Mental health, and awareness of it, is especially important to me on a personal level. I wanted to create a multi-post series discussing mental health, both as means of personal reflections to share with others and also as a resource for others to spread knowledge about mental illnesses.
For this first post, I wanted to start on the very basics of mental illness and what forms mental illness takes.
What is Mental Illness?
How Common is it?
Nearly 1 in 5 U.S. adults live with mental illness (51.5 million in 2019). (NIH)
What's the Difference between Regular Mental Illness and Severe?
There are two different broad categories of mental illness: Any Mental Illness (AMI) and Serious Mental Illness (SMI). AMI refers to all recognized mental illnesses, whereas SMI is a smaller, more severe subset of AMI. SMIs result in serious functional impairment.
Who is More Likely to Get it?
Young adults aged 18-25 yrs had the highest prevalence of mental illness (29.4%), compared to adults aged 26-49 yrs (25.0%) and aged 50 yrs and older (14.1%). The prevalence of AMI is also higher among women (24.5%), compared to men (16.3%). (NIH)
Is Mental Illness Genetic?
We still don't know the exact cause of most mental illnesses, but recent research has shown that the cause is often a combination of biological, psychological, and environmental factors. Certain disorders do show that there may be potential genetic roots, like attention deficit hyperactivity disorder (ADHD) and bipolar disorder.
How are Mental Disorders Diagnosed?
Medical history or a physical exam can indicate the presence of a mental disorder. Most commonly though a psychological evaluation provided by a registered psychologist or psychiatrist will reveal signs of a mental disorder. In a psychological evaluation you will answer questions about your thinking, feelings, and behaviors.
Types of Disorders
Anxiety disorders (like, panic disorder, obsessive-compulsive disorder, and phobias)
Depression, bipolar disorder, and other mood disorders
Post-traumatic stress disorder
Psychotic disorders (like, schizophrenia)
Well first to understand what anxiety disorders are, we first have to learn what "anxiety" even means. Anxiety is a feeling of fear, dread, and uneasiness. Sometimes, anxiety can result in physical reactions like sweating or restlessness. It's that nervous, fluttery feeling you get before a big test or you have an important meeting. But normally, that feeling goes away. And sometimes, that anxiety can actually give you a boost of energy.
But the difference for people with anxiety disorders is that the fear isn't temporary and can be overwhelming. Anxiety disorders are conditions in which that anxiety doesn't "just go away" and the anxiety can actually get worse over time. The symptoms often interfere with basic tasks and activities for a person with an anxiety disorder -- it might even make them perform not as well at a job or make it hard for them to order their food at a restaurant.
There are many types of anxiety disorders:
Generalized anxiety disorder (GAD). This is when a person worries about ordinary issues like health, money, work, and family. The difference between having GAD and just general anxiety (because there is a difference!) is that the fear gets to be excessive and occurs frequently. A person with GAD may think and worry about their health every day, instead of every once in a while.
Panic disorder. Panic disorder = panic attacks. What is panic attack? It's when a person experiences a sudden period of intense fear when there is actually no real danger. Panic attacks come on quickly, often without any warning. The episode may last for several minutes, where a person feels so overwhelmed that they literally find it difficult to breathe effectively.
Phobias. This one we hear about a lot. Like fear of spiders is called arachnophobia. It's when a person is so scared of something that poses little or no actual danger. People with phobias are so fearful that they may go out of their way to avoid what scares them. A person with claustrophobia may be so scared that they actively avoid crowded places or being in a car because they feel so overwhelmed in those environments.
We still don't know exactly what causes anxiety disorders, but we do know that anybody can get them. People with anxiety disorders will experience similar symptoms, like anxious thoughts/beliefs that are hard to control, shortness of breath, pounding or rapid heartbeat, and changes in behavior.
Mood disorders, like the name implies, affect your mood or general emotional state. These types of disorders lead to feelings and thoughts that are distorted or inconsistent with the actual circumstances. Most often, mood disorders will interfere with a person's ability to function because their emotional state is so unbalanced.
The two main types of mood disorders are Depression and Bipolar Disorder.
Depression. Depression is a serious medical illness. It isn't just a person feeling sad or "blue," it's much more intense than that. The feelings of sadness and overwhelmed don't just go away. And for many, the cause of the sadness can't even be explained. If you lose a loved one or got into a fight with somebody you care about, then you might experience sadness. But people with depression might wake up at the start of their day and already feel down and "empty" without anything even happening to them the day before or that current day. Depression can severely interfere with everyday life. A person may lose interest in their favorite activity, or may gain weight because they overeat. There's a constant feeling of tiredness, with no explanation. A person will feel hopeless, irritable, anxious, or guilty. Some people may even have thoughts of death or running away.
(**For anybody reading this with any thoughts of harming themselves, please call the National Suicide Prevention Lifeline at (800)273-8255**)
Bipolar Disorder. Also called Manic-depressive illness. We throw around the word "bipolar" a lot today. Like when someone suddenly changes their mind, someone might comment that they're bipolar. But bipolar disorder is actually a very serious mental illness. People with bipolar disorder will experience unusual mood changes -- they will go from extremely happy and energetic, to hopeless and depressed, then back again. The "up" feeling is called mania. During a state of mania, a person might not sleep for several days because they have so much pent up energy. The "down" feeling is called depression. Bipolar disorder often starts when a person is in their late teens or early adulthood.
Eating disorders are medical conditions, NOT lifestyle choices. A person with an eating disorder suffers from severe problems with thoughts about food and eating behaviors. It's not just a person is on a diet. The person is severely restricting their food intake, often to the point of significant weight loss. That same person is also counting calories of everything they eat or drink. That person refuses to eat out because they can't control what's in their food. Because eating disorders directly affect a person's nutritional intake, they can lead to long-term, physical health problems like fertility issues or heart conditions.
The three common types of eating disorders are:
Binge-eating. A person with binge-eating disorder isn't just killing a bag of chips. The person will lose control of their eating and might eat three bags of chips and a sleeve of oreos. That person will eat beyond the point of feeling full, leading to extreme discomfort. But more so, after a binge episode, a person will experience strong feelings of guilt, shame, and distress due to what happened. Binge-eating can lead to extreme weight gain, and it is the most common eating disorder in the U.S.
Bulimia nervosa. People with bulimia nervosa, bulimia for short, will experience the same kind of binge episode people with binge-eating disorder will. But after the binge, a person with bulimia will purge the food out of guilt and shame for over-eating. A purge can occur by a person forcing themselves to throw up, using laxatives, or over-exercising. Unlike binge-eating disorder or anorexia nervosa, people with bulimia often will remain at their normal weight, making it even harder for other people to detect.
Anorexia nervosa. Anorexia is the least common of the three eating disorders, but it often is the most damaging and serious. Anorexia has the highest rate of death out of any mental disorder. A person with anorexia will restrict their food and avoid certain kinds of food. Many people with anorexia may also have body dysmorphia, meaning they have a skewed idea of what they look like. This means that a person can look at themselves in the mirror and think they actually look two sizes larger than what's actually in the reflection.
Researchers believe that eating disorders are caused by a complex interaction of many factors, such as biological, behavioral, psychological, and social. Anybody is at risk to develop an eating disorder, but they are more common in women. Sometimes, people with one eating disorder may develop one of the other eating disorders instead. For anorexia nervosa, you can also have a bulimia sub-type, which means you have anorexia and are loosing weight, but also experience the same binge-purge episodes that somebody with just bulimia have. The main reason why eating disorders are some of the most severe and long-term damaging mental disorders is that eating disorders directly affect people's physical bodies; eating disorders go beyond just the psychological.
Personality disorders are a group of mental illnesses. The symptoms of each personality disorder are different and can range from mild to severe. One of the common things about personality disorders though is that they often make it hard for people with the disorder to have strong, trusting relationships. A person with a personality disorder often doesn't even realize they have a disorder and will tend to blame others for their problems. This can lead to serious strain on a person's relationships and being able to maintain said relationships.
Personality disorders affect a person's patterns of thoughts and behaviors; they have to do with ingrained, inflexible patterns of perceiving and thinking that impair an individual's functioning. Personality disorders are usually recognized by adolescence or earlier, but become less obvious as the person ages. The three different types of personality disorders are: Cluster A (odd or eccentric behavior), Cluster B (dramatic, emotional, or erratic behavior), and Cluster C (anxious fearful behavior). Within each cluster, there are numerous kinds of specific personality disorders.
Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is one of the more commonly known of the mental disorders. People with PTSD usually develop the disorder after experiencing or seeing a traumatic event. For example, it is common for veterans to be diagnosed with PTSD after returning from combat and witnessing the horrific sights of war. But the traumatic event doesn't necessarily have to entail danger. Sometimes the event could be the sudden, unexpected death of a loved one. It's perfectly normal to feel afraid and upset after a traumatic event occurred to you. The difference for someone with PTSD is they often relive the traumatic event in their head, which means they continually feel the painful after-effects and intense emotions long after the event originally happened. PTSD symptoms may start later than directly after the event, and they symptoms may come and go during a person's lifetime.
Psychotic disorders are also called psychoses, and they cause abnormal thinking and perceptions. People with psychoses will lose touch with reality, experiencing delusions and hallucinations. A delusion is a false belief, like somebody is plotting against you. A hallucination is a false perception, like seeing or hearing something that isn't actually there. Schizophrenia is a type of psychotic disorder and is probably one of the best known out of psychotic disorders. People with other mental disorders may also experience psychoses, such as someone with bipolar disorder may experience delusions during mania. Psychotic episodes can be extremely violent and disturbing, and someone undergoing psychoses may need to be hospitalized because they are a risk to themselves and/or others.