3.1 Why do people develop mental health problems?

A Family Guide to Concurrent Disorders - Part I: What are concurrent disorders?

Outline - Chapter 3: Mental health problems

• Why do people develop mental health problems?
• Mental health disorders
  • Anxiety
  • Mood
  • Psychosis
  • Impulsivity
• Personality disorders

We don't know exactly what causes mental health problems, nor can we predict who will have a few episodes and who will develop chronic problems. However, it's becoming more apparent that a mix of biological, psychological and social factors influence the development of mental health problems. That is why the biopsychosocial approach can be helpful in understanding key factors in what can be a very complex explanation. One way of explaining how biological, psychological and social factors influence one another is to look at stress and vulnerability.

The stress-vulnerability model

In general, the stress-vulnerability model holds that the greater the number of possible causes that are present, the greater the risk that a person may develop a mental health problem.

Treatment for mental health problems involves decreasing stress factors (e.g., working to develop a strong social network) and finding ways to decrease vulnerability (e.g., developing better coping skills or using medication to help balance chemical processes in the brain.

Stress

Although stress does not cause mental health problems, it can trigger them, or make them worse.

Social factors

Events, either in childhood or adulthood, can contribute to the onset of a mental health problem. For example, some studies suggest that early childhood trauma and losses, such as the death or separation of parents, or adult events, such as the death of a partner or child or loss of a job, can be precursors to a mental health problem. Other environmental risk factors include:

• living in poverty
• lack of social support.

Vulnerability

Biological factors

Biological vulnerability is the tendency to develop problems in a specific area of the body—for example, respiratory system problems such as asthma. Similarly, people can have a biological tendency to develop mental health problems such as depression, bipolar disorder or schizophrenia.

Vulnerability doesn't mean that problems will happen. It means that if certain factors come together, a person has a higher risk of developing a problem, and a higher risk of the problem being more severe.

Genetics

Some mental health problems seem to be genetic, or run in families. For example, the rate of schizophrenia in the general population is about one per cent. That rises to nine per cent for a child with one sibling with the diagnosis, 13 per cent for a child with one parent with the diagnosis and 46 per cent for a child with both parents with the diagnosis.²

Brain chemistry

Research indicates that chemical processes in the brain are involved in the development of mental health problems. Recent research has also pointed to abnormalities in brain structure as a possible factor in the development of mental health problems, particularly schizophrenia.³

Psychological factors

The temperament a person is born with (e.g., a tendency to internalize feelings) may play a part in increasing the risk of developing mental health problems. Psychological risk factors include:

• poor social skills
• poor coping skills
• problems with communication.

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² You can find more information about research into the role of genetics on the Psychosis Sucks! website, created by the Fraser Health Authority in British Columbia.

³ The National Institute of Mental Health in the United States is a good source of information about new developments in research into the biological basis of mental health problems.

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