Understanding Mental Illness
The fact is, a mental illness is a disorder of the brain – your body’s most important organ – and one in four adults experience mental illness in a given year, including depression, bipolar disorder, schizophrenia, and PTSD.
Like most diseases of the body, mental illness has many causes – from genetics to other biological, environmental and social / cultural factors. And just as with most diseases, mental illnesses are no one’s fault. The unusual behaviors associated with some illnesses are symptoms of the disease – not the cause.
But most importantly, mental illnesses are treatable through medication and psychosocial therapies – allowing those who live with them the opportunity to lead full and productive lives.
FACT VS. FICTION
FICTION: People living with a mental illness are often violent.
FACT: Actually, the vast majority of people living with mental health conditions are no more violent than anyone else. People with mental illness are much more likely to be the victims of crime.
FICTION: Mental illness is a sign of weakness.
FACT: A mental illness is not caused by personal weakness — nor can it be cured by positive thinking or willpower — proper treatment is needed.
FICTION: Only military personnel who have been in combat can be diagnosed with PTSD.
FACT: While PTSD is prevalent in men and women who have seen combat, experiencing or witnessing a traumatic event can trigger PTSD, including violent personal assaults such as rape or robbery, natural or human-caused disasters, or accidents.
FICTION: People with a mental illness will never get better.
FACT: For some people, a mental illness may be a lifelong condition, like diabetes. But as with diabetes, proper treatment enables many people with a mental illness to lead fulfilling and productive lives.
FICTION: Children aren’t diagnosed wtih mental illness.
FACT: Millions of children are affected by depression, anxiety and other mental illnesses. As a matter of fact, 1 in 10 children live with a diagnosable mental illness. Getting treatment is essential.
FICTION: “Mental illness can’t affect me!”
FACT: Mental illness can affect anyone. While some illnesses have a genetic risk, mental illness can affect people of all ages, races and income levels, whether or not there is a family history.
Bipolar Disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of Bipolar Disorder are more severe than the normal ups-and-downs that everyone goes through from time to time. Bipolar Disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But Bipolar Disorder can be treated. A combination of professional counseling and medication helps most people live productive and fulfilling lives.
Bipolar Disorder symptoms are sometimes not recognized as parts of a larger problem, so it can be years before a person is properly diagnosed and treated. While some experience symptoms during childhood, Bipolar Disorder often develops in a person’s late teens or early adult years. It has been reported that at least half of all cases start before age 25. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person’s life.
Bipolar Disorder mood changes are called episodes, and people usually shift from manic to depressive episodes.
People with Bipolar Disorder tend to experience:
- Excessively “high”, euphoric mood;
- Extreme irritability;
- Unrealistic beliefs in one’s abilities and powers, such as feeling able to control world events;
- Decreased need for sleep without feeling tired;
- Racing thoughts or fast speech;
- Distractibility or difficulty concentrating;
- Spending sprees;
- Increasing sadness or feeling very “down”;
- Worried or empty feelings;
- Difficulty concentrating;
- A tendency to forget things a lot;
- A lost interest in fun activities and a tendency to be less active;
- Trouble sleeping;
- Thoughts about of death or suicide.
Depression is a serious medical illness; it’s not something that you make up in your head. More than a feeling of being “down in the dumps” or “blue” for a few days, the symptoms of Depression are severe and debilitating. Depression is characterized by feeling “down,” “low” and “hopeless” for weeks at a time. Factors that can contribute to the onset of Depression include stress, poor nutrition, physical illness, personal loss, relationship difficulties and the presence of other physical disorders.
Depression isn’t always easy to detect, and people with depressive conditions can experience different symptoms. It may be expressed through lack of appetite or overeating; insomnia or an unnatural desire to sleep; the abuse of drugs and alcohol; sexual promiscuity; or hostile, aggressive, or risk-taking behavior.
People with Depression tend to experience:
- Persistent sad, anxious or “empty” feelings;
- Feelings of hopelessness and / or pessimism;
- Feelings of guilt, worthlessness and / or helplessness;
- Irritability, restlessness;
- Loss of interest in activities or hobbies once pleasurable, including sex;
- Fatigue and decreased energy;
- Difficulty concentrating, remembering details and making decisions;
- Insomnia, early-morning wakefulness, or excessive sleeping;
- Overeating, or appetite loss;
- Thoughts of suicide, suicide attempts;
- Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment.
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after exposure to a traumatic event or ordeal in which grave physical, psychological, or sexual harm occurred or was threatened. When in danger, it’s natural to feel afraid, and this fear triggers many split-second changes in the body to prepare to defend against the danger, or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in PTSD, this reaction is changed, damaged, and often over activated. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.
People with PTSD tend to experience:
- Sleeping problems, including bad dreams;
- Avoiding places, events, or objects that are reminders of the experience;
- Strong feelings of guilt, depression, or worry;
- Loss of interest in activities that were enjoyable in the past;
- Feelings of detachment or numbness;
- Being easily startled.
Schizophrenia is a chronic, severe, and disabling brain disorder that affects about 1.1 percent of the U.S. population age 18 and older in a given year. It is not the same as “split personality”. People with Schizophrenia sometimes hear voices others don’t hear, believe that others are broadcasting their thoughts to the world, or become convinced that others are plotting to harm them. These experiences can make them fearful and withdrawn, and cause difficulties when they try to have relationships with others.
Scientists are unsure exactly what causes Schizophrenia but have found that genetic differences, environmental influences, and differences in brain structure and function are factors. Treatment can help relieve many symptoms of Schizophrenia. While most people who have the illness cope with symptoms throughout their lives, many are able to lead rewarding and meaningful lives in their communities. Researchers are developing more effective medications and using new research tools to understand the causes of Schizophrenia. In the years to come, this work may help prevent and better treat the illness.
People with Schizophrenia tend to experience:
- Hallucinations: Seeing, hearing, smelling or feeling things that no one else is experiencing. Voices are the most common type of hallucination in Schizophrenia;
- A decline in social functioning and an increase in isolating themselves;
- Delusions, such as believing they have super-natural powers, they are being sent messages through the television or other outlets, or they are someone else, such as a famous historical figure;
- Talking in a garbled way that is hard to understand, or stopping abruptly in the middle of a thought;
- Agitated body movements, repetition of certain body movements over and over, or going into a catatonic state;
- Trouble understanding information and using it to make decisions;
- Trouble executing everyday tasks, such as personal hygiene.
Schizoaffective Disorder is a psychiatric condition which shares elements with both Bipolar Disorder and Schizophrenia. Patients suffering from Schizoaffective Disorder typically experience a course of mood instability which can be reminiscent of Bipolar Illness with swings into mania and depression, as well as recurrent Unipolar depressive episodes. However, these individuals also suffer from ongoing psychotic symptoms which can include delusions and hallucinosis, and which may persist in between major episodes of mood instability. Patients with Schizoaffective Disorder are generally thought to have a better prognosis than patients with Schizophrenia, but not as favorable as patients with fully remitting Bipolar Disorder, or Recurrent Major Depressive Disorder.
Borderline Personality Disorder (BPD)
Borderline Personality Disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, BPD was listed in the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.
Because some people with severe BPD have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name “Borderline Personality Disorder” is misleading, a more accurate term does not exist yet.
People with BPD tend to experience:
- Problems with regulating emotions and thoughts;
- Impulsive and reckless behavior;
- Unstable relationships with other people.
People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.
According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have BPD in a given year.
BPD is often viewed as difficult to treat. However, recent research shows that BPD can be treated effectively, and that many people with this illness improve over time.
According to the DSM, Fourth Edition, Text Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms:
- Extreme reactions — including panic, depression, rage, or frantic actions — to abandonment, whether real or perceived;
- A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation);
- Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices);
- Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating;
- Recurring suicidal behaviors or threats or self-harming behavior, such as cutting;
- Intense and highly changeable moods, with each episode lasting from a few hours to a few days;
- Chronic feelings of emptiness and / or boredom;
- Inappropriate, intense anger or problems controlling anger;
- Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.
Seemingly mundane events may trigger symptoms. For example, people with BPD may feel angry and distressed over minor separations—such as vacations, business trips, or sudden changes of plans—from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative meanings than people who do not have the disorder.
Obsessive Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) is characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). It’s also possible to have only obsessions or only compulsions and still have OCD.
With OCD, you may or may not realize that your obsessions aren’t reasonable, and you may try to ignore them or stop them. But that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts in an effort to ease your stressful feelings.
OCD often centers on themes, such as a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped. Despite efforts to ignore or get rid of bothersome thoughts, the thoughts or urges keep coming back. This leads to more ritualistic behavior — and a vicious cycle that’s characteristic of OCD.
People with OCD tend to experience:
- Repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; acts of violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly tidy;
- Doing the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again;
- Inability to control unwanted thoughts and behaviors;
- Lack of pleasure when performing the behaviors or rituals, but brief relief from the anxiety the thoughts cause;
- Spending at least 1 hour a day on the thoughts and rituals, which can cause distress and get in the way of daily life.
For more information on OCD, please visit the NIMH website.
Dissociative Identity Disorder (DID)
Someone with Dissociative Identity Disorder (DID) escapes reality in ways that are involuntary and unhealthy. The person experiences a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity.
The symptoms of DID — ranging from amnesia to alternate identities — depend in part on the type you have. Symptoms usually develop as a reaction to trauma and help keep difficult memories at bay. Times of stress can temporarily worsen symptoms, making them more obvious. Dissociative disorders cause problems with functioning in everyday life.
Treatment for DID may include talk therapy (psychotherapy) and medication. Although treating dissociative disorders can be difficult, many people learn new ways of coping and lead healthy, productive lives.
People with DID tend to experience:
- Memory loss (amnesia) of certain time periods, events and people;
- Mental health problems, such as depression, anxiety, and suicidal thoughts and attempts;
- A sense of being detached from yourself;
- A perception of the people and things around you as distorted and unreal;
- A blurred sense of identity;
- Significant stress or problems in your relationships, work or other important areas of your life.
For more information on DID, please visit the Cleveland Clinic website.
Eating Disorders are a group of serious conditions in which a person is so preoccupied with food and weight that he or she can often focus on little else. The main types of Eating Disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.
Eating Disorders can cause serious physical problems and, at their most severe, can even be life threatening. Most people with Eating Disorders are females, but males can also have Eating Disorders. An exception is binge-eating disorder, which appears to affect almost as many males as females.
Treatments for Eating Disorders usually involve psychotherapy, nutrition education, family counseling, medications and hospitalization.
Anorexia signs and symptoms may include:
- Refusal to eat and denial of hunger;
- An intense fear of gaining weight;
- A negative or distorted self-image;
- Excessive exercise;
- Flat mood or lack of emotion;
- Fear of eating in public;
- Preoccupation with food;
- Social withdrawal;
- Thin appearance;
- Trouble sleeping;
- Soft, downy hair present on the body (lanugo);
- Menstrual irregularities or loss of menstruation (amenorrhea);
- Abdominal pain;
- Dry skin;
- Frequently being cold;
- Irregular heart rhythms;
- Low blood pressure;
Bulimia signs and symptoms may include:
- Eating until the point of discomfort or pain, often with high-fat or sweet foods;
- Self-induced vomiting;
- Laxative use;
- Excessive exercise;
- An unhealthy focus on body shape and weight;
- A distorted, excessively negative body image;
- Low self-esteem;
- Going to the bathroom after eating or during meals;
- A feeling that you can’t control your eating behavior;
- Abnormal bowel functioning;
- Damaged teeth and gums;
- Swollen salivary glands in the cheeks;
- Sores in the throat and mouth;
- Irregular heartbeat;
- Sores, scars or calluses on the knuckles or hands;
- Menstrual irregularities or loss of menstruation (amenorrhea);
- Constant dieting or fasting;
- Possibly, drug or alcohol abuse.
Binge-eating disorder signs and symptoms may include:
- Eating to the point of discomfort or pain;
- Eating much more food during a binge episode than during a normal meal or snack;
- Eating faster during binge episodes;
- Feeling that your eating behavior is out of control;
- Frequently eating alone;
- Feeling depressed, disgusted or upset over the amount eaten.
For more information on Eating Disorders, please visit the National Eating Disorders Association (NEDA) website.
Attention Deficit Disorder (ADD) / Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is a chronic condition that affects millions of children and often persists into adulthood. ADHD includes a combination of problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.
Children with ADHD also may struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.
While treatment won’t cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcome.
ADHD has been called Attention Deficit Disorder (ADD) in the past. But ADHD is now the preferred term because it describes both of the primary features of this condition: inattention and hyperactive-impulsive behavior. In some children, signs of ADHD are noticeable as early as 2 or 3 years of age.
People with ADHD / ADD tend to experience:
- Difficulty paying attention;
- Frequently daydreaming;
- Difficulty following through on instructions and apparently not listening;
- Frequently has problems organizing tasks or activities;
- Frequently forgetful and loses needed items, such as books, pencils or toys;
- Frequently fails to finish schoolwork, chores or other tasks;
- Easily distracted;
- Frequently fidgets or squirms;
- Difficulty remaining seated and seemly in constant motion;
- Excessively talkative;
- Frequently interrupts or intrudes on others’ conversations or games;
- Frequently has trouble waiting for his or her turn.
For more information on ADHD / ADD, please visit the NIMH website.