Mental illnesses

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mental illnesses

Introduction:
Mental illnesses are disorders of the brain that disrupt a person’s thinking, feeling, moods, and ability to relate to others. Mental illness is an illness that affects or is manifested in a person’s brain that often results in a diminished capacity for coping with the ordinary demands of life. It may affect the way a person thinks, behaves, and interacts with other people.
Mental illnesses can affect persons of any age, race, religion, or income. Five million people in the United States alone suffer from a serious chronic brain disorder.
The term "mental illness" encompasses numerous psychiatric disorders, and just like illnesses that affect other parts of the body, they can vary in severity. Many people suffering from mental illness may not look as though something is wrong, while others may appear confused, agitated, or withdrawn.
The term "mental illness" is an unfortunate one because it implies a distinction between "mental" disorders and "physical" disorders. Research shows that there is much that is "physical" in "mental" disorders (and vice-versa). For example, the brain chemistry of a person with major depression differs from that of a non-depressed person, and medication can be used (often in combination with psychotherapy) to bring the brain chemistry back to normal. Similarly, a person who is suffering from hardening of the arteries in the brain—which reduces the flow of blood and thus oxygen in the brain—may experience "mental" symptoms such as confusion and forgetfulness.
The term ‘psychiatric disability’ is used when mental illness significantly interferes with the performance of major life activities, such as learning, thinking, communicating, and sleeping, among others.
Someone can experience a mental illness over many years. The type, intensity and duration of symptoms vary from person to person. They come and go and do not always follow a regular pattern, making it difficult to predict when symptoms and functioning will worsen, even if treatment recommendations are followed. Although the symptoms of mental illness often can be controlled effectively through medication and/or psychotherapy, or may even go into remission, for some people the illness continues to cause periodic episodes that require treatment. Consequently, some people with mental illness will need no support, others may need only occasional support, and still others may require more substantial, ongoing support to maintain their productivity.
Unfortunately, in most parts of the world, mental health and mental disorders are not regarded with anything like the same importance as physical health. Instead, they have been largely ignored or neglected. Partly as a result, the world is suffering from an increasing burden of mental disorders, and a widening "treatment gap". Today, some 450 million people suffer from a mental or behavioral disorder, yet only a small minority of them receives even the most basic treatment. In developing countries, most individuals with severe mental disorders are left to cope as best they can with their private burdens such as depression, dementia, schizophrenia, and substance dependence. Globally, many are victimized for their illness and become the targets of stigma and discrimination.
Mental and behavioral disorders are estimated to account for 12% of the global burden of disease, yet the mental health budgets of the majority of countries constitute less than 1% of their total health expenditures. The relationship between disease burden and disease spending is clearly disproportionate. More than 40% of countries have no mental health policy and over 30% have no mental health program. Over 90% of countries have no mental health policy that includes children and adolescents. Moreover, health plans frequently do not cover mental and behavioral disorders at the same level as other illnesses, creating significant economic difficulties for patients and their families. And so the suffering continues, and the difficulties grow.
In this paper I will focus on some major psychological disorders that are Alzheimer's disease, autism, depression, eating disorders, panic disorder, posttraumatic stress disorders, and schizophrenia.

Alzheimer's Disease:
Alzheimer's Disease is a disorder occurring in the middle age and characterized by relatively consistent changes in the aging brain. This disease usually begins with a defect in recent memory; there is a failure to register current events. As the disease progress, there is a loss of remote memory and a decline in reasoning capacity, confusion, impaired judgment, disorientation, and loss of language skills. Depression and some personality changes are common in early stages of this disorder.
The chances of getting Alzheimer's disease increase with age. It usually occurs after age 65. However, most people are not affected even at advanced ages.
Approximately 100,000 victims die and 360,000 new cases of Alzheimer's disease are diagnosed each year. It is estimated that by 2050, 14 million Americans will have this disease. America is not alone in dealing with this terrible affliction. In every nation where life expectancy has increased, so has the incidence of Alzheimer's disease. Alzheimer's disease is becoming tragically common. It is estimated that by 2020, 30 million people will be affected by this devastating disorder worldwide and by 2050; the number could increase to 45 million.
A variety of possible causes have been suggested. For example, a genetic basis has been suggested by high incidence of AD in certain families. A possible viral origin has been investigated. Also, an autoimmune basis has been hypothesized in which brain protein leaks into circulation through a defective blood brain barrier. In addition, trace metals such as aluminum may be involved in AD. Elevated aluminum levels have been found in the brains of patients who died from AD.
A variety of therapies have been applied in AD, but the results were disappointing. Unsuccessful treatments have included hyperbaric oxygen and chemical agents of many types such as vitamins, vasodilators, and numerous psychotropic drugs.
Autism:
Infantile Autism is considered to be the most severe psychological disorder affecting children. The autistic child has little or no language either receptive or expressive. The child may be mute, or if speech is present it is echolalic, which means that the child will echo other people’s voices or what he hears on television. Receptive speech is also deficient, in that the child may be able to respond only to simple commands ("sit down", "eat", "shut the door", etc), and not to abstract speech such as pronouns (yours, mine, his, etc). The child’s failure to express or understand language is the most common complaint that the parents have when they bring their child for examination. The problem of language can be identified during the child’s second year of life.
The child behaves as if he or she has an apparent sensory deficit; that is; behaves as if blind and deaf. Usually, autistic children will not maintain eye-to-eye contact with the parents and/or will not orient their head in a reliable manner to other people’s speech.
Autistic children usually do not develop close relationships with their parents and do not develop toy play the way average children do. They show no particular interest in toys and do not usually spend their spare time playing with them. Autistic children often are delayed or fail to develop common self-help skills such as dressing, eating, and toileting themselves.
It is generally accepted that autism is caused by abnormalities in brain structures or functions. Using a variety of new research tools to study human and animal brain growth, scientists are discovering more about normal development and how abnormalities occur.
Today, more than ever before, people with autism can be helped. A combination of early intervention, special education, family support, and in some cases, medication, is helping increasing numbers of children with autism to live more normal lives. Special interventions and education programs can expand their capacity to learn, communicate, and relate to others, while reducing the severity and frequency of disruptive behaviors. Medications can be used to help alleviate certain symptoms.
Depression:
Depression is a term used to describe a mood, a symptom, and syndromes of affective disorders. As a mood, it refers to a transient state of feeling sad, cheerless, unhappy, and down. As a symptom, it refers to a complaint that often accompanies a group of biopsychosocial problems. In contrast the depressive syndromes include a wide spectrum of psychobiological dysfunctions that vary in frequency, severity, and duration. Normal depression is a transient period of sadness and fatigue that generally occurs in response to identifiable stressful life events. The moods associated with normal depression vary in length but do not exceed 7 to 10 days. If the problems continue for a longer period and if the symptoms grow in complexity and severity, clinical levels of depression may be present; clinical depression generally involves sleep disorders, anergia, hopelessness, and despair. Some times problems assume psychotic proportions, and the depressed individual may attempt suicide and/or may experience hallucinations, delusions, and serious psychological and motor retardation.
There are three major common types of depressive disorders, which differ in the number of their symptoms, severity and persistence.
·     Major depression: it is manifested by several symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
·     Dysthymia: involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
·     Bipolar disorder: also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, over talkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment.
Eating disorders:
The eating disorders anorexia nervosa and bulimia, have attracted a considerable amount of attention in the past few years
·     Anorexia nervosa: occurs when someone deliberately restricts their food intake beyond
a point where the body is able to sustain itself. Someone is defined as anorexic at the point at which they have lost 25 per cent of their body weight. Anorexic are often teenage girls, although not always. Anorexic tend to be preoccupied by their weight, and seem to have a severely distorted body image, such that they regard themselves as fat even when they are not. This means that they refuse to eat. Anorexic will often hide food away to avoid eating it.
There have been a number of theories to explain anorexia. One theory is that girls who become anorexic are unconsciously trying to hold back the onset of maturity, because they do not want to face up the full social role as women in modern society. Another view is that it is unconsciously seen as a way of avoiding pregnancy because fatness and pregnancy are seen as the same thing.
Anorexic patients often have to be hospitalized, and closely watched to sure that they start eating again. Often the treatment will follow a behavior-shaping pattern in which any privilege is dependent on their eating something.
·     Bulimia: is an eating disorder that is similar to anorexia and which also often affects
teenage girls, though it can affect older people too. In this syndrome, the person is still extremely concerned about her own weight, but she becomes obsessed by food. Bulimic patients tend to alternate between eating excessively and by trying to get rid of what they have eaten by throwing up. This problem can lead to a number of serious physiological problems like serious digestive problems. A bulimic person turns to food to compensate for loneliness, temporary stress or feeling of social inadequacy. As a consequence, the treatment of bulimia often involves teaching the patients new ways of living, such as social interaction skills and alternative ways of handling stress.
Generally, bulimics tend to hide their behavior from others because they feel very ashamed of it. As a result, they can suffer from loneliness without any close friends. This leaves them alone with their problem; consequently, it may become more severe.
Panic disorder:
Five criteria have been established as defining panic disorder and are as follows:
1-     At some time panic attack occurs that is unexpected and not tied to a specific situation.
2-     Four such attacks occur within a 4-week period.
3-     The following symptoms: chest pain, heart palpitations, shortness of breath, dizziness or abdominal distress.
About 1.7% of the adult U.S. population ages 18 to 54 - approximately 2.4 million Americans has panic disorder in a given year with a higher rate among women.
Heredity, other biological factors, stressful life events, and thinking in a way that exaggerates relatively normal bodily reactions are all believed to play a role in the onset of panic disorder. The exact cause or causes of panic disorder are unknown and are the subject of intense scientific investigation.
Treatment for panic disorder includes medications and a type of psychotherapy known as cognitive-behavioral therapy, which teaches people how to view panic attacks differently and demonstrates ways to reduce anxiety. Appropriate treatment by an experienced professional can reduce or prevent panic attacks in 70% to 90% of people with panic disorder. Most patients show significant progress after a few weeks of therapy. Relapses may occur, but they can often be effectively treated just like the initial episode.     
Posttraumatic stress disorder:
Posttraumatic stress disorder is unique among other psychiatric diagnoses because of the great importance placed on the etiological agent, the traumatic stressor. In fact, one cannot make a PTSD diagnosis until the patient has actually the stressor criterion, which means that he or she has been exposed to a historical event considered traumatic. Clinical experience with the PTSD has shown, however, that there are individual differences regarding the capacity to deal with catastrophic stress. Although some people exposed to traumatic events do not develop PTSD, others go on to develop the full-blown syndrome. Because of individual differences in this appraisal process, different people appear to have different trauma thresholds.
Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. PTSD is diagnosed when symptoms last more than 1 month.
About 3.6 percent of U.S. adults ages 18 to 54 (5.2 million people) have PTSD during the course of a given year. About 30 percent of the men and women who have spent time in war zones experience PTSD. One million war veterans developed PTSD after serving in Vietnam. PTSD has also been detected among veterans of the Persian Gulf War, with some estimates running as high as 8 percent.
PTSD can develop at any age, including in childhood. Symptoms typically begin within 3 months of a traumatic event, although occasionally they do not begin until years later. Once PTSD occurs, the severity and duration of the illness varies. Some people recover within 6 months, while others suffer much longer.
Research has demonstrated the effectiveness of cognitive-behavioral therapy, group therapy, and exposure therapy, in which the patient gradually and repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma.
     Schizophrenia:
     Schizophrenia is a complex psychobiological illness in which the individual experiences major changes in personality and major disabilities in the conduct in his or her life. The name of schizophrenia refers to a split between the mind and reality, which means that Schizophrenic have retreated from reality into a private world. The illness has a predictable course with a predictable outcome. Till now, neither the exact cause of Schizophrenia nor its cure is known. However, we do know some of the genetic pre-determinants, some of the biological reactions, and some of the interpersonal and social situations that induce symptoms in individuals who suffer from Schizophrenia.
Overall, there seem to be four main factors involved in the onset of Schizophrenia. Each of these four factors have at some time or other been proposed as the sole cause of the disorder, but modern thinking suggests that all of them act together. The four factors are: genetics, family influence, brain chemistry, and the role of society.
The official diagnostic system of the American psychiatric Association known as (DSM IV) requires the existence of Schizophrenic illness for at least 6 months, thus defining Schizophrenia as a chronic illness. It also requires the presence of at least one of the following during the active face of the illness:
1-     Bizarre delusions.
2-      Somatic, grandiose, religious, or other delusions without persecutory or jealous content.
3-     Delusions with persecutory or jealous content.
4-     Auditor hallucination.
5-     Incoherence, marked loosening of associations, or marked illogical thinking.
The DSM also requires evidence of deterioration from previous level of function in work, social relations, and self care. The diagnostic manual subdivides Schizophrenia into the disorganized type, the catatonic type, the paranoid type, the undifferentiated type, and the residual type. The subtypes are characterized by various symptoms.
Children over the age of five can develop schizophrenia, but it is very rare before adolescence. Although some people who later develop schizophrenia may have seemed different from other children at an early age, the psychotic symptoms of schizophrenia – hallucinations and delusions – are extremely uncommon before adolescence.
The illness begins usually in adolescence (ages 13 to 17). Often this early episode is misdiagnosed. The initial episode is usually self-limiting, lasting few weeks, followed by remission in which the patient appears near normal. The second episode appears within 6 months to 1 year and tend to be more severe than the first; it lasts for few weeks and demonstrate psychiatric symptoms. The third episode of the illness is considered to be the most definable episode of psychosis. This occurs within a year or two of the initial episode and results in major disruptions in the patient’s life.
The subsequent course of the illness is marked by exacerbations and remissions. The number of exacerbations the patient experiences each year is related to the age and not to the treatment received or the environment. Between the age of 20 and 30, the patient will experience an average of six exacerbations per year. Between the age of 30 and 40, the patient will experience two exacerbations per year, and between 40 and 50 one exacerbation per year. During the exacerbations the patient has frank psychotic symptoms, including delusions and hallucinations, disorganization of thought, and inability to function. During the remissions, the patient is quite often free of psychotic symptoms, particularly if given appropriate psychopharmacological agents.
There is one type of schizophrenia that has a somewhat later onset-paranoid schizophrenia. The usual of onset is in the early 20s for that particular disorder.
Suicide is a serious danger in people who have schizophrenia. If an individual tries to commit suicide or threatens to do so, professional help should be sought immediately. People with schizophrenia have a higher rate of suicide than the general population. Approximately 10 percent of people with schizophrenia (especially younger adult males) commit suicide. Unfortunately, the prediction of suicide in people with schizophrenia can be especially difficult.
Schizophrenia seems to occur in approximately 1 % of the population. The incidence is very similar in all cultures and subcultures, in industrial as well as preindustrial societies, and in all human races. There no evidence that social class differences affect the incidence of schizophrenia.
Starting the 1980’s, treatment of schizophrenia consisted of psychopharmacology, psychotherapy, and environmental manipulation. With good supportive therapy, the quality of life of schizophrenic patients could greatly improve. The patient could spend most of his or her life in the community rather than in the hospital. Environmental manipulation consists of helping the patient to create a psychosocial milieu in which disabilities are minimized and the patient is most comfortable.
The outlook for people with schizophrenia has improved over the last 25 years. Although no totally effective therapy has yet been devised, it is important to remember that many people with the illness improve enough to lead independent, satisfying lives. As we learn more about the causes and treatments of schizophrenia, we should be able to help more patients achieve successful outcomes.
     Conclusion:
     Mental illness is a term rooted in history that refers collectively to all of the diagnosable mental disorders. Mental disorders are characterized by abnormalities in cognition, emotion or mood, or the highest integrative aspects of behavior.
Mental disorders are common in the United States and internationally. An estimated 22.1 percent of Americans ages 18 and older—about 1 in 5 adults—suffer from a diagnosable mental disorder in a given year.
It is a myth that mental illness is a weakness or defect in character and that sufferers can get better simply by "pulling themselves up by their bootstraps." Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. Mental illnesses are real illnesses—as real as heart disease and cancer—and they require and respond well to treatment.


     


     References:
Psychology: Bernstein, Clarke-Stewart, Penner, Roy, Wickens. Fifth Edition.
Foundations of Psychology: Nickey, Hayes, 1994.
Concise Encyclopedia of Psychology: Corsini, Auerbach, Second Edition.
Behavior and Personality, Psychological Behaviorism: Arthur, W. Staats.

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