Mental Illness 101

1. Mental Illness 101

2. Overview • Nationwide 50 million Americans suffer from a mental illness in a given year • Mental Illness is more common than: • Cancer • Diabetes • Heart Disease • Psychiatric disorders are the number 1 reason for hospital admissions nationwide

3. Overview Continued • Mental illness is treatable

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

5. Causes • Psychological Causes • Severe psychological trauma suffered as a child, such as emotional, physical or sexual abuse • An important early loss, such as the loss of a parent • Neglect • Poor ability to relate to others

6. Causes • Environmental Factors • Death or divorce • A dysfunctional family life • Living in poverty • Feelings of inadequacy, low self-esteem, anxiety, anger or loneliness • Changing jobs or schools • Social or cultural expectations (For example, a society that associates beauty with thinness can be a factor in the development of eating disorders.) • Substance abuse by the person or the person's parents

7. Stress • Academic • Homesickness • Peer relationships • Family • Identity • Work • Illness

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

9. Types of Mental Illness • Mood Disorders • Anxiety Disorders • Psychotic Disorders • Personality Disorders • Impulse Control and Addictive Disorders • Eating Disorders/Body Image • Other ( Adjustment Disorders, Dissocative Disorders, Factitious Disorders, Sexual and Gender Disorders, Somotoform Disorders, Mental Retardation)

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

11. Symptoms of Anxiety Disorders • Feelings of panic, fear and uneasiness • Uncontrollable, obsessive thoughts • Repeated thoughts or flashbacks of traumatic experiences • Nightmares • Ritualistic behaviors, such as repeated hand washing • Problems sleeping • Cold or sweaty hands • Shortness of breath • Palpitations • An inability to be still and calm • Dry mouth • Numbness or tingling in the hands or feet • Nausea • Muscle tension

12. How Common Are Anxiety Disorders? • Anxiety disorders affect about 19 million adult Americans. • Most anxiety disorders begin in childhood, adolescence and early adulthood. • They occur slightly more often in women than in men, and occur with equal frequency in Caucasians, blacks and Hispanics.

13. Treatment of Anxiety Disorders • Medication-Medicines used to reduce the symptoms of anxiety disorders include anti-depressants and anxiety-reducing medications. • Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder. • Cognitive-behavioral therapy: People suffering from anxiety disorders often participate in this type of psychotherapy in which the person learns to recognize and change thought patterns and behaviors that lead to troublesome feelings.

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

15. Situational/Adjustment • Variable mood correlated to circumstances  Minimal change in sleep, appetite, energy  No change in self-attitude  Suicidal thought unlikely  Typically lasts less than one month

16. Seasonal • Seasonal depression, called seasonal affective disorder (SAD), is a depression that occurs each year at the same time, usually starting in fall or winter and ending in spring or early summer. It is more than just "the winter blues" or "cabin fever." • Symptoms of winter SAD may include the seasonal occurrence of: • Fatigue • Increased need for sleep • Decreased levels of energy • Weight gain • Increase in appetite • Difficulty concentrating • Increased desire to be alone

17. Dysthmia • Dysthymia, sometimes referred to as chronic depression, is a less severe form of depression but the depression symptoms linger for a long period of time, perhaps years. Those who suffer from dysthymia are usually able to function normally, but seem consistently unhappy. • Symptoms of dysthymia include: • Difficulty sleeping • Loss of interest or the ability to enjoy oneself • Excessive feelings of guilt or worthlessness • Loss of energy or fatigue • Difficulty concentrating, thinking or making decisions • Changes in appetite • Thoughts of death or suicide

18. Clinical Depression • An illness, not a weakness • Serious disturbances in work, social, and physical functioning including suicidal thought • Not relieved by circumstances • May last for months or years untreated • Persistent and intense mood change

19. Clinical DepressionWho and When • 1.5 million young adults in US each year  Fewer than half seek treatment  1 of 4 women and 1 of 10 men develop depression during their lifetime • Often begins in early adult years • Family history, substance abuse, and stress increase risk

20. Clinical DepressionSigns and Symptoms • Extreme sadness, guilt, shame • Decreased concentration, poor academic performance or work performance • Decreased interest/enjoyment in daily activities • Increased irritability, arguments • Change in sleep, appetite, energy • Social withdrawal • Hopelessness, helplessness, suicidal thought

21. Clinical DepressionTreatment • Anti-Depressant medications (effective,improved safety & tolerability, not habit forming) • Psychotherapy (individual, group, cognitive behavioral,self-help) • Day treatment, hospitalization • Exercise, sleep hygiene, light therapy, ECT

22. Psychotic Depression • Roughly 25% of people who are admitted to the hospital for depression suffer from what is called psychotic depression. • What Are the Symptoms of Psychotic Depression? • Anxiety (fear and nervousness) • Agitation • Paranoia • Insomnia (difficulty falling and staying asleep) • Physical immobility • Intellectual impairment • Psychosis

23. Bipolar Disorder • 2% general population over a lifetime • Half of cases begin before age 20 • Episodic extremes between states • depressed state and excitable, • euphoric/irritable, impulsive state • Strong family linkage • Occurs equally in men and women

24. Symptoms of Bipolar Disorder • Symptoms of mania ("the highs"): • Excessive happiness, hopefulness, and excitement • Sudden changes from being joyful to being irritable, angry, and hostile • Restlessness • Rapid speech and poor concentration • Increased energy and less need for sleep • High sex drive • Tendency to make grand and unattainable plans • Tendency to show poor judgment, such as deciding to quit a job • Drug and alcohol abuse • Increased impulsivity

25. Bipolar Disorder • Some people with bipolar disorder can become psychotic, seeing and hearing things that aren't there and holding false beliefs from which they cannot be swayed. • During depressive periods ("the lows”) symptoms include: • Sadness • Loss of energy • Feelings of hopelessness or worthlessness • Loss of enjoyment from things that once were pleasurable • Difficulty concentrating • Uncontrollable crying • Difficulty making decisions • Irritability • Increased need for sleep • Insomnia • A change in appetite causing weight loss or gain • Thoughts of death or suicide • Attempting suicide

26. Bipolar DisorderTreatment • Mood stabilizer medication • Psychotherapy • May require emergency hospitalization

27. Facts About Suicide • 3rd leading cause of death in 15-24 year olds • Men 4 times more than women • Highest rate in white men over 65 • Alcoholism associated with up to half of all suicides • Mood disorders account for 60-80% of suicides • 50-75% seek help before suicide but 50% have never seen a psychiatrist

28. Risk for Suicide • History of attempt • Males>Females • Family history of suicide • Native American • Mood Disorder or Substance Abuse • White>Black

29. Social/Environmental FactorsCan Increase Risk for Suicide • Humiliating life events • Loss • History of childhood abuse • Interpersonal discord • Social isolation

30. What to Do?Listen For: • Life isn’t worth living • I feel my family would be better off without me. • Suicide is the only way out. • Take my (something); I don’t need it anymore. • Ending the pain is all I care about. • Next time, I’ll take enough pills to do it right.

31. Do Voice concerns Get professional help immediately Tell someone or call the police Don’t Assume the situation will take care of itself Leave the person alone Be sworn to secrecy Act shocked Challenge or dare Argue or debate moral issues How to Help

32. Asking About Suicide • How depressed do you get? • Ever so depressed that you think about hurting • yourself or taking your own life? • What kinds of ideas do you have about suicide? • When do you feel most like hurting yourself?

33. Suicide Prevention • Decrease social isolation • Identify victimization, rejection, mental illness,and substance abuse • Treat depression • Reduce hopelessness • Skill building around mood regulation • Secure or remove firearms • Decrease barriers around help seeking

34. Post Traumatic Stress • Can develop after a person has experienced or witnessed a traumatic or terrifying event in which serious physical harm occurred or was threatened. • PTSD is a lasting consequence of traumatic ordeals that cause intense fear, helplessness, or horror, such as a sexual or physical assault, the unexpected death of a loved one, an accident, war, or natural disaster. • Families of victims can also develop posttraumatic stress disorder, as can emergency personnel and rescue workers.

35. Symptoms of PTSD • Symptoms of PTSD most often begin within three months of the event. • In some cases, however, they do not begin until years later. • The severity and duration of the illness vary. Some people recover within six month, while others suffer much longer. • Symptoms of PTSD often are grouped into three main categories, including:re-living, avoiding, and increased arousal

36. Symptoms of PTSD • Re-living: may include flashbacks, hallucinations and nightmares. They also may feel great distress when certain things remind them of the trauma, such as the anniversary date of the event. • Avoiding: may avoid people, places, thoughts or situations that may remind him or her of the trauma. Have feelings of detachment and isolation from family and friends • Increased arousal: excessive emotions; problems relating to others, including feeling or showing affection; difficulty falling or staying asleep; irritability; outbursts of anger; difficulty concentrating; and being "jumpy" or easily startled. The person may also suffer physical symptoms, such as increased blood pressure and heart rate, rapid breathing, muscle tension, nausea and diarrhea.

37. Who can suffer from PTSD? • Victims of trauma related to physical and sexual assault face the greatest risk for PTSD. • How Common Is PTSD? • About 3.6% of adult Americans -- about 5.2 million people -- suffer from PTSD during the course of a year, and an estimated 7.8 million Americans will experience PTSD at some point in their lives. PTSD can develop at any age, including childhood. Women are more likely to develop PTSD than are men. This may be due to the fact that women are more likely to be victims of domestic violence, abuse and rape.

38. Treatment • Treatment for PTSD may involve psychotherapy (a type of counseling), medication or both. • Therapy • Cognitive-behavior therapy, which involves learning to recognize and change thought patterns that lead to troublesome emotions, feelings and behavior. • Psychodynamic therapy focuses on helping the person examine personal values and the emotional conflicts caused by the traumatic event. • Family therapy may be useful because the behavior of the person with PTSD can have an affect on other family members. • Group therapy may be helpful by allowing the person to share thoughts, fears and feelings with other people who have experienced traumatic events.

39. Obsessive Compulsive Disorder • Common obsessions include: • Fear of dirt or contamination by germs. • Fear of causing harm to another. • Fear of making a mistake. • Fear of being embarrassed or behaving in a socially unacceptable manner. • Fear of thinking evil or sinful thoughts. • Need for order, symmetry or exactness. • Excessive doubt and the need for constant reassurance

40. Treatment • Medication • Therapy: Various types of psychotherapy, including individual, group and family therapy

41. Personality Disorders • Personality disorders: People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school or social relationships. • In addition, the person's patterns of thinking and behavior significantly differ from the expectations of society and are so rigid that they interfere with the person's normal functioning. • Examples include antisocial personality disorder, obsessive-compulsive personality disorder and paranoid personality disorder.

42. Psychotic Disorders • Schizophrenia: • People with this illness have changes in behavior and other symptoms -- such as delusions and hallucinations -- that last longer than six months, usually with a decline in work, school and social functioning. • Schizoaffective disorder: • People with this illness have symptoms of schizophrenia, as well as a serious mood or affective disorder, such as severe depression, mania (a disorder marked by periods of excessive energy) or bipolar disorder (a disorder with cyclical periods of depression and mania).

43. Psychotic Disorders • Schizophreniform disorder: • People with this illness have symptoms of schizophrenia, but the symptoms last less than six months. • Brief psychotic disorder: • People with this illness have sudden, short periods of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick -- usually less than a month.

44. Psychotic Disorders • Delusional disorder: People with this illness have delusions involving real-life situations that could be true, such as being followed, being conspired against or having a disease. These delusions persist for at least one month. • Shared psychotic disorder: This illness occurs when a person develops delusions in the context of a relationship with another person who already has his or her own delusion(s). • Substance-induced psychotic disorder: This condition is caused by the use of or withdrawal from some substances, such as alcohol and crack cocaine, that may cause hallucinations, delusions or confused speech.

45. Psychotic Disorders • Psychotic disorder due to a medical condition: Hallucinations, delusions or other symptoms may be the result of another illness that affects brain function, such as a head injury or brain tumor • Paraphrenia: This is a type of schizophrenia that starts late in life and occurs in the elderly population.

46. Symptoms of a Psychotic Disorder • Hallucinations and delusions. • Hallucinations are unusual sensory experiences or perceptions of things that aren't actually present, such as seeing things that aren't there, hearing voices, smelling odors, having a "funny" taste in your mouth and feeling sensations on your skin even though nothing is touching your body. • Delusions are false beliefs that are persistent and organized, and that do not go away after receiving logical or accurate information. For example, a person who is certain his or her food is poisoned, even if it has been proven that the food is fine, is suffering from a delusion.

47. Psychotic Disorders • Other possible symptoms of psychotic illnesses include: • Disorganized or incoherent speech • Confused thinking • Strange, possibly dangerous behavior • Slowed or unusual movements • Loss of interest in personal hygiene • Loss of interest in activities • Problems at school or work and with relationships • Cold, detached manner with the inability to express emotion • Mood swings or other mood symptoms, such as depression or mania

48. How Common Are Psychotic Disorders? • About 1% of the population worldwide suffers from psychotic disorders. These disorders most often first appear when a person is in his or her late teens, 20s or 30s. They tend to affect men and women about equally.

49. Treatment • Medication • Psychotherapy: Various types of psychotherapy, including individual, group and family therapy, may be used to help support the person with a psychotic disorder.

50. Eating Disorders • Eating disorders involve extreme emotions, attitudes and behaviors involving weight and food. Anorexia nervosa, bulimia nervosa and binge eating disorder are the most common eating disorders.