6.4: Mental Health - Risks, Causes, and Treatments

Mental illnesses, in general, are thought to be caused by a variety of genetic and environmental factors, these include:

• Inherited traits. Mental illness is more common in people whose blood relatives also have a mental illness. Certain genes may increase your risk of developing a mental illness, and your life situation may trigger it.
• Environmental exposures before birth. Exposure to environmental stressors, inflammatory conditions, toxins, alcohol or drugs while in the womb can sometimes be linked to mental illness.
• Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When the neural networks involving these chemicals are impaired, the function of nerve receptors and nerve systems change, leading to depression and other emotional disorders.

Certain factors may increase your risk of developing a mental illness, including:

• A history of mental illness in a blood relative, such as a parent or sibling
• Stressful life situations, such as financial problems, a loved one’s death or a divorce
• An ongoing (chronic) medical condition, such as diabetes
• Brain damage as a result of a serious injury (traumatic brain injury), such as a violent blow to the head
• Traumatic experiences, such as military combat or assault
• Use of alcohol or recreational drugs
• A childhood history of abuse or neglect
• Few friends or few healthy relationships
• A previous mental illness

Treatment begins with getting a medical diagnosis to understand which mental illness may be causing your symptoms. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is used for diagnosis. Treatment depends on the type of mental disorder and may include medications, physicians, psychotherapist, psychiatrists, and social workers or family members.

• Psychotherapy
  • Psychotherapy or “talk therapy” can help people with anxiety disorders. To be effective, psychotherapy must be directed at the person’s specific anxieties and tailored to his or her needs. A typical “side effect” of psychotherapy is temporary discomfort involved with thinking about confronting feared situations.
• Cognitive Behavioral Therapy (CBT)
  • CBT is a type of psychotherapy that can help people with anxiety disorders. It teaches a person different ways of thinking, behaving, and reacting to anxiety-producing and fearful situations. CBT can also help people learn and practice social skills, which is vital for treating social anxiety disorder.
  • Two specific stand-alone components of CBT used to treat social anxiety disorder are cognitive therapy and exposure therapy. Cognitive therapy focuses on identifying, challenging, and then neutralizing unhelpful thoughts underlying anxiety disorders. Exposure therapy focuses on confronting the fears underlying an anxiety disorder in order to help people engage in activities they have been avoiding.
• Stress-Management Techniques
  • Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy. While there is evidence that aerobic exercise has a calming effect, the quality of the studies is not strong enough to support its use as treatment. Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, avoiding them should be considered. Check with your physician or pharmacist before taking any additional medications.
  • The family can be important in the recovery of a person with an anxiety disorder. Ideally, the family should be supportive but not help perpetuate their loved one’s symptoms. Talking with a trusted friend or member of the clergy can also provide support, but it is not necessarily a sufficient alternative to care from an expert clinician.
• Medication
  • Medication does not cure anxiety disorders but often relieves symptoms. Medication can only be prescribed by a medical doctor (such as a psychiatrist or a primary care provider), but a few states allow psychologists to prescribe psychiatric medications.
  • Medications are sometimes used as the initial treatment of an anxiety disorder, or are used only if there is insufficient response to a course of psychotherapy. In research studies, it is common for patients treated with a combination of psychotherapy and medication to have better outcomes than those treated with only one or the other.
  • The most common classes of medications used to combat anxiety disorders are antidepressants, anti-anxiety drugs, and beta-blockers. Be aware that some medications are effective only if they are taken regularly and that symptoms may recur if the medication is stopped.