Responding to unusual behaviour linked to mental illness

Overview

A loved one who lives with mental illness might show behaviour you think is unusual. It might be hard for you to understand, accept and cope with.
Some of your loved one’s behaviour might be linked to their mental illness, but some not.
Some unusual behaviours can be linked to different mental illnesses. We explain these in this factsheet and suggest ways for you to respond to them.
It’s important to find your own way to cope and deal with any unusual behaviour your loved one displays. What works for you might not work for someone else.
Support is available if your loved one needs help for their mental health. You can seek support too.
You can help your loved one become more independent.

People will have different thoughts about what ‘unusual behaviour’ is. In this section, it means any behaviour that you think is unusual and linked to your loved one’s illness.

Need more advice?

If you need more advice or information you can contact our Advice and Information Service.

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Behaviour and mental health

How are behaviour and mental health related?

Behaviour includes the things we say, the places we go, body language, gestures, and movements. Behaviour may be affected by:

personality,
moods and emotions,
relationships with other people,
culture,
current life events,
previous experiences,
habits,
physical illness,
mental illness, or thinks like learning disability, dementia, or autism,
medication, drug, or alcohol use, and
other circumstances such as tiredness, pain, stress, or confusion.

The reasons why we do things are complex. Nobody fully understands the reasons for all their own behaviour. We all do some things without realising it or knowing where the behaviour came from.

Mental illness might affect the way people behave.

For example:

if you live with bipolar disorder and you’re experiencing mania, you might spend a lot of money or move around very quickly,
if you live with depression, you might eat less or have sleep issues,
if you live with schizophrenia, you might be fearful of leaving your home or might lose interest in life and activities.

You may feel that your loved one’s illness has a big impact on their behaviour. But there may be other things that affect them too, such as those mentioned in the list above. So, we can only give general tips on how to help someone with unusual behaviour.

On this page we give suggestions as to how you can respond to different types of behaviour.

It’s important to find the approaches that work best for you. At the end of this factsheet there is a template diary you can use to make your own guide.

Some carer support groups talk about unusual behaviour and may offer suggestions or emotional support. You can search for carer support groups on the following websites:

Rethink Mental Illness: www.rethink.org
Carers UK: www.carersuk.org, and
Carers Trust: www.carers.org/search/network-partners.

Delusions & paranoia

What are delusions?

Delusions are false beliefs. For example, your loved one may believe that:

people are trying to poison them,
they are being targeted by the police, or
that they are on a special mission.

Psychosis is a term used to describe when people lose some contact with reality. Common symptoms are hearing voices or having strong beliefs that aren’t shared by most people.

See our webpage on Psychosis for more information.

Avoiding conflict

Think carefully before you say you don’t agree with the beliefs, or you challenge your loved one too directly. Think about how they might react to this and whether it might cause conflict. Or if they might even accuse you of being part of a conspiracy against them.

Remember that your loved one truly believes these things. And their experiences may feel very real to them, even if they seem unreal to you. It might be difficult for your loved one to accept logical arguments if they’re experiencing delusions.

You might want to avoid the following things.

Laughing. It may be tempting to laugh if your loved one’s belief is very unusual. But it’s best to not do this. It might upset them or make them angry.
Agreeing with the beliefs. You may feel that it is easier just to agree. But doing this might strengthen their beliefs.

You might want to try the following things:

listening,
acknowledging feelings,
- “this must be very frightening”, or
- “it sounds very distressing for you.”
building trust
- “I am on your side”,
- “I want to help”, or
- "maybe if we talk about it you may feel less anxious”.

Exploring evidence and giving other explanations
You can try to get your loved one to reflect on a particular belief. You could ask questions like.

You say that man was following you, but can you be sure?
How many times have you seen him?
Did you see where he walked to? He could have just been walking in the same direction a few times because he lives nearby.

It may be best to ask these questions at different times. Your loved one may become distressed if you ask them to many questions at once.

Sometimes you can try helping your loved one to test their belief. For example, if they think their food is poisoned, you could offer to taste it for them. You could ask them why they think it is poisoned. If they think they are being followed, you could offer to go for a walk with them. Try not to be disappointed if your loved one continues to have delusions.

Reassurance
Your loved one may feel things are going on that aren’t really happening. Or feel worried about things that aren’t real. You could try to comfort them and help them feel a bit safer.

You can do this by reassuring your loved one by saying things such as:

“I know you think the police are following you, but I haven’t seen any evidence of this.”
“You don’t need to worry, you haven’t done anything wrong, so the police will not be interested in you.”

Distraction
You may feel as though your loved one spends a lot of time worrying about their beliefs. They may seem obsessed with them. The following things may help.

Suggest that your loved one tries something else to keep their mind off things.
Set boundaries so that you can only discuss a particular belief at certain times. It may also help to set a time limit for how long you will talk about the belief.
Suggest that your loved one talks to a professional about the way they feel because of the situation. Your loved one might not want to speak about their beliefs, but they may be willing to talk about their feelings. A professional might be someone from their NHS mental health team if they’re with one. Or their GP, or a therapist or social worker, for example.

Sometimes conversations might not go as well as you would like. Some carers tell us that their loved one has an ‘answer for everything’ and that it can be tiring trying to discuss things. Make sure you take regular breaks from the situation if you feel like this.

Delusions about you

You might find it particularly difficult to deal with a situation if your loved one believes that you have harmed them. Or that you will try to harm them in the future. They might not accept anything you say or do to prove that you care about them and want to help.

It may also help if:

someone else, like a relative, a friend, or a professional talks to your loved one, and
you can keep in contact with your loved one by email, letter, or text if things are difficult face-to-face.

It can be very difficult for you if your loved one is having delusions about you. You might want to get some extra support in this situation. Further information about support for you can be found at the bottom of this page.

What is paranoia?

Sometimes people have suspicious thoughts or worries. When these fears are exaggerated it is known as paranoia.

These fears are sometimes based on fact or truth, but not always. In some cases they can be based on past or current experiences.

Your loved one may feel threatened by something or somebody. They are a real worry to the individual experiencing them.

Paranoid thoughts can commonly be:

a fear that something bad will happen,
a belief that something has happened or is happening because of someone else, or
beliefs that things are worse than they really are.

Some examples of paranoid thoughts are:

Others are trying to steal your things or money
Someone wants to harm or kill you
You are being watched or followed
The police, government or another organisation is picking on you
People are secretly talking about you
Someone is messing with or controlling your thoughts or actions

Paranoia can be a feature in several different mental health conditions. These include psychosis, schizophrenia, anxiety disorders and dementia.

What triggers paranoia for one person can be different to another.

For more information see our webpages on the following:

Motivation & withdrawal

How can I help with low motivation?

Your loved one might feel they have no energy or motivation to do the things they used to do. This might be because of their illness. This can be common in people who live with depression and schizophrenia. You may feel frustrated that your loved one doesn’t want to do things to make their situation better.

First, you might want to check whether your loved one feels tired. This can be a common side effect of medication. A doctor might be able to give advice or help with this.

Sometimes your loved one’s low motivation can affect your own motivation. Try to take time to do activities you enjoy.

How can I help someone with low motivation?

Acceptance
Accept that this may be a part of your loved one’s illness. It’s good to help them with their motivation but try not to put unreasonable pressure on them.

Encouragement
Think about including your loved one in daily activities like shopping or housework, if you think it will help. You might find that it helps just to ask them whether they would like to help. If they say no, you can think about:

asking them another time,
asking them what they’d like to do, or
offer them an alternative activity.

When you ask them next time, they may say ‘yes’.

Organise regular activities
If your loved one gets into a habit of taking part in a certain activity regularly, they may start to enjoy it. You could suggest activities your loved one enjoys. Or you could explore new activities. This could include activities with other people, joining a group or club or doing hobbies.

Take small steps
Your loved one may want their life to improve but might be finding it hard. You can work with your loved one to break down goals into small steps. You can reassure and encourage them by noting and praising each small success they make.

See our webpage on Recovery for more information.

What if my loved one withdraws from other people?

Your loved one may feel that they don’t want to see you or other people. Sometimes this is called ‘social withdrawal’. The following may help.

You could let your loved one know that you are there for them if they want to talk.
You could offer to go with them if they’re worried about being around others in a social situation.
You can encourage them to leave the house. You could ask if they’d like to go for a coffee or for a walk, for example.
Check in with them regularly by visiting, or by phone or text.
Continue to invite them to things so they feel included. But you can reassure them that if they don’t want to come, it’s OK.

A little bit of activity and interaction can help to lift them out of their withdrawal. Doing this gradually can help your loved one to see other people and interact more.

Anger and aggression

How can I respond to anger and aggression?

Generally, people who live with mental illness are no more aggressive or violent than anyone else. But for some people who live with mental illness get feelings of anger and aggression.

How can I help prevent anger and aggression?

Try to work out which situations make your loved one aggressive. Keeping a diary might help. You may be able to work out ways of avoiding these situations. For example, talking about certain topics might upset your loved one.

Your loved one might be more aggressive if they have taken drugs or alcohol. It might be harder to reason with them if they have.

If your loved one is getting help from the NHS or social services, you can get in touch with staff to talk about the situation. If you want to know how they can get help from services, see further down this pages for more information.

Your loved one can see their GP if they feel they need help dealing with anger. They may be able to refer your loved one to a local anger-management programme.

You and your loved one might find the following resources useful:

NHS: Controlling Anger self-help guide: https://web.ntw.nhs.uk/selfhelp
Mind: How to cope with anger: www.mind.org.uk/information-support/types-of-mental-health-problems/anger/about-anger/#.W-1FEej7TIV
NHS: Dealing with anger page: www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/anger/#dealing-with-anger

How can I respond to my loved one if they’re angry?

If your loved one is angry it is best to try and stay calm. To help them you may want to try some of these.

It might be best not to say to your loved one that they’re angry. Maybe try ‘you seem upset’ instead.
Listen to your loved one and try to find out why they’re angry. You could ask them to explain. Or you could tell them what you think they mean and ask them if this is right.
Be prepared to repeat yourself and be patient.
Use your loved one’s name.
Try not to talk down to them or argue.
Respect their feelings by not telling them that they shouldn’t be angry.
Try not to get upset or angry yourself. Use a calm voice and facial expression.
Admit if you have made a mistake and say sorry if it’s appropriate.
Ask for more time before responding if you need it.

See our webpage on Getting help for someone in a mental health crisis for more information.

What can I do if someone’s at risk?

If you or another are at risk or are experiencing domestic abuse you can contact:

The Police

Phone: 101 for non-emergencies. Call 999 if you need urgent help
Website: www.police.uk/pu/contact-the-police

Refuge Women’s Domestic Abuse Helpline
Female advisers can tell you about your options and support available to help you to make any decisions about the future. They can support you to increase your safety and help you find a refuge place, or other specialist service.

Phone: 0808 2000 247
Website: www.nationaldahelpline.org.uk

Women’s Aid
Provides life-saving services in England to build a future where domestic abuse isn’t tolerated. You can connect to a support worker by instant messaging or email. You can also speak to other women in our supportive community of survivors and get information on the website.

Email: helpline@womensaid.org.uk
Website: www.womensaid.org.uk

Mankind
Their confidential helpline is available for male victims of domestic abuse across the UK. It’s also for their friends, family, neighbours, work colleagues and employers.

Phone: 01823 334244
Website: www.mankind.org.uk

Your loved one can get help from the following organisation if they commit domestic abuse. Or if they feel like they're at risk of doing so:

Respect Phoneline
You can talk to a friendly helpline advisor in confidence. They’ll listen to you without judgement and give you honest advice.

Phone: 0808 8024040
Website: www.respectphoneline.org.uk

Anxiety & risky behaviour

How can I help my loved one if they’re anxious?

Anxiety can be difficult to deal with. Your loved one might worry about things that may not happen. They may think about the worst thing that can happen. Or they may feel anxious about a specific event such as an appointment or a job interview coming up.

How can I help them?

Try to keep your voice calm
Try not to talk too fast or too loudly. Speak clearly and use simple sentences. Use your loved one’s name.

Ask them what’s wrong and how you can help
You could suggest that your loved one takes slow, deep breaths. It may help them to sit down. Telling them just to calm down might not be helpful.

Make the situation more comfortable
If you are in a place your loved one isn’t familiar with, ask them if they would like to go somewhere else. This could be somewhere:

more private,
more familiar, or
more comfortable where you can discuss things.

Listen
Your loved one might find it helpful to talk through their concerns. Especially with someone who wants to understand and help them. There won’t always be a practical way forward, and your loved one won’t always be able to get what they are looking for. But they may feel better after talking things through.

What if my loved one has anxieties about the future?

Your loved one may be anxious about something which may happen in the future. You can try to help them to break down their anxiety. You can do this by encouraging them to think about the likelihood of it happening.

If it is likely to happen, you can talk about how they can prepare for it now. You may be able to think of ideas that your loved one hasn’t thought of. Your loved one may feel a bit better about the situation if they have prepared.

Try to be patient if your loved one doesn’t want to talk about how they’re feeling. You can ask them again later.

See our webpage on Anxiety disorders for more information.

What can I do about risky behaviour?

Some people with mental illness can act in a risky way. This could include:

spending too much,
drinking a lot and taking drugs,
driving too fast,
having more sexual partners, or
self-harm, with or without the intend to die by suicide.

You can try to help and support your loved one by:

telling your loved one that you are there to support them,
talking to your loved one about what might happen because of their behaviour,
suggesting ways they could be safer, and
seeing whether your loved one would like to speak to a professional about their mental health. This might be someone like their GP or someone at their NHS mental health team. They may not be worried about their risky behaviour, but there may be other things that do worry them.

What if my loved one is a risk to themselves or others?
You might be worried that your loved one is a serious risk to themselves or others because of their mental health. They might not agree to see their GP or other mental health professionals. You could ask for a Mental Health Act assessment to try to get your loved one help.

See our webpage on Getting help for someone in a mental health crisis for more information.

For more information see our webpages on the following:

Lying and mental illness

Is lying linked to mental illness?

Lying is common in the general population and people do it for all sorts of reasons. People might lie to:

cover something up,
improve their ego,
get a job,
influence others,
protect other people, or
change the behaviour of others.

Lying is generally not a symptom of mental illness. But people might choose to tell lies that are linked to their mental illness, such as:

telling employers they’re fine, when they’re not, as they’re concerned about their job,
telling family members that they’re going to the gym, when they’re really going to therapy, because of stigma,
a man saying hay fever has made him teary, as he doesn’t want friends thinking he’s been crying.

If your loved one has told a lie it’s hard to say whether their mental illness has influenced them.

You might find it helpful to keep a record of your loved one’s lies or any manipulative behaviour. It may be helpful to a doctor.

If someone has delusional beliefs then they will believe the things they say, even if they sound unusual. These aren't lies. We give tips on how to deal with these beliefs in the previous section above.

Social media, text & email

What about social media, text and email?

Your loved one might have sent an email, a text message or out a post on social media that worries you.

Your loved one may have written something upsetting about you. Or something that made you think they were going to harm themselves or others. They might have been very specific. Or they might have written something vague such as ‘what’s the point?’

These situations could be difficult if:

you don’t know where your loved one is,
you don’t have enough direct contact to be able to decide whether they are at risk, and
you have not seen the message quickly, your loved one might not still feel the same way.

Each situation will be different. But you could think about the following.

Will it help if I respond?
Think about the impact your response will have on your loved one. Will it harm your relationship if you don’t respond at all?
If I need to respond, should I do it now or should I wait?
If the situation seems urgent, you may wish to respond as soon as you can. Other times, you may feel that you have time to think about a response.
How should I contact them?
You don’t have to respond directly to their message. You could ring them or visit them. You might find it easier to see your loved one in person. Or find out where they are, so that you can offer more support and try to get them help if they need it.
Should I speak to a friend or family member?
Other people might be able to help you think of the best thing to do.
What should I say?
This always depends on your circumstances. But think about the following.
- ‘I’m sorry to hear about the way you are feeling.’
- ‘Is there anything I can do to help?’
- ‘It seems as though things have been really hard for you recently.’
- ‘I am here if you need me.’

Help & support

How can I get help for my loved one?

You may think that your loved one need help for their mental health or help from social services.

For more information see our webpages on the following:

How can improve my loved one’s independence?

If your loved one finds it hard to do things, you may want to help them. For example, you might help them to:

fill in benefits forms,
get up in the morning,
pay their bills,
eat properly,
go to appointments, and
take medication.

You may find yourself taking on more than you were expecting to. It’s important for you and your loved one that they don’t rely on you too much. Your loved one could lose confidence in doing things for themselves, and you may feel stressed and tired.

How can I help them?

Set boundaries
Decide how much you can do for your loved one and agree boundaries. This might include exactly what you help them with and when you do it. It is better if you can agree this early on, but you can review the situation at any time. Explain the reasons why you need to set boundaries.

Work towards independence
Take steps to slowly build your loved one’s confidence and independence by agreeing goals. To start with, your loved one’s goals may be to do things like:

make a meal from scratch,
walk the dog, or
fill in a form.

Get help from professionals
If your loved one is with an NHS mental health team (CMHT), you could talk to their care coordinator or key contact. They may help them develop independent living skills. For example, by getting help from an occupational therapist or supported housing.

Your loved one might need more help to live their daily life than you can give them. They might be able to get help from social services.

For more information see our webpages on the following:

What support can I get?

Supporting a person with unusual behaviour can be stressful, and you may need support yourself. You could:

talk to friends and family,
talk to your own doctor,
take some time out to concentrate on yourself,
ask for a carer’s assessment from your local authority, and
join a support group for carers, friends and family.

You can search for carer support groups on the following websites:

Rethink Mental Illness: www.rethink.org
Carers UK: www.carersuk.org, and
Carers Trust: www.carers.org/search/network-partners.

Get a carer’s assessment
You can contact your local authority’s social care team to ask for a carer’s assessment if you need support to care for your loved one. They may be able to arrange additional help or a break for you and your loved one.

For more information see our webpages on the following:

Last updated September 2022
Next update September 2025

Version number 9

You can access a fully referenced version of this information by downloading the PDF factsheet by using the link at the top of this page.

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