Risk Factors for Mental Health Conditions

Mental Health Risk Factors

Mental health disorders range from mood disorders, such as depression and bipolar disorder, to personality disorders, and anxiety disorders. They affect approximately one in five adults in the United States, or around 59 million people, and only half of these individuals receive mental health condition treatment.

Many common risk factors can lead to the development of a mental health disorder. Still, it’s important to note that mental health disorders are not an individual’s fault, nor does one specific trigger cause them. Instead, they are multifactorial in origin, meaning that there is usually a combination of risk factors, including environmental, biological, psychological, and sociological elements that contribute to the development of a disorder.

Genetic Predisposition

Having a first-degree relative (parent or sibling) with a mental health disorder does increase your risk of developing a mental health disorder. For example, schizophrenia is thought to have up to 70-80% genetic heritability. However, having that increased risk does not necessarily mean you will develop that mental illness. There are specific mental health disorders that have a genetic predisposition, and these include:

• Schizophrenia
• Autism
• Depression
• Bipolar disorder
• Attention deficit hyperactivity disorder (ADHD)

Independent of family history, some specific genetic mutations or polymorphisms may increase the risk of having a mental health disorder. A polymorphism is a variation in DNA sequences in at least 1% of the population. Multiple genes have been studied that are candidates for increasing the likelihood of developing certain mental health disorders, regardless of family history.

Childhood Trauma

When a child grows up experiencing trauma, such as abuse or neglect, their brain is shaped by these traumatic events. They may not show signs of a mental diagnosis right away because they are in the survival “fight or flight” mode. Still, as they progress into adulthood, they are at an increased risk of developing a mental health disorder.

Research has consistently shown that exposure to adverse childhood experiences (ACEs) is linked to an increased likelihood of post-traumatic stress disorder (PTSD), depression, anxiety, and substance abuse in adulthood.

A 2023 study from the JAMA Psychiatry journal showed that the ability to remember the trauma had a larger effect in adulthood than the trauma itself. Adults who did not remember the trauma showed the same level of anxiety and depression as adults who did not experience childhood trauma. In other words, the strongest predictor of certain mental health disorders, such as anxiety and depression in adulthood, was the memory of the childhood trauma rather than the documented trauma that occurred.

Interventions such as eye movement desensitization and reprocessing (EMDR) to treat these memories can help prevent mental health disorders from occurring later in adulthood.

Brain Injury

Motor vehicle accidents and falls most commonly cause traumatic brain injury (TBI) and are tightly linked to mental health disorders. Research has shown that mental health disorders are both short-term and long-term effects of TBI, affecting 46%-74% of individuals post-TBI. Mental health disorders that develop due to a TBI are termed “post-traumatic psychiatric disorders.”

Disorders such as depression, anxiety, PTSD, suicidality, and personality disorders are known to increase as a result of a TBI. A recent study in 2024 showed that TBI is a risk factor for bipolar disorder and schizophrenia. Individuals who have suffered a TBI are most at risk for developing a mental health disorder if the following factors are present:

• Unemployment: indicates that socioeconomic factors have a significant role in developing a mental health disorder due to a lack of access to medical and mental health treatment. Employment not only provides financial security but also a sense of belonging, purpose, and social support.
• Lower Glasgow Coma Scores (GCS): a neurological assessment tool used to determine an individual’s level of consciousness after a head injury (the lower the score, the worse the level of consciousness after the injury).
• Frontal lobe injuries: The frontal lobe region is crucial for cognitive functions, impulse control, emotional regulation, and social behavior, and injury to this area increases vulnerability to mental health disorders.
• Limb injury, which most likely increases pain and suffering, increases the risk of a mental health disorder.
• Post-traumatic coma, which plays a significant role in brain recovery.

Substance Abuse

Substance abuse is a known risk factor for mental health disorders and vice versa, hence why the concurrent diagnosis of a mental health disorder and substance use disorder is known as a dual diagnosis.

Substance use disorders include alcohol and drug misuse (both illicit and prescription) and can rewire the brain, resulting in an imbalance of neurotransmitters that can affect mood regulation and decision-making skills.

Additionally, drugs and alcohol can affect certain brain regions that are responsible for cognition and impulse control. This neurochemical imbalance and affected brain regions can increase the risk of mental health disorders such as depression and anxiety.

Substance abuse can lead to a cycle of shame, guilt, loneliness, impulsive behaviors, and poor self-esteem, leading to a negative feedback loop that can continually feed into poor mental health outcomes. The cycle of feeling depressed or anxious and trying to self-medicate with alcohol or drugs can spiral into a dangerous cycle of substance dependence and worsening mental health.

Social Factors

People who are exposed to unfavorable social circumstances are more vulnerable to mental health disorders than those who are not. Social factors, such as employment, education, safe housing, food security, and discrimination, are all major determinants of mental health. Individuals who experience adverse social outcomes such as unsafe housing, lack of social support, and financial insecurity are at risk for mental health disorders because they are under chronic stress, which can change their stress response and brain chemistry over time.

Environmental Factors

The space in which we live and work can have a profound impact on our mental health. Natural light, toxins, pollution, access to green space, and noise levels all factor into overall mental wellness. Studies have shown that people who live in an environment with higher crime rates, more pollution, less green space, and constant noise pollution are at risk of poor sleep, mental health conditions such as depression and anxiety, and chronic stress, which can affect overall physical health. Additionally, certain important environmental factors associated with urban living, such as social deprivation, high population density, and environmental pollution, can increase the risk of depression, anxiety, and other psychiatric disorders.

Psychological Stressors

Psychological stressors can take a toll on our mental health and, over time, lead to depression and anxiety. Negative life stressors such as the loss of a loved one, divorce, job loss, chronic medical problems, or moving to a new location are all examples of psychological stressors that can increase the risk of mental health disorders.

Spiritual Factors

Spirituality can provide a sense of purpose, community, hope, and optimism to one’s life. The power of belief can be a coping mechanism for life’s turmoil. When spiritual conflicts occur or the loss of spirituality happens, it can lead to a lot of loneliness, confusion, and disconnection, which can increase the risk of depression or anxiety.

Poor Coping Skills and Lack of Emotional Regulation

People who lack healthy and adaptable coping skills often struggle with daily stressors, which can affect their personal relationships and professional demeanor.

Poor coping skills can lead to rash decision making, unhealthy behaviors, poor spending habits, unstable relationships, and the need to misuse alcohol and drugs. These can lead to financial stress, loneliness, poor physical health outcomes, and legal trouble, which can increase the likelihood of developing a mental health disorder. Additionally, when people struggle to manage their emotions and have unhealthy reactions to stress, it can worsen already present or undiagnosed mental health conditions.

Poor coping skills include lashing out, substance abuse, self-harm, frivolous spending, aggression, projecting, isolation, emotional eating, overworking, negative self-talk, denial, oversleeping, avoidance behaviors, catastrophizing, and codependence.

Physical Health Conditions

Physical health conditions are a risk factor for mental health conditions because they can create stress in all aspects of a person’s life. From navigating the complicated healthcare system and insurance coverage to chronic pain, limited mobility, side effects of medication, and social isolation, all of these factors can lead to an increased risk of depression and anxiety.

Preventative Factors for Mental Health Conditions

Protective or preventative factors can help decrease your risk of mental health disorders, and similar to risk factors, these can be environmental, biological, and social. For example, suppose you do not have any first-degree relatives with a diagnosable mental health disorder. In that case, you are at a biological advantage for protective factors for developing mental health disorders.

Other preventative factors that decrease the likelihood of developing a mental health condition include the following:

• A good social support system
• Employment
• Financial security
• Having access to green space and safe working and living environments
• Healthy coping skills
• Adopting healthy daily living patterns
• Access to mental health and medical treatment
• Access to food and education
• Living in a safe environment without abuse, trauma, or bullying
• Spirituality or finding a greater purpose in life
• Stable and nurturing relationships
• Resiliency, hope, and optimism
• Positive self-esteem
• Prioritizing physical health

What to Do If You’re At Risk

Anyone can develop a mental health disorder. Still, some people may be more at risk than others, and it is important to lean into protective factors. Social support systems, regular self-care, utilizing mental health resources, and improving your physical health are all protective factors that can help if you are at risk for developing a mental health condition.

Seeking appropriate mental health treatment, like psychotherapy, can help protect against mental health conditions and provide you with tools to navigate stressful scenarios and adopt healthy coping tools to help improve and maintain your overall well-being.