Mental Illness 101

1
Mental Illness 101
2
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

3
Overview Continued

• Mental illness is treatable

4
Causes

• Biological Causes
• Biochemical Disturbances
• Genetics
• Infections- can cause brain damage
• Brain defects or injury
• Prenatal damage
• Poor nutrition, exposure to toxins

5
Causes

• 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

6
Causes

• Environmental Factors
• 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

7
Stress

• Academic
• Homesickness
• Peer relationships
• Family
• Identity
• Work
• Illness

8
Stigmization

• 35 of people with diagnosable disorders seek
  treatment
• The single most common barrier to seeking
  treatment is Shame

9
Types of Mental Illness

• 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)

10
Anxiety Disorders

• Panic Disorder
• Obsessive Compulsive Disorder
• Post Traumatic Stress Disorder
• Social Anxiety Disorder
• Specific Phobias
• Generalized Anxiety Disorder

11
Symptoms of Anxiety Disorders

• 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

12
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, blacks and Hispanics.

13
Treatment of Anxiety Disorders

• Medication-Medicines used to reduce the symptoms
  of anxiety disorders include anti-depressants and
  anxiety-reducing 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.

14
Types of Depression

• Situational/Adjustment
• Bereavement
• Seasonal
• Clinical Depression
• Psychotic Depression
• Bipolar (Manic-Depressive Illness)
• Dysthymia
• Post-Partum Depression

15
Situational/Adjustment

• Variable mood correlated to circumstances
• ? Minimal change in sleep, appetite, energy
• ? No change in self-attitude
• ? Suicidal thought unlikely
• ? Typically lasts less than one month

16
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
• Increased need for sleep
• Decreased levels of energy
• Weight gain
• Increase in appetite
• Difficulty concentrating
• Increased desire to be alone

17
Dysthmia

• 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
• 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

18
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

19
Clinical DepressionWho 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

20
Clinical DepressionSigns 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

21
Clinical DepressionTreatment

• 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

22
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?
• Anxiety (fear and nervousness)
• Agitation
• Paranoia
• Insomnia (difficulty falling and staying asleep)
• Physical immobility
• Intellectual impairment
• Psychosis

23
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

24
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

25
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
• 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

26
Bipolar DisorderTreatment

• Mood stabilizer medication
• Psychotherapy
• May require emergency hospitalization

27
Facts About Suicide

• 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

28
Risk for Suicide

• History of attempt
• MalesFemales
• Family history of suicide
• Native American
• Mood Disorder or Substance Abuse
• WhiteBlack

29
Social/Environmental FactorsCan Increase Risk
for Suicide

• Humiliating life events
• Loss
• History of childhood abuse
• Interpersonal discord
• Social isolation

30
What to Do?Listen For

• Life isnt worth living
• I feel my family would be better off without me.
• Suicide is the only way out.
• Take my (something) I dont need it anymore.
• Ending the pain is all I care about.
• Next time, Ill take enough pills to do it right.

31
How to Help

• Do
• Voice concerns
• Get professional help immediately
• Tell someone or call the police

• Dont
• 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

32
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?

33
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

34
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.

35
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 month, while
  others suffer much longer.
• Symptoms of PTSD often are grouped into three
  main categories, includingre-living, avoiding,
  and increased arousal

36
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.

37
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.

38
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.

39
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

40
Treatment

• Medication
• Therapy Various types of psychotherapy,
  including individual, group and family therapy

41
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.

42
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).

43
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.

44
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.

45
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.

46
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.

47
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

48
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.

49
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.

50
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.

51
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.

52
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.

53
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.

54
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.

55
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.

56
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.

57
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

58
References

• http//www.webmd.com/mental-health/mental-health-t
  ypes-illness
• A topical approach to Life Span Development, John
  W Santrock