Common Mental DisordersSearch for Providers
There are many different types and variations of mental disorders. The good news is that with professional help and a personalized treatment program, individuals with mental disorders can recover and lead happier, more rewarding lives. Here are some descriptions to help you or your loved ones gain an increased understanding of what you may be dealing with.
This list includes:
- Antisocial Personality Disorder
- Anxiety Disorders (general, panic, social)
- Attention-Deficit/Hyperactivity Disorder (ADD/ADHD)
- Autism Spectrum Disorders
- Bipolar Disorder
- Borderline Personality Disorder
- Dementia and Alzheimer's Disease
- Dual Diagnosis (Substance Abuse and Mental Illness)
- Eating Disorders
- Intellectual Disabilities (Mental Retardation)
- Learning Disabilities
- Obsessive-Compulsive Disorder (OCD)
- Post-Traumatic Stress Disorder (PTSD)
- Substance Use Disorders /Addictions
Antisocial Personality Disorder
This is a mental health condition characterized by an individual’s long-term pattern of manipulating, exploiting or violating the rights of others. It is commonly referred to as psychopathy or sociopathy, although neither term is recognized professionally for diagnosis.
People with antisocial personality disorder typically act out their conflicts and ignore normal rules of social behavior. They tend to lack empathy and be excessively opinionated and self-assured as well as impulsive, irresponsible, cynical, callous and deceitful. They may show no respect for other people and feel no remorse when confronted with the effects of their behavior on others or of any suffering their actions may cause.
Often, there is a history of legal difficulties, the result of belligerent and irresponsible behavior, as well as aggressive, exploitive and even violent relationships.
Antisocial personality disorder is 70 percent more prevalent in males than females. During any given 12-month period, between 0.2 and 3.3 percent of the population have the disorder. The condition is quite common among people who are in prison and these individuals are at high risk for substance abuse, especially alcoholism, since it may help to relieve tension, irritability and boredom.
Symptoms tend to peak during the late teenage years and early 20s. As with most personality disorders, the intensity of antisocial personality disorder typically decreases with age. By the time they reach their 40s or 50s, most people will experience fewer of the extreme symptoms.
Antisocial personality disorder is one of the most difficult personality disorders to treat since people with this condition rarely seek treatment on their own. They may only start treatment when required to by a court.
Anxiety Disorders (General, Panic and Social)
Anxiety is a normal reaction to stress –— it is your mind and body's natural response to threatening events. A certain amount of worry can help you focus on an upcoming deadline or cope with a tense situation, but when anxiety is severe and symptoms continue for several weeks, it can result in an excessive, irrational dread of ordinary situations.
Approximately 18 percent of adults are affected by anxiety disorders in a given year. Anxiety disorders also affect one in eight children. Research shows that untreated children with these conditions are at a higher risk of performing poorly in school, missing out on important social experiences, and engaging in substance abuse.
Anxiety disorders are serious illnesses of the brain, causing individuals to perceive threats that don’t exist and sending their bodies’ natural “fight or flight” mechanism into overdrive. The belief that danger lurks around every corner and that something terrible will happen if certain things aren't done a certain way leaves people with this disorder feeling keyed-up and constantly on edge.
When not treated, anxiety disorders can negatively affect personal relationships and the ability to work, study and function normally. In addition, they can lead to low self-esteem, substance abuse, and isolation from others. Unlike the relatively mild, brief anxiety caused by a stressful event (such as speaking in public or a first date), anxiety disorders last at least six months and usually worsen if not treated.
THE BIG THREE
There are three major types of anxiety disorders, Generalized Anxiety Disorder, Panic Disorder and Social Anxiety Disorder.Each anxiety disorder has different symptoms, but they all revolve around excessive, irrational fear and dread. Other recognized anxiety disorders include separation anxiety, specific phobias, and substance/medication-induced anxiety disorder.
Generalized Anxiety Disorder (GAD)
People with Generalized Anxiety Disorder (GAD) experience chronic, exaggerated worry and tension regarding ordinary issues and anxiety levels are frequently high enough to cause fatigue, headaches, nausea and other physical symptoms.
GAD affects 3.1% of the U.S. population and often comes on gradually. According to the Anxiety and Depression Association of America, women are twice as likely to be affected. Evidence also suggests that biological factors, family background and life experiences all play a role.
Characterized by “panic attacks,” panic disorder results in sudden feelings of terror that can strike anytime, anywhere, repeatedly and often without warning — even while asleep. Most attacks average a couple of minutes, but some may go on for up to 10 minutes and, in rare cases, can last an hour or more. The episodes of intense fear generally include physical symptoms like chest pain, heart palpitations, breathlessness, dizziness or intestinal distress.
Panic disorder strikes between 3 and 6 million Americans, and is also twice as common in women as men. It can appear at any age, but most often it begins in young adults. The distressing condition sends more people to the doctor than any other anxiety disorder.
Approximately one-third of individuals who suffer from this become so consumed with fear that they cannot leave their homes — a condition known as agoraphobia. The good news is that early treatment of panic disorder can often stop the progression to agoraphobia. In fact, most people with panic disorder get better with treatment.
Social Anxiety Disorder / Social Phobia
Social Anxiety Disorder (also known as social phobia) is a strong fear of being judged by others and of being embarrassed. People with the disorder often have an irrational concern about being humiliated in public for “saying something stupid,” or “not knowing what to say.”
Physical symptoms can mirror panic attacks and include blushing, sweating profusely, trembling, nausea, abdominal distress, rapid heartbeat, shortness of breath, dizziness and headaches. Afflicted adults may experience feelings of detachment and loss of self-control in the company of others.
Social anxiety affects about 15 million American adults. Men and women are equally prone to it and it usually begins in childhood or early adolescence. Children with social anxiety are prone to clinging behavior, tantrums and even mutism.
Anxiety disorders commonly occur along with other mental or physical illnesses, including depression and alcohol or substance abuse. Even though some drugs make people feel less anxious when they are high, anxiety becomes even worse when the drugs wear off. In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder.
Attention-Deficit/Hyperactivity Disorder (ADD/ADHD)
Attention-deficit hyperactivity disorder (ADHD) is a condition characterized by inattention, hyperactivity and impulsivity. Although ADHD has its onset and is usually diagnosed in childhood, it often persists into adolescence and adulthood and may not be diagnosed until later years.
According to the Center for Disease Control and Prevention, ADHD is the most commonly diagnosed behavior disorder in young people, affecting an estimated 9 percent of children aged 3-17 — as well as 2-4 percent of adults.
There are actually thought to be three different types of ADHD, each with different symptoms: predominantly inattentive, predominantly hyperactive/impulsive and combined.
Children with ADHD have difficulty sitting still and paying attention in class. Even those of normal or above-normal intelligence struggle in school. Behaviors often disrupt classrooms and lead to rejection by other kids. As individuals with ADHD grow older, some may be more prone to drug abuse, anti-social behavior, and injuries of all sorts.
More than half the children diagnosed with ADHD continue to have symptoms during their adolescent years and into adulthood. Symptoms for adults who are living with the condition — and especially those who are undiagnosed and untreated — include distractibility, disorganization, forgetfulness, procrastination, tardiness, boredom, anxiety, depression, mood swings and low self-esteem.
All of these symptoms can be variable and situational as well as constant. Some people with ADHD can concentrate if they are interested or excited, while others have difficulty concentrating under any circumstances. Some avidly seek stimulation; others avoid it. Some become oppositional, ill-behaved and later, antisocial; others may become ardent people-pleasers. Some are outgoing, and others withdrawn.
National Resource Center on ADHD – What We Know - Info Sheets on ADHD
Autism Spectrum Disorder
Autism Spectrum Disorder (ASD) is a complex neurological and developmental disorder that begins early in life and is characterized to varying degrees by difficulties in social interaction, issues with verbal and nonverbal communication, and repetitive behaviors. ASD affects the structure and function of the brain and nervous system. Because it affects development, ASD is called a developmental disorder, but it can last throughout a person's life.
With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome.
It is considered a spectrum disorder because of the wide range of symptoms, skills and levels of impairment or disability. The disorder also can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art. About 25 percent of those with an ASD diagnosis are nonverbal but can learn to communicate using other means.
ASD affects more than 3 million individuals in the U.S. and tens of millions worldwide. Government statistics on autism suggest that prevalence rates have increased 10 to 17 percent annually in recent years. Incidence is four to five times greater for boys than girls, with 1 in 42 boys diagnosed with ASD versus 1 in 189 girls.
Autism appears to have its roots in very early brain development. The most obvious signs tend to emerge between 2 and 3 years of age, although many children show symptoms of autism by 12 months to 18 months of age. Children with autism do not progress through normal stages of child development, although some develop typically up to age 3, and then development stalls. Signs include trouble making eye contact, poor skills in pretend or imitation and deficits in nonverbal communication. When an affectionate, babbling toddler suddenly becomes silent, withdrawn, self-abusive, or indifferent to social overtures, something is wrong.
People with autism tend to appear indifferent and remote and may seem unable to form emotional bonds with others. In addition, they will often have unusual responses to sensory experiences, such as certain sounds or the way objects look.
Because ASD is a complex disorder that sometimes occurs along with other illnesses or learning disorders, the comprehensive evaluation may include brain imaging and gene tests, along with in-depth memory, problem-solving and language testing.
Early interventions with school-based programs and getting proper medical care can greatly reduce symptoms and increase a child's ability to grow and learn new skills. Most children on the spectrum respond well to highly structured, specialized programs. A popular treatment, applied behavior analysis (ABA) is particularly effective at helping those with ASD control their behavior.
Bipolar disorder, also known as manic-depressive illness, causes extreme shifts in a person’s mood, energy and ability to function as common emotions become intensely and often unpredictably amplified. Individuals living with bipolar disorder can shift from opposite extremes — or “poles” — of happiness, energy and clarity to sadness, fatigue and confusion. The periods of highs and lows are called episodes of mania and depression, and can last from one day to months.
According to the National Institute of Mental Health, approximately 5.7 million American adults — about 2.6 percent of the population age 18 and older — have bipolar disorder. It is equally prevalent among men and women, and most often, develops in late adolescence. Because of its irregular patterns, however, some individuals may suffer for years before receiving a proper diagnosis.
What distinguishes bipolar disorder from other disorders like depression is the occurrence of at least one episode of abnormal mood elevation such as mania or hypomania (which involves less severe levels of excessive excitement, agitation or euphoria). People living with bipolar disorder typically struggle more during depressive episodes, which tend to be more frequent and last longer than manic or hypomanic episodes.
Sometimes, a person with severe episodes of mania or depression also experience psychotic symptoms like hallucinations or delusions, which occasionally leads to a misdiagnosis of schizophrenia.
As a long-term, recurrent illness, bipolar disorder requires careful, ongoing management. Proper treatment is very effective in stabilizing mood swings and related symptoms, even for those with the most severe forms. It is usually easier to control the disorder through continuous, preventive treatment, and maintaining a good relationship and communication with one’s physician may avert a full-blown episode.
Children and Adolescents with Bipolar Disorder
Both children and adolescents can develop bipolar disorder, and it is a condition that tends to run in families, Unlike many adults with bipolar disorder, children and young adolescents with the illness often experience very fast mood swings between depression and mania many times within a day. Children with mania are also more likely to be irritable and prone to destructive tantrums than to be overly happy and elated.
Individuals with bipolar disorder are prone to other mental health problems, including substance abuse. When mired in depression, they may self-medicate symptoms with drugs and/or alcohol. During manic or hypomanic episodes, they may feel invincible and engage in risky behavior. This can become a vicious cycle, as mood symptoms are then triggered or prolonged by substance abuse, and any overall treatment plan should address the substance abuse as well as the bipolar disorder itself.
Depression and Bipolar Support Alliance – Texas Support Group Locator
Depression and Bipolar Support Alliance – Online Support Groups
Borderline Personality Disorder
Borderline personality disorder (BPD) is a serious psychiatric disorder marked by unstable moods, self-image, thinking and behavior. An estimated 1.6 percent of U.S. adults have BPD in a given year, and the condition usually begins during adolescence or early adulthood. Symptoms typically decrease in intensity with age, subsiding by the time people reach their 40s or 50s.
Most people who have BPD have trouble regulating emotions and thoughts, demonstrate impulsive self-damaging behaviors and have unstable, intense relationships with other people. Some symptoms include noticeable mood swings with periods of intense depressed mood, irritability and/or anxiety; impulsive behaviors like excessive spending and sexual encounters, reckless driving and substance abuse; inappropriate, intense or uncontrollable anger; and recurring suicidal threats or self-injurious behaviors. Other symptoms may include chronic boredom, frantic efforts to avoid abandonment and paranoid thoughts or temporary psychosis.
Seemingly mundane events may trigger symptoms. For example, people with BPD may feel angry and distressed over minor separations from people to whom they feel close, or to sudden changes in plans. As many as 80 percent of people with BPD have suicidal behaviors, and about 4 to 9 percent commit suicide.
Those who receive proper treatment usually improve over time and experience fewer or less severe symptoms. Long-term, outpatient psychotherapy is the primary treatment approach. Although medications can help treat specific symptoms and stabilize mood swings, they are rarely effective without a foundation of therapy.
NIMH-funded research indicates that some 85 percent of people with borderline personality disorder also meet the diagnostic criteria for another mental illness. Women with BPD are more likely to have co-occurring disorders such as major depression, anxiety disorders, or eating disorders. In men, BPD is more likely to co-occur with disorders such as substance abuse or antisocial personality disorder.
Dementia and Alzheimer’s Disease
Dementia is a general term that encompasses a wide range of symptoms associated with serious declines in mental abilities — notably memory loss — that make it difficult to perform daily activities. Alzheimer’s disease, the most common and well-known form, accounts for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, represents another 10 percent of cases. Other conditions can cause dementia symptoms as well, but these may be reversed when caused by things like vitamin deficiencies and thyroid problems.
The serious mental declines that characterize Alzheimer’s and other forms of dementia should not be mistaken for the “senility” that is common with normal aging. Initial signs of dementia include difficulty remembering names, events or recent conversations. Additional symptoms may include depression and apathy.
Dementia results from damaged brain cells, which are unable to communicate with each other. As the disease progresses, an individual may exhibit more confusion, changes in behavior, disorientation, poor judgment, and even problems walking, speaking or swallowing. They may become suspicious of their family members, caregivers, friends or other acquaintances without cause.
A diagnosis of dementia requires that two or more of the following core mental functions are substantially impaired: memory, communication and language, focus and attention, visual perception, judgment and reasoning.
In everyday activities, those afflicted by dementia typically have issues with short-term memory: They may get lost easily and have a hard time planning and preparing meals or keeping track of appointments, keys or money.
According to the Alzheimer’s Association, there is no cure for most progressive dementias like Alzheimer's disease, and there are no treatments that keep them from progressing. However, Mental Health America reports that some experimental drugs have shown promise in easing symptoms in some patients, while others may help control behavioral symptoms.
Affecting the parts of the brain that control thought, memory and language, Alzheimer’s Disease (AD) is not a normal part of aging, although the risk of getting the disease increases with age.
AD is named after Dr. Alois Alzheimer, a German psychiatrist who described changes in the brain tissue of a woman who had died in 1906 of an unusual mental illness. He found abnormal deposits (now called senile or neuritic plaques) and tangled bundles of nerve fibers (now called neurofibrillary tangles) in her brain, and these plaques and tangles are now recognized characteristics of AD.
The Alzheimer’s Association estimates that 5.2 million Americans had Alzheimer's disease in 2014,including approximately 200,000 individuals younger than age 65. It is the sixth leading cause of death in the United States and the fifth leading cause of death for those aged 65 and older.
Alzheimer’s disease advances in stages, ranging from mild forgetfulness to severe dementia, and nearly two-thirds of American seniors living with Alzheimer's are women. The course of the disease and the rate of decline vary greatly between individuals, potentially lasting from 5 to 20 years following the onset of symptoms.
Major depressive disorder is one of the most common mental disorders in the United States. Negatively affecting how people feel, think and act, it involves an imbalance of brain chemicals —neurotransmitters and neuropeptides — that create a variety of emotional and physical symptoms. People with depression most commonly experience deep feelings of sadness, emptiness and fatigue as well as a marked loss of interest or pleasure in activities. Episodes of depression often follow stressful events like marital problems or the death of a loved one. Symptoms may creep up slowly, evident in a gradual withdrawal from normal life activities.
According to the National Institute of Mental Health, approximately 6.7 percent of U.S. adults experience major depressive disorder each year. It affects more than 6.5 million of America’s 35 million seniors aged 65 and up, and women are nearly twice as likely as men to experience it.
Depression may have psychotic features like delusions or hallucinations. The disorder may occur in a seasonal pattern characterized by the onset of depression during the winter months when there is less natural sunlight. This form of depression generally lifts during the spring and summer. In addition, depression may occur during or after pregnancy. This is experienced by an estimated 10-15 percent of women. It is far more serious than common “baby blues” when many women feel overwhelmed with the responsibility of caring for a newborn.
There are several forms of depressive disorders: major, persistent and bipolar.
Major depressive disorder is characterized by symptoms that interfere with a person’s ability to work, sleep, study, eat and enjoy life. These can range from mild to severe. Most often, individuals with major depression will have several episodes of depression over their lifetime, but some people may experience a single episode.
Persistent depressive disorder is indicated when a depressed mood lasts for at least two years. Individuals diagnosed with persistent depressive disorder may have episodes of major depression as well as periods with less severe symptoms.
Bipolar disorder, also called manic-depressive disorder, is not as common as major depression or persistent depressive disorder. It is characterized by mood changes that typically cycle from highs (e.g., mania) to lows (e.g., depression). However, some people with bipolar disorder do not get depression. Rather, they have manic symptoms that alternate with normal moods.
Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain called neurotransmitters, especially serotonin and norepinephrine. Other antidepressant medications act on the neurotransmitter dopamine.
While some patients may experience some improvement within the first week or two of treatment, it can take two to three months to realize the full benefits. If there has been little to no improvement after several weeks, their doctor will alter the dose of the medication, or will add or substitute another medication. Typically, psychiatrists will advise patients to take medication for depression for six months or longer after symptoms have improved. If there have been two or three episodes of major depression, they may recommend long-term maintenance treatment to reduce the risk of future episodes.
Depression and Bipolar Support Alliance http://www.DBSAlliance.org/
Dual Diagnosis / Co-occurring Disorder
(Substance Abuse and Mental Illness)
Dual diagnosis is a term used to describe people who have both a mental illness and problems with drugs and/or alcohol. It may also be called a co-occurring or co-existing disorder. Recovery and treatment must address both the substance disorder and the psychiatric disorder.
Recent scientific studies have suggested that nearly one-third of people with all mental illnesses and approximately one-half of people with severe mental illnesses also abuse substances. And while 8.9 million adults are diagnosed with both a mental and substance use disorder, 55.8 percent receive no treatment at all.
The complex relationship between psychiatric illness and substance abuse or dependence takes a toll in multiple ways. Drugs and alcohol can worsen underlying mental illnesses. This can happen both during intoxication (e.g., a person with depression becomes suicidal in the context of drinking alcohol) and during withdrawal from a substance (e.g., a person with panic attacks experiences worsening symptoms during heroin withdrawal).
Substance abuse may trigger the first onset of a psychiatric condition as well. For example, if a teenager or young adult hears voices after taking drugs and becomes paranoid, that substance-induced reaction could prompt a first episode of psychosis. In other cases, alcohol or drug dependence is the primary condition. A person with a substance use disorder may develop symptoms of a psychiatric disorder such as episodes of depression, hallucinations or delusions.
People who are actively using drugs or alcohol are less likely to follow through with their treatment plans, being noncompliant about their medications or missing appointments — which sometimes leads to more psychiatric hospitalizations and other adverse outcomes. Similarly, active substance abusers are less likely to receive adequate medical care and have greater chances of experiencing severe medical complications and early death.
Individuals with mental illness who abuse drugs and/or alcohol, and who are untreated are more prone to impulsive and potentially violent acts, more likely to attempt suicide and to die from their suicide attempts and less likely to achieve lasting sobriety.
Undiagnosed, untreated or undertreated co-occurring disorders also increase the likelihood of incarceration and homelessness. And, while treatment is proven to be effective, many who need it don’t have access to care.
Eating disorders like anorexia, bulimia, and binge eating disorder are marked by unhealthy dietary practices like under- or over consumption of food. They are some of the most challenging mental illnesses, as they involve extreme emotions, attitudes and behaviors surrounding weight and food issues.
Scientific studies suggest that nearly one in 20 people will experience symptoms of an eating disorder at some point in their lives, while two percent of American adults struggle with binge eating disorder, the most common type.
A person with an eating disorder may have started out just eating smaller or larger amounts of food, but at some point, the urge to eat less or more spiraled out of control. Untreated, eating disorders can result in severe medical complications and even death.
This serious, sometimes chronic and potentially life-threatening condition is defined as the inability to maintain a weight that is 85 percent of what is recommended for the person’s natural body type. Many people with anorexia nervosa see themselves as overweight when the opposite is true, and they become obsessed with eating, food and weight control. Typical behaviors include weighing themselves repeatedly and eating very small quantities of specific foods. Some individuals also engage in binge-eating followed by extreme dieting, excessive exercise, self-induced vomiting, and/or abuse of laxatives, diuretics or enemas.
Physical symptoms of a more chronic, or long-lasting, form of anorexia nervosa involve a thinning of the bones, muscle weakness, heart damage, brain damage and multi-organ failure. People with anorexia nervosa are 18 times more likely to die early compared with people of similar age in the general population.
This eating disorder is characterized by a destructive pattern of binge eating and purging by self-induced vomiting or the abuse of laxatives, enemas or diuretics. People with bulimia may also exercise excessively, or severely restrict their food intake with crash diets.
Unlike people with anorexia nervosa who are clearly very thin, those with bulimia nervosa usually maintain a healthy or normal weight, or may even be slightly overweight. They also obsess over weight, and are intensely unhappy with their body size and shape.
The binge-eating and purging cycle usually occurs in secret, because the individual has feelings of shame or disgust. Physical symptoms include a chronically inflamed and sore throat, decaying teeth, intestinal problems, severe dehydration, and electrolyte imbalances, which can trigger a heart attack.
Binge eating disorder
As the most prevalent eating disorder in the U.S, binge eating disorder involves the consumption of very large amounts of food in a short period of time. Although it can develop at any age, it is seen most often in young adults. In contrast to other eating disorders, one-third to one-fourth of all patients with binge eating disorder are men. It has also been linked with Obsessive Compulsive Disorder (OCD).
An individual with binge-eating disorder loses control over his or her eating. However, in contrast to bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise or fasting. As a result, people with binge-eating disorder often are overweight or obese, and at higher risk for developing cardiovascular disease and high blood pressure. Their binge eating creates feelings of shame, guilt and distress, all of which can trigger more binge eating.
Eating disorders frequently occur in people with other mental illnesses like depression, anxiety disorders and substance abuse issues. For people with a co-existing mental illness, effective treatment of this second condition is critically important.
Intellectual Disability (Mental Retardation)
Intellectual disability, formerly called mental retardation, involves impairments of general mental abilities that impact functioning. It is characterized by deficits in learning and reasoning (Intellectual functioning) and a lack of skills necessary for daily living (adaptive functioning), it affects about 1 percent to 3 percent of the population. In approximately 85 percent of cases, the degree of disability is considered mild and many people lead productive lives and learn to function on their own, Others are more seriously impaired and require a structured environment and assistance.
Some cases of intellectual disability can be attributed to abnormal chromosomes (such as Down syndrome), infections, exposure to toxins, head trauma, problems during pregnancy or birth, or nutritional or environmental factors.
Delayed motor, language and social milestones may be identifiable as early as age 2 and symptoms can range from mild to severe. Mild levels of intellectual disability may not be identifiable until school age when a child develops difficulty with academics.
According to the American Psychiatric Association, impairments in adaptive functioning must occur in three areas, conceptual (including language, reading, math, reasoning and memory) social (empathy, social judgment and interpersonal skills) and practical (personal care, money management, work tasks, etc.).
Typically, an IQ score of 70 to 75 indicates a significant limitation in intellectual functioning, but it must be interpreted in the context of impairments in general mental abilities and may not accurately reflect overall intellectual functioning.
Once a diagnosis is made, the focus is on looking at the individual’s strengths and needs and identifying supports that might help improve functioning at home, in school/work, and in the community. Services for people with intellectual disabilities range from early intervention and special education to transition services, vocational programs, residential options and case management.
Obsessive-Compulsive Disorder (OCD)
Obsessive Compulsive Disorder (OCD) is a disorder of the brain and behavior that causes severe anxiety. People with this diagnosis suffer intensely from recurrent unwanted thoughts (obsessions) or rituals (compulsions) they feel they cannot control.
Common obsessions include contamination fears, imagining having harmed self or others, imagining losing control of aggressive urges, intrusive sexual thoughts or urges, excessive religious or moral doubt, or a need to tell, ask or confess. Often, people with OCD perform rituals such as hand washing, counting, checking or cleaning in the hope of preventing obsessive thoughts or making them go away. At best, performing these rituals may produce temporary relief from the anxiety created by the obsessive thoughts.
As a chronic, relapsing illness, OCD is two to three times more common than schizophrenia and bipolar disorder and strikes men and women in roughly equal numbers. The National Institute of Mental Health estimates that more than 2 percent of the U.S. population — nearly one out of every 40 people — will receive an OCD diagnosis., and the International OCD Foundation claims it affects about 2.2 million American adults and 1 in 200 kids and teens.
The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. Left untreated, obsessions and the need to perform rituals can take over a person's life, and severe OCD can keep a person from working or carrying out normal responsibilities at home.
The most common treatment for OCD is a combination of cognitive-behavioral psychotherapy (CBT) and medication. An effective type of behavioral therapy known as “exposure and response prevention” (E/RP) exposes a person to whatever triggers the obsessive thoughts (exposure), then teaches techniques to avoid performing the compulsive rituals (response prevention). The cognitive portion of CBT is often added to E/RP to help challenge the irrational beliefs associated with OCD.
OCD is sometimes accompanied by depression, eating disorders, substance abuse, attention deficit/hyperactivity disorder or other anxiety disorders. When a person also has other disorders, OCD is often more difficult to diagnose and treat.
On average, people with OCD see three to four doctors and spend over nine years seeking treatment before they receive a correct diagnosis. Studies have also found that it takes an average of 17 years from the time OCD begins for people to obtain appropriate treatment.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a serious, potentially debilitating anxiety disorder that can occur after a person has experienced or witnessed a traumatic event. It might follow a serious accident or natural disaster as well as a terrorist incident, war, the sudden death of a loved one or a violent personal assault.
Although it is commonly associated with members of the military returning from war, post-traumatic stress disorder afflicts nearly eight million American adults — approximately 3.5% of the adult population. Women are twice as likely to develop it than men and a person’s lifetime risk of developing PTSD is estimated at 8.7 percent.
Most people who experience such traumatic or life-threatening events recover from them, but people with PTSD continue to be severely depressed and anxious for months or even years following the event. They may relive the event through flashbacks or nightmares; suffer sadness, fear, or anger; or feel detached or estranged from other people. They may also have strong negative reactions to ordinary things like loud noises or an accidental touch.
Women are more than twice as likely to develop PTSD as men and are more prone to certain symptoms. For example, they are more likely to be jumpy, to have more trouble feeling emotions, and to avoid things that remind them of the trauma than men. In contrast, men are more likely to feel angry and to have trouble controlling their anger than women. More often, women with PTSD will feel depressed and anxious, while men are more likely to have problems with alcohol or drugs.
PTSD and children
How PTSD is expressed in children has a lot to do with their ages. Here are some guidelines:
Birth to age 6. Children 6 and under may get upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom.
Ages 7-11. Children in this group may act out the trauma through play, drawings or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
Ages 12-18. Older children have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.
People with post-traumatic stress disorder often struggle with other mental issues as well. Common coexisting conditions include panic attacks, substance abuse, depression and suicidal thoughts. Primary types of psychotherapy used to treat PTSD include cognitive behavior therapy (CBT), exposure therapy and cognitive restructuring. Medicines like selective serotonin reuptake inhibitors (SSRIs), commonly used for anxiety and depression, are often used as well.
Schizophrenia is a chronic, severe and disabling brain disorder that has been recognized throughout recorded history and affects about 1 percent of Americans — about 2.4 million adults. It occurs at similar rates in all ethnic groups around the world and affects men and women with equal frequency. Most often, common symptoms such as hallucinations and delusions appear in men in their late teens or early twenties, and in women in their late twenties to early thirties. This disorder rarely occurs in children, although awareness of childhood-onset schizophrenia is increasing.
People with schizophrenia may hear voices that others don't or they may believe that others are reading their minds, controlling their thoughts, or plotting to harm them. These experiences can terrify them, and make them extremely agitated or withdrawn. Individuals suffering from schizophrenia may not make sense when they talk, may sit for hours barely moving or talking, or may seem perfectly fine until they talk about what they are really thinking.
The cause and course of the illness is unique to each individual, but schizophrenia generally interferes with a person's ability to think clearly, manage emotions, make decisions and relate to others.
No single symptom positively identifies the disorder and an individual's symptoms can change over time. Generally, the symptoms are divided into three broad categories: positive symptoms, negative symptoms and cognitive symptoms.
In addition to hallucinations and delusions, positive symptoms include disorganized speech and grossly disorganized or catatonic behavior. Symptoms categorized as “negative” range from emotional flatness and lack of content in speech to an Inability to start or follow through with activities and an inability to experience pleasure. Cognitive symptoms include poor executive functioning (the ability to understand information and use it to make decisions) and problems with working memory.
Another common cognitive deficit associated with schizophrenia is anosognosia, which means lack of insight. Approximately one-half of individuals with schizophrenia do not believe that they are ill. This condition is the most common reason why individuals with schizophrenia do not take their medications.
In addition, it is not uncommon for people with schizophrenia to experience depression, although it may be difficult to distinguish depression from negative symptoms that affect someone's ability to display emotions. About 25 percent of people with schizophrenia also have a substance abuse disorder — often as a byproduct of the illness. This can make antipsychotic medications less effective and make patients less likely to follow their treatment plans.
Of note: it is also very common for patients with schizophrenia to smoke cigarettes. Beyond the normal health risks, those who smoke are more likely to relapse and be readmitted to a hospital. Smoking may also make their medications less effective.
Substance Use Disorders / Addictions
A substance use disorder describes a problematic pattern of using alcohol or another substance that results in evident distress or impairment in daily life. An individual with this disorder will often continue to use the substance despite consequences.
The ten classes of drugs that can lead to a substance use disorder include alcohol, caffeine, cannabis (marijuana), hallucinogens (LSD, ecstasy), inhalants, opioids (heroin), sedatives/hypnotics/anxiolytics (anti-anxiety drugs, barbiturates, sleeping medications), stimulants (amphetamines, cocaine), tobacco/nicotine, and other.
Substance abuse affects an estimated 25 million Americans. Approximately 14 percent of Americans will develop an alcohol use disorder and 7.5 percent will develop another drug use disorder over the course of their lifetimes.
An addiction (or substance use disorder) is characterized by compulsive use, cravings and a preoccupation with obtaining the drug as well as continued use in spite of harmful consequences and difficulty stopping use or abstaining.
Individuals with a substance abuse disorder may need to increase the amount of alcohol or drugs they consume to obtain the desired effect. And, they may experience painful withdrawal symptoms, such as nausea, anxiety, hand tremors, irritability, fatigue or seizures (alcohol-induced) when they stop use.
In addiction, the person’s brain becomes sensitized to cues in the environment and to emotional states, such as stress, that have been associated with use. As a result, the urge or desire to return to using the drug becomes compelling. Even after treatment, relapse (i.e., a return to drug or alcohol use) is common in addiction.
When a substance use disorder is diagnosed, it is classified as “mild,” “moderate” or “severe.” The term “addiction” is not considered a diagnostic term, but clinicians commonly use it when a substance use disorder is considered “severe.” The word “dependence” is also commonly used. “Abuse” typically refers to a pattern of drug use considered less severe than dependence or addiction.
Gambling is recognized as the only non-substance-related disorder that, when severe, may be considered an addiction. Sexual behavior (including pornography), Internet use and potential other behaviors that seem “addictive” eventually may be classified as an addiction (or, technically, as a non-substance-use-related disorder) in the Diagnostic and Statistical Manual of Mental Disorders(DSM) used by mental health professionals in the United States.
Detoxification is often the first step in treatment. Detoxification means ridding the body safely from the drug(s) that were being used. This is a medical procedure that may require hospitalization or may be accomplished on an outpatient basis, depending on the severity of the symptoms.
Following detoxification, many individuals will benefit from inpatient rehabilitation, which may last for 4 weeks or longer. Alternatives to inpatient rehabilitation are partial hospitalization or intensive outpatient programs, in which the patient participates for 4 to 6 weeks or longer.
There are several medications that have been approved for the treatment of addiction. A consultation with an addiction psychiatrist or other physician who is knowledgeable about addiction treatment is recommended.
Most clinicians and treatment programs also encourage the patient to participate in an appropriate 12-step program , such as Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, etc.
- What is Mental Health?
- What is Mental Illness?
- Common Mental Disorders
- Mental and Emotional Health Concerns
- Understanding Treatment
- Types of Mental Health Professionals
- Types of Treatment
- Treatment Settings
- Preparing for Your Visit
- More Ways to Support Your Mental Health
- Glossary of Mental Health Terms
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