Mental health plays an essential role in every part of life from how we think and feel to how we build relationships and handle stress. For some people, mental health conditions can become so severe that they have a significant impact on a person’s daily life. This means the illness gets in the way of one or more major life activities such as holding down a job, keeping healthy relationships, going to school or taking care of everyday responsibilities. These conditions are known as serious mental illnesses or SMIs.
In 2022, the National Institute of Mental Health (NIMH) estimated that around 15.4 million adults in the U.S. currently live with a serious mental illness. These conditions can affect people of all ages, backgrounds and walks of life. While they can be overwhelming sometimes, with the right care and support, recovery is possible.
Examples of serious mental illness
While the term SMI describes a level of impact rather than a specific diagnosis, several mental health conditions can be classified under SMI due to their potential for severe functional impairment. These conditions include:
Schizophrenia
Schizophrenia is a chronic brain disorder that affects how a person thinks, feels and behaves. People with schizophrenia may experience:
- Hallucinations — Seeing or hearing things that aren’t there
- Delusions — False beliefs
- Disorganized thinking
- Lack of motivation
Bipolar disorder
Bipolar disorder is characterized by dramatic shifts in mood, energy and activity levels. These mood shifts include periods of intense highs, known as hypomania or mania, and severe lows, or depression.
Major depressive disorder (MDD)
MDD is more than just feeling sad. It involves persistent sadness, loss of interest in activities, fatigue and other symptoms that significantly impact a person’s daily life for at least two weeks. When MDD is severe and recurring, it can fall under SMI.
Panic disorder
Panic disorder, an anxiety disorder, is marked by recurring and unexpected panic attacks that are sudden surges of intense fear or discomfort. These panic attacks are accompanied by distressing physical and cognitive symptoms. The fear of future panic attacks can also lead to avoiding situations, people or places.
Obsessive-compulsive disorder (OCD)
OCD involves uncontrollable, recurring thoughts, obsessions, and behaviors, compulsions, that a person feels the urge to do over and over. These can become so time-consuming and distressing that they severely interfere with a person’s daily life.
Post-traumatic stress disorder (PTSD)
PTSD is a condition that can develop after a person has experienced or witnessed a traumatic event. Symptoms of PTSD can include:
- Flashbacks
- Nightmares
- Severe anxiety
- Uncontrollable thoughts about the event
When PTSD is persistent and debilitating, it’s considered a SMI.
Borderline personality disorder (BPD)
BPD is a mental health condition that is characterized by unstable moods, behaviors and relationships. People with BPD may struggle with self-image, impulsive actions, intense emotions and a fear of abandonment.
It’s important to remember that all of these conditions exist on a spectrum, and not everyone who is diagnosed with one of these conditions will meet the criteria for SMI. The key factor for SMI is the amount of impairment that is caused by the mental health condition.
What can cause a serious mental illness?
Just like many other complex health conditions, there isn’t usually a single cause for SMI. Instead, it’s believed to come from a combination of interacting factors:
Genetic factors
Research shows that many mental health conditions can run in families, suggesting that genetics can play a role. However, having a genetic predisposition to a condition doesn’t mean that a person will develop a SMI; it just means that they may be more vulnerable.
Biological factors
Biological factors include differences in brain structure, chemistry and function. Imbalances in neurotransmitters, brain chemicals that send signals, are thought to contribute to many conditions that can be classified as an SMI.
Psychological factors
Individual experiences such as severe psychological trauma (childhood abuse, neglect or violence), significant life stressors or ongoing negative thought patterns can contribute to the development or worsening of SMI.
Environmental factors
Environmental factors like the exposure to certain toxins, infections, substance use, social isolation, poverty or discrimination can play a role. In those people who are already vulnerable, stressful environments can be a trigger or make symptoms worse.
Symptoms of serious mental illness
The symptoms of SMI can vary widely depending on the specific mental health condition, but they can fall into a few key categories, including:
Emotional symptoms
- Severe mood swings, from extreme highs to extreme lows
- Persistent sadness, irritability or anger
- Loss of pleasure or interest in activities (anhedonia)
- Chronic anxiety or fear
- Numbness or feeling emotionally disconnected
Cognitive symptoms
- Difficulty concentrating, focusing or paying attention
- Problems with memory, short-term or long-term
- Disorganized thinking or racing thoughts
- Difficulty making decisions or problem-solving
- Delusions
- Hallucinations
Behavioral symptoms
- Withdrawal from social activities and relationships
- Insomnia or excessive sleep
- Significant changes in appetite or weight
- Personal hygiene neglect
- Agitation or restlessness
- Lack of energy or motivation
- Engaging in impulsive or risky behaviors
- Difficulty doing daily tasks
- Self-harm or suicidal thoughts
Recognizing these symptoms, especially when they’re severe and persistent, is the first step toward getting the help you need and deserve.
Treating serious mental illness
While SMI presents some big challenges, it can also be treated. The goal of treatment is to help reduce symptoms, improve functioning and enhance your overall well-being. Treatment plans are highly individualized and often involve a combination of approaches:
Psychotherapy
Various types of therapy can be highly effective, including:
Cognitive behavioral therapy (CBT)
CBT can help individuals identify and challenge negative thought patterns and behaviors.
Dialectical behavior therapy (DBT)
DBT focuses on emotional regulation, distress tolerance, mindfulness and interpersonal effectiveness, often used for borderline personality disorder, self harm and suicidal behaviors.
Family-focused therapy (FFT)
FFT involves working with family members in the person’s treatment process to help improve communication and build stronger support.
Psychoeducation
The therapist works to educate the individual and their family about the mental health condition, its symptoms and healthy management strategies.
Medication management
Psychiatric medications can play an essential role in managing symptoms, with the highest prevalence being in those with schizophrenia, bipolar disorder, severe recurrent depression and PTSD. Finding the right medication or combination involves careful monitoring and adjustment by a psychiatrist or psychiatric nurse practitioner.
Structured mental health programs
When more intensive support is needed than weekly therapy can provide, but the individual doesn’t require 24-hour care, structured mental health programs can be beneficial.
Intensive Outpatient Programs (IOPs) offer a structured environment with a treatment program that meets several days a week for a few hours each day. They allow individuals to receive significant therapeutic support while living at home.
Partial Hospitalization Programs (PHPs) provide an even more intensive day treatment program, where individuals participate in therapy and other programming for most of their day for five days a week, but allow them to return home at night. These programs offer a higher level of care than weekly therapy, providing stability and comprehensive support for severe symptoms.
Lifestyle modifications
Healthy routines can make a big difference. Some steps you can take to build your own healthy routine include:
- Establishing consistent routines, especially sleep
- Getting regular physical activity
- Eating a nutritious diet
- Adopting stress management techniques
- Limiting substance use
- Building a strong support system
Why access to care matters
The earlier someone with SMI can receive a diagnosis and start treatment, the better their chances are for long-term recovery. Here’s why quality of care is so important:
- Early diagnosis can help prevent symptoms from getting worse and reduce the risk of serious complications.
- Comprehensive treatment can address all aspects of health, mental, physical and emotional well-being.
- Supportive environments empower individuals to heal, grow and thrive.
- Long-term stability is possible with consistent care and community support.
- Access to professional care can help normalize mental health issues, reducing stigma and encouraging people to seek help without shame.
When someone is met with understanding, compassion and access to high-quality services, the path forward can become clearer and brighter.
How Guidelight Health can help you navigate a serious mental illness
At Guidelight, we believe that no one should face a serious mental illness alone. Our expert team is here to provide hope, clarity and compassionate support. We welcome adults and adolescents ages 12 to 18, and we treat a wide range of mental health conditions.
We understand the complexities of SMI and are deeply committed to providing compassionate, evidence-based care that can make a tangible difference. Guidelight offers personalized treatment plans designed to address your unique needs. We focus on helping you regain your daily functioning, improve your relationships, and rediscover your sense of purpose and joy. Everyone deserves a place to feel seen, supported and safe, especially when facing significant mental health challenges. Guidelight is here to be your partner on your journey toward recovery and lasting well-being.
Everyone has a seat at Guidelight. Contact our team today for more information or to schedule an initial evaluation.