What are the signs of mental health issues?

The manifestations of mental health issues are far more than just what the general public understands as loss of control over emotions or a pessimistic, world-weary attitude. They often lie in everyday details that are easily overlooked, and in many cases, these signs are mistaken for signs of “laziness,” “rebellion,” or simply “a bad mood,” resulting in missed opportunities for intervention.

When I used to provide psychological services in the community, I met a girl who worked in internet operations. She was originally regarded as the “life of the party” in her department—her schedule was filled with watching anime, going camping, and exploring new cafes, leaving her even busier than her work. But suddenly, for three months in a row, she canceled all her social activities, left work on time every day, and went straight home to rest. She didn’t even bother to check updates on the variety shows she had been watching for three years, and lost interest in her favorite taro milk tea after just a few sips. Her colleagues assumed she was going through a breakup or some personal issue. It wasn’t until she stayed awake until 3 a.m. for two consecutive weeks that she went to the hospital and was diagnosed with moderate depression. She herself was shocked, thinking it was just due to the excessive workload recently.

In fact, there is currently no universally agreed-upon standard for identifying early warning signs of psychological issues in academic circles. Some researchers believe that persistent sleep disturbances or a loss of interest for more than three days warrant active intervention, while experienced clinical counselors argue that given the high levels of stress associated with modern work and life, occasional episodes of low mood or lack of energy are normal stress responses that should not be overreacted to. Instead, hastily labeling oneself as “depressed” or “anxious” based on online test results can lead to the misinterpretation of temporary emotional fluctuations as genuine psychological burdens.

Many people think that when there is a psychological issue, it means one is unable to live a normal life, but that’s not necessarily the case. I once worked with a junior high school boy who had consistently ranked in the top 20% of his class. Suddenly, after half a semester, his grades dropped to well below the 100th percentile. In class, he would stare blankly at the blackboard for entire periods; at home, he would lock himself in his room and refuse to talk to his parents. At first, the parents thought it was due to early romantic relationships or rebellious behavior, so they punished him, which only made him want to stop going to school altogether. It wasn’t until we conducted an assessment that we discovered he had been experiencing bullying at school, which had triggered post-traumatic stress disorder. His inability to concentrate and his deliberate avoidance of social interactions were actually mechanisms of psychological self-protection—just like how our hands instinctively pull back when they touch hot water, our minds also “withdraw” to reduce external stimuli when they are injured.

There is another, more subtle manifestation that many people tend to overlook. Instead of being depressed, such individuals may appear particularly “positive.” Last year, a boss in the cross-border e-commerce industry came to see me. He said that for half a year straight, he had only been sleeping 3 hours a day, constantly working on supply chain issues and conducting live broadcasts without feeling any fatigue at all. He thought this was just a sign that he was getting into the groove of starting his own business. However, during a weekly meeting, when one of his subordinates reported a minor error in the data, he suddenly burst into tears in front of everyone—completely uncontrollably. It was only after some tests that it turned out he suffered from severe anxiety accompanied by mild manic tendencies. That constant sense of “overexcitement” was actually his way of trying to fill the emotional void left by not having enough to do, as he was too afraid to face the panic that would overtake him when he had time to relax.

To be honest, after working in this field for a while, I came to realize that psychological issues are somewhat similar to the common cold. Some people experience symptoms like a fever and runny nose, while others suffer from a sore throat and general body aches. There isn’t a single, universal standard for how these issues manifest. If you notice that your current state is different from your usual self and it persists for a week or two despite trying to adjust, don’t just endure it and blame yourself for being sensitive. Talk to a professional counselor—even just sharing your concerns can be beneficial.