Mental Illness

Anxiety disorders are the most common and treatable mental health disorders, affecting more than 19 million people a year. There is a difference between everyday anxiety and anxiety disorders. People with anxiety disorders feel significant tension when there is no real danger and take extreme action to avoid the source of their anxiety. They know their reactions aren’t always logical but cannot control them. As with all mental health disorders, they can interfere with everyday functioning in life and work roles.

Anxiety disorders fall into five main categories:

Panic Disorder

Signs and symptoms include: a sense of terror or doom, rapid heartbeat, sweating, dizziness, shallow breathing, shaking. Some think they are having a heart attack and go to the ER.

Phobias

Irrational fears of certain objects or situations that are disruptive to a person’s life. Specific phobias can include fear of flying, elevators, heights, meeting new people (social phobia), and places they fear are hard to escape from (agoraphobia).

Obsessive-Compulsive Disorder

Unexpected attacks of fear - panic attacks - and fear of having these attacks. Signs and symptoms include thoughts (obsessions) or practicing rituals (compulsions) that the person cannot control.

Generalized Anxiety Disorder

Six months or more of persistent feelings of exaggerated worry and tension that are unfounded and unrelenting. Symptoms may include fatigue, headaches and irritability.

Post-Traumatic Stress Disorder (PTSD)

Delayed reaction to a traumatic event such as war, accident or attack. Signs and symptoms include flashbacks, nightmares and intense emotions.

Though specific anxiety disorders differ, two general treatment methods, therapy and medications, have proven effective. In cognitive behavioral therapy, the person learns to replace anxious thoughts and actions with positive, rational ones and learns techniques of stress reduction.

Bipolar Disorder, also known as manic depression, is a mental health disorder involving extreme mood swings. A person’s mood can swing from mania, an excessive “high” to a deep depression, with periods of normal mood in between. The length of each mood can vary from days to months.

More than 2.5 million Americans have the disorder. Studies show that 80-90% of those with bipolar disorder have relatives with some form of depression. Bipolar disorder can be triggered by this genetic vulnerability and environmental factors.

Signs and symptoms of mania include:

• Excessive energy, activity, restlessness, racing thoughts and rapid talking
• Feel on top of the world
• Overconfident
• Easily irritated or distracted
• Decreased need for sleep
• Uncharacteristically poor judgment
• Increased sexual drive
• Abuse of drugs

Signs and symptoms of depression include:

• A persistent sad, helpless and hopeless mood
• Loss of interest or pleasure in activities once enjoyed
• Sleeping too little or too much
• Reduced appetite and weight loss or increased appetite and weight
• Fatigue or loss of energy
• Low self esteem, feelings of worthlessness and guilt
• Agitation or irritability
• Difficulty concentrating or making decision
• Thoughts of death or suicide

Treatment is essential for recovery and bipolar disorder is treatable with medication in combination with therapy. Mood stabilizers and other drugs are available to help manage the different symptoms and newer drugs are becoming available every day. Therapy helps with relationships and learning coping strategies. Support groups are also an important resource for connecting to others, for families and loved ones as well as the person with bipolar disorder.

Clinical depression is a serious medical illness that affects 11 million Americans each year, children as well as adults. 25% of women and 10% of men will experience one or more episodes of depression during their lifetimes. Complex interactions involving brain structures and brain chemistry are connected to a clinical depression.

Depression affects mood, feelings and behavior. People with depression feel sad, helpless and hopeless and don’t find much pleasure in life. A single event, such as the loss of a loved one, loss of a job or developing a chronic illness can bring on depression. Factors such as family history, prolonged stress, serious illness, medicines and abuse of alcohol and drugs may contribute to depression.

Signs and symptoms, lasting two weeks or longer, can include:

• A persistent sad, helpless and hopeless mood
• Loss of interest or pleasure in activities once enjoyed
• Reduced appetite and weight loss or increased appetite and weight gain
• Sleeping too little or too much
• Fatigue or loss of energy
• Low self-esteem, feelings of worthlessness and guilt
• Agitation or irritability
• Difficulty concentrating or making decisions
• Thoughts of death or suicide

It is important for persons experiencing a clinical depression to get proper treatment. The good news about depression is that there are effective treatments available today. Treatments include therapy and/or medication that help you get back into life.

A person who has both an alcohol or drug problem and an emotional/psychiatric problem is said to have a co-occurring disorder. To recover fully, the person needs treatment for both problems.

How common is a Co-Occurring Disorder?

It is more common than you might imagine. According to a report published by the Journal of the American Medical Association:

"Thirty-seven percent of alcohol abusers and fifty-three percent of drug abusers also have at least one serious mental illness. Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs."

What kind of mental or emotional problems are seen in people with a co-occurring disorder?

The following psychiatric problems commonly occur in tandem with alcohol or drug dependency:

• Depressive disorders, such as depression and bipolar disorder.
• Anxiety disorders, including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and phobias.
• Other psychiatric disorders, such as schizophrenia and personality disorders

Which develops first - substance abuse or the emotional problem?

It depends. Often the psychiatric problem develops first. In an attempt to feel calmer, more peppy, or more cheerful, a person with emotional symptoms may drink or use drugs; doctors call this "self-medication." Frequent self-medication may eventually lead to physical or psychological dependency on alcohol or drugs. If it does, the person then suffers from not just one problem, but two. In adolescents, however, drug or alcohol abuse may merge and continue into adulthood, which may contribute to the development of emotional difficulties or psychiatric disorders.

In other cases, alcohol or drug dependency is the primary condition. A person whose substance abuse problem has become severe may develop symptoms of a psychiatric disorder: perhaps episodes of depression, fits of rage, hallucinations, or suicide attempts.

If someone I know appears to have a substance abuse problem and the symptoms of a psychiatric disorder, how can I help?

Encourage the person to acknowledge the problems and seek help for themselves. Suggest a professional evaluation with a licensed physician, preferably at a medical center that’s equipped to treat addiction problems and psychiatric conditions. If the person is reluctant, do the legwork yourself - find the facility, make the appointment, offer to go with the person. A little encouragement may be all it takes. If you talk to the physician first, be honest and candid about the troubling behavior. Your input may give the doctor valuable diagnostic clues.

There Is Hope

As a relative or friend, you can play an important role in encouraging a person to seek professional diagnosis and treatment. By learning about co-occurring disorders, you can help this person find and stick with an effective recovery program.

The more you know about co-occurring disorders, the more you will see how substance abuse can go hand-in-hand with another psychiatric condition. As with any illness, a person with a co-occurring disorder can improve once proper care is given. By seeking out information, you can learn to recognize the signs and symptoms and help someone live a healthier or more fulfilling life.

Schizophrenia affects 2.5 million persons in the United States and knows no racial, cultural or economic boundaries. It is a mental health disorder that affects the way a person thinks, feels and acts. The person may have trouble concentrating or organizing thoughts, expresses inappropriate emotions or is unable to express emotions at all.

Signs and Symptoms include:

• Delusions which are false beliefs
• Hallucinations which include imaginary voices that give commands or insults
• Disordered thought or speech
• Social withdrawal
• Apathy

Medications, therapy and rehabilitation programs (skill development) are treatment options for persons with schizophrenia.