Mental Illness 101
Overview
• Nationwide 50 million Americans suffer
from a mental illness in a given year
• Mental Illness is more common than:
– Cancer
– Diabetes
– Heart Disease
• Psychiatric disorders are the number 1
reason for hospital admissions nationwide
• Mental illness is treatable
Biological Causes of Mental Illness
• Biological Causes
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Biochemical Disturbances
Genetics
Infections- can cause brain damage
Brain defects or injury
Prenatal damage
Poor nutrition, exposure to toxins
Psychological Causes of Mental Illness
• Psychological Causes
– Severe psychological trauma suffered as a child,
such as emotional, physical or sexual abuse
– An important early loss, such as the loss of a
parent
– Neglect
– Poor ability to relate to others
Environmental Factors of Mental
Illness
• Environmental Factors
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Death or divorce
A dysfunctional family life
Living in poverty
Feelings of inadequacy, low self-esteem, anxiety, anger or
loneliness
– Changing jobs or schools
– Social or cultural expectations (For example, a society that
associates beauty with thinness can be a factor in the
development of eating disorders.)
– Substance abuse by the person or the person's parents
Stress
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Academic
Homesickness
Peer relationships
Family
Identity
Work
Illness
Stigmatization
• 35% of people with diagnosable disorders
seek treatment
• The single most common barrier to seeking
treatment is Shame
Types of Mental Illness
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Mood Disorders
Anxiety Disorders
Psychotic Disorders
Personality Disorders
Impulse Control and Addictive Disorders
Eating Disorders/Body Image
Other ( Adjustment Disorders, Dissocative
Disorders, Factitious Disorders, Sexual and
Gender Disorders, Somotoform Disorders, Mental
Retardation)
Anxiety Disorders
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Panic Disorder
Obsessive Compulsive Disorder
Post Traumatic Stress Disorder
Social Anxiety Disorder
Specific Phobias
Generalized Anxiety Disorder
Symptoms of Anxiety Disorders
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Feelings of panic, fear and uneasiness
Uncontrollable, obsessive thoughts
Repeated thoughts or flashbacks of traumatic experiences
Nightmares
Ritualistic behaviors, such as repeated hand washing
Problems sleeping
Cold or sweaty hands
Shortness of breath
Palpitations
An inability to be still and calm
Dry mouth
Numbness or tingling in the hands or feet
Nausea
Muscle tension
How Common Are Anxiety
Disorders?
• Anxiety disorders affect about 19 million adult
Americans.
• Most anxiety disorders begin in childhood,
adolescence and early adulthood.
• They occur slightly more often in women than in
men, and occur with equal frequency in
Caucasians, African-Americans, and Hispanics.
Treatment of Anxiety Disorders
• Medication-Medicines used to reduce the symptoms of
anxiety disorders include anti-depressants and anxietyreducing medications.
• Psychotherapy (a type of counseling) addresses the
emotional response to mental illness. It is a process in which
trained mental health professionals help people by talking
through strategies for understanding and dealing with their
disorder.
• Cognitive-behavioral therapy: People suffering from
anxiety disorders often participate in this type of
psychotherapy in which the person learns to recognize and
change thought patterns and behaviors that lead to
troublesome feelings.
Types of Depression
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Situational/Adjustment
Bereavement
Seasonal
Clinical Depression
Psychotic Depression
Bipolar (Manic-Depressive Illness)
Dysthymia
Post-Partum Depression
Situational/Adjustment
Variable mood correlated to
circumstances
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Minimal change in sleep, appetite, energy
No change in self-attitude
Suicidal thought unlikely
Typically lasts less than one month
Seasonal
• Seasonal depression, called seasonal affective disorder
(SAD), is a depression that occurs each year at the same
time, usually starting in fall or winter and ending in spring or
early summer. It is more than just "the winter blues" or "cabin
fever."
• Symptoms of winter SAD may include the seasonal
occurrence of:
• Fatigue
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Increased need for sleep
Decreased levels of energy
Weight gain
Increase in appetite
Difficulty concentrating
Increased desire to be alone
Dysthymia
• Dysthymia, sometimes referred to as chronic
depression, is a less severe form of depression but
the depression symptoms linger for a long period of
time, perhaps years. Those who suffer from dysthymia
are usually able to function normally, but seem
consistently unhappy.
• Symptoms of dysthymia include:
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Difficulty sleeping
Loss of interest or the ability to enjoy oneself
Excessive feelings of guilt or worthlessness
Loss of energy or fatigue
Difficulty concentrating, thinking or making decisions
Changes in appetite
Thoughts of death or suicide
Clinical Depression
• An illness, not a weakness
• Serious disturbances in work, social, and
physical functioning including suicidal thought
• Not relieved by circumstances
• May last for months or years untreated
• Persistent and intense mood change
Clinical Depression
Who and When
• 1.5 million young adults in US each year
– Fewer than half seek treatment
– 1 of 4 women and 1 of 10 men develop
depression during their lifetime
• Often begins in early adult years
• Family history, substance abuse, and
stress increase risk
Clinical Depression
Signs and Symptoms
• Extreme sadness, guilt, shame
• Decreased concentration, poor academic
performance or work performance
• Decreased interest/enjoyment in daily activities
• Increased irritability, arguments
• Change in sleep, appetite, energy
• Social withdrawal
• Hopelessness, helplessness, suicidal thought
Clinical Depression
Treatment
• Anti-Depressant medications (effective,
improved safety & tolerability, not habit
forming)
• Psychotherapy (individual, group,
cognitive behavioral, self-help)
• Day treatment, hospitalization
• Exercise, sleep hygiene, light therapy,
ECT
Psychotic Depression
• Roughly 25% of people who are admitted to the
hospital for depression suffer from what is called
psychotic depression.
• What Are the Symptoms of Psychotic Depression?
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Anxiety (fear and nervousness)
Agitation
Paranoia
Insomnia (difficulty falling and staying asleep)
Physical immobility
Intellectual impairment
Psychosis
Bipolar Disorder
• 2% general population over a lifetime
• Half of cases begin before age 20
• Episodic extremes between states
– depressed state and excitable,
– euphoric/irritable, impulsive state
• Strong family linkage
• Occurs equally in men and women
Symptoms of Bipolar Disorder
• Symptoms of mania ("the highs"):
– Excessive happiness, hopefulness, and excitement
– Sudden changes from being joyful to being irritable, angry, and
hostile
– Restlessness
– Rapid speech and poor concentration
– Increased energy and less need for sleep
– High sex drive
– Tendency to make grand and unattainable plans
– Tendency to show poor judgment, such as deciding to quit a job
– Drug and alcohol abuse
– Increased impulsivity
Bipolar Disorder
• Some people with bipolar disorder can become psychotic,
seeing and hearing things that aren't there and holding false
beliefs from which they cannot be swayed.
• During depressive periods ("the lows”) symptoms include:
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Sadness
Loss of energy
Feelings of hopelessness or worthlessness
Loss of enjoyment from things that once were pleasurable
Difficulty concentrating
Uncontrollable crying
Difficulty making decisions
Irritability
Increased need for sleep
Insomnia
A change in appetite causing weight loss or gain
Thoughts of death or suicide
Attempting suicide
Bipolar Disorder
Treatment
• Mood stabilizer medication
• Psychotherapy
• May require emergency hospitalization
Facts About Suicide
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3rd leading cause of death in 15-24 year olds
Men 4 times more than women
Highest rate in white men over 65
Alcoholism associated with up to half of all
suicides
• Mood disorders account for 60-80% of suicides
• 50-75% seek help before suicide but 50% have
never seen a psychiatrist
Risk for Suicide
• History of attempt
–Males>Females
–Family history of suicide
–Native American
–Mood Disorder or Substance Abuse
–White>African-American
Social/Environmental Factors
Can Increase Risk for Suicide
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Humiliating life events
Loss
History of childhood abuse
Interpersonal discord
Social isolation
What to Do?
Listen For:
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Life isn’t worth living
I feel my family would be better off without me.
Suicide is the only way out.
Take my (something); I don’t need it anymore.
Ending the pain is all I care about.
Next time, I’ll take enough pills to do it right.
How to Help
• Do
– Voice concerns
– Get professional
help immediately
– Tell someone or
call the police
• Don’t
– Assume the situation
will take care of itself
– Leave the person
alone
– Be sworn to secrecy
– Act shocked
– Challenge or dare
– Argue or debate moral
issues
Asking About Suicide
• How depressed do you get?
• Ever so depressed that you think about
hurting
• yourself or taking your own life?
• What kinds of ideas do you have about
suicide?
• When do you feel most like hurting
yourself?
Suicide Prevention
• Decrease social isolation
• Identify victimization, rejection, mental
illness, and substance abuse
• Treat depression
• Reduce hopelessness
• Skill building around mood regulation
• Secure or remove firearms
• Decrease barriers around help seeking
Post Traumatic Stress
• Can develop after a person has experienced or
witnessed a traumatic or terrifying event in which
serious physical harm occurred or was threatened.
• PTSD is a lasting consequence of traumatic ordeals
that cause intense fear, helplessness, or horror, such
as a sexual or physical assault, the unexpected death
of a loved one, an accident, war, or natural disaster.
• Families of victims can also develop posttraumatic
stress disorder, as can emergency personnel and
rescue workers.
Symptoms of PTSD
• Symptoms of PTSD most often begin
within three months of the event.
• In some cases, however, they do not
begin until years later.
• The severity and duration of the illness
vary. Some people recover within six
months, while others suffer much longer.
• Symptoms of PTSD often are grouped
into three main categories, including:
re-living, avoiding, and increased arousal
Symptoms of PTSD
• Re-living: may include flashbacks, hallucinations and
nightmares. They also may feel great distress when certain
things remind them of the trauma, such as the anniversary date
of the event.
• Avoiding: may avoid people, places, thoughts or situations that
may remind him or her of the trauma. Have feelings of
detachment and isolation from family and friends
• Increased arousal: excessive emotions; problems relating to
others, including feeling or showing affection; difficulty falling or
staying asleep; irritability; outbursts of anger; difficulty
concentrating; and being "jumpy" or easily startled. The person
may also suffer physical symptoms, such as increased blood
pressure and heart rate, rapid breathing, muscle tension,
nausea and diarrhea.
Who can suffer from PTSD?
• Victims of trauma related to physical and sexual
assault face the greatest risk for PTSD.
• How Common Is PTSD?
– About 3.6% of adult Americans -- about 5.2
million people -- suffer from PTSD during the
course of a year, and an estimated 7.8 million
Americans will experience PTSD at some point
in their lives. PTSD can develop at any age,
including childhood. Women are more likely to
develop PTSD than are men. This may be due
to the fact that women are more likely to be
victims of domestic violence, abuse and rape.
Treatment
• Treatment for PTSD may involve psychotherapy (a
type of counseling), medication or both.
• Therapy
– Cognitive-behavior therapy, which involves learning to recognize and
change thought patterns that lead to troublesome emotions, feelings and
behavior.
– Psychodynamic therapy focuses on helping the person examine
personal values and the emotional conflicts caused by the traumatic
event.
– Family therapy may be useful because the behavior of the person with
PTSD can have an affect on other family members.
– Group therapy may be helpful by allowing the person to share
thoughts, fears and feelings with other people who have experienced
traumatic events.
Obsessive Compulsive Disorder
• Common obsessions include:
– Fear of dirt or contamination by germs.
– Fear of causing harm to another.
– Fear of making a mistake.
– Fear of being embarrassed or behaving in a
socially unacceptable manner.
– Fear of thinking evil or sinful thoughts.
– Need for order, symmetry or exactness.
– Excessive doubt and the need for constant
reassurance
Treatment
• Medication
• Therapy: Various types of
psychotherapy, including
individual, group and family
therapy
Personality Disorders
• Personality disorders: People with personality
disorders have extreme and inflexible personality
traits that are distressing to the person and/or cause
problems in work, school or social relationships.
• In addition, the person's patterns of thinking and
behavior significantly differ from the expectations of
society and are so rigid that they interfere with the
person's normal functioning.
• Examples include antisocial personality disorder,
obsessive-compulsive personality disorder and
paranoid personality disorder.
Psychotic Disorders
• Schizophrenia:
– People with this illness have changes in behavior and other
symptoms -- such as delusions and hallucinations -- that
last longer than six months, usually with a decline in work,
school and social functioning.
• Schizoaffective disorder:
– People with this illness have symptoms of schizophrenia,
as well as a serious mood or affective disorder, such as
severe depression, mania (a disorder marked by periods of
excessive energy) or bipolar disorder (a disorder with
cyclical periods of depression and mania).
Psychotic Disorders
• Schizophreniform disorder:
– People with this illness have symptoms of
schizophrenia, but the symptoms last less
than six months.
• Brief psychotic disorder:
– People with this illness have sudden, short
periods of psychotic behavior, often in
response to a very stressful event, such as
a death in the family. Recovery is often
quick -- usually less than a month.
Psychotic Disorders
• Delusional disorder: People with this illness have delusions
involving real-life situations that could be true, such as being
followed, being conspired against or having a disease. These
delusions persist for at least one month.
• Shared psychotic disorder: This illness occurs when a
person develops delusions in the context of a relationship with
another person who already has his or her own delusion(s).
• Substance-induced psychotic disorder: This condition is
caused by the use of or withdrawal from some substances,
such as alcohol and crack cocaine, that may cause
hallucinations, delusions or confused speech.
Psychotic Disorders
• Psychotic disorder due to a medical
condition: Hallucinations, delusions or
other symptoms may be the result of
another illness that affects brain
function, such as a head injury or brain
tumor
• Paraphrenia: This is a type of
schizophrenia that starts late in life and
occurs in the elderly population.
Symptoms of a Psychotic
Disorder
• Hallucinations and delusions.
– Hallucinations are unusual sensory experiences or
perceptions of things that aren't actually present, such as
seeing things that aren't there, hearing voices, smelling
odors, having a "funny" taste in your mouth and feeling
sensations on your skin even though nothing is touching
your body.
– Delusions are false beliefs that are persistent and
organized, and that do not go away after receiving logical or
accurate information. For example, a person who is certain
his or her food is poisoned, even if it has been proven that
the food is fine, is suffering from a delusion.
Psychotic Disorders
• Other possible symptoms of psychotic illnesses
include:
– Disorganized or incoherent speech
– Confused thinking
– Strange, possibly dangerous behavior
– Slowed or unusual movements
– Loss of interest in personal hygiene
– Loss of interest in activities
– Problems at school or work and with relationships
– Cold, detached manner with the inability to express
emotion
– Mood swings or other mood symptoms, such as
depression or mania
How Common Are
Psychotic Disorders?
• About 1% of the population worldwide
suffers from psychotic disorders. These
disorders most often first appear when a
person is in his or her late teens, 20s or
30s. They tend to affect men and
women about equally.
Treatment
• Medication
• Psychotherapy: Various types of
psychotherapy, including
individual, group and family
therapy, may be used to help
support the person with a
psychotic disorder.
Eating Disorders
• Eating disorders involve extreme
emotions, attitudes and behaviors
involving weight and food. Anorexia
nervosa, bulimia nervosa and binge
eating disorder are the most common
eating disorders.
Impulse control and
addiction disorders:
• People with impulse control disorders are unable to
resist urges, or impulses, to perform acts that could
be harmful to themselves or others.
• Pyromania (starting fires), kleptomania (stealing) and
compulsive gambling are examples of impulse
control disorders.
• Alcohol and drugs are common objects of addictions.
Often, people with these disorders become so
involved with the objects of their addiction that they
begin to ignore responsibilities and relationships.
Adjustment Disorder
• Adjustment disorder occurs when a person
develops emotional or behavioral symptoms
in response to a stressful event or situation.
– The stressors may include natural disasters, such
as an earthquake or tornado; events or crises, such
as a car accident or the diagnosis of a major illness;
or interpersonal problems, such as a divorce, death
of a loved one, loss of a job or a problem with
substance abuse.
– Adjustment disorder usually begins within three
months of the event or situation and ends within six
months after the stressor stops or is eliminated.
Dissociative disorders
• People with these disorders suffer severe
disturbances or changes in memory,
consciousness, identity, and general
awareness of themselves and their
surroundings.
– These disorders usually are associated with
overwhelming stress, which may be the result of
traumatic events, accidents or disasters that may
be experienced or witnessed by the individual.
• Dissociative identity disorder, formerly called multiple
personality disorder, or "split personality", and
depersonalization disorder are examples of dissociative
disorders.
Factitious Disorders
• Conditions in which physical and/or
emotional symptoms are experienced in
order to place the individual in the role of
a patient or a person in need of help.
Sexual and gender
disorders
• Sexual and gender disorders: These
include disorders that affect sexual
desire, performance and behavior.
Sexual dysfunction, gender identity
disorder and the paraphilias are
examples of sexual and gender
disorders.
Somatoform disorders
• A person with a somatoform disorder,
formerly known as psychosomatic
disorder, experiences physical
symptoms of an illness even though
a doctor can find no medical cause
for the symptoms.
Mental Retardation
• Condition of limited mental ability
– Low IQ on traditional test of intelligence
– Difficulty adapting to everyday life
– Onset of characteristics by age 18
• Some causes include
– Organic retardation
– Cultural-familial retardation-IQ's 55-70- result
from growing up in a below average intellectual
environment
References
• http://www.webmd.com/mentalhealth/mental-health-types-illness
• A topical approach to Life Span
Development, John W Santrock