What are the most common Serious Mental Disorders?

Definition of Mental Disorders

            Mental illness refers to a wide range of mental health conditions disorders that affect your mood, thinking and behaviour, psychological disorder or psychiatric disorder, is mental or behavioural pattern that causes either suffering or a poor ability to function in ordinary life. Many disorders are described. Conditions that are excluded include social norms. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviours. Many people have mental health concerns from time to time (Mayo Clinic, 2013).

A mental disorder, also called a mental illness, psychological disorder or psychiatric disorder, is mental or behavioural pattern that causes either suffering or a poor ability to function in ordinary life. Many disorders are described. Conditions that are excluded include social norms. Signs and symptoms depend on the specific disorder. The causes of mental disorders are often unclear. Theories may incorporate findings from a range of fields. Mental disorders are usually defined by a combination of how a person feels, acts, thinks or perceives. This may be associated with particular regions or functions of the brain, often in a social context. A mental disorder is one aspect of mental health. The scientific study of mental disorders is called psychopathology. Services are based in psychiatric hospitals or in the community, and assessments are carried out by psychiatrists, clinical psychologists and clinical social workers, using various methods but often relying on observation and questioning. Treatments are provided by various mental health professionals. Psychotherapy and psychiatric medication are two major treatment options. Other treatments include social interventions, peer support and self-help. In a minority of cases there might be involuntary detention or treatment. Prevention programs have been shown to reduce depression. Common mental disorders include depression, which affects about 400 million, dementia which affects about 35 million, and schizophrenia, which affects about 21 million people globally. Stigma and discrimination can add to the suffering and disability associated with mental disorders, leading to various social movements attempting to increase understanding and challenge social exclusion (Stein, 2013).

1. Schizophrenia as the worst
2. Bipolar as second worst
3. Depression as third worst (although more people with depression are on disability overall)

The law defines the following conditions as a serious mental illness:

1. Schizophrenia
2. Paranoid and other psychotic disorders
3. Bipolar disorders (hypomanic, manic, depressive, and mixed)
4. Major depressive disorders (single episode or recurrent)
5. Schizoaffective disorders (bipolar or depressive)
6. Pervasive developmental disorders
7. Obsessive-compulsive disorders
8. Depression in childhood and adolescence
9. Panic disorder
10. Post traumatic stress disorders (acute, chronic, or with delayed onset)
11. Bulimia Nervosa 307.51
12. Anorexia Nervosa 307.1  (Mental Health Wales, 2015).

Serious mental illness includes diagnoses which typically involve psychosis (losing touch with reality or experiencing delusions) or high levels of care, and which may require hospital treatment. Here we look at two of the most common severe mental illnesses: schizophrenia and bipolar disorder (or manic depression).

SCHIZOPHRENIA

Schizophrenia is a serious mental illness that affects a person's thinking, and that can consequently alter their perception of reality, their emotions and their behaviour. Often the onset of schizophrenia occurs when a person is in their late teens or early twenties, although it can also begin in later years. Approximately 1 in every 100 people will be affected by schizophrenia.

Causes

Scientists have identified a number of potential causes or triggers of schizophrenia - from genetic factors to emotional causes such as a traumatic experience, physical injuries to the brain and problems in the brain's development.

Symptoms

Symptoms of schizophrenia can be put into two categories: positive symptoms and negative symptoms.

Positive symptoms usually occur in the initial phase of the illness. They tend to be the more extreme, and are termed 'positive' because they involve an 'excessive' experience, such as a psychotic or delusional episode. Positive symptoms can include:

• Delusions: personal beliefs that are false and based on incorrect inference about external reality; these beliefs are firmly held despite any evidence to the contrary.
• Hallucinations: when a person experiences or perceives things that don't exist. This may be via any of the senses: a hallucination might be seen, heard, smelt or felt.
• Disturbances in the thought process: these can include a chaotic stream of thoughts or a sudden loss of all thoughts (Mental Health Wales, 2015).

Negative symptoms tend to be longer-term symptoms. They are termed 'negative' because they describe a loss of normal functions - that is, a 'subduing' of experience. Negative symptoms include:

a.      A lack of emotion and motivation

b.      Tiredness or a lack of energy

c.       Becoming withdrawn and isolated

d.      A loss of concentration

e.       A loss of interest in life

f.        Sleep deprivation

Treatment

Schizophrenia is very treatable. People diagnosed with schizophrenia are normally prescribed medication which targets the positive symptoms. There are a number of antipsychotic medications now available, and you can discuss the choice with your doctor, taking into account side-effects and other issues. However, medication should only be a part of a recovery package for schizophrenia (Mental Health Wales, 2015).

BIPOLAR DISORDER (or MANIC DEPRESSION)

Bipolar disorder (or manic depression) is a serious mental illness that causes extreme shifts in a person's mood. People with bipolar disorder often have recurring episodes of mania and depression throughout their lives, although many are free of symptoms between these episodes.

Causes

Bipolar disorder is known to run in families, so genes are believed to be a significant factor. However, as with schizophrenia, stressful life events or physical injuries as well as other factors can lead to the onset of symptoms of the illness (Mental Health Wales, 2015).

Symptoms

The main symptoms of bipolar disorder are as follows:
Manic behaviour such as:

1. A continuous elevated or euphoric mood
2. Irritability and restlessness
3. Increased energy
4. Inflated self-esteem
5. Little need for sleep
6. Talkativeness
7. Increased sex drive
8. Racing thoughts
9. Inability to focus or concentrate
10. Risk-taking
11. Increased spending

Depressive behaviour such as:

1. A persistent subdued or sad mood
2. Anxiety
3. Loss of interest or pleasure in life
4. Change in appetite or body weight
5. Insomnia/oversleeping
6. Fatigue
7. Loss of energy
8. Lack of sex drive
9. Self-harm and suicidal thoughts
10. Feelings of guilt and worthlessness
11. Difficulty concentrating

A person can have symptoms of both mania and depression at the same time. Psychotic behaviour may also be present during severe episodes of either mania or depression. This can include delusions and hallucinations.

Treatment

As with schizophrenia, there are effective treatments available for manic depression. Often care and treatment will combine medication and psychosocial treatment. The most common treatment used during the manic phase of bipolar disorder is lithium carbonate, a mood stabilising medication. Depression may be treated with anti-depressants and talking treatments such as cognitive behavioural therapy (CBT). The most effective care package for serious mental illness takes into account all areas of life. For more information on taking a 'whole person approach' to recovering from serious mental illness, click here (Mental Health Wales, 2015).

Severe mental illness Defined by Duration and Disability

Severe mental illness is often defined by its length of duration and the disability it produces. These illnesses include disorders that produce psychotic symptoms, such as schizophrenia and schizoaffective disorder, and severe forms of other disorders, such as major depression and bipolar disorder.  Illnesses that produce distortions of perception, delusions, hallucinations, and unusual behaviours are sometimes called thought disorders. Because the symptoms reflect a loss of contact with perceived reality, the disorders are also sometimes known as psychotic disorders. Severe mental illnesses are treatable, and with proper treatment and management of the illness, people with these disorders can experience recovery.

Schizophrenia

Schizophrenia is the most common thought disorder. It is not a "split personality" or a "multiple personality." (Hazelden, 2015)

Symptoms of schizophrenia fall into four categories:

Psychotic symptoms (also called positive symptoms) Hallucinations False perceptions False beliefs Bizarre behavior Disordered speech Delusions	Negative symptoms Apathy Loss of interest Poor follow-through Loss of pleasure Illogical, limited amount of speech Lack of facial and vocal expressions
Cognitive symptoms Problems with attention, psychomotor speed Slower processing of information, memory, planning and organizing	Mood Problems with depression, anxiety, anger, mood shifts

Schizoaffective disorder                  

Schizoaffective disorder is quite similar to schizophrenia, and is usually long-term.

People with either schizophrenia or schizoaffective disorder can have symptoms of depression, mania, or both types of symptoms. However, people with schizoaffective disorder tend to have more severe depressive or manic symptoms. This means that the symptoms occur more often and last for longer periods of time (Hazelden, 2015)

Depressive symptoms Feeling hopeless, sad Loss of interest Significant weight change Trouble sleeping or oversleeping Feeling restless or sluggish Feeling worthless or guilty Difficulty concentrating Irritability Thoughts about death or suicide

Manic symptoms Euphoric or irritable mood Decreased need for sleep Grandiosity (thinking you have abilities or powers you don't have) Spending more money than you have Rapid speech and movements Distractedness

Bipolar disorder

Bipolar disorder causes extreme mood swings ranging from mania or extreme happiness, grandiosity, euphoria or irritability, or decreased need for sleep. Typically a person with bipolar disorder cycles from one extreme to the other while experiencing periods with few or no symptoms in between (Hazelden, 2015)

Bipolar disorder is not simply having mood swings. Typically, bipolar disorder involves dramatic shifts not only in mood but in overall outlook, behaviour, and energy level.  The cycles of bipolar disorder include depression, mania and what is referred to as a "mixed state."

The manic symptoms of bipolar disorder include:

1. Decreased need for sleep
2. Inflated self-esteem or grandiosity
3. Racing thoughts
4. Distractibility
5. Increase in goal-directed activities
6. More talkative then usual or more pressured speech
7. Excessive involvement in pleasurable activities that often are self-defeating

Sources

Hazelden (2015). Innovative resources for treating substance use, mental health and co-occuring disorders. Available at http://www.bhevolution.org/public/severe_mental_illness.page Retrieved on 30/08/2015

Mayo Clinic (2013). What is mental disorder? Available at www.mayoclinic.org/diseases-conditions/mental-illness/ Retrieved on 30/08/2015.

Mental Health Wales (2015). What is serious mental illness Available at http://www.mentalhealthwales.net/mhw/whatis.php. Retrieved on 30/08/2015.

Stein, D. J (2013). "What is a mental disorder? A perspective from cognitive-affective science.” Canadian journal of psychiatry. Revue canadienne de psychiatrie 58 (12): 656–662