It is not always possible to pinpoint a single cause for mental illness. It is usually an interplay of various biological, psychological and social factors.
Biological factors: Genetic issues, chemical imbalances of neurotransmitters, abnormality of structure/function of the brain, structural or functional damage to the brain, long time substance abuse etc induce changes in the brain can be an underlying cause of mental illness.
Psychological factors: Poor or abusive parenting, parental neglect, adverse childhood experiences like sexual abuse, prolonged emotional stress, feelings of inadequacy, low self-esteem, anxiety, anger, or loneliness, psychological issues related to other physical health issues are believed to make an individual vulnerable.
Social factors: Separation or divorce, death of loved ones, domestic violence, abuse, adjustment issues, social or cultural expectations (For example, a society that associates beauty with thinness can be a factor in the development of eating disorders. Work-related stress and lack of proper support systems, financial issues, legal issues, poverty homelessness can trigger the onset of mental illnesses.
Risk factors are those elements that make it more likely for one to develop a mental disorder, compared to others. This means that having risk factors can expose a person to mental health issues and increase the chance of developing mental illness. Risk factors (causes) can reside within the individual, within the family, community or environment surrounding the individual. These can be biological or psychosocial or social in nature. Some risk factors can play a causal role in mental disorders and some may not. These include:
History of mental disorder/ genetic vulnerability
Evidence shows that a history of mental disorders in the family (parents or close relatives) can increase the chance of that person developing a mental disorder in later stages of life. The observation that there is sometimes a family history of mental health problems has led to many researchers focussing on possible genetic links or risk factors in mental disorders. Early attempts to identify single genes responsible for particular conditions have now been superseded by studies looking at many possible patterns across the whole genome which may be associated with increased risk of mental disorders. Equally intriguing is the emerging area of epigenetics which explores whether some kinds of environmental risk factors such as being abused as a child, drinking or drug taking may alter gene expression or the function of the nervous system, making future problems more likely.
People with serious health conditions are likely to develop mental health issues. Illnesses such as heart disease, cancer or diabetes are often given more attention, and mental health issues are underestimated in people with these illnesses. This in turn results in mental health issues never being discovered or completely ignored, which in the long run counteracts the efforts to attain wholesome wellbeing. Chronic and serious physical illnesses continue to act as a major hindrance in the diagnosis and treatment of mental ill-health.
The changes occurring during the prenatal and postpartum periods in a pregnant woman can often account for a mental illness. It is said that one-fifth of pregnant women experience mental distress/ mental ill-health. Socioeconomic status, marital quality, domestic violence, unintended pregnancy and lack of social support are among the key factors which influence the mental health of pregnant women. These coupled with physical and hormonal changes occurring during pregnancy act as a catalyst for developing mental illnesses.
Alcohol and substance use
Excessive alcohol consumption and substance abuse (use of illicit drugs) are a major cause of mental illnesses. These co-occurring disorders are difficult to diagnose, as mental illnesses hide well behind alcohol or drug addictions. Even during the treatment, the medications administered maybe less effective because of the continuous use of alcohol or other illicit drugs. Substance abuse increases the complexity of treatment programs, as the person will have to deal with crippling addictions and crushing mental illnesses at the same time. Medications, individual and group counselling sessions, self-help measures and peer support can go a long way, but the chances of treatment program failure stand high.
Symptoms resembling mental illnesses can also be caused due to factors like microbial pathogens, toxins or infections that cause changes in brain chemistry, poor diet and exercise levels. Mental ill-health/ distress is frequent after a traumatic brain injury. Any injuries, whether internal or external, to brain tissue, can subsequently lead to a mental illness.
Disturbed family environment
A disturbed family environment and communication problems in the family can act as risk factors for mental disorders. This can affect the family members, especially children leading to insecure attachment, unsupportive parenting, low sense of self-esteem, traumas, inability to communicate, a difficult learning environment, family violence or conflict, domestic violence and many more.
The socioeconomic factor, poverty or poor living conditions may be additional risk factors that may contribute to the development or maintenance of mental disorders. Socioeconomic status can deprive individuals and families in different ways related to finance, employment, social status and social relations. Also, it can affect a person’s education as well as access to professional help.
Social inequalities also pose a greater risk for mental health issues. This can include inequalities in all levels like caste, gender, economic status, race, colour etc which in turn causes discrimination.