5.2: What Is Mental Illness?

Similar to any physical disease, mental illness is a disease. Mental illness disrupts a person’s thinking, feeling, mood, ability to relate to other people and to function at home, work, or school. People with a mental illness are often unable to effectively cope with stressors. Mental illness may cause inappropriate behavior. It may cause a person to be confused and disoriented towards others and events around them. Mental illness may cause people to be agitated and could cause aggressive or depressed behaviors.

It is important to remember that a person with a mental illness did not do something wrong to get the mental illness. They cannot control having the mental illness just as a person with cancer cannot control having cancer. They cannot just “get over” their disease. Mental illness does not discriminate. Mental illness affects people of all ages, cultures, religions, socioeconomic status, and gender. It is important to know that while mental illness can cause great disruption to a person’s life, it is treatable. Recovery is possible.

Mental illness includes depression, anxiety, schizophrenia, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), phobias, and bipolar disorder. According to the National Alliance on Mental Illness (NAMI, 2013) 1 in 4 adults will experience a mental health disorder in a given year, which means about 60 million Americans! One in 17 Americans lives with a serious mental illness such as schizophrenia, bipolar or major depression (NAMI, 2013). Suicide, a serious problem related to mental illness, is the 10th leading cause of death in the United States (NAMI, 2013). As you can see, mental health disorders affect many people and can have serious consequences!

Mental health disorders are not specific to just the United States. Mental health disorders exist throughout the entire world. According to the World Health Organization (WHO, 2015), depression affects about 350 million people globally. Bipolar disorder affects about 60 million people worldwide (WHO, 2015). Schizophrenia affects about 21 million people worldwide (WHO, 2015)!

Mental health disorders can have devastating consequences. Suicide is a very real threat, particularly for those who suffer from a mental health disorder. According to the WHO (2009), 1 million people commit suicide worldwide per year, which is one death every 40 seconds. The 10-24 year old age group is the highest risk group for suicide (WHO, 2009).

Within the United States and throughout the world, there exist differences in cultural and religious beliefs, lived experiences, expression of mental health issues, and the actual treatment of mental health disorders. Stigma, or viewing people with a mental illness in an unfavorable or negative way, is not specific to the United States. This can lead to people with mental illness not reporting symptoms and not wanting to seek treatment.

According to the World Health Organization (2015), approximately 76% to 85% of people who suffer from a mental illness in low to middle income countries do not receive treatment, while 35% to 50% of people in high income countries do not receive treatment. Many people do not receive the treatment they need due to lack of resources, poor quality of care, lack of social support, and stigma toward people with mental health disorders. Home Health Aides/Personal Care Aides can work to treat all people with respect and learn to identify the signs of mental health disorders to assist the people with whom they work receive the care they need.

Self Check Activity \(\PageIndex{1}\)

True or False

1. People who have a mental illness cannot recover.True or False. _______

2. A person with a mental illness can control their symptoms and try harder to “get over” it.True or False. _______

3. Mental illness is a disease.True or False. _______

4. Stigma means viewing people with a mental illness in a negative way and can result in people with mental health disorders not seeking or receiving the treatment they need. True or False. _______

Answer

1. False

2. False

3. True

4. True

FEEDBACK:

1. People with mental illness can recover with appropriate health and support and live healthy and productive lives.

2. A person with a mental illness cannot just “get over it”. Mental illness is an illness just like diabetes, heart failure, or kidney disease. It cannot be controlled by the person and they are not displaying symptoms on purpose.

3. Mental illness is an illness just like diabetes, heart failure, or kidney disease.

4. Stigmas are looking at someone in a negative way and placing stereotypes upon them. This can result in a person not seeking the help that they need.

What Causes Mental Illness?

There are many factors that contribute to mental illness. There is no one specific factor that causes mental illness. However, mental illness can be caused or made to become worse by physical factors, environmental factors, heredity, and stress (Leahy, Fuzy & Grafe, 2013).

Physical Factors

Physical illness, disability or even the aging process can cause or make mental illness worse. Substance abuse or intoxication from alcohol or other drugs may mask mental illness. This means that people who abuse alcohol or drugs on a regular basis may have a mental illness and not even know it. This is because some of the signs and symptoms of mental illness are similar to the behavior of an intoxicated person.

According to NAMI (2015), about one third of all people experiencing a mental illness and about half of people living with a severe mental illness also have a substance abuse problem. A person who has had a traumatic brain injury (TBI) (suffered damage to the brain from a trauma) may also end up with changes in their personality, cognition, mood, and behavior. Chemical imbalances in the brain can cause mental illness. The brain has naturally occurring chemicals called neurotransmitters. It is thought that changes in neurotransmitters may cause mental illness. Changes in hormone levels can also cause mental health disorders.

Environmental Factors

There has been some research indicating that exposure to certain viruses, chemicals, or alcohol in the womb may also be linked to a person having a mental illness. Traumatic life experiences such as being in combat or experiencing sexual abuse or rape may also lead to a mental illness.

Genetic Factors

Genetic factors, or genes which we inherit are also thought to have a role in mental illness. Mental illness has a strong genetic basis, which means that it tends to run in families. People are more likely to have a mental illness if their parent or close relative also has a mental illness. This does not mean that if your mother or father has a mental illness that you will also have one. It just means your chances are higher than if a person does not have a parent who has a mental illness. It is believed that environmental factors and stressors may trigger these inherited genes to result in mental illness.

Stress Factors

Mental illness may be brought about by stressors, such as traumatic events or poor interpersonal relationships with loved ones. A difficult break up, the death of a partner or child, or other loss such as loss of a job or pet can lead to mental illness. People may have difficulty coping during stressful situations and display signs and symptoms similar to those that people with mental illness display. In many cases after the initial reaction to the traumatic event and after the person receives help, the signs and symptoms go away.

Effects of Mental Illness

Individuals

People who suffer from mental illness experience many different effects. While there are similarities among people who experience depression or schizophrenia for example, no two people will have the exact same experience. Each person who suffers from a mental health disorder has a unique experience. People who suffer from mental illness may have: difficulty relating to others, mood swings (go from one mood such as happy to another mood such as depressed), may have negative thoughts about themselves, hear voices or see things that are not there. They may withdraw from the people they love and no longer have an interest in doing the things they used to love to do. They may have suicidal thoughts, meaning they have thoughts about wanting to die. People who suffer from mental illness will have trouble functioning in at least one area of their life: work, school, or home.

Families

Families of people who suffer from mental illness are also greatly affected. Since people with mental illness may have difficulty relating to others or experience changes in their mood, this affects the people around them. Families may have trouble understanding why their loved one does not want to spend time with them or seems to be angry or depressed all the time. Families may feel helpless and not know how to make things better. Children of parents who suffer from a mental illness may be neglected as their parent is unable to focus on providing their care. Finances of the family may also be affected if a person with a mental illness has trouble at work and loses their job.

Types of Mental Illness

Anxiety

Anxiety disorders are a group of disorders in which people feel anxious, frightened, distressed, or terrified to an extent that is more excessive than would be considered appropriate to the situation. They can interfere with a person’s life so much that the person with anxiety has trouble functioning in their everyday life. Anxiety can lead people to become depressed, have low self-esteem, abuse substances, and have suicidal thoughts. About 41 million Americans live with an anxiety disorder (NAMI, 2013). Anxiety disorders are very common and also very treatable.

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is when people have anxiety every day for at least six months, which interferes with their ability to function in their everyday lives. They may feel constantly worried, afraid, and feel physical symptoms such as heart palpitations, trouble breathing, nausea, and headaches. Most of us worry and have anxiety at one time or another. The difference is that we can use positive coping skills to deal with our worries. People with GAD do not necessarily worry about something in particular and they are unable to use positive coping skills. GAD can lead to depression, substance abuse, loss of employment and relationships, and suicidal thoughts.

Phobias

Phobias are a type of anxiety disorder in which a person has an abnormal fear about something in particular. For example, some people may have a fear of germs, spiders, heights, being outside the home, crowds, closed in spaces, water, or animals. Most people have fears about many of those things, but the difference is that they are able to function when faced with their fear. A person with a phobia has an irrational fear, which is a fear that is not reasonable. They become unable to function in the face of these fears. In some cases, there may not be a reason for the fear, and in other cases, the person may have had a bad experience which has led to the excessive fear about the particular situation.

Obsessive-Compulsive Disorder

Obsessive–compulsive disorder (OCD) is a type of anxiety disorder in which the person has repetitive thoughts (obsessions) and repetitive behaviors (compulsions). These repetitive thoughts and behaviors impede (interfere with) the person’s ability to function in their everyday life. For example, a person who has a fear of germs may obsess (think continuously) about getting germs and spend excessive amounts of time washing their hands (compulsions). They may wash their hands for hours, leading to missing work and raw and bleeding hands.

Post-Traumatic Stress Disorder

Post–traumatic stress disorder (PTSD) is a type of anxiety disorder in which the person has experienced a traumatic event such as sexual abuse, rape, a natural disaster, or combat and experiences severe distress afterward. The person may have flashbacks (replay the event in their mind) about the event, have insomnia (trouble sleeping), nightmares, and feel constantly on edge, irritable, scared, or angry. It is normal for people to experience these things right after a traumatic event. The difference is that a person with PTSD is unable to function in their everyday life, to cope with their thoughts and feelings in a positive way, and feel that no matter what they do, they cannot “get back to normal.”

Self Check Activity \(\PageIndex{2}\)

1. Anxiety is a very common and treatable mental health disorder.True or False. _______

2. People with anxiety are at risk for suicide.True or False. _______

Matching: Match the type of anxiety disorder with its symptoms

Anxiety disorder	Symptoms
3. Phobias	a. After a traumatic event, this disorder is characterized by flashbacks, nightmares, insomnia, and feeling on edge.
4. Generalized anxiety disorder	b. This anxiety disorder is diagnosed after 6 months of excessive worry which interferes with home, school, work, and other daily functions. Heart palpitations, nausea, and headaches may be experienced.
5. Post-traumatic Stress Disorder	c. This anxiety disorder is characterized by obsessions and compulsions which interfere with a person’s ability to function in their everyday life.
6. Obsessive-Compulsive Disorder	d. This type of anxiety disorder is characterized by an irrational fear about something in particular, which interferes with a person’s ability to function in their everyday life.

Answer

1. True

2. True

3. D

4. B

5. A

6. C

FEEDBACK:

1. Anxiety is a very common, but treatable mental health disorder. About 41 million Americans live with an anxiety disorder.

2. People who experience anxiety are at a high risk for suicide.

3. Phobias, are a special type of anxiety disorder in which a person experiences an irrational fear about something in particular, such as being in public or of germs.

4. Generalized anxiety disorder (GAD) is diagnosed after 6 months of excessive worry, often about nothing specific. The person experiences physical symptoms such as nausea, headaches, heart palpitations, and has a general feeling of dread.

5. Post-traumatic stress disorder is a special type of anxiety disorder which often occurs after experiencing a traumatic event such as rape, abuse, an accident, or serving in the military. People with PTSD may experience flashbacks, insomnia, and nightmares.

6. Obsessions (repetitive thoughts) and compulsions (repetitive behaviors) characterize Obsessive-compulsive disorder (OCD). Obsessions and compulsions interfere with a person’s ability to function.

Depression

Depression is an extremely common type of mental illness. Depression may involve extreme sadness, insomnia, trouble concentrating, over or under-eating, substance abuse, guilt, and thoughts of suicide. Depression often results in a disruption of a person’s ability to function normally in their life. They may have trouble getting out of bed, performing self-care, caring for their children, or going to work. Mood disorders such as depression is the third leading cause of hospitalizations within the United States (NAMI, 2013).

Depression left untreated can result in suicide, which is the 10th leading cause of death in the United States (NAMI, 2013). In the elderly, depression is very common and is something a HHA/PCA should monitor when working with the elderly. Some people may have one episode of depression, while others experience recurrent depression, or depression that occurs periodically. It is important to assist a person with depression to seek help. Depression is a very treatable disorder with proper treatment.

Self Check Activity \(\PageIndex{3}\)

1. Untreated depression can lead to suicide.True or False. _______

Answer

1. True

FEEDBACK:

1. Untreated depression can lead to suicide. If a person is experiencing depression, they should seek help.

Schizophrenia

Schizophrenia is a serious mental illness that impacts a person’s ability to think clearly, make decisions, have relationships with others, manage stress and emotions, and function in their everyday lives. About 2.4 million Americans live with schizophrenia (NAMI, 2013). People with schizophrenia have psychoses. Psychoses are a loss of contact with what is real. They can include delusions (abnormal thoughts) or hallucinations (seeing or hearing things that are not real). Delusions may demonstrate paranoia (thinking someone is out to hurt you).

Behavior may be bizarre. For example, a person with schizophrenia may not dress appropriate to the weather, become catatonic (motionless and not move any muscle or body part), have repetitive movements of body parts and speech that is disorganized (does not make sense).

A person with schizophrenia may also have sleeping and eating problems, an inability to relate to others, and trouble providing self-care. People with schizophrenia are at a very high risk of suicide. Most people with schizophrenia are not dangerous to other people. With medication, support from others, and the help of a psychiatrist and therapist, a person with schizophrenia can usually be able to regain their ability to function within the community.

Self Check Activity \(\PageIndex{4}\)

Match the term with the definition

Term	Definition
1. This means a loss of contact with reality	a. Phobia
2. These are abnormal thoughts.	b. Obsession
3. These are repetitive behaviors that interfere with functioning	c. Compulsion
4. This means seeing or hearing something not real.	d. Psychosis
5. This is an irrational fear about something specific	e. Hallucination
6. These are repetitive thoughts that interfere with functioning.	f. Delusions

Answer

1. D

2. F

3. C

4. E

5. A

6. B

FEEDBACK:

1. A psychosis is a loss of contact with reality. The person is not able to clearly understand what is going on around them and may believe that they see or hear things which are not real.

2. Delusions are abnormal thoughts, which are not based in reality. The person may think that someone is going to harm them.

3. Compulsions are repetitive behaviors, such as repeatedly washing one’s hands or wiping a surface.

4. Hallucinations are seeing things that are not real. The person may believe that they see a person, bugs, or other objects that are not really there.

5. A phobia is an irrational fear about something in particular. The person believes they will be harmed by the object and avoids it at all costs. It interferes with their ability to function. For example, having a phobia of crowds can leave a person to never leave their house.

6. Obsessions are repetitive thoughts which interfere with everyday functioning. Thinking about germs obsessively can interfere with one’s life.