What is mental illness?
- A mental illness is a disease that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines.
- There are more than 200 classified forms of mental illness. Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality, personal habits and/or social withdrawal.
- Mental health problems may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, mental illnesses are often physical as well as emotional and psychological. Mental illnesses may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination of these.
Early Warning Signs:
Not sure if you or someone you know is living with mental health problems? Experiencing one or more of the following feelings or behaviors can be an early warning sign of a problem:
- Eating or sleeping too much or too little
- Pulling away from people and usual activities
- Having low or no energy
- Feeling numb or like nothing matters
- Having unexplained aches and pains
- Feeling helpless or hopeless
- Smoking, drinking, or using drugs more than usual
- Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared
- Yelling or fighting with family and friends
- Experiencing severe mood swings that cause problems in relationships
- Having persistent thoughts and memories you can’t get out of your head
- Hearing voices or believing things that are not true
- Thinking of harming yourself or others
- Inability to perform daily tasks like taking care of your kids or getting to work or school
What Is Mental Health?
Mental health includes an individual’s emotional, psychological, and social well-being. It affects how people think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood. Over the course of your life, if you experience mental health problems, your thinking, mood, and behavior could be affected. Many factors contribute to mental health problems, including:
- Biological factors, such as genes or brain chemistry
- Life experiences, such as trauma or abuse
- Family history of mental health problems
Mental health problems are common but there are treatment options and people with mental health problems can get better and many can recover completely.
Mental Health Glossary:
The information below provides a brief explanation of certain mental illnesses.
What is Bipolar Disorder?
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives.
Bipolar disorder often develops in a person’s late teens or early adult years. At least half of all cases start before age 25. Some people have their first symptoms during childhood, while others may develop symptoms late in life.
Bipolar disorder is not easy to spot when it starts. The symptoms may seem like separate problems, not recognized as parts of a larger problem. Some people suffer for years before they are properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person’s life.
What is Depression?
There are several forms of depressive disorders. The most common are major depressive disorder and dysthymic disorder.
Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person’s ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person’s lifetime, but more often, it recurs throughout a person’s life.
Dysthymic disorder, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.
Some forms of depressive disorder exhibit slightly different characteristics than those described above, or they may develop under unique circumstances. However, not all scientists agree on how to characterize and define these forms of depression. They include:
Psychotic depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.
Postpartum depression, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.
Seasonal affective disorder (SAD), which is characterized by the onset of a depressive illness during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.
Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes-from extreme highs (e.g., mania) to extreme lows (e.g., depression). Visit the NIMH website for more information about bipolar disorder.
What is Generalized Anxiety Disorder?
People with generalized anxiety disorder (GAD) go through the day filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. Sometimes just the thought of getting through the day produces anxiety.
GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months. People with GAD can’t seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They can’t relax, startle easily, and have difficulty concentrating. Often they have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.
When their anxiety level is mild, people with GAD can function socially and hold down a job. Although they don’t avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe.
GAD affects about 6.8 million adult Americans and about twice as many women as men. The disorder comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age. It is diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems. There is evidence that genes play a modest role in GAD.
Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone. GAD is commonly treated with medication or cognitive-behavioral therapy, but co-occurring conditions must also be treated using the appropriate therapies.
What is Obsessive Compulsive Disorder?
People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.
For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror-sometimes they get “caught” in the mirror and can’t move away from it. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.
Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items.
Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house. The difference is that people with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Although most adults with OCD recognize that what they are doing is senseless, some adults and most children may not realize that their behavior is out of the ordinary.
OCD affects about 2.2 million American adults, and the problem can be accompanied by eating disorders, other anxiety disorders, or depression. It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families.
The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If OCD becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.
OCD usually responds well to treatment with certain medications and/or exposure-based psychotherapy, in which people face situations that cause fear or anxiety and become less sensitive (desensitized) to them. NIMH is supporting research into new treatment approaches for people whose OCD does not respond well to the usual therapies. These approaches include combination and augmentation (add-on) treatments, as well as modern techniques such as deep brain stimulation.
What is Panic Disorder?
Panic disorder is a real illness that can be successfully treated. It is characterized by sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. During these attacks, people with panic disorder may flush or feel chilled; their hands may tingle or feel numb; and they may experience nausea, chest pain, or smothering sensations. Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of losing control.
A fear of one’s own unexplained physical symptoms is also a symptom of panic disorder. People having panic attacks sometimes believe they are having heart attacks, losing their minds, or on the verge of death. They can’t predict when or where an attack will occur, and between episodes many worry intensely and dread the next attack.
Panic attacks can occur at any time, even during sleep. An attack usually peaks within 10 minutes, but some symptoms may last much longer. Panic disorder affects about 6 million American adults and is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited.
People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred. For example, if a panic attack happened in an elevator, someone with panic disorder may develop a fear of elevators that could affect the choice of a job or an apartment, and restrict where that person can seek medical attention or enjoy entertainment.
Some people’s lives become so restricted that they avoid normal activities, such as grocery shopping or driving. About one-third become housebound or are able to confront a feared situation only when accompanied by a spouse or other trusted person. When the condition progresses this far, it is called agoraphobia, or fear of open spaces.
Early treatment can often prevent agoraphobia, but people with panic disorder may sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correctly diagnoses their condition. This is unfortunate, because panic disorder is one of the most treatable of all the anxiety disorders, responding in most cases to certain kinds of medication or certain kinds of cognitive psychotherapy, which help change thinking patterns that lead to fear and anxiety.
Panic disorder is often accompanied by other serious problems, such as depression, drug abuse, or alcoholism. These conditions need to be treated separately. Symptoms of depression include feelings of sadness or hopelessness, changes in appetite or sleep patterns, low energy, and difficulty concentrating. Most people with depression can be effectively treated with antidepressant medications, certain types of psychotherapy, or a combination of the two.
What is Post Traumatic Stress Disorder?
PTSD is an anxiety disorder that some people get after seeing or living through a dangerous event.
When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in PTSD, this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.
Anyone can get PTSD at any age. This includes war veterans and survivors of physical and sexual assault, abuse, accidents, disasters, and many other serious events.
Not everyone with PTSD has been through a dangerous event. Some people get PTSD after a friend or family member experiences danger or is harmed. The sudden, unexpected death of a loved one can also cause PTSD.
What is Schizophrenia?
Schizophrenia is a chronic, severe, and disabling brain disorder that has been recognized throughout recorded history. It affects about 1 percent of Americans.
People with schizophrenia may hear voices other people don’t hear or they may believe that others are reading their minds, controlling their thoughts, or plotting to harm them. These experiences are terrifying and can cause fearfulness, withdrawal, or extreme agitation. People with schizophrenia may not make sense when they talk, may sit for hours without moving or talking much, or may seem perfectly fine until they talk about what they are really thinking. Because many people with schizophrenia have difficulty holding a job or caring for themselves, the burden on their families and society is significant as well.
Available treatments can relieve many of the disorder’s symptoms, but most people who have schizophrenia must cope with some residual symptoms as long as they live. Nevertheless, this is a time of hope for people with schizophrenia and their families. Many people with the disorder now lead rewarding and meaningful lives in their communities. Researchers are developing more effective medications and using new research tools to understand the causes of schizophrenia and to find ways to prevent and treat it.
This brochure presents information on the symptoms of schizophrenia, when the symptoms appear, how the disease develops, current treatments, support for patients and their loved ones, and new directions in research.
What are Eating Disorders?
An eating disorder is marked by extremes. It is present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape.
A person with an eating disorder may have started out just eating smaller or larger amounts of food than usual, but at some point, the urge to eat less or more spirals out of control. Eating disorders are very complex, and despite scientific research to understand them, the biological, behavioral and social underpinnings of these illnesses remain elusive.
The two main types of eating disorders are anorexia nervosa and bulimia nervosa. A third category is “eating disorders not otherwise specified (EDNOS),” which includes several variations of eating disorders. Most of these disorders are similar to anorexia or bulimia but with slightly different characteristics. Binge-eating disorder, which has received increasing research and media attention in recent years, is one type of EDNOS.
Eating disorders frequently appear during adolescence or young adulthood, but some reports indicate that they can develop during childhood or later in adulthood. Women and girls are much more likely than males to develop an eating disorder. Men and boys account for an estimated 5 to 15 percent of patients with anorexia or bulimia and an estimated 35 percent of those with binge-eating disorder. Eating disorders are real, treatable medical illnesses with complex underlying psychological and biological causes. They frequently co-exist with other psychiatric disorders such as depression, substance abuse, or anxiety disorders. People with eating disorders also can suffer from numerous other physical health complications, such as heart conditions or kidney failure, which can lead to death.
What is Borderline Personality Disorder?
Borderline personality disorder (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual’s sense of self-identity. Originally thought to be at the “borderline” of psychosis, people with BPD suffer from a disorder of emotion regulation. While less well known than schizophrenia or bipolar disorder (manic-depressive illness), BPD is more common, affecting 2 percent of adults, mostly young women. There is a high rate of self-injury without suicide intent, as well as a significant rate of suicide attempts and completed suicide in severe cases. Patients often need extensive mental health services, and account for 20 percent of psychiatric hospitalizations. Yet, with help, many improve over time and are eventually able to lead productive lives.
What is Social Anxiety Disorder?
Social phobia, also called social anxiety disorder, is diagnosed when people become overwhelmingly anxious and excessively self-conscious in everyday social situations. People with social phobia have an intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.
While many people with social phobia realize that their fears about being with people are excessive or unreasonable, they are unable to overcome them. Even if they manage to confront their fears and be around others, they are usually very anxious beforehand, are intensely uncomfortable throughout the encounter, and worry about how they were judged for hours afterward.
Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others) or may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost anyone other than the family.
Physical symptoms that often accompany social phobia include blushing, profuse sweating, trembling, nausea, and difficulty talking. When these symptoms occur, people with social phobia feel as though all eyes are focused on them.
Social phobia affects about 15 million American adults. Women and men are equally likely to develop the disorder, which usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved. Social phobia is often accompanied by other anxiety disorders or depression, and substance abuse may develop if people try to self-medicate their anxiety.
Social phobia can be successfully treated with certain kinds of psychotherapy or medications.
Source: National Institute of Mental Health
What To Do In A Crisis:
The main goal in a mental health emergency is to stabilize the situation and get the person to professional help as quickly as possible. The following tips noted below may assist you:
- Do not try to manage the situation alone – sometimes just having another party present or on the phone with your loved one will defuse a situation.
- Start at the top of your Emergency Contacts list and work your way down – if it is an evening or weekend and you cannot reach providers or agencies, call the most appropriate hot-line.
- Speak to your loved one in a calm, quiet voice – if it seems he/she isn’t listening or can’t hear you, it is possible that auditory hallucinations (“voices”) may be interfering. Don’t shout; raising your voice won’t help and may escalate tensions.
- Keep instructions and explanations simple and clear – say, “We’re going to the car now, “not, “After we get in the car, we’ll drive to the doctor’s office so she can examine you.”
- Respond to delusions by talking about the person’s feelings not about the delusions – say, “This must be frightening, “not “You shouldn’t be frightened – nobody’s going to hurt you.”
- Don’t stare – direct eye contact may be perceived as confrontational or threatening.
- Don’t touch unless absolutely necessary – touch may be perceived as a threat and trigger a violent reaction.
- Don’t stand over the person – if the person is seated, seat yourself to avoid being perceived as trying to control or intimidate.
- Don’t give multiple choices or ask multi-part questions – choices will increase confusion. Say, “Would you like me to call your psychiatrist?” not “Would you rather I called your psychiatrist or your therapist?
- Don’t threaten or criticize – acute mental illness is a medical emergency. Suggesting that the person has chosen to be in this condition won’t help and may escalate tension.
- Don’t argue with others on the scene – conduct all discussion of the situation with third parties quietly and out of the person’s hearing.
- Don’t whisper, joke or laugh – this may increase agitation and/or trigger paranoia.
- Print a copy of this list to keep with your list of essential telephone numbers.
Source: Treatment Advocacy Center
Frequently Asked Questions:
Where can I go to find therapy?
Different kinds of therapy are more effective based on the nature of the mental health condition; however, there are different types of therapies that can work. (See Resources section of website for local providers).
Where can I learn about types of mental health treatment?
Mental health conditions are often treated with medication, therapy or a combination of the two. Treatment is very personal and should be discussed with the person with the mental health condition and his or her team. Psychotherapy is the therapeutic treatment of mental illness provided by a trained mental health professional. Psychotherapy explores thoughts, feelings, and behaviors and seeks to improve an individual’s well-being. Psychotherapy paired with medication is the most effective way to promote recovery. Examples include: Cognitive Behavioral Therapy, Exposure Therapy, Dialectical Behavior Therapy.
What are the different types of mental health professionals?
There are many types of mental health professionals and finding the right one for individuals requires some research. Feeling comfortable with the professional you choose is very important to the success of your treatment. Click here to help you understand the differences between services provided
The following mental health professionals can provide psychological assessments and therapy; however, cannot generally prescribe medications (although some states will allow it):
- Clinical Psychologist – A psychologist with a doctoral degree in psychology from an accredited/designated program in psychology. Psychologists are trained to make diagnoses and provide individual and group therapy.
- School Psychologist – A psychologist with an advanced degree in psychology from an accredited/designated program in School Psychology. School Psychologists are trained to make diagnoses, provide individual and group therapy, and work with school staff to maximize efficiency in the schools setting.
The following mental health professionals can provide counseling; however, cannot prescribe medication:
- Clinical Social Worker – A counselor with a masters degree in social work from an accredited graduate program. Trained to make diagnoses, provide individual and group counseling, and provide case management and advocacy; usually found in the hospital setting.
- Licensed Professional Counselor – A counselor with a masters degree in psychology, counseling or a related field. Trained to diagnose and provide individual and group counseling.
- Mental Health Counselor – A counselor with a masters degree and several years of supervised clinical work experience. Trained to diagnose and provide individual and group counseling.
- Certified Alcohol and Drug Abuse Counselor – Counselor with specific clinical training in alcohol and drug abuse. Trained to diagnose and provide individual and group counseling.
- Nurse Psychotherapist – registered nurse who is trained in the practice of psychiatric and mental health nursing. Trained to diagnose and provide individual and group counseling.
- Marital and Family Therapist – counselor with a masters degree, with special education and training in marital and family therapy. Trained to diagnose and provide individual and group counseling.
- Pastoral Counselor – clergy with training in clinical pastoral education Trained to diagnose and provide individual and group counseling.
- Peer Specialist– counselor with lived experience with mental health or substance use conditions. Assists clients with recovery by recognizing and developing strengths, and setting goals. Many peer support programs require several hours of training.
Other Therapists – therapist with an advance degree trained in specialized forms of therapy. Examples include art therapist, music therapist.
The following mental health professionals can prescribe medication; however, they may not provide therapy:
- Psychiatrist– A medical doctor with special training in the diagnosis and treatment of mental and emotional illnesses. A psychiatrist can prescribe medication, but they often do not counsel patients.
- Child/Adolescent Psychiatrist – A medical doctor with special training in the diagnosis and treatment of emotional and behavioral problems in children. Child and Adolescent psychiatrists can also precribe medication; however, they may not provide psychotherapy.
- Psychiatric or Mental Health Nurse Practitioner – A registered nurse practitioner with a graduate degree and specialized training in the diagnosis and treatment of mental and emotional illness.
Additionally, your Primary Care Physician, Physician’s Assistant or Nurse Practiotioner (depending on your state) are often qualified to provide medication.
What is a support group?
Many people find peer support a helpful tool to aid in their recovery. There are a variety of organizations that offer support groups for consumers, their family members and friends. Some support groups are peer-led while others may be led by a mental health professional.
Where can I learn more information about clinical trials?
Sometimes consumers of mental health services may consider participating in a research study when they have not experienced improvement despite having tried a variety of medications and treatments. Research studies (also known as clinical trials) may involve the use of new medications or new treatment approaches whose safety and effectiveness is being tested. Consumers however should be cautioned that there are risks associated with clinical trials – make sure you are aware of them before you enroll.
Source: Mental Health America
Snapshot of Mental Illness Today:
According to the Treatment Advocacy Center and the National Institute of Mental Health 2010 Report, there are close to 8 million adults in the United States living with severe mental illness, and over 3.5 million with untreated severe mental illness. According to the National Alliance for the Mentally Ill (NAMI), the Commonwealth of Virginia received a “D” ranking for its mental health system. There are over 1 million Virginians with mental illness and over 300,000 each year live with a serious mental illness and need urgent care. Virginia’s public mental health system provides services to only 19% of adults who live with a serious mental illness. Consequences of a lack of treatment options lead to overburdened systems. Approximately 1 in 4 Virginia’s jail inmates live with a mental health problem. Suicide is the third-leading cause of death among youth and young adults aged 15-24. The Commonwealth ranks 39th in the country for mental health services. The Hampton Roads region mirrors the decline of services and facilities for the mentally ill at both the national and state levels.
Why do individuals with severe psychiatric disorders often not take their medications?
The single most significant reason why individuals with schizophrenia and bipolar disorder fail to take their medication is because of their lack of awareness of their illness (anosognosia). The single most common reason cited by 55 percent of individuals was that they did not believe they were sick. Other important reasons are concurrent alcohol or drug abuse and a poor relationship between psychiatrist and patient. Medication side effects, widely assumed to be the most important reasons for medication non adherence, are, in fact, a less important reason compared to the other factors cited.
Source: Journal of Clinical Psychiatry