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5.5: Mental Health Disorders

Last updated

Jan 13, 2025
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- 5.4: Challenges to our Mental Health
- 5.6: Mental Health - Risks, Causes, and Treatments

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Mental Health Disorders

Mental health disorders are classified into four main categories: Mood Disorders, Anxiety Disorders, Psychotic Disorders, and Eating Disorders. These conditions impact emotional, cognitive, and behavioral functioning in various ways.

Mood Disorders

Mood disorders affect emotional states, ranging from extreme sadness to extreme happiness. Common examples include:

Depression
Bipolar disorders
Seasonal affective disorder

Anxiety Disorders

Anxiety disorders are marked by excessive fear, dread, or stress responses. Types include:

General anxiety
Specific phobias and Agoraphobia
Post-traumatic stress disorder
Panic disorder
Social anxiety disorder

Psychotic Disorders

Psychotic disorders distort reality and thinking. Examples include:

Schizophrenia

Eating Disorders

Eating disorders are severe disturbances in eating behaviors, often linked to psychological and social factors. Examples include:

Anorexia Nervosa
Bulimia Nervosa
Binge Eating

Health Assessment: Mental Health Symptoms

The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure (Adult) is a questionnaire designed to help individuals and healthcare providers identify symptoms across a wide range of mental health domains. This tool encourages awareness and facilitates discussions with a mental health professional.

Instructions

Access the Questionnaire:
- Download the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure (Adult) PDF from the American Psychiatric Association or use the direct link provided in your course materials.
Complete the Questionnaire:
- Answer all 23 questions honestly based on how you have been feeling over the past two weeks.
Scoring and Interpretation:
- Review your responses for each item within a domain.
- Identify the highest score for each domain and record it in the “Highest Domain Score” column.
- Use the following guidelines to determine if additional inquiry is needed:
  - For most domains: A rating of 2 (Mild) or greater on any item suggests the need for further exploration.
  - For substance use, suicidal ideation, and psychosis: A rating of 1 (Slight) or greater on any item indicates the need for follow-up.
- Consider discussing your results with a licensed mental health professional for a more detailed assessment, especially if scores meet or exceed these thresholds.
Reflect on Your Results:
- Summarize Your Scores: Note any domains where you scored higher.
- Describe Your Feelings: Reflect on your emotional reaction to completing the questionnaire. Were you surprised by your scores? Why or why not?
Identify Next Steps:
- Explore recommended resources or seek professional support if scores indicate a need for further inquiry.
- If your scores were low, reflect on strategies to maintain and enhance your mental well-being.
Set a SMART Goal for Mental Health:
- Based on your reflection, create a goal to support your mental health that is specific, measurable, achievable, relevant, and time-bound (SMART). For example: "I will dedicate 15 minutes daily to practicing gratitude journaling for the next month to enhance my emotional well-being and focus on positive aspects of my life."

Additional Resources

American Psychiatric Association: Visit psychiatry.org for mental health resources.
National Alliance on Mental Illness (NAMI): Call the helpline at 1-800-950-NAMI (1-800-950-6264) or visit nami.org.
Crisis Support: Text HOME to 741741 to connect with a trained crisis counselor.

This assessment is intended to foster awareness, encourage proactive mental health care, and provide a starting point for professional discussions if needed.

Depression

Depression, clinically referred to as major depressive disorder (MDD) or clinical depression, is the most prevalent mood disorder, profoundly affecting how individuals feel, think, and function in daily life. It is more than occasional sadness or a temporary "low mood"; depression involves persistent feelings of sadness, hopelessness, or disinterest that interfere with everyday activities such as working, sleeping, eating, and socializing.

Approximately 1 in 6 adults will experience depression at some point in their lives, making it one of the leading causes of disability worldwide. There are varying levels of depression and causes of depression. Depression can occur at any age and affects people of all genders, cultures, and backgrounds, though risk factors such as genetics, life stressors, and medical conditions can influence its onset. A person with persistent depressive disorder (also called dysthymia) has suffered from a depressed mood that lasts for at least two years. A woman with perinatal depression has experienced full-blown major depression during pregnancy or after delivery (postpartum depression).

Symptoms of depression include:

Feeling sad or anxious often or all the time
Not wanting to do activities that used to be fun
Feeling irritable‚ easily frustrated‚ or restless
Having trouble falling asleep or staying asleep
Waking up too early or sleeping too much
Eating more or less than usual or having no appetite
Experiencing aches, pains, headaches, or stomach problems that do not improve with treatment
Having trouble concentrating, remembering details, or making decisions
Feeling tired‚ even after sleeping well
Feeling guilty, worthless, or helpless
Thinking about suicide or hurting yourself

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.

Bipolar Disorder

Bipolar disorder is a mood disorder characterized by intense mood swings. Sometimes you may feel extremely “up,” elated, irritable, or energized. This is called a manic episode. Other times you may feel “down,” sad, indifferent, or hopeless. This is called a depressive episode. You may have both manic and depressive symptoms together. This is called a mixed episode.

Symptoms of Bipolar include:

The symptoms of a manic episode can include
- Feeling very up, high, or elated
- Feeling jumpy or wired, more active than usual
- Having a very short temper or seeming extremely irritable
- Having racing thoughts and talking very fast
- Needing less sleep
- Feeling like you are unusually important, talented, or powerful
- Do risky things that show poor judgment, such as eating and drinking too much, spending or giving away a lot of money, or having reckless sex
The symptoms of a depressive episode can include
- Feeling very sad, hopeless, or worthless
- Feeling lonely or isolating yourself from others
- Talking very slowly, feeling like you have nothing to say, or forgetting a lot
- Having little energy
- Sleeping too much
- Eating too much or too little
- Lack of interest in your usual activities and being unable to do even simple things
- Thinking about death or suicide

The symptoms of a mixed episode include both manic and depressive symptoms together. For example, you may feel very sad, empty, or hopeless, while at the same time feeling extremely energized.

Seasonal Affective Disorder (SAD)

SAD is a specific type of Depression (a mood disorder) that comes and goes with the seasons.

Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.

Symptoms of SAD include:

Sadness
Gloomy outlook
Feeling hopeless, worthless, and irritable
Loss of interest or pleasure in activities you used to enjoy
Low energy
Difficulty sleeping or oversleeping
Carbohydrate cravings and weight gain
Thoughts of death or suicide

General Anxiety

Generalized Anxiety Disorder is an anxiety disorder characterized by excessive worrying. People with GAD excessively worry about ordinary daily issues such as health, money, work, and family on most days for at least 6 months.

Symptoms of GAD include:

Feeling restless, wound-up, or on-edge
Being easily fatigued
Having difficulty concentrating; mind going blank
Being irritable
Having muscle tension
Difficulty controlling feelings of worry
Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep

Panic Disorder

Panic disorder is an anxiety disorder characterized by recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom.

Symptoms of panic disorder include:

Heart palpitations, a pounding heartbeat, or an accelerated heart rate
Sweating
Trembling or shaking
Sensations of shortness of breath, smothering, or choking
Feelings of impending doom
Feelings of being out of control

People with panic disorder often worry about when the next attack will happen and actively try to prevent future attacks by avoiding places, situations, or behaviors they associate with panic attacks. Worry about panic attacks, and the effort spent trying to avoid attacks, cause significant problems in various areas of the person’s life, including the development of agoraphobia.

Specific Phobias

A phobia is an anxiety disorder characterized by a strong, irrational fear of something that poses little or no real danger. There are many specific phobias such as the fear of heights which is called Acrophobia, or the fear of spiders termed Arachnophobia. A person who has a fear of public spaces is termed Agoraphobia. If you become anxious and extremely self-conscious in everyday social situations, you could have a social phobia, also referred to as a social anxiety disorder.

Symptoms of specific phobias include:

May have an irrational or excessive worry about encountering the feared object or situation
Take active steps to avoid the feared object or situation
Experience immediate intense anxiety upon encountering the feared object or situation
Endure unavoidable objects and situations with intense anxiety

Social Anxiety Disorder (social phobia)

Social anxiety disorder is an anxiety disorder characterized by a general intense fear of, or anxiety toward, social or performance situations. They worry that actions or behaviors associated with their anxiety will be negatively evaluated by others, leading them to feel embarrassed.

Symptoms of Social Anxiety Disorder include:

Feeling highly anxious about being with other people and having a hard time talking to them
Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others
Being very afraid that other people will judge them
Worrying for days or weeks before an event where other people will be
Staying away from places where there are other people
Having a hard time making friends and keeping friends
Blushing, sweating, or trembling around other people
Feeling nauseous or sick to your stomach when other people are around

Post-traumatic stress disorder

PTSD is an anxiety disorder that develops in some people who have experienced a shocking, scary, or dangerous event. The “fight of flight” reaction is a natural process meant to keep a person from harm when in traumatic experiences, however for those with PTSD the reaction continues for a long period or they experience the reaction even when they are not in danger.

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

At least one re-experiencing symptom
- Flashbacks
- Intrusive Thoughts
- Nightmares or Bad Dreams
- Frightening Thoughts
- Emotional Distress at Trauma Triggers
- Physical Reactions to Triggers
At least one avoidance symptom
- Avoiding External Reminders
- Avoiding Internal Reminders
- Withdrawal from Social Interaction
- Neglecting Responsibilities
At least two arousal and reactivity symptoms
- Irritability or Angry Outbursts
- Hypervigilance
- Exaggerated Startle Response
- Difficulty Sleeping
- Difficulty Concentrating
- Risky or Self-Destructive Behavior
At least two cognition and mood symptoms
- Negative Thoughts About Oneself or the World
- Distorted Guilt or Blame
- Loss of Interest in Enjoyable Activities
- Emotional Numbness
- Memory Problems
- Feelings of Detachment

Schizophrenia

Schizophrenia is a psychotic disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends. Schizophrenia is typically diagnosed in the late teen years to the early thirties and tends to emerge earlier in males (late adolescence – early twenties) than females (early twenties – early thirties).

Symptoms of Schizophrenia include:

Psychotic Symptoms
- Hallucinations, such as hearing voices or seeing things that aren’t there
- Delusions, which are firmly held beliefs not supported by objective facts (e.g., paranoia – irrational fears that others are “out to get you” or believing that the television, radio, or internet are broadcasting special messages that require some response)
Negative Symptoms
- Reduced motivation and difficulty planning, beginning, and sustaining activities
- Diminished feelings of pleasure in everyday life
- “Flat affect,” or reduced expression of emotions via facial expression or voice tone
- Reduced speaking
Cognitive Symptoms
- Difficulty processing information to make decisions
- Problems using information immediately after learning it
- Trouble focusing or paying attention

Eating Disorders and Mental Health

Eating disorders are not a choice, rather they are serious and often fatal illnesses that are associated with severe disturbances in people’s eating behaviors and related thoughts and emotions. Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors.

Review Chapter 4 for more in-depth explanations of common eating disorders.

Suicide

Suicide is a major public health concern. In 2020, an estimated 12.2 million American adults seriously thought about suicide, 3.2 million planned a suicide attempt, 1.2 million attempted suicide, and 45,979 died by suicide. In 2020, suicide was among the top 9 leading causes of death for people ages 10-64 and the second leading cause of death for people ages 10-14 and 25-34. Depression, substance use disorders, and psychosis are the most relevant risk factors for suicide, with anxiety, personality, eating, and trauma-related disorders also contributing to the risk of suicide. Most people, at least 90%, who have died by suicide have suffered from mental disorders^[7]. Suicide is complicated and tragic but it is often preventable. Knowing the warning signs for suicide and how to get help can help save lives.

Suicidal thoughts or actions are a sign of extreme distress and should not be ignored.

Warning signs that someone may be at immediate risk for attempting suicide include:

Talking about wanting to die or wanting to kill themselves
Talking about feeling empty or hopeless or having no reason to live
Talking about feeling trapped or feeling that there are no solutions
Feeling unbearable emotional or physical pain
Talking about being a burden to others
Withdrawing from family and friends
Giving away important possessions
Saying goodbyes to friends and family
Putting affairs in order, such as making a will
Taking great risks that could lead to death, such as driving extremely fast
Talking or thinking about death often

Other serious warning signs that someone may be at risk for attempting suicide include:

Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
Making a plan or looking for ways to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun
Talking about feeling great guilt or shame
Using alcohol or drugs more often
Acting anxious or agitated
Changing eating or sleeping habits
Showing rage or talking about seeking revenge

Risk Factors for Suicide

Depression, other mental disorders, or substance use disorder
Chronic pain
A history of suicide attempts
Family history of a mental disorder or substance use
Family history of suicide
Exposure to family violence, including physical or sexual abuse
The presence of guns or other firearms in the home
Having recently been released from prison or jail
Exposure, either directly or indirectly, to others’ suicidal behavior, such as that of family members, peers, or celebrities

How can you help? 5 Action Steps for Helping Someone in Emotional Pain

Ask: “Are you thinking about killing yourself?” It’s not an easy question but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
Keep them safe: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal means can make a difference.
Be there: Listen carefully and learn what the individual is thinking and feeling. Findings suggest acknowledging and talking about suicide may in fact reduce rather than increase suicidal thoughts.
Help them connect with help
- Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), 24 hours a day, 7 days a week. The service is available to everyone.
- You can also connect 24/7 to a crisis counselor by texting the Crisis Text Line.Text HOME to 741741.
- The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889.
- You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
Stay Connected: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.

Mental health disorders are complex conditions that can significantly impact an individual’s emotional, psychological, and physical well-being. While the causes of these disorders often involve a combination of genetic, biological, environmental, and psychological factors, their effects are deeply personal, influencing thoughts, behaviors, and relationships in unique ways. Early recognition of symptoms and access to effective treatment are critical in improving outcomes and enhancing quality of life. Understanding mental health disorders not only fosters empathy but also helps reduce stigma, encouraging individuals to seek support. By addressing mental health with the same urgency as physical health, we can build a more compassionate and inclusive society where everyone has the opportunity to thrive.