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Mental Health Disorders: Overview

Mental illness refers to a wide range of mental health disorders that affect an individual’s mood, thinking, and behavior. It is common for individuals to experience mental health concerns on occasion, but these concerns develop into mental health disorders when the signs and symptoms are ongoing, interfering with every aspect of the individual’s life. A mental illness, if left untreated, can wreak havoc on an individual’s ability to function, and can create problem in many aspects of life including school, work, and relationships. It is important for individuals who are struggling with a mental health disorder to seek proper treatment in order to prevent future complications.

Types of Mental Health Disorders

Mental health disorders fall on a spectrum including:

  • Anxiety disorders
  • Mood disorders
  • Psychotic disorders
  • Personality disorders
  • Behavioral disorders
  • Dissociative disorders
  • Stress response syndrome
  • Factitious disorders
  • Sexual and gender disorders
  • Somatic symptom disorders

Regardless of the diagnosis, each mental health disorder should be taken seriously and treatment should include medication (if appropriate) combined with psychotherapy. Sometimes treatment requires a length of stay at a residential treatment facility before the client can be treated on an outpatient basis. Treatment for a mental health disorder is long-term and can last years or even throughout the individual’s life. This is mainly due to the fact that there are no cures for mental illnesses. Treatment aims to lessen the symptoms associated with the specific disorder. With the proper treatment regimen, it is possible for an individual to be symptom-free over a long-term period.

Mood Disorders: Depression and Bipolar Disorder

Mood disorders, also known as affective disorders, include the bipolar spectrum. Bipolar disorder involves persistent feelings of sadness and periods of heightened energy and erratic behavior that can occur in isolation or fluctuate back and forth over time. Depressive disorders are also categorized as mood disorders Although major depressive disorder (MDD) is the most well-known depressive disorder, there are other depressive disorders including:

  • Persistent depressive disorder: Differs from major depressive disorder in that the symptoms usually wax and wane over a period of years.
  • Adjustment disorder with depressed mood: Characterized by the presence of emotional or behavioral symptoms that occur as a response to an identifiable stressor, within three months of the onset of the stressor.
  • Seasonal affective disorder: This disorder tends to become apparent in the fall, peak in the winter, and resolve in the springtime. It is more prevalent among those living in the Pacific Northwest and the Northeast where grey skies are prominent 4-6 months out of the year.
  • Postpartum depression: Often interferes with the mother’s ability to care for herself and her newborn child. Postpartum depression occurs in approximately 10-15% of the female general population and develops most commonly in the first four months following delivery.
  • Premenstrual dysphoric disorder: Characterized by severe irritability, depression, or anxiety in the week or two before menstruation begins. Symptoms usually go away two to three days after menstruation ends.

Major Depressive Disorder

Major depressive disorder (MDD) is the most common depressive disorder, as it affects more than 15 million adults in the United States. It is the leading cause of disability in the U.S. for individuals 15-44 years of age. Major depressive disorder is often difficult to initially diagnose, as many individuals may not show the clear-cut signs and symptoms of depression. In order to make a formal diagnosis, the individual must exhibit at least five of the following symptoms that have lasted for at least two weeks, with at least one of the symptoms being depressed mood. Additionally, these symptoms must cause apparent distress in both social and occupational functioning.

  • Sleep disturbance
  • Loss of interest in activities
  • Feelings of guilt
  • Loss of energy
  • Difficulty concentrating
  • Change in appetite
  • Psychomotor agitation
  • Sadness
  • Suicide ideations


Bipolar Disorder

Bipolar disorder, or manic depression, is a mood disorder characterized by periods of deep depression that alternate with periods of excessive elation and irritable mood, formally known as mania.

Episodes of mania must last for at least one week in duration and are characterized by the following symptoms:

  • Distractibility
  • Irresponsibility and erratic behavior
  • Grandiosity
  • Flight of ideas
  • Increased activity associated with weight loss and sexual libido
  • Decreased sleep
  • Pressured speech

Depressive episodes must last for at least two weeks in duration and are characterized by the following symptoms:

  • Sleep disturbance
  • Loss of interest in activities
  • Feelings of guilt
  • Loss of energy
  • Difficulty concentrating
  • Change in appetite
  • Psychomotor agitation
  • Sadness
  • Suicide ideations

Bipolar disorder is categorized into three types: bipolar disorder type I (BPI), bipolar disorder type II (BPII) and cyclothymia. Differences depend on the frequency, duration and severity of the alternating symptoms.

  • Bipolar disorder type I (BPI): characterized by alternative severe depression and mania.
  • Bipolar disorder type II (BPII): characterized by episodes of severe depression that are punctuated by hypomanic episodes. Hypomania is a less severe form of mania that does not result in psychosis or cause impairments in social or occupational functioning.
  • Cyclothymic disorder: characterized by at least two years in duration of both hypomanic and depressive symptoms without meeting the full criteria for hypomania, mania or major depression.

Anxiety Disorders

Anxiety disorders are the most common mental health disorders, affecting 40 million adults (or 18%) in the United States each year. One in eight children in the U.S. also suffers from anxiety. Individuals with anxiety disorders respond to specific objects and situations with fear, dread, and panic that ultimately interferes with their daily living. Although there are many types of anxiety disorders, they share the same general symptoms:

  • Restlessness: Having an excessive amount of energy but being unable to complete a task. Examples include pacing back and forth, inability to sit still, or inability to relax.
  • Being easily fatigued: Extreme exhaustion no matter the amount of sleep.
  • Difficulty concentrating: Unable to perform simple tasks such as job responsibilities, and having difficulty remembering dates and times.
  • Irritability: Feelings of agitated mood and impatience for no specific reason. An example would be yelling at a pet, partner, or child over something trivial.
  • Sleep disturbance: Increased need for sleep; difficulty falling asleep or staying asleep.
  • Muscle tension
  • Headaches
  • Rapid heart beat (palpitations)
  • Abdominal pains, constipation, or diarrhea

The following are specific types of anxiety disorders:

  • Generalized anxiety disorder (GAD): Characterized by excessive worry over everyday occurrences. The worrying is almost impossible to control and must occur the majority of days for at least a six-month duration.
  • Panic disorder: Panic disorder is diagnosed when an individual experiences recurrent panic attacks followed by at least a one-month period worrying about an oncoming panic attack. Panic attacks mimic life-threatening situations where the individual feels they are dying. They will often present with chest pain and shortness of breath that typically peaks within 10 minutes.
  • Social anxiety disorder: Formerly referred to as social phobia, this disorder is an excessive and persistent fear of social interactions in which the individual is exposed to the scrutiny of others. Examples include meeting people, public speaking, using public bathrooms, or eating in a public place such as a restaurant.
  • Specific phobia: Characterized by excessive worry or fear of specific situations that are irrational or out of proportion. Common examples of specific phobias include animals, insects, blood, needles, flying, and heights.
  • Agoraphobia: Characterized by excessive fear or worry of situations where escape may be difficult. Examples include enclosed spaces, crowded spaces, bridges, heights, tunnels, being outside of the home alone, or in a moving vehicle.
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Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) was once categorized as an anxiety disorder, but is now placed in its own category. Body dysmorphic disorder, hoarding disorder, trichotillomania, and dermatillomania belong in the same category.

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:

  • Obsessive thoughts
  • Fear of contamination
  • Need for symmetry and order
  • Intrusive sexual thoughts
  • Intrusive aggressive thoughts
  • Feelings of doubts associated with needing to check if the stove is on or the doors are locked, for example
  • Concerns about losing or throwing away something valuable
  • Concerns about losing or throwing away something valuable
  • Fears about practicing sinful behavior

Compulsive actions

  • Checking
  • Counting
  • Cleaning
  • Praying
  • Rearranging, balancing and ordering
  • Asking for reassurance
  • Hoarding

Post Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD), similar to OCD, was previously categorized under anxiety disorders, but is now considered a Trauma and Stressor-Related Disorder. This category 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 event. Individuals who have been witnessed war, natural disasters, death, or 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.
  • Adolescents generally display the same signs and symptoms as adults.

Psychotic Disorders

Psychotic disorders are a group of mental health disorders that are characterized by distorted thinking and awareness making it difficult for individuals to use good judgment, 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 suffers from delusions, which are defined as false, fixed beliefs involving real-life situations, 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, resulting in hallucinations, delusions, or confused speech.

Impulse Control Disorders

Individuals 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.

Personality 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. As a result, they can be difficult to treat. These maladaptive patterns often will affect 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, characterized by unstable and intense moods resulting in impaired impulse control and unhealthy behaviors such as cutting or 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

Co-occurring Disorders

An individual who is diagnosed with one or more mental health disorders, coupled with one or more substance abuse disorders, is known to have co-occurring disorders. Formerly referred to as dual diagnosis, co-occurring disorders 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. Having two disorders also increases the likelihood of relapse in these individuals. Both disorders must be treated 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 symptoms 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. Many individuals may need to undergo long-term treatment, such as at a residential treatment center.

  • Depression, anxiety, bipolar disorder, psychotic disorders, obsessive-compulsive disorder, or post-traumatic stress disorder are generally treated with medications in conjunction with psychotherapy
  • Personality disorders are treated with psychotherapy alone.
  • 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 disorders when a component of trauma is involved.
  • Most mental health disorders will be treated with some form of family therapy, individual therapy, and/or group therapy.

In general, psychotherapy works towards the following goals:

  • Identifying and managing underlying issues that trigger harmful behavior
  • Learning coping skills to better manage distress
  • Learning how to regulate and cope with unhealthy emotions
  • Learning how to improve self-image and self-esteem
  • Developing skills to improve relationships and social skills
  • Developing healthy problem-solving skills

The following psychotherapy approaches are used to treat mental health disorders:

  • Cognitive-behavioral therapy (CBT): Identifies the negative thoughts, feelings, and distorted emotions associated with depression and anxiety, and uses behavioral techniques to transform these negative thought patterns into positive outlooks and positive actions. Behavioral techniques include self-control therapy, problem solving, and social skills 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. Building relationships, learning coping mechanisms, and developing conflict resolution skills can help diminish these triggers and form positive behavior patterns in future conflicts.
  • Eye movement desensitization (EMDR): An eight-phase treatment technique that includes brief, interrupted exposures to the traumatic event, and recalling the 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. Bilateral (left and right side) visual, auditory, or tactile stimuli are used to desensitize the intensity of the traumatic feelings.

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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.