1. TYPES OF MENTAL ILLNESS

2. “NEUROSES” NO BREAK WITH REALITY DEPRESSION, ANXIETY, SUBSTANCE ABUSE VERY COMMON CONTINUOUS NOT DISCRETE MUCH CO-MORBIDITY

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

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

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

8. 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

9. CAUSES VARIED SOME GENETIC EARLY LOSS EVENTS AND ABUSE CURRENT LOSSES OR TRAUMAS

10. 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

11. PROGNOSIS (COURSE) COURSE HIGHLY VARIABLE MDD FREQUENT AND CHRONIC DYSTHYMIA CHRONIC DISTRESS ENDS WITH POSITIVE EVENTS OR ADJUSTMENT

12. 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?

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

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

16. MAJOR TYPES PHOBIAS - INTENSE FEAR OF A SPECIFIC OBJECT OR SITUATION PANIC - SITUATIONAL, EPISODIC OBSESSIVE-COMPULSIVE - PREOCCUPYING THOUGHTS OR BEHAVIORS GENERALIZED ANXIETY DISORDER

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

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

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

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

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

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

23. 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

24. TREATMENT VARIATION IN TREAT OR PUNISH? MUCH TREATMENT INVOLUNTARY GROUP THERAPY - AA LESS MEDICATION