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