as someone who can help, and who will not judge them.
  • Suggest that you, another relative or a friend go along to the appointment.
  • Discuss the situation beforehand with the doctor, especially if the person is reluctant to talk about how they feel. Write down some notes about your concerns as clearly as possible beforehand.

If there is outright resistance to the idea of getting medical help, talk to the doctor yourself to work out a plan.

The doctor may be able to visit the person at home to make an assessment. If this is not possible, they should still be able to tell you where to get help and support – for the person and for the family and others who are worried.

How to explain to a doctor

Book a longer appointment so there is time to explain, and take this pamphlet with you as a discussion-starter. When explaining your concerns, give specific examples rather than vague expressions.

For example, instead of saying or writing:

Jack gets very frustrated, say

Jack was so angry last night that he kicked his bedroom door down.

Mia looks awful, say

Mia wears dirty clothes to school and doesn’t wash or comb her hair any more – she used to be fussy about her appearance.

Paul is very shy these days, say

For the past week Paul has only come out of his room to get food.

Donna thinks we hate her, say

Last night Donna would not come out of her room or eat with us. She said we are all plotting against her.

How to get more information

SANE Helpline

Call the SANE Helpline for information and advice.

Phone 1800 18 SANE (7263) or email This email address is being protected from spambots. You need JavaScript enabled to view it.

Living with mental illness

The SANE Guide to Staying Alive provides practical step-by-step hints and advice for consumers, carers and health professionals on dealing with suicidal thoughts and behaviour.

The SANE Guide to Medication and other Treatments explains how all the different aspects of treatment work, by looking at clinical care, medication, support in the community and helping yourself.

Last updated: 29 May, 2017
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Last updated: 29 May, 2017

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