About mental illness

Understanding Basic Concepts of Mental Illness


Good mental health, like good physical health is more than just the absence of illness. To live reasonably well in modern society requires an understanding of health in all its aspects. For an individual, good mental health is  a consistent sense of positive well-being; for the neighbourhood and the nation, mental fitness is the belief, perhaps unspoken, that most communities have a general resourcefulness that makes possible a vigorous, harmonious and creative way of life in which all citizens can find a pathway to reach their potential.

Such a hopeful philosophy requires that we be positive and delibrate in caring for our own health. It also requires that the laws, institutions and customs we give our assent to should be such that a healthy way of life is possible and indeed encouraged.

Normal human growth and development:
Our chance of health are influenced by our genetic inheritance and by the circumstances and conditions in which we grow and mature. What are the factors involved? There are many understandings: Maori people speak of the four cornerstones of health: taha wairua (spirituality), taha hine ngaro (mental aspects), taha whanau ( the family and social group), and taha tinana ( the body). If any dimension is threatened, the wairoa (total well-being) is threatened.

A similar approach lists five aspects:

Mental  health involves all these aspects.


A complex web of relations and activities binds human beings in a variety of work, family, recreational and social groups. Arising from this complexity is the need for everyone to develop social competence, the confidence, skills and abilities needed to deal with daily life. A person who is socially competent and personally resourceful can 'cope'.

A downturn in mental health can result from an individual's response to the crises and challenges that life brings. Emotional upsets, worries, great distress and extended demands on one's coping powers can result in a variety of unpleasant episodes from anxiety to depression. Such bad patches are very common - one person in eight - and need not last long given early assessment and a suitable plan of action.

Major mental disorders affect only one in a hundred, and organic and/or biochemical factors are implicated, arising from within the body or from substances ingested or absorbed by body tissue. The person's perception of reality is distorted, and may bring bizarre thoughts, speech, behaviour. Early assessment and appropriate treatment to relieve distress can bring relief, but thereafter much time is needed for healing and adjustment. One third will recover well,  one third may have other episodes over the years and one third may sustain a degree of permanent impairment. They may (like diabetics) require maintenance medication to support their chances of moderate health and contentment.

Mental illness needs attention, not neglect.


Assessing a person's current state of well-being involves all the dimensions which contribute to health. Changes in sleep pattern, weight and appetites are considered, as well as the actions and reactions of daily life.

Appearance:  should be well cared for and what is usual in the social context (allowing for the vagaries of fashion!).

:  should be coherent, capable of dealing with the average range of concepts so as to result in clear communication by speech or writing.

:  Speech should flow clearly, talk should be logical and readily understood.

:  should generally be equable. A sufficient 'emotional vocabulary' from joy, happiness and contentment through to fear, anger and sadness should be well understood and capable of expression so as to fit the context in which the emotion arises.

:  The energy generated by one's feelings, and the actions deliberately decided upon, should be used to solve problems and enhance relationships, rather than to result in chaos and destruction to self or others.

A mentally fit person has well worked out ethical beliefs, can concentrate and stay on task, can discriminate need from want or desire, and can maintain integrity in time, place and person. Well-being means not subject to unreasoning fear, but facing each new day in hopeful anticipation.

Mental health - keep it in mind.

Above resource material prepared by:
The Richmond Fellowship of New Zealand

Postal Address:
Level 3, 249 Madras St.

Phone 03 365 3211 Fax 03 365 3905
Freephone 0800 474 246




One in five people in New Zealand will experience some degree of mental illness at some stage in their life.

Of all the people living in New Zealand today,
30,000 of them have suffered or will suffer from schizophrenia.

People with a physical illness may have physical symptoms such as stomach cramps or joint aches. Everyone can understand this.

People with a mental illness may have symptoms such as hearing voices which no one else can hear, paranoid feelings, delusions, or depression.


Schizophrenia is based on two Greek words -
'schizo' which means split in many parts and 'phrenos' meaning mind.

It means that the links between the way a person thinks, perceives, feels and acts become disconnected from one another.


Schizophrenia is a name given to a whole range of mental illnesses that share the fact that the person affected with the illness loses touch with reality.

A person's ability to take things in and make sense of them is seriously affected.
Assembling coherent thoughts, deciding on how one feels and acting on those feelings can be very difficult to do.

Schizophrenia is a serious mental illness and people with schizophrenia need prompt treatment and ongoing support

It is very important that this illness is recognised as early as possible so that with treatment the disruption of a person's life can be minimised.


There is no such thing.
There is an extremely rare condition called multiple personality disorder.
It has no link with schizophrenia.


Like all mental illness, schizophrenia carries stigma in our society.
This condition is often invisible because we have become experts at hiding or ignoring people who suffer from it.
People with schizophrenia are often discriminated against in work, education, housing, and social situations.

In fact, one in five people in New Zealand will experience a degree of mental illness at some time in their lives.
One individual in every one hundred will develop schizophrenia.
This person could be your family member, colleague, friend or neighbour.


Schizophrenia is a disorder of the brain and people with schizophrenia have an imbalance in the chemicals of the brain.
We know that there is a biochemical cause of the symptoms of schizophrenia because drugs do work to allay the symptoms.

Damage to the nervous system before and during birth can be a factor. There is a genetic factor in that some people inherit a predisposition for schizophrenia.
However, families or parenting problems do not cause schizophrenia.


Schizophrenia is an illness which has a range of symptoms.

There are
Positive symptoms which are those that affect the senses.
The person may hear voices or see things that other people say do not exist.
These voices or hallucinations are outside what a person would usually experience.
The intermittent nature of positive symptoms means that sometimes these symptoms are more active than at other times.

There are
negative symptoms which are hard to explain to other people.
They may make a person feel flat and tired, and uninterested in the company of other people.
Difficulties with negative symptoms may lead to unresponsiveness and withdrawal from daily activities by the person with schizophrenia.

Cognitive symptoms of schizophrenia relate to problems concentration and learning.
It may become difficult to follow what people are saying or hard for the person to assemble their thoughts.


Schizophrenia is a serious mental illness. Early intervention and prompt treatment ensures a good outcome and can minimise disruption to a person's life.

It is very important that this illness is recognised as early as possible so that with treatment, the disruptions to a person's life can be minimised.


Bipolar disorder, which is also known as manic-depressive illness and will be called by both names throughout this publication--is a mental illness involving episodes of serious mania and depression. The person's mood usually swings from overly "high" and irritable to sad and hopeless and then back again, with periods of normal mood in between.
Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as an illness, and people who have it may suffer needlessly for years or even decades.
Effective treatments are available that greatly alleviate the suffering caused by bipolar disorder and can usually prevent its devastating complications. These include marital break-ups, job loss, alcohol and drug abuse, and suicide.
Here are some facts about bipolar disorder.


Manic-Depressive Illness Has a Devastating Impact on Many People.

 At least 2 million Americans suffer from manic-depressive illness. For those afflicted with the illness, it is extremely distressing and disruptive.

 Like other serious illnesses, bipolar disorder is also hard on spouses, family members, friends, and employers.

 Family members of people with bipolar disorder often have to cope with serious behavioral problems (such as wild spending sprees) and the lasting consequences of these behaviors.

 Bipolar disorder tends to run in families and is believed to be inherited in many cases. Despite vigorous research efforts, a specific genetic defect associated with the disease has not yet been detected.

 Bipolar illness has been diagnosed in children under age 12, although it is not common in this age bracket. It can be confused with attention-deficit/hyperactivity disorder, so careful diagnosis is necessary.

 D/ART: A National Educational Program
The National Institute of Mental Health (NIMH) has launched the Depression/Awareness, Recognition, and Treatment (D/ART) campaign to help people:
Recognize the symptoms of depressive disorders, including bipolar disorder

 Obtain an accurate diagnosis

 Obtain effective treatments

 D/ART Also:
Encourages and trains health care professionals to recognize the signs of manic-depressive illness and utilize the most up-to-date treatment approaches

 Organizes citizens' advocacy groups to extend the D/ART program

 Works with industry to improve recognition, treatment, and insurance coverage for depressive disorders


Bipolar disorder involves cycles of mania and depression.
Signs and symptoms of mania include discrete periods of:
Increased energy, activity, restlessness, racing thoughts, and rapid talking

 Excessive "high" or euphoric feelings

 Extreme irritability and distractibility

 Decreased need for sleep

 Unrealistic beliefs in one's abilities and powers

 Uncharacteristically poor judgment

 A sustained period of behavior that is different from usual

 Increased sexual drive

 Abuse of drugs, particularly cocaine, alcohol, and sleeping medications

 Provocative, intrusive, or aggressive behavior

 Denial that anything is wrong

 Signs and symptoms of depression include discrete periods of:
Persistent sad, anxious, or empty mood

 Feelings of hopelessness or pessimism

 Feelings of guilt, worthlessness, or helplessness

 Loss of interest or pleasure in ordinary activities, including sex

 Decreased energy, a feeling of fatigue or of being "slowed down"

 Difficulty concentrating, remembering, making decisions

 Restlessness or irritability

 Sleep disturbances

 Loss of appetite and weight, or weight gain

 Chronic pain or other persistent bodily symptoms that are not caused by physical disease

 Thoughts of death or suicide; suicide attempts

It may be helpful to think of the various mood states in manic-depressive illness as a spectrum or continuous range. At one end is severe depression, which shades into moderate depression; then come mild and brief mood disturbances that many people call "the blues," then normal mood, then hypomania (a mild form of mania), and then mania.
Some people with untreated bipolar disorder have repeated depressions and only an occasional episode of hypomania (bipolar II). In the other extreme, mania may be the main problem and depression may occur only infrequently. In fact, symptoms of mania and depression may be mixed together in a single "mixed" bipolar state.


This publication was written by Mary Lynn Hendrix of the Office of Scientific Information, National Institute of Mental Health. Expert assistance was provided by Frederick K. Goodwin, M.D., Robert M. Post, M.D., Hagop S. Akiskal, M.D., and William Z. Potter, M.D.
All material in this pamphlet is free of copyright restrictions and may be copied, reproduced, or duplicated without permission from the Institute; citation of the source is appreciated.

On this Page:


Understanding Basic Concepts of Mental Illness

Understanding Schizophrenia

What is Bipolar Disorder?


SF Nelson

Supporting Families in Mental Illness