Defining Mental Health Disorders

Defining Mental Health DisordersExperiencing unpleasant emotions, changeable moods and unhealthy thought patterns is part of being human. Sometimes, however, these mental conditions grow in intensity or interfere with life to the extent that people can be said to have mental health disorders or mental illnesses. As with other health conditions, mental health disorders can range in the degree of suffering and impaired functioning they cause, but they should always be taken seriously.

The Mayo Clinic defines mental illnesses as disorders affecting mood, behavior and thinking. The National Alliance on Mental Illness (NAMI) notes that they disrupt sufferers’ daily functioning and ability to relate to others. The American Psychiatric Association produces a publication known as the Diagnostic and Statistical Manual (DSM), which details symptoms and diagnostic criteria for specific disorders. They note that to be considered a mental illness, symptoms of distress must not be those that would be expected and culturally sanctioned in response to a given event or those that are evidence of social deviance or societal conflict.

A 2010 article published in Psychological Medicine notes that various editions of the DSM have acknowledged the difficulty of distinguishing between mental disease and normal psychological responses to given situations. The authors state that no precise boundaries can be adequately specified and that there is no definition of mental illness that covers all situations. They note that this is similar to other medical conditions that are defined by symptom presentation and deviance from the norm.

The Prevalence and Nature of Mental Illness

NAMI makes the following points about mental disorders:

  • They can affect people of all demographic categories.
  • They do not arise from weakness or lack of character.
  • They can not be overcome by willpower, but are treatable. Between 70 and 90 percent of people see significant symptom reduction with a combination of medication and psychosocial interventions.
  • In a given year one quarter of adults can be expected to experience a mental health disorder. About six percent will experience a serious mental illness.
  • According to the World Health Organization, four of the top 10 leading causes of disability in developed countries are mental disorders.

Mental Illness and Substance Abuse

It is important to identify and address mental disorders, not only to relieve the emotional suffering they cause but because they contribute to the development of other disorders as well. The Centers for Disease Control and Prevention notes that mental disorders can affect the occurrence and treatment of many diseases including cancer, asthma, diabetes and cardiovascular disease. They also note that mental disorders are associated with chronic disease risk factors such as lack of sleep and physical activity or use of substances like tobacco and alcohol.

The Mayo Clinic notes that mental illness can have a wide range of complications including family and relationship difficulties, increased risk of accidents, self-harm or harm to others and problems with drugs and alcohol. Substance abuse can be both a cause and effect of mental disorders. The Mayo Clinic notes that both maternal use of drugs and alcohol during pregnancy and personal drug use can increase the risk of developing mental health problems.

When addiction and mental health disorders co-exist, as they often do, treating both in an integrated and coordinated manner is the best approach for optimal treatment outcomes. A publication titled “Substance Abuse Treatment for People with Co-Occurring Disorders” discusses specific mental health conditions and notes the following:

  • Mood and Anxiety Disorders – About half of people who have substance use disorders have a mood or anxiety disorder at some point in their lives. Older adults are at especially high risk because mood disorder symptoms tend to become more frequent with age. Depression and anxiety are common substance withdrawal symptoms especially in the first months of sobriety, and anxiety symptoms seem to arise from substance use more often than substance use is initiated to deal with pre-existing anxiety. It is important for counselors to monitor and assess levels of depression and anxiety and to respond to exacerbations appropriately.
  • Post-traumatic Stress Disorder (PTSD) – The rate of PTSD among substance abusers is 12 to 34 percent compared to lifetime prevalence among the general population of about eight percent. Among women with substance use disorders, the rate is 30 to 59 percent. Many of these women have experienced physical and/or sexual abuse. Those with PTSD may use a variety of drugs including those considered the most problematic and dangerous. Counselors must work at building trust, establishing safety and teaching coping skills.
  • Personality Disorders – There is no clear pattern of substance abuse among people suffering from personality disorders. People with borderline personality disorder (BPD) may pattern their drug use after those in their social circles. They may also combine numerous substances such as alcohol and sedative-hypnotic drugs. People with antisocial personality disorder (APD) may also engage in polydrug use. A challenge for clinicians working with patients suffering from personality disorders is the development of a healthy therapeutic relationship.
  • Eating Disorders – Substance abusers with eating disorders are more likely to use stimulants than are other people in substance abuse treatment. They may also abuse drugs related to dieting or purging. People with eating disorders may alternate between episodes of substance abuse and times of disordered food consumption. Counselors should consider both disorders when addressing relapse prevention and risk factors and should employ nutritional consultation and the setting of weight range goals.

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