Mental Disorder – At A Glance
A mental disorder is characterised by a clinically significant disturbance in an individual’s cognition, emotional regulation or behaviour. It is usually associated with distress or impairment in important areas of functioning. There are many different types of mental disorders. Mental disorders may also be referred to as mental health conditions. The latter is a broader term covering mental disorders, psychosocial disabilities and (other) mental states associated with significant distress, impairment in functioning or risk of self-harm.
It is expected the number of people living with a mental disorder, with anxiety and depressive disorders rose significantly because of the COVID-19 pandemic. While effective prevention and treatment options exist, most people with mental disorders do not have access to effective care. Many people also experience stigma, discrimination and violations of human rights.
Anxiety disorders are characterised by excessive fear and worry and related behavioural disturbances. Symptoms are severe enough to result in significant distress or significant impairment in functioning. There are several different kinds of anxiety disorders, such as: generalised anxiety disorder (characterised by excessive worry), panic disorder (characterised by panic attacks), social anxiety disorder (characterised by excessive fear and worry in social situations), separation anxiety disorder (characterised by excessive fear or anxiety about separation from those individuals to whom the person has a deep emotional bond) and others. Effective psychological treatment exists and depending on the age and severity, medication may also be considered.
Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. During a depressive episode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day, for at least two weeks. Several other symptoms are also present, which may include poor concentration, feelings of excessive guilt or low self-worth, hopelessness about the future, thoughts about dying or suicide, disrupted sleep, changes in appetite or weight and feeling especially tired or low in energy. People with depression are at an increased risk of suicide. Yet, effective psychological treatment exists and depending on the age and severity, medication may also be considered.
People with bipolar disorder experience alternating depressive episodes with periods of manic symptoms. During a depressive episode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day. Manic symptoms may include euphoria or irritability, increased activity or energy and other symptoms such as increased talkativeness, racing thoughts, increased self-esteem, decreased need for sleep, distractibility and impulsive reckless behaviour. People with bipolar disorder are at an increased risk of suicide. Yet effective treatment options exist including psychoeducation, reduction of stress and strengthening of social functioning and medication.
Post-Traumatic Stress Disorder (PTSD)
PTSD may develop following exposure to an extremely threatening or horrific event or series of events. It is characterised by all of the following:
1) re-experiencing the traumatic event or events in the present (intrusive memories, flashbacks, or nightmares);
2) avoidance of thoughts and memories of the event(s) or avoidance of activities, situations or people reminiscent of the event(s); and
3) persistent perceptions of heightened current threat.
The prevalence of PTSD and other mental disorders is high in conflict-affected settings. These symptoms persist for at least several weeks and cause significant impairment in functioning. Effective psychological treatment exists.
Schizophrenia is characterised by significant impairments in perception and changes in behaviour. Symptoms may include persistent delusions, hallucinations, disorganised thinking, highly disorganised behaviour or extreme agitation. People with schizophrenia may experience persistent difficulties with their cognitive functioning. Yet, a range of effective treatment options exist, including medication, psychoeducation, family interventions and psychosocial rehabilitation.
Eating disorders, such as anorexia nervosa and bulimia nervosa, involve abnormal eating and preoccupation with food as well as prominent body weight and shape concerns. The symptoms or behaviours result in significant risk or damage to health, significant distress, or significant impairment of functioning. Anorexia nervosa often has its onset during adolescence or early adulthood and is associated with premature death due to medical complications or suicide. Individuals with bulimia nervosa are at a significantly increased risk for substance use, suicidality and health complications. Effective treatment options exist, including family-based treatment and cognitive-based therapy.
Disruptive behaviour and dissocial disorders
This disorder, also known as conduct disorder, is one of two disruptive behaviour and dissocial disorders, the other is oppositional defiant disorder. Disruptive behaviour and dissocial disorders are characterised by persistent behaviour problems such as persistently defiant or disobedient to behaviours that persistently violate the basic rights of others or major age-appropriate societal norms, rules or laws. Onset of disruptive and dissocial disorders, is commonly, though not always, during childhood. Effective psychological treatments exist, often involving parents, caregivers and teachers, cognitive problem-solving or social skills training.
Neurodevelopmental disorders are behavioural and cognitive disorders, that arise during the developmental period and involve significant difficulties in the acquisition and execution of specific intellectual, motor, language or social functions.
Neurodevelopmental disorders include disorders of intellectual development, autism spectrum disorder and attention deficit hyperactivity disorder (ADHD) amongst others. ADHD is characterised by a persistent pattern of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational or social functioning. Disorders of intellectual development are characterised by significant limitations in intellectual functioning and adaptive behaviour, which refers to difficulties with everyday conceptual, social and practical skills that are performed in daily life. Autism spectrum disorder (ASD) constitutes a diverse group of conditions characterised by some degree of difficulty with social communication and reciprocal social interaction, as well as persistent restricted, repetitive and inflexible patterns of behaviour, interests or activities.
Effective treatment options exist including psychosocial interventions, behavioural interventions, occupational and speech therapy. For certain diagnoses and age groups, medication may also be considered.
Obsessive compulsive disorder
Obsessive compulsive disorder (OCD) is an anxiety disorder. Obsessions are recurrent thoughts, images or impulses that are intrusive and unwanted. Compulsions are time-consuming and distressing repetitive rituals. Treatments include cognitive behaviour therapy (CBT) and medications.
Paranoia is the irrational and persistent feeling that people are ‘out to get you’. Paranoia may be a symptom of conditions including paranoid personality disorder, delusional (paranoid) disorder and schizophrenia. Treatment for paranoia includes medications and psychological support.
People affected by psychosis can experience delusions, hallucinations and confused thinking. Psychosis can occur in a number of mental illnesses, including drug-induced psychosis, schizophrenia and mood disorders. Medication and psychological support can relieve or even eliminate, psychotic symptoms.
Dissociation and dissociative disorders
Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories or sense of identity. Dissociative disorders include dissociative amnesia, depersonalisation disorder and dissociative identity disorder.
Who is at risk from developing a mental disorder?
At any one time, a diverse set of individual, family, community and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances – including poverty, violence, disability and inequality – are at higher risk. Protective and risk factors include individual psychological and biological factors, such as emotional skills as well as genetics. Many of the risk and protective factors are influenced through changes in brain structure and/or function.
Health systems and social support
Health systems have not yet adequately responded to the needs of people with mental disorders and are significantly under resourced. The gap between the need for treatment and its provision is wide all over the world and is often poor in quality when delivered.
People with mental disorders also require social support, including support in developing and maintaining personal, family and social relationships. People with mental disorders may also need support for educational programmes, employment, housing and participation in other meaningful activities. It is important to have a wide-ranging Mental Health Action Plan that recognises the essential role of mental health in achieving good health for all people.
Such a plan should aim to achieve at least four major objectives:
- to strengthen effective leadership and governance for mental health;
- to provide comprehensive, integrated and responsive mental health and social care services in community-based settings;
- to implement of strategies for promotion and prevention in mental health; and
- to strengthen information systems, evidence and research for mental health.
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