Mental Health Disorders: Overview
Obsessive Compulsive Disorder
Obsessive-compulsive disorder (OCD) was once categorized as an anxiety disorder but is now placed in its own category under “Obsessive-Compulsive Disorders” which also includes body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder.
OCD is characterized by having unwanted repetitive and persistent thoughts that are intrusive in nature. These distressful thoughts are either repressed or carried out by compulsions, which are repetitive actions in response to the persistent thoughts. These compulsions are carried out as a way to relieve the tension and anxiety brought on by the unwanted obsessive thoughts.
Signs and symptoms of obsessive-compulsive disorder
- Fear of contamination
- Need for symmetry and order
- Sexual thoughts
- Aggressive thoughts
- Feelings of doubts associated with leaving the stove on or doors unlocked
- Concerns about losing something or throwing away something valuable
- Fears about having a disease or medical illness
- Fears about practicing sinful behavior
- Rearranging, balancing and ordering
- Asking for reassurance
Post Traumatic Stress Disorder
Post traumtic stress disorder (PTSD), similar to OCD, was previously categorized under anxiety disorders but is now included under the category “Trauma and Stressor-Related Disorders” which also includes reactive attachment disorder, disinhibited social engagement disorder, acute stress disorder, and adjustment disorder. Posttraumatic stress disorder (PTSD) is a mental health disorder that involves severe anxiety, fear, flashbacks and negative thoughts after experiencing or witnessing a traumatic life-threatening event. Individuals who have been witnessed war, natural disasters, famine, physical or sexual assault are at risk of developing PTSD.
Signs and Symptoms of PTSD
- Persistent re-experiencing of the traumatic event via dreams, perceptions, images, hallucinations or flashbacks.
- Avoidance of triggers such as people, places, thoughts and feelings that were associated with the traumatic event.
- Feelings of detachment, negative self-esteem, negative emotional states and the inability to remember associated events.
- Marked changes in arousal and activity such as irritable behavior, hypervigilance, increased arousal, reckless behavior, sleep disturbance and concentration problems.
- Children with PTSD may exhibit signs of social withdrawal, parental attachment, excessive clinging, nightmares, and poor academic performance whereas adolescents generally display the same signs and symptoms as adults.
Psychotic disorders are a group of mental health disorders that are characterized by distorted thinking and awareness making it difficult for individuals to make good judgment calls, communicate with others effectively, differentiate reality from fantasy and behave appropriately.
- Schizophrenia: Auditory hallucinations (hearing voices) and delusions (false beliefs) are the hallmark of this disorder. Other symptoms of this disorder include disorganized speech, loss of interest, blunted emotions, memory problems, poor organizational skills and deficits in interpersonal relationships. Symptoms must last for the duration of at least six months.
- Schizoaffective disorder: The combination of a mood disorder and a psychotic disorder, without meeting the definition of each. Characterized by symptoms of depression and/or mania are coupled with symptoms of schizophrenia.
- Schizophreniform disorder: Similar to schizophrenia in that it includes the same symptoms however the duration of symptoms must last longer than one month but less than six months.
- Brief psychotic disorder: Characterized by the same symptoms as schizophrenia and schizophreniform disorders but symptoms are present for less than one month and the individual makes a full recovery.
- Delusional disorder: When an individual has a delusion, which is defined as a false, fixed belief involving a real-life situation that could be true but is not, such as being followed, being plotted against, or having a disease, for at least one month in duration.
- Shared psychotic disorder aka folie à deux: When one individual in a relationship has a delusion and the other individual in the relationship adopts this same delusion.
- Substance-induced psychotic disorder: Characterized by the use of or withdrawal from drugs, such as hallucinogens and crack cocaine, that causes hallucinations, delusions, or confused speech.
Impulse Control Disorders
Individuals with impulse control disorders are unable to resist urges, or impulses, perform acts that could be harmful to themselves or others. Pyromania (starting fires), kleptomania (stealing), and compulsive gambling are examples of impulse control disorders.
Individuals with personality disorders have extreme and inflexible personality traits that are distressing to the individual and others. These traits are usually ingrained from childhood or adolescence and carry into adulthood and as a result are very difficult to treat. These maladaptive patterns often will carry into every aspect of one’s life creating havoc in their personal relationships, home life and occupational functioning. Borderline personality disorder is the most common personality disorder and is characterized by unstable and intense moods resulting in impaired impulse control and unhealthy behaviors such as cutting and disordered eating. These individuals usually have chronic feelings of emptiness, unstable relationships, unstable self-image, intense anger and a deep fear of abandonment. The following are other types of personality disorders:
- Paranoid personality disorder
- Schizoid personality disorder
- Schizotypal personality disorder
- Antisocial personality disorder
- Histrionic personality disorder
- Narcissistic personality disorder
- Avoidant personality disorder
- Dependent personality disorder
- Obsessive- compulsive personality disorder
An individual who is diagnosed with one or more mental health disorders, coupled with one or more substance abuse disorders is known to have a co-occurring disorder. Formerly referred to as dual diagnosis, co-occurring disorders are known to affect approximately 8 million individuals in the United States. Individuals with co-occurring disorders are more likely to have impairments in daily functioning and within their relationships and work life compared to individuals with either a mental health or a substance abuse disorder alone. Having two disorders also increases the likelihood of relapse in these individuals. Treatment for co-occurring consists of treating both disorders simultaneously so one disorder does not linger and cause the individual to relapse.
Mental Health Treatment
Although there is no cure for mental health disorders, the signs and symptoms of mental illnesses can be reduced or even eliminated with the appropriate treatment regimens. The majority of mental health disorders are treated with a combination of medication and psychotherapy and many individual may need to undergo treatment at a long-term facility such as a residential treatment facility. Medications in conjunction with psychotherapy are generally prescribed for individuals who have been diagnosed with depression, anxiety, bipolar disorder, psychotic disorders, obsessive-compulsive disorder and posttraumatic stress disorder. Personality disorders are treated with psychotherapy alone. Family therapy, individual therapy and group therapy are generally all used for individuals who have been diagnosed with a mental health disorder. PTSD usually requires specific forms of trauma therapy including trauma informed care and Eye movement desensitization and reprocessing (EMDR). Studies have shown that EMDR can also be used to treat eating disorder when a component of trauma is involved. In general psychotherapy approaches work to address the following:
- Identify and manage underlying issues that trigger cutting
- Learn skills to better manage distress
- Learn how to regulate and cope with unhealthy emotions
- Learn how to improve self-image and self-esteem
- Develop skills to improve relationships and social skills
- Develop healthy problem-solving skills
The following are psychotherapy approaches that are used to treat mental health disorders:
- Cognitive-behavioral therapy (CBT): Identifies the negative thoughts, feelings and distorted emotions associated with depression and uses behavioral techniques to transform these negative thoughts into positive outlooks and positive actions. Behavioral techniques include self-control therapy, problem solving and social skill training.
- Dialectal Behavior Therapy (DBT): Similar to cognitive-behavioral therapy but also includes mindfulness and stress reduction techniques.
- Interpersonal Therapy (IPT): Works to recognize the inner conflicts within oneself. Identifies conflict within personal relationships and inner feelings associated with self-esteem. Techniques that involve building relationships, learning coping mechanisms, and developing conflict resolution skills can help diminish these triggers and form positive insight in future conflicts.
- Eye movement desensitization (EMD: An eight-phase treatment technique that includes brief, interrupted exposures to the traumatic event, eye movement tracking, and recall of feelings and emotions associated with the traumatic event. The therapist determines which traumatic memory to trigger first and asks the individual to hold this specific memory and associated symptoms in their mind and use their eyes to then track the therapist’s hand as it moves horizontally back and forth across the individual’s field of vision.
Most PPO Policies Accepted
Insurance coverage for mental health
The majority of private insurance plans cover most treatment regimens for mental health disorders. There are a large amount of affordable generic medications that can be used for treatment in place of more expensive brand names. Always check with your insurance provider to ensure that your psychotherapy and medications are covered by your insurance plan.