Transcript February 1, Types of Mental Illness

TYPES OF MENTAL ILLNESS
“NEUROSES”
• NO BREAK WITH REALITY
• DEPRESSION, ANXIETY, SUBSTANCE
ABUSE
• VERY COMMON
• CONTINUOUS NOT DISCRETE
• MUCH CO-MORBIDITY
MOOD
• EITHER (OR BOTH) PRESENCE OF
NEGATIVE MOOD
• OR ABSENCE OF POSITIVE MOOD
PHYSICAL SYMPTOMS
•
•
•
•
LOW ENERGY, FATIGUE
SLEEP DISTURBANCES
APPETITE DISTURBANCES
VULNERABILITY TO MANY
PHYSICAL ILLNESSES
PSYCHOLOGICAL SYMPTOMS
• EMOTIONAL - SADNESS, APATHY,
LACK OF PLEASURE
• COGNITIVE - HOPELESSNESS AND
HELPLESSNESS, LOW SELF-ESTEEM
• BEHAVIORAL - WITHDRAWAL,
SUICIDE ATTEMPTS
TYPES
• MAJOR DEPRESSION - ABOVE
• PSYCHOTIC - MORE SEVERE,
IMMOBILE, SUICIDAL
• DYSTHYMIA - LONGER LASTING
(TWO YEARS), LOWER LEVEL
• DISTRESS - REACTIVE TO LIFE
EVENT, GOES AWAY WHEN
CONDITIONS CHANGE, NOT A
DISORDER
CAUSES
•
•
•
•
VARIED
SOME GENETIC
EARLY LOSS EVENTS AND ABUSE
CURRENT LOSSES OR TRAUMAS
CHARACTERISTICS
• GREAT VARIANCE ACROSS SOCIETIES
(3% - 30%)
• IN U.S. 10% EACH YEAR; 20% OVER
LIFETIME
• 2/3 WOMEN
• INVERSE WITH SOCIAL CLASS
• MOST AMONG YOUNG, ELDERLY
PROGNOSIS (COURSE)
•
•
•
•
COURSE HIGHLY VARIABLE
MDD FREQUENT AND CHRONIC
DYSTHYMIA CHRONIC
DISTRESS ENDS WITH POSITIVE
EVENTS OR ADJUSTMENT
TREATMENT
• TREATED WITH SELECTIVE
SEROTONIN REUPTAKE INHIBITORS
(SSRI) - PROZAC, PAXIL, XOLOFT
• NOT MORE EFFECTIVE THAN OLDER
DRUGS
• BETTER TOLERATED, LESS
ADDICTIVE, FEWER OVERDOSES
• HIGHER RISK OF SUICIDE?
TREATMENT (CONT.)
• COGNITIVE THERAPY
• PSYCHOTHERAPY
• COMBINATION OF DRUGS AND
PSYCHOLOGICAL THERAPY MIGHT
BE BEST
SYMPTOMS
• PSYCHOLOGICAL
• UNEASE, FEAR, ANXIOUSNESS,
DREAD
• PHYSICAL
• HEART PALPITATIONS, TREMBLING,
STOMACH UPSET, FAINTING
MAJOR TYPES
• PHOBIAS - INTENSE FEAR OF A
SPECIFIC OBJECT OR SITUATION
• PANIC - SITUATIONAL, EPISODIC
• OBSESSIVE-COMPULSIVE PREOCCUPYING THOUGHTS OR
BEHAVIORS
• GENERALIZED ANXIETY DISORDER
COMORBIDITY
• VERY HIGH COMORBIDITY WITH
DEPRESSION
• MOST DEPRESSED PEOPLE ALSO
ANXIOUS
• ANXIOUS PEOPLE OFTEN DEPRESSED
CHARACTERISTICS
• GREAT VARIANCE ACROSS SOCIETIES
• IN U.S. 20% EACH YEAR, 30% OVER
LIFETIME
SOCIAL CHARACTERISTICS
• 2/3 FEMALE
• HIGH ETHNIC VARIATION
• E.G. BLACKS MORE PHOBIAS,
HISPANICS MORE PANIC, JEWS MORE
OBSESSIVE-COMPULSIVE
TREATMENT
•
•
•
•
MEDICATION
ANTI-ANXIETY - XANAX
SSRI’S
BEHAVIOR THERAPY
SUBSTANCE
DEPENDENCE/ABUSE
• DEPENDENCE
• FREQUENT AND EXCESSIVE USE
• GROWING TOLERANCE/PROBLEMS
WITH WITHDRAWAL
• ABUSE
• PROBLEMATIC CONSEQUENCES OF
USE - FAMILY, WORK, LEGAL
CHARACTERISTICS
• ALCOHOL ABUSE OR DEPENDENCE 10% YEAR, 25% LIFETIME
• DRUG ABUSE OR DEPENDENCE - 3%
YEAR; 12% LIFETIME
CHARACTERISTICS
•
•
•
•
•
2/3 MALE
YOUNG PEOPLE
MIXED RESULTS ON SOCIAL CLASS
MUCH ETHNIC VARIATION
E.G. ISLAMIC, ASIANS, JEWS LITTLE,
IRISH AND EASTERN EUROPE MUCH,
BLACKS CURVILINEAR
TREATMENT
•
•
•
•
VARIATION IN TREAT OR PUNISH?
MUCH TREATMENT INVOLUNTARY
GROUP THERAPY - AA
LESS MEDICATION