Emotional and physical (including sexual) abuse and / or neglect can often impact lastingly upon self–esteem, relationships and an ability to engage fully in daily life. Feelings arising from abuse can include shame, anxiety, self–loathing, inability to trust, and a desire to withdraw from interaction with others.

Irrespective of the drug of choice or addictive behaviour, the destructive cycle of insatiable need and shame can be extremely debilitating and impinge into every aspect of life. In particular, behaviours driven by addiction may affect relationships and increasingly diminish self–care.

Persistent anger can be extremely damaging; permeating into relationships, social and / or work interactions; the consequences of which may result in guilt, social exclusion, self–harm or potentially violence (verbal and / or physical) directed towards others.

Everyone will feel anxious on occasion, however, sustained feelings of anxiety (which can include frightening panic attacks) can be overwhelming; triggered by concerns including health, employment, financial, social situations and phobias. When anxiety occurs frequently, it can be extremely debilitating.

The grief which follows bereavement can manifest both emotionally and physically. Emotions, ranging from numbness to anger, guilt and / or anxiety and physical loss of appetite and sleep are not uncommon reactions. The circumstances and timing of bereavement and closeness of relationship to the person mourned may also impact upon the nature of grief endured.

Whether planned or unexpected, the onset of change usually brings with it uncertainty which can feel very unnerving; involving possibly difficult challenges and stress. Managing that cycle can often feel daunting, even if the anticipated outcomes are positive.

Inclusive of a wide range of potential causes and symptoms, depression is often experienced as the draining of any pleasure from daily life. Symptoms usually involve low mood, sadness, feelings of hopelessness and emptiness and possibly problems with sleeping, fatigue, appetite and libido.

Food is an integral feature of life, but where it becomes a focus for coping or control it may lead to significant reduction in both mental and physical wellbeing. Anxiety, shame, secretive behaviour, social withdrawal and exclusion are frequently associated problems experienced.

Loneliness can be extremely damaging to mental health under any circumstance; during the lockdowns following the onset of the coronavirus pandemic many people experienced escalation of those effects. Anxiety concerning going out and meeting other people may increase, with normalisation of greatly reduced social interaction often prevalent.

Whilst loss might involve bereavement, it may also be initiated by reduced health, the end of a relationship or job (expectedly or otherwise) or other valued situation or routine; possibly causing pronounced grief, guilt and quite possibly anger. 

Difficult events or relationships (often occurring during formative years) may lead to erosion of confidence and self–esteem; which can undermine attitudes and beliefs towards sense of purpose, success, failure and enjoyment of life. In particular, relationships with emotionally damaging or neglectful parents (or primary carers) can be very painful.

Behaviour which is obsessive or compulsive, sometimes resulting from life events, usually involves recurring invasive thoughts, feelings and / or images which drive fears associated with a failure to complete repetitive actions or tasks. In some instances, obsession can involve fixation with another person, often within romantic context.

Interactions with family, friends, colleagues, or even unfamiliar people can evoke a wide range of pressures and conflicts; dependent upon the impact of these relationships and the situations in which they are experienced. It could be argued that the majority of negative impact upon mental health is initiated by tensions within relationships.

A number of emotional challenges can result in a cycle of self–harm, which can take various forms; often creating feelings of panic, shame, self–punishment and helplessness. Often, self–harm will originate from an instinctive desire to express or focus deeply felt pain, anger and / or frustration. There may be risk of physical repercussions, which can be severe if not treated.

Experiencing significant (often sudden, unexpected) distress involving threat to life and / or sense of continuity or identity, either directly or vicariously, can result in both pronounced mental and physical reactions. These can include anxiety, hypervigilance, insomnia, anger, depression, guilt and often, detailed flashbacks.

Working often implies spending more time with colleagues than with family or friends; potentially arising time management pressure, hierarchical issues, frustrations, communication problems, even bullying. Equally, not working can equally cause significant difficulties. Either work or lack of work can cause significant stress, which in turn may affect mental health.