Wednesday, 17 May 2017

Mental Health Disorders Explained | Mental Health Awareness Month

     Hello my pretties. Happy Mental Health Awareness Month! I hope you all are doing well. Even though school is out I am still crazy stressed out about next semester. There will be many changes made this coming semester but we don't need to discuss or worry about them until it's time.
     Anyways, today I thought I would talk about the top five most commonly diagnosed mental health disorders. I got the top five list from my therapist but all the information I will be talking about comes from my Abnormal Psychology textbook by Thomas F. Outmans and Robert E. Emery as well as excerpts from the Diagnostic and Statistical Manual (DSM-5). This post will probably be one of my longer post so please bare with me. So let's begin.

     Before I begin, I just want to explain how I'm formatting this post. Under each disorder will be a description of what it is and just general information about it. I will also include diagnostic criteria and medication treatment for it. All these disorders should be treated by seeing a therapist as well.

1. Generalized Anxiety Disorder
Excessive anxiety (irrational fear) and worry are the two primary symptoms of Generalized Anxiety Disorder (GAD). To meet the criteria for this disorder the person must have:

A. Trouble controlling these worries and they must cause significant distress or impairment in occupational or social function.
B. The worry must occur more days than not for a period of at least six months and it must be present in a number of activities and events.
C. The worry must not be focused on having a panic attack (panic disorder), being embarrassed in public (social anxiety), or being contaminated (obsessive compulsive disorder).
D. Must have at least three of the of the six symptoms listed below.

Other symptoms according to the DSM-5 include:
1. restlessness or feeling keyed up or on edge
2. being easily fatigued
3. difficulty concentrating or mind going blank
4. irritability
5. muscle tension
6. sleep disturbance

Treatments include:
A. Benzodiazepines such as Xanax (Alprazolam) or Klonopin (Clonalepam).
B. Antidepressant medications such as the SSRIs listed below.

2. Major Depressive Disorder 
It should be no surprise that Major Depressive Disorder (MDD) is number two on this list. Major Depressive Disorder is characterized by at least one major depressive episode in the absence of any history of manic episodes. Most people with MDD make a full recovery but most cases follow and intermittent course with repeated episodes. In that case, a diagnosis of Persistent Depressive Disorder (Dysthymia) is made but for the sake of this post I am going to focus solely on MDD.

To meet the criteria for Major Depressive Disorder, you must have:

     A. Five (or more) of the following symptoms have been present during the same two week period.
You must have at least one of these symptoms (along with the other five or more), (a) depressed mood or (b) loss of interest or pleasure.

Other symptoms according to the DSM-5 include:
- Note: All of these must be indicated by a subjective report or noticed by others

     1. Depressed mood most of the day, nearly every day, (i.e. feeling sad, empty or hopeless).              
         - Note: In children or adolescence, can be irritable mood.
     2. Little to no interest or pleasure in all, or almost all, activities most of the day, nearly every day.
     3. Significant weight loss when not dieting or weight gain (5% of body weight in a month) or decrease/increase in appetite nearly every day.
     - Note: In children consider failure or make expected weight gain.
     4. Insomnia or hypersomnia nearly everyday.
     5. Psychomotor agitation or retardation nearly every day. 
     6. Fatigue or loss of energy nearly every day.
     7. Feelings of worthlessness or excessive or inappropriate guilt (may be delusional) nearly every day.
     8. Diminished ability to think or concentrate, or indecisiveness, nearly every day. 
     9. Recurrent thoughts of death (not fear of dying), recurrent suicidal ideation without a plan or suicide attempt or a specific plan for committing suicide. 

B. Symptoms must cause significant distress or impairment in social, occupational or other important areas of functioning.
C. The episode is not attributable to the psychological effects of a substance or another medical condition.
D. The occurrence or the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, delusional disorder, or other specified/non-specified schizophrenia spectrum and other psychotic disorder.
E. There has never been a manic episode or hypomanic episode.

Treatments include: 
a. Selective Serotonin reuptake inhibitors (SSRIs) such as Prozac (Fluoxetine) and Zoloft (Sertraline).
b. Tricyclic antidepressants (TCAs) such as Elavil (Amitriptyline) and Tofranil (Imipramine).

3. Bipolar Disorder Type II
Bipolar disorder is characterized by major depressive episodes as explained above as well as manic or hypomanic episodes. A hypomanic episode is characterized by episodes of increased energy that are not sufficiently severe enough to qualify as full-blown mania. People have at least one major depressive episode and at least one hypomanic episode would be given a diagnosis of Bipolar Type II, which is more common than Bipolar Type I.

To meet the criteria for Bipolar Disorder Type II, you must have three of the seven symptoms (listed below) for a manic disorder and must be present for only three-four days (versus seven days for a full-blown manic episode).

A. A distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally persistently increased goal-directed activity or energy, lasting seven days and present most of the days, nearly every day.
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is irritable) are present to a significant degree and represent a noticeable change from usual behavior.

Other symptoms according to the DSM-5 include:
    1. Inflated self-esteem or grandiosity.
    2. Decreased need for sleep (feels rested after only three hours of sleep).
    3. More talkative than usual or pressure to keep talking.
    4. Flight of ideas or subjective experience that thoughts are acting.
    5. Distractibility (attention too easily drawn to unimportant or irrelevant external stimuli).
    6. Increase in goal-directives activity either socially, at work, school or sexually, or psychomotor agitation. (purposelessness nongoal-directed activity).
    7. Excessive involvement in activities that have a high potential or painful consequences (unrestrained shopping sprees, sexual indiscretions or foolish business investments).

C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others or there are psychotic features.
D. The episode is not attributable to the physiological effects of a substance (drug abuse, a medication, other treatment) or to another medical condition.

Treatments include:
a. Lithium is said to be extremely helpful for people with bipolar disorder especially if they take it during a depressive disorder and if they take it between episodes it can help reduce the risk for a relapse.
b. Antipsychotic medications such as Abilify (Aripiprazole) as well as the antidepressant medications mentioned earlier.

4. Post Traumatic Stress Disorder
Post Traumatic Stress Disorder (PTSD) obviously follows a trauma such as rape, military combat, bombings, airplane crashes, car crashes, earthquakes, and major fires. PTSD has a delayed onset and lasts longer than one month. (If the stress of a trauma occurs within a month post exposure to said trauma it is called Acute Stress Disorder). Both ASD and PSTD have the same symptoms but the duration is what differs ASD from PTSD.

To meet the criteria for Post Traumatic Stress Disorder you must have only four of the five symptoms.

A. Exposure to actual or threatened death, serious injury or sexual violence in one (or more) of the following ways:
    1. Directly experiencing the traumatic event(s).
    2. Witnessing, in person, the event(s), as it occurs to others.
    3. Learning that the traumatic events :s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
    4. Experiencing repeated or extreme exposure to averse details of the traumatic event(s) such as first responders picking up human remains, police officer repeatedly exposed to details of child abuse etc...
    - Note: Criterion A4 does not apply to exposure via electronic media, TV, movies or pictures unless this exposure is work related.

Other symptoms according to the DSM-5 are:
    1. Recurrent, involuntary and intruding distressing memories or the traumatic event(s).
    - Note: In children 6 years and older, receptive play may occur in which themes or aspects of the traumatic event(s) are expressed such as a child playing the "vagina game" with a toy doll turned out to be a victim of child abuse.
    2. Recurrent distressing dreams in which the content and/pr affect of the dream are related to the traumatic event(s).
    - Note: In children, there many be frightening dreams without recognizable content.
    3. Dissociative reactions such as flashbacks, in which the individual feels or acts as if the traumatic event(s) were recurring. Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awards of present surroundings).
     - Note: In children, trauma-specific reenactment may occur in play.
    4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

C. Persistent avoidance os stimuli associated with the traumatic event(s) beginning after the traumatic event(s) occurred as evidenced by one or both of the following.
    1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
    2. Avoidance of or efforts to avoid external reminders such as people, places, conversations, activities, objects, situations etc...that arouse distressing memories, thoughts or feelings about or slowly associated with the traumatic event(s).

D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
    1. Inability to remember important aspects of the traumatic event(s) typically due to dissociative amnesia and not to other factors such as head injury, alcohol or drugs.
    2. Persistent and exaggerated negative beliefs or expectations about oneself, others or the world such as, "I am bad." "Anyone can betray anyone." "The world is completely dangerous." "My whole nervous system is permanently ruined."
    3. Persistent distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
    4. Persistent negative emotional state such as always being fearful, angry, horrified, guilty or shameful.
    5. Markedly diminished interest or participation in significant actives.
    6. Feelings of detachment or estrangement from others.
    7. Persistent inability to experience positive emotions such as happiness, satisfaction or loving feelings.

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
    1. Irritable behavior or angry outburst with little or not provocation, typically expressed as verbal or physical aggression towards people or objects.
    2. Recklessness or self-destructive behavior,
    3. Hypervigilance.
    4. Exaggerated startle response.
    5. Problems with concentration.
    6. Sleep disturbances such as trouble falling or staying asleep or restless sleep.

F. Duration of the disturbance (criteria B, C, D, and E) is more than one month,

G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

H. The disturbance is not attributable to the physiological effects of a substance such as medication, alcohol or another medical condition.

Treatments include:
a. SSRI medications are the main source of treatment for people with PTSD.
b. Antianxiety medications are not effective for PTSD.

5. Substance Abuse
Substance abuse can come in many forms but the main forms are drugs (either prescription or illegal) and alcohol. This disorder is probably one of the most common cases of death, especially for celebrities such as Heath Ledger, Cory Monteith, Prince, Judy Garland, Michael Jackson just to name a few.

To meet the criteria for Substance abuse you must have:

A. A problematic patter ot alcohol or drug use leading to a clinically significant impairment or distress, as manifested by at least two of the following, occurring within a twelve month period.

Other symptoms according to the DSM-5 are:
    1. Alcohol or drugs are often taken in a larger amount or over a long period than was intended.
    2. There is a persistent desire or unsuccessful effort to cut down or control alcohol or drug use.
    3. A great deal of time is spent in activities necessary to obtain alcohol or drugs, use alcohol or drugs, or recover from its effects.
    4. Craving, or a strong desire or urge to use alcohol or drugs.
    5. Recurrent alcohol or drug use resulting in a failure to fulfill major role obligations at work, school or home.
    6. Continued alcohol or drug use despite having persistent or recurrent social or interpersonal problems cause or exerted by the effects of alcohol or drugs.
    7. Important social, occupational to recreational activités are given up or reduced because of alcohol or drug use.
    8. Recurrent alcohol or drug use in situations in which is is physically hazardous.
    9. Alcohol or drug use is continued despite having knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol or drugs.
    10. Tolerance, as defined by either of the following.
        a. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
        b. A markedly diminished effect with continued use of the same amount of alcohol or drugs.
    11. Withdrawal, as manifested by either of the following:
        a. The characteristics withdrawal syndrome for alcohol or drug are present.
        b. Alcohol or drugs (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

Treatments include:
a. Going to a rehab facility.
b. There are no medications to treat alcohol or drug abuse.

    So that concludes my post about the top five most commonly diagnosed mental health disorders. As always, please share this post if you liked it and leave a comment for me below if you would like me to do a post on a particular topic pertaining to mental health. Have a great week and I’ll catch you all in my next post!

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