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Why do mental health conditions usually come in pairs?

Updated: May 7

There is no particular format for mental health or any health-related issue, however, in my experience, I have found that should someone have a mental illness, another is usually present as well although it could take longer to develop.

In my case, I have been diagnosed with both anxiety disorder and OCD and I’m still trying to work out what came first; the chicken or the egg. It’s not uncommon to have illnesses such as anxiety or depression and then introduce a controlling factor to subsidize that like OCD or addiction disease.

How it starts

No one person is the same as another. Usually, mental illness can be triggered by a few things:


Trauma is really anything that has a detrimental effect on you and your life. It could be something that happened progressively over a long period of time (such as abuse, ill-treatment, or poor living conditions), that you might not have identified till many years later or it could be something more specific that happened in a split second. Many people will start experiencing the effects of their trauma before they understand its cause.

Trauma really is a very broad term and can span an entire spectrum of instances. Really trauma is specific to you, it isn’t and shouldn’t be comparable to someone else and what they consider traumatic.

Life Change

Life change can refer to anything in life that uprooted you or made you metaphorically unbalanced. Even though change is essential and some find it liberating, it's not natural for everyone. It could be a choice or something that you were pushed into; even so, it can be uncomfortable and usually brings with it stress and anxiety before, during, and after the change occurs.

Now a lot of things fall into these brackets and genetics can play a part too, don’t get overwhelmed trying to search for a singular moment that caused it all. Some people may never truly identify their causes especially if they began in childhood or have been blanked out by a brilliantly clever brain.

There tend to be multiple reasons and triggers for mental illnesses but these two I find to be the most prominent.

The Control Factor

This is usually something we develop to control something we perceive to be “uncontrollable”.

Say we experience a traumatic event or a turbulent childhood, we may not realise the effect it has on us at the time, we might not have a name for that effect or diagnosis but we know things aren’t right. We might start adopting control mechanisms to regain balance in our lives.

Mental illness is usually triggered by the feeling of losing control of something; our bodies, thoughts, or actions. When you feel out of control what do you do? Try and get it back.

Alcohol or drug abuse is a common control mechanism, it's used to gain confidence or…momentarily forget. Unfortunately, this “control mechanism” can easily and quickly become uncontrollable in itself, and addiction disease becomes another illness to deal with.

OCD is another common one. For most people, it’s a physical way to feel in control. By doing certain things you create a safety net around you, a feeling of protection. OCD rituals begin to feel familiar like they are balancing the scales in your life, for everything that feels unsettling around you, you are doing something that makes it better. But again, this can soon become uncontrollable, making daily tasks or sleep unachievable.

Control mechanisms are natural, we have them as a fallback for most things. Some people will laugh when everyone expects them to cry or tell a joke in moments of sincerity; these are all forms of protection and mostly they aren’t harmful. The key is noticing when they become more overwhelming than what you are trying to protect yourself from.

What can be done?

There is no easy fix. Mental illness is usually present and building for years, as said before you may not even be aware of it instead just refer to some things as personality traits or “quirks”. Managing any mental illness does take time, dedication, and self-reflection. It’s not something that can be put off till the weekend or completed in an intense one-week course but the commitment to self-care and reflection doesn’t have to be another stressor in your life. Finding resources that suit you can be a trial and error in itself but you will learn about yourself and grow in confidence and strength.

The first step is being honest with yourself. Acknowledging there is a problem and committing yourself to its resolution. Find goals you want to work towards and aids that will help you in their achievement.


First things first. Identify your mental illnesses. I would never advise anyone to self-diagnose, but I also understand the strain on our health service and waiting times. Be responsible when researching mental illness and make a note of your triggers and symptoms before searching for anything so you can compare; too often we’ll see a list of symptoms and then start questioning whether or not we’ve experienced them.

Keep a journal noting down anything relevant or prominent about how you are feeling, try and identify patterns of behaviour or link certain emotions with places, people, or encounters. The Discovery Journal can help with this.


Once you know what you are dealing with or “putting a name to a face”, take some time to reflect. Learning about yourself is one of the most important things you can do in this process.

Reflecting is the art of thinking about a singular situation or experience and being able to sit with it and understand all perspectives.

Don’t get confused between “overthinking” and “reflecting”. Overthinking can be harmful and it mostly involves making up stories and scenarios that haven’t occurred or creating worry, based on assumptions. Reflecting is simply looking at a particular experience and thinking about how and why it made you feel the way you do.

Lastly, try and consider your priorities. If you are dealing with multiple mental illnesses try and establish which one is causing the most pain or is dangerous to yourself or others around you. It's always beneficial to get to the root cause in the long term but if something is detrimentally affecting your quality of life, this should be managed first.

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