Healthy Surrey:

Healthy Surrey

Severe and enduring mental illness

Information about severe mental health conditions with links to useful resources.

Last updated 20 February 2024.

The phrase serious/severe mental illness (SMI) is often used in healthcare settings and refers to psychological problems that are often so debilitating, that peoples' ability to engage in everyday and work life activities is severely impaired.

Common diagnoses associated with SMI include bipolar disorder, psychotic disorders such as schizophrenia, personality disorder and major depressive disorder.

Contents

Bipolar disorder (manic depression)

Bipolar disorder is a condition that causes mood swings that alternate between two poles on a spectrum - feeling depressed and feeling euphoric/high. These are more extreme than everyday ups and down mood changes and can interfere with work, relationships and everyday life.

There can be many different factors that cause or trigger episodes of bipolar disorder, including stress or trauma.

During the manic or high phases, people may experience one or some of the following symptoms:

  • Excessive energy or movements, sleeping very little
  • Talking and/or jumping topics very quickly
  • Making odd decisions
  • Less inhibited behaviour
  • Irritated by those not sharing their ideas
  • Behaving in a bizarre way
  • Grandiose ideas, self-importance, believing one has special powers
  • May have hallucinations like hearing voices or seeing things others cannot.

During manic periods it may be difficult for the person to see that there is anything wrong, even though other people may notice changes in their appearance and behaviour that are very different from how they are normally.

The symptoms of depression during low phases are outlined on the common mental health problems page.

Useful contacts

  • Bipolar UK - provides peer support services, local support groups, an online forum, and an e-community for people with bipolar disorder, their family and friends.

Psychosis

Psychosis (also known as a psychotic experience or psychotic episode) is when you perceive or interpret reality in a very different way from people around you. Psychosis can stop a person from thinking clearly and telling the difference between reality and their imagination. One might be said to 'lose touch' with reality.

The two main symptoms of psychosis are:

  • Hallucinations – where a person hears, sees (or smells) things that are not really there, a common hallucination is when people hear voices in their head
  • Delusions – where a person believes things that, when examined rationally, are obviously untrue.

The combination of hallucinations and delusional thinking can often cause a severe disruption to peoples' perception, thinking, emotion and behaviour.

Psychosis is a symptom of more severe and enduring mental health conditions such as schizophrenia or bipolar disorder. Psychosis can also be triggered by physical conditions, such as: severe stress and lack of sleep, drug or alcohol misuse, medical conditions involving the brain or nervous system.

The charities Rethink and Mind have more information on psychosis, including information for friends and family.

Useful contacts

Schizophrenia

Schizophrenia is a long-term mental health condition that causes a range of different psychological symptoms, including:

  • A lack of interest in things, feeling disconnected from feelings
  • Disorganised thinking and speech
  • Hallucinations – hearing or seeing things that do not exist
  • Delusions – paranoid delusions and strong beliefs that others do not share
  • Changes in behaviour like wanting to avoid people, lack of basic self-care.

The exact cause of schizophrenia is unknown. However, most experts believe the condition is caused by a combination of genetic and environmental factors.

It is important that schizophrenia is diagnosed as early as possible, as the chances of recovery improve the earlier it is treated. Many people do recover from schizophrenia, although they may have periods when symptoms return (relapses). Support and treatment can help reduce the impact of the condition.

Useful contacts

Personality disorder

Personality disorders are conditions where an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others.

Often personality disorders exist alongside other mental health problems, especially depression and substance misuse.

The main symptoms are:

  • Being overwhelmed by negative feelings such as distress, anxiety, worthlessness and anger
  • Avoiding other people and feeling empty and emotionally disconnected
  • Difficulty managing negative feelings without self-harming (for example, abusing drugs and alcohol, or taking overdoses)
  • Difficulty maintaining stable and close relationships, especially with partners, children and professional carers
  • Periods of losing contact with reality.

Useful contacts

  • Surrey Recovery College has a course on Understanding Personality Disorders, Managing Intense Emotions and Moving on from Self Harm.
  • The charity Mind has information and advice for people experiencing personality disorder, including for carers, family and friends

Medication

There are many types of medication you can take to improve mental illness. It is important to know about your medication and what the side effects may be. For more information and downloadable leaflets, visit the Surrey Choice and Medication website.

Surrey Recovery College has a course on Understanding Mental Health Medication.

The Mind website provides more information on Psychiatric medication. Explaining what psychiatric drugs are, what to know before taking them, information on side effects and details on coming off medication

Other useful contacts

  • Rethink - offers information, support and webchat for people affected by severe mental illness.
    • Mental Illness Advice Service Phone: 0808 8010 525. Practical help on issues such as the Mental Health Act, community care and welfare benefits, living with mental illness, medication and care. The phoneline receives next generation text service calls.
    • Email: advice@rethink.org
  • Mind has several phonelines: an information line 0300 323 3393, a welfare benefits line 0300 222 5782 and a legal line 0300 466 6463 (for advice on mental health related law).
  • POhWER Advocacy in Surrey – a range of advocacy services for people with mental health conditions.
    • Phone: 0300 456 2370, SMS: send the word 'powher' with your name and number to 81025
    • Email: pohwer@pohwer.net