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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 mental health concerns develop into mental health disorders when the signs and symptoms are ongoing and begin to interfere 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 through many aspects of daily 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 any future complications.

Types of Mental Health Disorders

Mental health disorders range from spectrum that includes anxiety disorders, mood disorders, psychotic disorders, personality disorders, behavioral disorders and other less common disorders such as dissociative disorders, stress response syndrome, factitious disorders, sexual and gender disorders and somatic symptom disorders. Regardless of the type, each mental health disorder should be taken seriously and treatment should include medication (if available) 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 is no cure for mental health disorders however treatment aims to lesson the signs and symptoms that are associated with the specific disorder. Therefore with the correct treatment regimen, it is possible for the individual to be symptom-free over a long-term period.

Mood Disorders: Depression and Bipolar Disorder

Mood disorders are also known as affective disorders and involve persistent feelings of sadness or periods of extreme heightened energy that can occur in isolation or fluctuate together over time. Depressive disorders are characterized under mood disorders and although major depressive disorder is the most well known depressive disorder, there are other depressive disorders that include the following:

  • 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 stressors.
  • Seasonal affective disorder: This disorder starts to become apparent in the fall, pique in the winter and resolve in the springtime and is more apparent for individual 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 and 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 in duration 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 Affective Disorder

Bipolar affective disorder or more commonly manic-depressive illness 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 can be characterized into three types: bipolar disorder type I (BPI), bipolar disorder type II (BPII) and cyclothymia and 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 group of mental health disorders affecting 18% or 40 million adults in the United States each year and these disorders affect one in eight children in the U.S. 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 multiple types of anxiety disorder, many of these specific disorders share the same general symptoms:

  • Restlessness: Having an excessive amount of energy but not able to complete a task. Examples include pacing back and forth, unable to sit still in one place or the inability to relax.
  • Being easily fatigued: Extreme exhaustion no matter the amount of sleep.
  • Difficulty concentrating: Unable to perform simple tasks such as accounting or job functions and having difficulty remembering dates and times.
  • Irritability: Feelings of agitated mood and impatience for no specific reason. An example would be yelling at the dog, your partner or kids for something very trivial.
  • Sleep disturbance: Increase need for sleep, unable to fall asleep or stay asleep.
  • Muscle tension
  • Headaches
  • Rapid heart beat (palpitations)
  • Abdominal pains or diarrhea
  • Muscle tension

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 individuals experience recurrent panic attacks followed by at least one-month duration of having a fear of 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 performances in which the individual is exposed to the scrutiny of others. Examples include 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 from these fearful things may be difficult. Examples include enclosed spaces, crowded spaces, bridges, heights, and tunnels, being outside a home alone or 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 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

Obsessive thoughts

  • 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

Compulsive actions

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

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

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.

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 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

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 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.

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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.