Mayo Clinic Health Library

Mental health: What's normal, what's not

Updated: 07-20-2013

What's the difference between mental health and mental illness? Sometimes the answer is clear, but often the distinction between mental health and mental illness isn't so obvious. For example, if you're afraid of giving a speech in public, does it mean you have a mental health condition or a run-of-the-mill case of nerves? Or, when does shyness become a case of social phobia?

Here's help understanding how mental health conditions are identified.

Why is it so tough to tell what's normal?

It's often difficult to distinguish normal mental health from mental illness because there's no easy test to show if something's wrong. Also, primary mental health conditions can be mimicked by physical disorders. Mental health conditions are judged not to be due to a physical disorder and are diagnosed and treated based on signs and symptoms, as well as on how much the condition affects your daily life. Signs and symptoms can affect your:

  • Behavior. Obsessive hand-washing or drinking too much alcohol might be signs of a mental health condition.
  • Feelings. Sometimes a mental health condition is characterized by a deep or ongoing sadness, euphoria or anger.
  • Thinking. Delusions — fixed beliefs that are not changeable in light of conflicting evidence — or thoughts of suicide might be symptoms of a mental health condition.

What is the Diagnostic and Statistical Manual of Mental Disorders (DSM)?

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.

Mental health providers use the DSM to diagnose everything from anorexia to voyeurism and, if necessary, determine appropriate treatment. Health insurance companies also use the DSM to determine coverage and benefits and to reimburse mental health providers.

How do mental health providers diagnose mental health conditions?

To determine if you have a mental health condition, a mental health provider will work with you and your loved ones to assess:

  • Your symptoms. Your mental health provider will ask about your symptoms, when they began and how they've affected your life. How you perceive your thoughts and behaviors and how much your signs and symptoms affect your daily activities can help determine what's normal for you. For instance, you might realize that you aren't coping well or that you don't want to do the things you used to enjoy. You might feel sad, hopeless or discouraged. If your sadness has a specific cause, such as divorce, your feelings could be a normal, temporary reaction. However, if you have symptoms that are severe or don't go away, you could have depression. You might also need to have a physical exam to rule out any underlying health conditions.
  • Others' perceptions. Your perceptions alone might not give you an accurate picture of your behavior, thoughts or ability to function. Other people in your life can help you understand whether your behavior is normal or healthy. For example, if you have bipolar disorder, you might think your mood swings are just part of the normal ups and downs of life. Your thoughts and actions, however, might appear abnormal to others or cause problems at work, in relationships or in other areas of your life.

When is an evaluation or treatment needed?

Each mental health condition has its own set of signs and symptoms. In general, however, professional help may be warranted if you or a loved one experiences:

  • Marked change in personality, eating or sleeping patterns
  • Inability to cope with problems or daily activities
  • Strange or grandiose ideas
  • Excessive anxiety
  • Prolonged depression or apathy
  • Thinking or talking about suicide
  • Substance abuse
  • Extreme mood swings or excessive anger, hostility or violent behavior

Many people who have mental health conditions consider their signs and symptoms a normal part of life or avoid treatment out of shame or fear. If you're concerned about your mental health or a loved one's mental health, don't hesitate to seek advice.

Consult your family doctor, make an appointment with a counselor or psychologist, or encourage your loved one to seek help. With appropriate support, you can identify mental health conditions and explore treatment options, such as medications or counseling.