What Are Mental Illnesses?
Mental illnesses (mental disorders) are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life and may require real help to get under control. It can be frustrating for many who struggle with mental illness as mental health disorders can be hard to treat. The importance of continuing treatment, however, cannot be stated enough. Mental health problems may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, mental illnesses are often physical as well as emotional and psychological. Mental illnesses may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination of these. With proper care and treatment many people learn to cope or recover from a mental illness or emotional disorders.
If you or someone you know is in crisis now, seek help immediately. Call 1-800-273-TALK (8255) to reach a 24 hour crisis center or dial 911 for immediate assistance.
There are more than 200 classified forms of mental illness. Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include – but are definitely not limited to – changes in mood, personality, personal habits, and/or social withdrawal.
Mental illnesses are serious medical illnesses. They cannot be overcome through “will-power” and are not related to a person’s “character” or intelligence, and although they were once thought to be rare, they are relatively common. In any year:
- nearly one in five (19 percent) U.S. adults experience some form of mental illness
- one in 24 (4.1 percent) has a serious mental illness
- one in 12 (8.5 percent) has a substance use disorder
Mental illness is treatable, in fact, most people who have mental illnesses continue to function in their daily lives.
(A serious mental illness is a mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. Examples of serious mental illness include major depressive disorder, schizophrenia, and bipolar disorder.)
Without treatment, the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives. The economic cost of untreated mental illness is more than 100 billion dollars each year in the United States.With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.
Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now-unwarranted sense of hopelessness to erect attitudinal, structural, and financial barriers to effective treatment and recovery.
It is time to take these barriers down.
How Are Mental Disorders Classified?
Defining and classifying mental disorders is an important issue for mental health professionals and those living with a mental disorder. There are two established systems that classify mental disorders:
ICD-10 Chapter V: Mental and Behavioral Disorders put together by the World Health Organization. The ICD-10 puts mental disorders in the following categories:
- F0: Organic, including symptomatic, mental disorders
- F1: Mental and behavioral disorders due to use of psychoactive substances
- F2: Schizophrenia, schizotypal, and delusional disorders
- F3: Mood [affective] disorders
- F4: Neurotic, stress-related and somatoform disorders
- F5: Behavioral syndromes associated with physiological disturbances and physical factors
- F6: Disorders of personality and behavior in adults
- F7: Mental retardation
- F8: Disorders of psychological development
- F9: Behavioral and emotional disorders with onset usually occurring in childhood and adolescence
- In addition, a group of “unspecified mental disorders” (NOS)
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association, stopped using the 5 disorder axis known in other revisions of the book. Now the main categorization in the DSM looks something like this:
|Disorders usually first diagnosed in infancy, childhood or adolescence..||Mental retardation, ADHD|
|Delirium, dementia, and amnesia and other cognitive disorders||Alzheimer’s disease|
|Mental disorders due to a general medical condition||AIDS-related psychosis|
|Substance-related disorders||Alcohol abuse, drug addiction|
|Schizophrenia and other psychotic disorders||Delusional disorder|
|Mood disorders||Major depressive disorder, Bipolar disorder|
|Anxiety disorders||Generalized anxiety disorder, Social anxiety disorder|
|Somatoform disorders||Somatization disorder|
|Factitious disorders||Münchhausen syndrome|
|Dissociative disorders||Dissociative identity disorder|
|Sexual and gender identity disorders||Dyspareunia, Gender identity disorder|
|Eating disorders||Anorexia nervosa, Bulimia nervosa|
|Impulse control disorders not elsewhere classified||Kleptomania|
|Adjustment disorders||Adjustment disorder|
|Personality disorders||Narcissistic personality disorder|
What Are Mental Health Disorders?
There exist many categories of mental disorders, some of them more common than others. The following are a standard list of more common mental health disorders.
Anxiety Disorders are disorders in which the person suffers significant impairment in functioning or dread in everyday situation or in response to everyday items. Anxiety disorders include: phobias, panic disorder, agoraphobia, social anxiety disorder, and generalized anxiety disorder.
Conduct Disorders are those which are diagnosed in childhood or adolescence that involve long-term behavioral problems such as defiant behavior, drug use, or criminal activity. These behaviors may continue into adulthood. Diagnosed in adulthood, conduct disorders include antisocial personality disorder.
Developmental Disorders are disorders that occur during a child’s development that may affect normal development. Developmental disorders include autism spectrum disorders, oppositional defiant disorder, conduct disorder, and attention deficit hyperactivity disorder. Developmental disorders may be diagnosed in childhood but can persist into adulthood.
Dissociative Disorders: People with dissociative disorders suffer severe disturbances or changes in memory, consciousness, identity, and general awareness of themselves and their surroundings. These disorders usually are associated with overwhelming stress, which may be the result of traumatic events, accidents, or disasters that may be experienced or witnessed by the individual. Dissociative identity disorder, formerly called multiple personality disorder, or “split personality,” and depersonalization disorder are examples of dissociative disorders.
Eating Disorders involve an intense concern about food, behaviors, and weight. Eating disorders include: bulimia nervosa, anorexia nervosa, exercise bulimia, and binge eating disorder.
Factitious disorders: Factitious disorders are conditions in which a person knowingly and intentionally creates or complains of physical and/or emotional symptoms in order to place the individual in the role of a patient or a person in need of help and include Münchhausen Syndrome and Münchhausen By-Proxy Syndrome.
Impulse Control and Addiction Disorders: People 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. Alcohol and drug are common objects of addictions. Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships.
Mood (Affective) Disorders affect mood or emotion of a person. Mood disorders that involve varying degrees of sustained sadness include major depression and dysthymia. Mood disorders that involve a sustained period of highs (mania or hypomania) coupled with depressed (or normal mood) states include bipolar disorder and cyclothymia.
Obsessive-Compulsive Disorder (OCD): People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes his or her hands.
Personality disorders are disorders that have maladaptive and rigid thoughts and behaviors. 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. Also, 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.n
Personality disorders are further classified:
- Cluster A: (Odd or Eccentric Personality Disorders) – This cluster of personality disorders generally refer to schizophrenia and related disorders, such as paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder.
- Cluster B: (Dramatic, emotional, and/erratic behaviors) – This cluster of personality disorders includes antisocial personality disorder, borderline personality disorder, narcissistic personality disorder, and histrionic personality disorder.
- Cluster C (anxious, fear-related disorders) – include avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder.
Psychotic disorders are mental illnesses that involve disordered patterns of belief, language use, and perception. People diagnosed with psychotic disorders may have hallucinations (seeing things that are not there or that others can’t see) and delusions, which are beliefs that are false and fixed in spite of all evidence to the contrary. Psychotic disorders include schizophrenia, schizoaffective disorder (mixed aspects of schizophrenia and a mood disorder), delusional disorder, and schizotypal disorder.
Post-Traumatic Stress Disorder (PTSD): PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.
Sexual and Gender Disorders: These include disorders that affect sexual desire, performance, and behavior. Sexual dysfunction, gender identity disorder, and the paraphilias are examples of sexual and gender disorders.
Sleep Disorders involve disruption of normal sleep patterns. This includes insomnia.
Somatic symptom disorders: A person with a somatic symptom disorder, formerly known as a psychosomatic disorder or somatoform disorder, experiences physical symptoms of an illness or of pain with an excessive and disproportionate level of distress, regardless of whether or not a doctor can find a medical cause for the symptoms. However, these symptoms cannot be explained by a medical disorder, substance use or another disorder. Somatoform disorders include conversion disorder, somatization disorder, and body dysmorphic disorder.
Stress-Response Syndromes (Adjustment Disorders): Stress response syndromes occur when a person develops emotional or behavioral symptoms in response to a stressful event or situation. The stressors may include natural disasters, such as an earthquake or tornado; events or crises, such as a car accident or the diagnosis of a major illness; or interpersonal problems, such as a divorce, death of a loved one, loss of a job, or a problem with substance abuse. Stress response syndromes usually begin within three months of the event or situation and ends within six months after the stressor stops or is eliminated.
What Are Some Causes of Mental Illness?
Mental illness may arise from a single factor or a combination of factors. In many cases of mental illness, there is no single accepted cause. Generally, it is thought that mental illness arises from a genetic predisposition coupled with environmental stressors. It has become clear, however, that mental illness correlates highly to childhood abuse or neglect. Some of the most accepted causes of mental illness include:
- Heredity (genetics): Many mental illnesses run in families, suggesting they may be passed on from parents to children through genes. Genes contain instructions for the function of each cell in the body and are responsible for how we look, act, think, etc. However, just because your mother or father may have or had a mental illness doesn’t mean you will have one. Hereditary just means that you are more likely to get the condition than if you didn’t have an affected family member. Experts believe that many mental conditions are linked to problems in multiple genes — not just one, as with many diseases — which is why a person inherits a susceptibility to a mental disorder but doesn’t always develop the condition. The disorder itself occurs from the interaction of these genes and other factors — such as psychological tra and environmental stressors — which can influence, or trigger, the illness in a person who has inherited a susceptibility to it.
- Biology: Some mental illnesses have been linked to an abnormal balance of brain chemicals called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or are not working properly, messages may not make it through the brain correctly, leading to symptoms of mental illness. In addition, defects in or injury to certain areas of the brain also have been linked to some mental conditions.
- Psychological trauma: Some mental illnesses may be triggered by psychological trauma suffered as a child, such as severe emotional, physical, or sexual abuse; a significant early loss, such as the loss of a parent; and neglect.
- Environmental stressors: Certain stressors — such as a death or divorce, a dysfunctional family life, changing jobs or schools, and substance abuse can trigger a mental health disorder in someone already at risk for mental illness.
How Are Mental Illnesses Diagnosed?
Diagnostic practice for mental illness may include an interview (mental status examination) where the diagnostician makes judgements about the patient’s appearance and behavior, self-reported symptoms, mental health history, and current life circumstances. Psychological testing is occasionally used where a patient has to check off signs and symptoms to form a diagnostic algorithm, however this is not the norm. Most diagnosticians simply diagnose their patients using an unstructured, open-ended approach.
Many people have comorbidly-occurring mental illnesses.
Comorbidity is the presence of one or more disorders (or diseases) in addition to a primary disease or disorder. Comorbidity may also indicate a medical condition in a person that causes, is caused by, or is otherwise related to another condition in the same person.
How Is Mental Illness Treated?
Mental illness may be treated in clinics, psychiatric hospitals and community health centers. Treatment is tailored for each patient and may encompass a number of different options (both together or separately).
1) Psychotherapy is an option for many mental illnesses and may include:
- Cognitive Behavioral Therapy – helps patient to modify patterns of behavior and thought associated with a particular disorder.
- Systematic Therapy (Family Therapy) – involves an individual and their network of significant others.
- Psychoanalysis – addresses underlying psychic conflicts and defense mechanisms.
2) Medication is often used to manage a number of mental illnesses. These may include:
- Antidepressants – treatment of depression, anxiety and other disorders.
- Anxiolytics – treatment of anxiety and related disorders.
- Mood Stabilizers – treatment of bipolar disorder.
- Antipsychotics – treatment of psychotic disorders.
- Stimulants – treatment of ADHD.
3) Brain-Stimulation Therapy (including ECT) may be used for those who have treatment-resistant depression or where otherwise indicated.
Sometimes mental illness becomes so severe that you need care in a psychiatric hospital. This is generally recommended when you can’t care for yourself properly or when you’re in immediate danger of harming yourself or someone else.Options include 24-hour inpatient care, partial or day hospitalization (PHP), or residential treatment, which offers a temporary supportive place to live. Another option may be intensive outpatient treatment (IOP).
Additional Mental Illness Resources:
National Alliance on Mental Illness– NAMI is the National Alliance on Mental Illness, the nation’s largest grassroots organization dedicated to improving the lives of individuals and families affected by mental illness. Through the dedicated efforts of grassroots leaders, NAMI focuses on three cornerstones of activity that offer hope, reform and health: support, education and advocacy.
NKM2 (No Kidding? Me, Too!) was founded by Joe Pantoliano (Joey Pants!) to help raise awareness of mental illnesses and stomp out the stigmas surrounding them.
Mental Health America is an advocacy organization that works to promote mental health by informing, educating, and enabling access to mental health services nation-wide.
National Institute of Mental Health (NIMH) – A division of the National Institutes of Health (NIH), the website provides a wealth of information on mental illnesses, current treatments, and clinical research.
Last audited 7/2018 BSH