State of Mind - Reframing Mental Illness |
By George Nostrand, Rutland Reader Correspondent
This article by former long-time GCEPD member George Nostrand originally ran in the Rutland Reader on January 30, 2013 and can be found online at http://www.rutlandreader.com/sate-of-mind-reframing-mental-illness/. It is reprinted here with George's permission.* * *  | | George Nostrand |
George Nostrand works for Vermont Psychiatric Survivors, a statewide peer-run organization assisting in the expansion of support groups run by and for people with lived experience withmental illness. He also works as a consultant, trainer and speaker. Send questions and comments to george.breakingthecycle@gmail.com This is the first in a series of stories in the Rutland Reader intended to advance the conversation on mental illness and how it affects our community. (Search "cover stories" at www.rutlandreader.com) The opinions expressed are those of the author and do not necessarily reflect those of his employers, past or present. * * * "There are people who choose their career paths, and others whose paths are chosen for them. When most of my friends were heading off to college, I was checking in for my first of several visits to the Brattleboro Retreat, a mental hospital in southern Vermont. For the next seven years, I was in and out of similar hospitals. I was labeled first with major depressive disorder, and later with bipolar disorder. I was tried on numerous different medications and told I would have this illness, "for the rest of my life." Try as I might, I was unable to stay in school, hold a job, maintain relationships and thus move forward in life. Since then I have been very fortunate in my life and recovery. I have also received a lot of support to get where I am today. For the past 15 years I have worked in the mental health field in a variety of capacities. I worked one-on-one with a man transitioning out of the Vermont State Hospital. I provided a variety of supports at a drop-in center. A majority of my focus has been on employment, helping people who have been diagnosed with mental illness find and keep jobs in the community. I have also facilitated training and educational opportunities, not only for people with mental illness but also family members, staff and even some policy makers and bureaucrats. What makes my story unique is that my expertise comes not from a text-book but rather my own personal experience. I understand the people I work with and what they are going through because I have, as they say, been there and done that. So when I speak, write or present on issues relating to mental illness, it is with a passion that literally burns within me. It is not only close to my heart, it is from my heart and from deep within my soul. Rather than scarring over and becoming hard, I have remained raw by having mental illness present in my daily life. Whether I am well and helping others or struggling myself, I am constantly reminded of how painful it is to live with an illness that no one understands. * * * When a person has a broken leg, the flu, diabetes or cancer you would not just say that he or she has a physical illness. You would say that he or she has a broken leg, the flu, diabetes or cancer. These physical illnesses are all quite different. The precipitating factors are different, the treatments are different and the times of recovery are different. When the illness relates to the brain or mind, however, we tend to clump them all together as mental illness. You would likely say, "This person has a mental illness," when referring to someone whether his or her diagnosis was depression, schizophrenia or Asperger's. There is a wide array of mental illnesses and degrees of mental illness. You could even argue that some are as different as diabetes is to the flu. It is also quite common to hear about "the mentally ill." Again, people don't talk about "the physically ill" as a population or "the diabetics." This is just one example of how our perceptions and means of addressing mental illness differ from physical illness. When you group people together based on one or two common traits then apply general sweeping characteristics to the whole group, it is called stereotyping. Recently, we saw stereotyping of mental illness rear its ugly head in the aftermath of the tragic school shooting in Newtown, Conn. Statistics have shown time and again that people with mental illness are actually less violent than the general population. In fact, most studies show that somewhere between 5 and 10 percent of murders are committed by people with mental illness. This means that 90 to 95 percent of murders are committed by "normal" people. Still, this false portrayal of "the mentally ill" as violent people was falling off the tongues of reporters, politicians and so-called experts everywhere - even before there was any evidence that the shooter in Connecticut was mentally ill. In fact, to this day it's unclear whether Adam Lanza had a diagnosed mental illness or not. * * * Despite all the research over the last 100-plus years, our true understanding of mental illness - what it is and where it comes from - is still questionable at best." Click here to read more!
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Mental Health vs. the Gun Control Debate
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 After the Newton, CT shootings at Sandy Hook Elementary School, arguments for gun control were countered - some may say willfully deflected - by shifting the focus from guns to a debate about mental health. On December 19, 2012, Al Jazeera America ran a very interesting story about this topic on its show, "Inside Story Americas". The theme of this show was "The mental health vs. gun control debate: In the wake of the Newton shootings, is the discourse on gun control being sidelines by a focus on mental healthcare?" This broadcast in its entirety can be found at: http://www.aljazeera.com/programmes/insidestoryamericas/2012/12/2012121972717242949.html Highlights of the story follow: * * * After the Newtown shootings, the argument was that if only the mentally ill could get the help they need, then this incident could be avoided. However, such stigmatization of those with mental illness ignores the facts. - People with mental illness have little to do with everyday violence;
- Only 4% of violent crimes are committed by those with mental illness;
- Of the various mental illnesses, only the serious illnesses are linked to violence, and even then only 16% of those with serious mental illness are prone to violence;
- Those who abuse drugs and alcohol - and who do NOT have a mental illness - are 7 times more likely than non-abusers to commit violence;
- Some studies show that bipolar and schizophrenia incidences of violence are negligible if drug and alcohol abuse are not factors;
- Individuals with mental illness are more likely to be victims of violence;
- If you could remove psychiatric illness as a risk factor in violence, the homicide rate would barely drop - at most by 4%.
Mental illness becomes the focus because mass killers tend to be mentally ill - but there is no suggestion that if you are mentally ill, you are more likely to commit a mass killing. The actual risk is very small; statistics do not back up the stereotypes. In cases such as Newtown, there is a tendency to push the identity of the killer off on some other group. As the shooter was a white male, there was an effort to find another diagnosis. In the case of the shooter, Adam Lanza, there was speculation and discussion that he had Asperger's syndrome (a high-functioning form of Autism) - despite that fact that there is no correlation between Asperger's and violent crime. This tremendous increase in stigmatizing mental illness appears to be an attempt to deflect responsibility for the crime onto people with mental illness, which is totally unacceptable. Click here to read more! |
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Myths and Facts about Mental Health
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The following information was compiled by the Substance Abuse & Mental Health Services Administration's (SAMHSA's) Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health. www.samhsa.gov
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Often people are afraid to talk about mental health because there are many misconceptions about mental illnesses. It's important to learn the facts to stop discrimination and to begin treating people with mental illnesses with respect and dignity.
Here are some common myths and facts about mental health.
Myth: There's no hope for people with mental illnesses.
Fact: There are more treatments, strategies, and community supports than ever before, and even more are on the horizon. People with mental illnesses lead active, productive lives.
Myth: I can't do anything for someone with mental health needs.
Fact: You can do a lot, starting with the way you act and how you speak. You can nurture an environment that builds on people's strengths and promotes good mental health. For example:
Avoid labeling people with words like "crazy," "wacko," "loony," or by their diagnosis. Instead of saying someone is a "schizophrenic" say "a person with schizophrenia."
Learn the facts about mental health and share them with others, especially if you hear something that is untrue.
Treat people with mental illnesses with respect and dignity, as you would anybody else.
Respect the rights of people with mental illnesses and don't discriminate against them when it comes to housing, employment, or education. Like other people with disabilities, people with mental health needs are protected under Federal and State laws.
Myth: People with mental illnesses are violent and unpredictable.
Fact: In reality, the vast majority of people who have mental health needs are no more violent than anyone else. You probably know someone with a mental illness and don't even realize it.
Myth: Mental illnesses cannot affect me.
Fact: Mental illnesses are surprisingly common; they affect almost every family in America. Mental illnesses do not discriminate-they can affect anyone.
Myth: Mental illness is the same as mental retardation.
Fact: The two are distinct disorders. A mental retardation diagnosis is characterized by limitations in intellectual functioning and difficulties with certain daily living skills. In contrast, people with mental illnesses-health conditions that cause changes in a person's thinking, mood, and behavior-have varied intellectual functioning, just like the general population.
Myth: Mental illnesses are brought on by a weakness of character.
Fact: Mental illnesses are a product of the interaction of biological, psychological, and social factors. Research has shown genetic and biological factors are associated with schizophrenia, depression, and alcoholism. Social influences, such as loss of a loved one or a job, can also contribute to the development of various disorders.
Myth: People with mental illnesses cannot tolerate the stress of holding down a job.
Fact: In essence, all jobs are stressful to some extent. Productivity is maximized when there is a good match between the employee's needs and working conditions, whether or not the individual has mental health needs.
Myth: People with mental health needs, even those who have received effective treatment and have recovered, tend to be second-rate workers on the job.
Fact: Employers who have hired people with mental illnesses report good attendance and punctuality, as well as motivation, quality of work, and job tenure on par with or greater than other employees. Studies by the National Institute of Mental Health (NIMH) and the National Alliance for the Mentally Ill (NAMI) show that there are no differences in productivity when people with mental illnesses are compared to other employees.
Myth: Once people develop mental illnesses, they will never recover.
Fact: Studies show that most people with mental illnesses get better, and many recover completely. Recovery refers to the process in which people are able to live, work, learn, and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life. For others, recovery implies the reduction or complete remission of symptoms. Science has shown that having hope plays an integral role in an individual's recovery.
Myth: Therapy and self-help are wastes of time. Why bother when you can just take one of those pills you hear about on TV?
Fact: Treatment varies depending on the individual. A lot of people work with therapists, counselors, their peers, psychologists, psychiatrists, nurses, and social workers in their recovery process. They also use self-help strategies and community supports. Often these methods are combined with some of the most advanced medications available.
Myth: Children do not experience mental illnesses. Their actions are just products of bad parenting.
Fact: A report from the President's New Freedom Commission on Mental Health showed that in any given year 5-9 percent of children experience serious emotional disturbances. Just like adult mental illnesses, these are clinically diagnosable health conditions that are a product of the interaction of biological, psychological, social, and sometimes even genetic factors.
Myth: Children misbehave or fail in school just to get attention.
Fact: Behavior problems can be symptoms of emotional, behavioral, or mental disorders, rather than merely attention-seeking devices. These children can succeed in school with appropriate understanding, attention, and mental health services.
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Misconceptions about Madness and Mayhem
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To speak directly to the violence potential of those with mental illness, we reprint a blog post originally published in the Harvard University Press blog on February 7, 2011 following the Arizona shootings that wounded Congresswoman Gabrielle Giffords and killed and wounded several others.
 | | Richard McNally |
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"In the recently published What Is Mental Illness?, Richard J. McNally unpacks the politically and emotionally fraught debate over how we define mental illness.
McNally is the Director of Clinical Training for the Harvard Department of Psychology, and also an advisor to the Diagnostic and Statistical Manual of Mental Disorders, the psychiatric bible that is currently being revised in preparation for the release of its fifth incarnation in 2013.
Now that some of the rhetoric surrounding the Arizona shootings has cooled, we (Harvard University Press) asked McNally to interpret what the discourse around that incident signals about public conceptions of mental illness."
"Last month's horrific mass killing in Tucson has awakened concerns about the role of mental illness in violence, especially homicide. Jared Loughner, a 22-year-old college dropout, stands accused of killing six people, including a nine-year-old girl, and wounding 14 others, including Arizona Congresswoman Gabrielle Giffords.
Homicidal rampages inevitably invite speculation about the mental status of perpetrators. Gleaning information from media reports, some eminent psychiatrists conclude that Loughner likely suffers from paranoid schizophrenia. Regardless of the accuracy of these provisional diagnostic conjectures, the facts of the case will surely heighten fears of "psychotic killers" lurking in our midst, poised to explode in murderous rage against citizens in public venues.
In reality, the public image of the dangerousness of people with mental illness is wildly inaccurate. Misconceptions abound regarding madness and mayhem. Claims that people with mental illness are more likely to commit violence than are other people must be qualified by specifying what we mean by the term "mental illness."
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How Prevalent is Mental Illness?
Facts About Common Mental Illnesses
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The following information was compiled by the Substance Abuse & Mental Health Services Administration's (SAMHSA's) Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health. www.samhsa.gov * * *  Mental health problems are health conditions involving changes in thinking, mood, and/or behavior, and they are associated with distress or impaired functioning. When they are more severe, they are called mental illnesses. These include anxiety disorders, attention-deficit/hyperactivity disorder, depressive and other mood disorders, eating disorders, schizophrenia, and others. When these occur in children under 18, they are referred to as serious emotional disturbances (SEDs). Here are some brief descriptions of some of the most common mental illnesses: Click here to read more!
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For More Valuable Information and Statistics . . .
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f you would like more information and statistics to help you understand the prevalence of mental health problems in the United States, check out the following link from the National Institute of Mental Health: http://www.nimh.nih.gov/statistics/index.shtml
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More On - State of Mind - Reframing Mental Illness
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"Despite all the research over the last 100-plus years, our true understanding of mental illness - what it is and where it comes from - is still questionable at best.
In recent decades, the trend has been to pin everything to a biological defect within the brain and then find a corresponding pill to address it. An untold amount of money has been spent by the pharmaceutical companies - in research as well as advertising - yet instead of seeing improvements, diagnosis of mental illness continues to grow each year and is expected to continue to do so. This is especially frightening when looking at the increased diagnosing of children.
Just like the body, the mind has many different parts and can be affected in many different ways. There can be birth defects, traumatic brain injuries and other physical damage done to the brain. But when most people think of mental illness they think of some of the more traditional diagnoses like schizophrenia, major depression, anxiety and obsessive compulsive disorder to name just a few. While diagnoses allow for people to receive services or insurance coverage, they don't always help clarify the person's issues.
Symptoms can cross diagnostic definitions. Therefore, it's more common than not for someone to receive multiple or different diagnoses over time. Consequently, treatment with medications can appear to be a crapshoot - individuals are subjected to trials on multiple medications, all with different effects and side effects.
To make matters worse, from what I have seen professionally and experienced personally, traditional treatment can be as damaging to the person long-term as the illness itself. In efforts to "fix the problem" and "save people from themselves," the systems of care designed to help people with mental illness ends up leaving them over-medicated, dependent on various government programs and systems of care and, most significantly, with little sense of hope or self-worth.
I have traveled all over the country speaking to different groups about mental illness and recovery, and while Vermont is more progressive than some states, its overall treatment of people with mental health issues is still, in most cases, appalling. If we looked at applying the same low standards in addressing physical illness in our society as we do in providing for the mentally ill, there would be a public outcry. And since people with mental illness are often so disenfranchised, their outcry is less likely to be heard.
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Fortunately, things are beginning to change. In recent years, journalist Robert Whitaker has helped fan the flames of a fierce debate and dialogue with his recent books, "Mad in America" and "Anatomy of an Epidemic." Whitaker challenges the philosophy of "medicate now and ask questions later." His intense and in-depth research is hard to refute.
Other leaders like Dr. Daniel Fisher, Sherry Mead and Mary Ellen Copeland, have called for and proposed different approaches.
Peers, or people with lived experience with mental illness, are not only acting as advocates but are also designing programs and providing care in new and unique ways.
One area that is now being highlighted in the search for answers is the connections between trauma and mental illness. This is most apparent in war veterans. Suicides have surged in the armed forces to the point where death by suicide is almost twice as likely as by enemy action. Trauma is a big factor in these cases.
Trauma is also being looked at in a broader sense in mental health. Trauma can result from one event or from a series of events. There may be immediate reactions like shock and denial, but trauma can also have long term effects on a person's well-being. Both short-term and long-term responses to trauma can be mild or severe. In some cases, people may suppress feeling and not be affected for years.
In reaction to these traumatic events or experiences, people can develop any number of coping mechanisms. Some may appear healthy or at least work temporarily. But more often than not these coping mechanisms can lead to problems later in life. People who have experienced trauma often have trouble trusting and communicating, impacting their ability to maintain healthy relationships. Their self-esteem, self-image and self-worth are all severally damaged. In some cases they may appear to shut down all together or develop their own reality, where they can be safe and separate from the world that has hurt them.
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For many, recovery is a long-term process. It takes time and painfully hard work to unlearn the unhealthy behaviors or coping mechanisms that have been part of their survival. Processing and working through the traumatic experiences in their lives cannot be done overnight.
Recovery is also a process that cannot be done alone. Friends, family and professionals all play a role. So does the larger community. The way in which we either accept or reject people who are different than us or are struggling can have a big impact on their recovery.
In my new professional role, I am looking at ways that people with mental illness can both support each other and be more included in the community - seen not just as takers, but as givers, too.
The next time you hear the term mental illness on television or read it in the paper ask yourself, "How much does this person who is speaking really know about mental illness?" More than likely, the answer is very little. When discussing it with others, realize that the terms "mental illness" or "the mentally ill" are often stereotypical in nature. And ask yourself, "What do I really know and what are my views on mental illness?" "
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More On - Mental Health vs. the Gun Control Debate
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From Al Jazeera America, "Inside Story Americas", broadcast on December 19, 2012, continued below.
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One of the panelists on the broadcast was Ari Ne'eman, the President and Co-founder of the Autistic Self Advocacy Network and a member of the National Council on Disability. As a person with autism, considered a mental illness, his words were quite personal. He shared that most people don't understand what it's like (in the wake of mass shootings) to have the national media present people like you as dangerous, unstable and un-empathetic individuals - to have the media spread stereotypes and stigmas without regard to facts. This is done particularly to those with psychiatric and neurological disabilities, who are some of the most stigmatized in our society.
Ne'eman stated that the response to Newtown in the disability community was twofold: 1) a feeling of the same kind of mourning and sympathy for the victims as everyone else felt; and 2) a fear that it would only be a matter of time before people started to blame them. This fear is rooted in experience; after the mass shootings at Virginia Tech, schools implemented policies that discriminated against and segregated those with autism, neurological disabilities, and psychiatric disabilities.
This quote by Ne'eman from the Autistic Self Advocacy Network sums it up well:
"There is something of a tendency in the aftermath for people to be searching for ways to try and push the identity of the killer off on some other group. When the killer belongs to a racial or religious minority that's a fairly simple or despicable enterprise. When the mass shooter belong(s) to the dominant culture - a white male - the tendency is to try and diagnose him [as] something and that involves the facts being entirely ignored."
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More On - Misconceptions about Madness and Mayhem
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"As I outline in my new book,What Is Mental Illness?, the current debate about how we diagnose and treat mental illness is shaped by the Diagnostic and Statistical Manual of Mental Disorders -- the DSM. Indeed, epidemiologic surveys based on the current edition of the DSM show that nearly 50% of American adults have suffered from mental disorder at some point in their lives, and that 25% have been mentally ill during the previous year. However, only about 6% have experienced a severe mental illness, such as schizophrenia or bipolar disorder, within the past year. Few disorders involve a psychotic "break with reality" marked by delusions and hallucinations. Anxiety disorders, nonpsychotic depression, and substance abuse and dependence are far more common than severe mental illness is. Even when we focus on severe mental illness, especially schizophrenia, we find that concerns about violence, especially homicide, are exaggerated. Consider the landmark MacArthur Violence Risk Assessment Study. The researchers studied 951 patients after their discharge from acute psychiatric facilities, comparing their subsequent commission of violence with a comparison group of 519 residents living in the same neighborhoods as the discharged patients. The MacArthur study refuted many misconceptions about psychosis and violence. Discharged mental patients without symptoms of alcohol or drug abuse were no more likely to commit violence than were their neighbors who had no symptoms of substance abuse. The presence of substance abuse increased the rate of violence in both the patient and comparison groups. Hence, to the extent that a mental disorder increases the odds of violence, it does so by increasing the risk for substance abuse. Patients with a schizophrenia diagnosis were less likely than were patients with other diagnoses to exhibit violence. Most episodes of violence in both groups occurred at home, directed against family members and friends. Strangers were seldom victims. Relative to comparison subjects, patients rarely used weapons. Ironically, despite widespread public fears of dangerous psychotic patients, individuals suffering from severe mental illness are far more likely to be victims of violence than perpetrators of violence. One study revealed that they experienced violent victimization at four times the rate of the general population. In another study, 25% of those with severe mental illness were victims of violence as compared to only 3% of the general population. Exposure to violence is especially common among the homeless mentally ill. The largest study of homeless people with severe mental illness indicated that 44% of them had been victims of violence during the previous two months. Although people with these severe conditions are certainly capable of violence, especially if they are abusing drugs and alcohol and suffering from persecutory delusions, they are more likely to be victims than they are victimizers. To the extent that people with mental illness pose mortal danger to anyone, studies show that they are actually a greater threat to themselves than to other people. According to the Centers for Disease Control, Americans are far more likely to die by suicide than by homicide. This is especially true of people suffering from schizophrenia, bipolar disorder, major depression, and alcoholism. About 10-15% of people with major depression die by their own hands. Between 1 and 2% of all deaths each year in the United States are suicides, and most people who kill themselves have a mental disorder. Nearly three-fourths of them were seriously depressed at the time of their death. The vast majority of people suffering from schizophrenia and other forms of major mental illness do not commit aggression against other people, let alone mass murder, as Jared Loughner has allegedly done. Even if most people who commit multiple homicides are mentally ill, very few people with mental illness perpetrate such crimes. They are more likely to be victims of violence than perpetrators of violence. The tragedy in Tucson illustrates the broad social implications of how our clinicians conceptualize mental illness. Indeed, how we distinguish normal mental distress from genuine emotional disorder is a highly contentious issue that lies at the core of the controversy concerning the ongoing revision of the DSM, due to appear in 2013. I wrote What is Mental Illness? to acquaint the general public with the exciting, but often controversial, developments in clinical science that are informing our evolving understanding of what it means to be mentally ill." Return to Top |
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How Prevalent is Mental Illness?
Facts About Common Mental Illnesses
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Here are some brief descriptions of some of the most common mental illnesses.
Anxiety Disorders
1. Panic Disorder
Panic disorder affects about 2.4 million adult Americans and is twice as common in women as in men. A panic attack is a feeling of sudden terror that often occurs with a pounding heart, sweating, nausea, chest pain or smothering sensations and feelings of faintness or dizziness. Panic disorder frequently occurs in addition to other serious conditions like depression, drug abuse, or alcoholism. If left untreated, it may lead to a pattern of avoidance of places or situations where panic attacks have occurred. In about a third of cases, the threat of a panic attack becomes so overwhelming that a person may become isolated or housebound-a condition known as agoraphobia. Panic disorder is one of the most treatable of the anxiety disorders through medications or psychotherapy. Early treatment of panic disorder can help prevent agoraphobia.
2. Obsessive-Compulsive Disorder (OCD)
OCD affects about 3.3 million adult Americans, and occurs equally in men and women. It usually appears in childhood. Persons with OCD suffer from persistent and unwelcome anxious thoughts, and the result is the need to perform rituals to maintain control. For instance, a person obsessed with germs or dirt may wash his hands constantly. Feelings of doubt can make another person check on things repeatedly. Others may touch or count things or see repeated images that disturb them. These thoughts are called obsessions, and the rituals that are performed to try to prevent or get rid of them are called compulsions. Severe OCD can consume so much of a person's time and concentration that it interferes with daily life. OCD responds to treatment with medications or psychotherapy.
3. Post-Traumatic Stress Disorder (PTSD)
PTSD affects about 5.2 million adult Americans, but women are more likely than men to develop it. PTSD occurs after an individual experiences a terrifying event such as an accident, an attack, military combat, or a natural disaster. With PTSD, individuals relive their trauma through nightmares or disturbing thoughts throughout the day that may make them feel detached, numb, irritable, or more aggressive. Ordinary events can begin to cause flashbacks or terrifying thoughts. Some people recover a few months after the event, but other people will suffer lasting or chronic PTSD. People with PTSD can be helped by medications and psychotherapy.
4. Generalized Anxiety Disorder (GAD)
GAD affects about 4 million adult Americans and twice as many women as men. GAD is more than day-to-day anxiety. It fills an individual with an overwhelming sense of worry and tension. A person with GAD might always expect disaster to occur or worry a lot about health, money, family, or work. These worries may bring physical symptoms, especially fatigue, headaches, muscle tension, muscle aches, trouble swallowing, trembling, twitching, irritability, sweating, and hot flashes. People with GAD may feel lightheaded, out of breath, or nauseous, or might have to go to the bathroom often. When people have mild GAD, they may be able to function normally in social settings or on the job. If GAD is severe, however, it can be very debilitating. GAD is commonly treated with medications.
5. Social Anxiety Disorder
Social phobia affects about 5.3 million adult Americans. Women and men are equally likely to develop social phobia, which is characterized by an intense feeling of anxiety and dread about social situations. These individuals suffer a persistent fear of being watched and judged by others and being humiliated or embarrassed by their own actions. Social phobia can be limited to only one type of situation-fear of speaking in formal or informal situations, eating, drinking, or writing in front of others-or a person may experience symptoms any time they are around people. It may even keep people from going to work or school on some days, as physical symptoms such as blushing, profuse sweating, trembling, nausea, and difficulty talking often accompany the intense anxiety. Social phobia can be treated successfully with medications or psychotherapy.
6. Attention-Deficit/Hyperactivity Disorder (ADHD)
ADHD affects as many as 2 million American children and is a diagnosis applied to children and adults who consistently display certain characteristic behaviors over a period of time. The most common behaviors fall into three categories: inattention, hyperactivity, and impulsivity. People who are inattentive have a hard time keeping their mind on any one thing and may get bored with a task after only a few minutes. People who are hyperactive always seem to be in motion. They can't sit still and may dash around or talk incessantly. People who are overly impulsive seem unable to curb their immediate reactions or think before they act. Not everyone who is overly hyperactive, inattentive, or impulsive has an attention disorder. While the cause of ADHD is unknown, in the last decade, scientists have learned much about the course of the disorder and are now able to identify and treat children, adolescents, and adults who have it. A variety of medications, behavior-changing therapies, and educational options are already available to help people with ADHD focus their attention, build self-esteem, and function in new ways.
Depressive Disorders
About 18.8 million American adults experience a depressive illness that involves the body, mood, and thoughts. Depression affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. People with a depressive illness cannot just "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years.
Depression can occur in three forms:
1. Major Depressive Disorder
Major depressive disorder involves a pervading sense of sadness and/or loss of interest or pleasure in most activities that interferes with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. This is a severe condition that can impact a person's thoughts, sense of self worth, sleep, appetite, energy, and concentration. The condition can occur as a single debilitating episode or as recurring episodes.
2. Dysthymia:
Dysthymia involves a chronic disturbance of mood in which an individual often feels little satisfaction with activities of life most of the time. Many people with dysthymia also experience major depressive episodes in their lives leading to a recurrent depressive disorder. The average length of an episode of dysthymia is about four years.
3. Bipolar Disorder
Bipolar Disorder, or manic-depressive illness, is a type of mood disorder characterized by recurrent episodes of highs (mania) and lows (depression) in mood. These episodes involve extreme changes in mood, energy, and behavior. Manic symptoms include extreme irritable or elevated mood; a very inflated sense of self-importance, risk behaviors, distractibility, increased energy, and a decreased need for sleep.
The most important thing to do for people with depression is to help them get an appropriate diagnosis and treatment. Treatment, usually in the form of medication or psychotherapy, can help people who suffer from depression.
*Do not ignore remarks about suicide.
If someone tells you they are thinking about suicide, you should take their distress seriously, listen, and help them get to a professional for evaluation and treatment. If someone is in immediate danger of harming himself or herself, do not leave the person alone. Take emergency steps to get help, such as calling 911. You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
Eating Disorders
1. Anorexia Nervosa
People with this disorder see themselves as overweight despite their actual body weight. With this disorder, a person works to maintain a weight lower than normal for their age and height. This is accompanied by an intense fear of weight gain or looking fat. At times, a person can even deny the seriousness of their low body weight. Eating becomes an obsession and habits develop, such as avoiding meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food. People with anorexia may repeatedly check their body weight, and many engage in other techniques to control their weight, like compulsive exercise or purging by vomiting or using laxatives. Some people fully recover after a single episode; some have a pattern of weight gain and relapse; and others experience a deteriorating course of illness over many years.
2. Bulimia Nervosa
Bulimia is characterized by episodes of binge eating-eating an excessive amount of food at once with a sense of lack of control over eating during the episode-followed by behavior in order to prevent weight gain, such as self-induced purging by vomiting or misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. Because purging or other compensatory behavior follows the binge-eating episodes, people with bulimia usually weigh within the normal range for their age and height. However, like individuals with anorexia, they may fear gaining weight, desire to lose weight, and feel dissatisfied with their bodies. People with bulimia often perform the behaviors in secrecy, feeling disgusted and ashamed when they binge, yet relieved once they purge.
Schizophrenia
More than 2 million Americans a year experience this disorder. It is equally common in men and women. Schizophrenia tends to appear earlier in men than in women, showing up in their late teens or early 20s as compared to their 20s or early 30s in women. Schizophrenia often begins with an episode of psychotic symptoms like hearing voices or believing that others are trying to control or harm you. The delusions- thoughts that are fragmented, bizarre, and have no basis in reality-may occur along with hallucinations and disorganized speech and behavior, leaving the individual frightened, anxious, and confused. There is no known single cause of schizophrenia. Treatment may include medications and psychosocial support like psychotherapy, self-help groups, and rehabilitation.
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