1. TYPES OF MENTAL ILLNESS

2. OVERVIEW DEPRESSION ANXIETY SUBSTANCE ABUSE

4. DEPRESSION UNLIKE SCHIZ AND BIPOLAR MUCH MORE COMMON – ESPECIALLY RECENTLY “AGE OF DEPRESSION”

5. ADULT PREVALENCE

6. Treatment for Depression

7. Diagnoses in Psychotherapy

8. Depression Articles 1966-2001

11. MOOD EITHER (OR BOTH) PRESENCE OF NEGATIVE MOOD OR ABSENCE OF POSITIVE MOOD

12. PHYSICAL SYMPTOMS LOW ENERGY, FATIGUE SLEEP DISTURBANCES APPETITE DISTURBANCES VULNERABILITY TO MANY PHYSICAL ILLNESSES

13. PSYCHOLOGICAL SYMPTOMS EMOTIONAL - SADNESS, APATHY, LACK OF PLEASURE COGNITIVE - HOPELESSNESS AND HELPLESSNESS, LOW SELF-ESTEEM BEHAVIORAL - WITHDRAWAL, SUICIDE ATTEMPTS

14. TYPES OF DEPRESSION CONTINUOUS HOW SEVERE AND HOW LONG

15. TYPES MAJOR DEPRESSION - ABOVE PSYCHOTIC (MELANCHOLIC) - MORE SEVERE, IMMOBILE, SUICIDAL DYSTHYMIA – LOWER LEVEL BUT LONGER LASTING (TWO YEARS) DISTRESS - REACTIVE TO LIFE EVENT, GOES AWAY WHEN CONDITIONS CHANGE, NOT A DISORDER

19. CAUSES VARIED CURRENT LOSSES AND TRAUMAS CHRONIC OPPRESSIVE SITUATIONS EARLY LOSS EVENTS AND ABUSE SOME GENETIC/BIOLOGICAL

20. 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

21. PROGNOSIS (COURSE) COURSE HIGHLY VARIABLE MDD USUALLY RECURRENT AVERAGE EPISODE ABOUT 3 - 6 MONTHS DYSTHYMIA CHRONIC DISTRESS ENDS WITH POSITIVE EVENTS

23. TREATMENT TREATED WITH SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI) - PROZAC, PAXIL, XOLOFT NOT MORE EFFECTIVE THAN EARLIER DRUGS FEWER SIDE EFFECTS, BETTER TOLERATED, LESS ADDICTIVE, FEWER OVERDOSES HIGHER RISK OF SUICIDE?

24. TREATMENT (CONT.) COGNITIVE THERAPY PSYCHOTHERAPY COMBINATION OF DRUGS AND PSYCHOLOGICAL THERAPY MIGHT BE BEST

26. SYMPTOMS PSYCHOLOGICAL UNEASE, FEAR, WORRY, ANXIOUSNESS, DREAD PHYSICAL HEART PALPITATIONS, TREMBLING, STOMACH UPSET, FAINTING

27. MAJOR TYPES PHOBIAS - INTENSE FEAR OF A SPECIFIC OBJECT OR SITUATION PANIC - SITUATIONAL, EPISODIC GENERALIZED ANXIETY DISORDER

28. MAJOR TYPES OBSESSIVE-COMPULSIVE - PREOCCUPYING THOUGHTS OR BEHAVIORS

29. MAJOR TYPES SOCIAL ANXIETY DISORDER

30. MAJOR TYPES POST-TRAUMATIC STRESS DISORDER

31. COMORBIDITY VERY HIGH COMORBIDITY WITH DEPRESSION MOST DEPRESSED PEOPLE ALSO ANXIOUS ANXIOUS PEOPLE OFTEN DEPRESSED

32. CHARACTERISTICS GREAT VARIANCE ACROSS SOCIETIES IN U.S. 20% EACH YEAR, 30% OVER LIFETIME

33. SOCIAL CHARACTERISTICS 2/3 FEMALE HIGH ETHNIC VARIATION E.G. BLACKS MORE PHOBIAS, HISPANICS MORE PANIC, JEWS MORE OBSESSIVE-COMPULSIVE

34. TREATMENT MEDICATION SSRI’S ANTI-ANXIETY - XANAX BEHAVIOR THERAPY

35. SUBSTANCE DEPENDENCE/ABUSE DEPENDENCE FREQUENT AND EXCESSIVE USE GROWING TOLERANCE/PROBLEMS WITH WITHDRAWAL ABUSE PROBLEMATIC CONSEQUENCES OF USE - FAMILY, WORK, LEGAL

36. CHARACTERISTICS ALCOHOL ABUSE OR DEPENDENCE - 10% YEAR, 25% LIFETIME DRUG ABUSE OR DEPENDENCE - 3% YEAR; 12% LIFETIME

37. 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

38. TREATMENT VARIATION IN TREAT OR PUNISH? MUCH TREATMENT INVOLUNTARY GROUP THERAPY - AA SOME MEDICATION