Mental Health and Substance Abuse Information

There are many websites dedicated to informing the public about mental health and substance abuse information and resources. Some of the major authorities on mental health and substance abuse are:

• Substance Abuse and Mental Health Services Administration
  http://mentalhealth.samhsa.gov/
• National Institute of Mental Health
  http://www.nimh.nih.gov/
• Missouri Department of Mental Health
  http://www.dmh.missouri.gov/

It is important to have a basic understanding of mental health and substance abuse issues. The nationwide authority in comprehensive mental health information is the National Institute of Mental Health (NIMH). The NIMH is the largest scientific organization in the world dedicated to research focused on the understanding, treatment, and prevention of mental disorders and the promotion of mental health. The NIMH identifies the following as diagnosable mental health issues that affect an estimated 26.2 percent of Americans ages 18 and older- about one in four adults- in any given year: Anxiety Disorders, Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorders (ASDs), Bipolar Disorder/ Manic Depressive Illness, Borderline Personality Disorder, Depression, Eating Disorders, Generalized Anxiety Disorders, Obsessive-Compulsive Disorder (OCD), Panic Disorder, Post-Traumatic Stress Disorder (PTSD), Schizophrenia and Social Phobia/ Social Anxiety Disorder. All of those mentioned occur in males and females of all ages, races, religions, ethnic backgrounds and geographical locations. Mental disorders are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).

Mood Disorders

Mood disorders include major depressive disorder, dysthymic disorder, bipolar disorder, and schizophrenia. Nearly 20.9 million adults, almost 9.5 percent of the U.S. population, have a mood disorder. These disorders often co-occur with anxiety disorders and substance abuse.

Major Depressive Disorder:

Classified by the presence of a combination of symptoms that interfere with one ’s daily activities and the loss of enjoyment in once-pleasurable activities. These symptoms disable the individual from functioning normally; episodes may occur only once in a lifetime, but are often reoccurring.

• Affects 14.8 million adults (6.7 percent of the population) in any given year
• Median age onset is 32
• Affects more women than men
• May be treated with medication and/or psychotherapy

Dysthymic Disorder:

Known as chronic, mild depression that persists for two years in adults, one year for children. It is less severe than major depression; dysthymic disorder is not disabling, but may prevent one from functioning normally.

• Affects 3.3 million adults (1.5 percent of the population) in any given year
• Median age onset is 31
• May be treated with medication and/or psychotherapy

Bipolar Disorder/ Manic Depressive Illness:

Serious mental disorder that causes dramatic shifts in one’s mood, energy and ability to function. Classified between “high” behavior (mania) to sadness and hopelessness (depression).

• Manic episodes may include distractibility, poor judgment and substance abuse
• Depressive episodes may include feelings of guilt, pessimism and suicidal thoughts. In severe episodes, one may experience psychosis and delusions.
• Affects 5.7 million adults (2.6 percent of the population) in any given year
• Median age onset is 25
• Treatment is possible and most effective if it is ongoing and combines medication and psychosocial therapy

Schizophrenia:

• Chronic, severe, and disabling disorder whose symptoms fall into three categories
• Positive symptoms may include hallucinations, delusions, thought and movement disorders
• Negative symptoms may include a loss or decrease in the ability to speak, express emotion, or to find pleasure in life
• Cognitive symptoms may include attention, memory and thought organization problems
• Affects 2.4 million adults (1.1 percent of the population) in any given year
• Occurs in men and women with nearly equal frequency; onset occurs in men in their late teens and early twenties, affects women in their twenties and early thirties
• Treatment should be ongoing and may include both antipsychotic medications and psychosocial treatment

Anxiety Disorders

Anxiety disorders include panic disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTST) and phobias. Nearly 40 million adults (18.1 percent) have an anxiety disorder in any given year. These disorders cause acute fearfulness and uncertainty. Anxiety disorders often co-occur with depressive disorders and substance abuse. Many anxiety disorders will appear by age 22.

Panic Disorder:

Defined by the presence of panic attacks: sudden attacks of terror occurring with physical symptoms like a racing heart, sweating and dizziness. Recurring panic attacks may impair one’s ability to live a fully functioning life.

• Affects 6 million adults (2.7 percent of the population) in any given year
• Median age of onset is 24
• Often co-occurs with depression and substance abuse; may be treated with certain medications and cognitive psychotherapy

Obsessive-Compulsive Disorder (OCD):

Classified by the occurrence of persistent thoughts (obsessions) and one’s attempt to control these thoughts through ritual actions (compulsions). The compulsions are an attempt to alleviate the anxiety that the obsessions trigger, but interfere with one’s daily obligations and ability to function normally.

• Affects 2.2 million adults (1 percent of the population) in any given year
• Occurs in nearly equal numbers of men and women
• Median age of onset is 19; however, many symptoms begin during childhood and adolescence
• Symptoms may vary in severity throughout the life cycle; treatment is available with certain medications and/ or exposure or cognitive therapy

Post-Traumatic Stress Disorder (PTSD):

Triggered by traumatic events, including violent assaults (rape, mugging, domestic abuse), terrorism, disasters and accidents. The development of PTSD may occur in the person harmed, the harm may have happened to a loved one or the person may have witnessed another being harmed. Flashbacks to the event may include images, sounds, smells or feelings that may evoke loss of interest, irritability or aggressiveness.

• Affects 7.7 million adults (3.5 percent of the population) in any given year
• PTSD can occur at any age; median age of onset is 23
• Treatment is generally very effective using certain kinds of medication and/ or psychotherapy

Generalized Anxiety Disorder (GAD):

Sufferers worry excessively, anticipate disaster and are overcome with anxiety provoked by everyday stresses like work, health issues, money or family. They have trouble relaxing, difficulty concentrating, and sleep problems, which may lead to a variety of physical symptoms.

• Affects 6.8 million adults (3.1 percent of the population) in any given year, and nearly twice as many women as men
• Median age of onset is 31; can begin during any stage of life
• GAD rarely occurs alone- may be accompanied by other anxiety disorders, depression or substance abuse
• Common treatment includes medication or cognitive-behavioral therapy

Social Phobia/ Social Anxiety Disorder:

Classified by overwhelming anxiety and excessive self-consciousness in daily social settings that may interfere with everyday life activities and relationships. Those affected have an intense, chronic fear of being watched and embarrassed and judged by others.

• Physical symptoms can include blushing, sweating, trembling and nausea
• Affects 15 million adults (6.8 percent of the population) in any given year
• Onset often occurs in childhood and adolescence; median age of 13
• Treatment includes psychotherapy and/ or medication

Eating Disorders

Eating disorders are identified by the presence of extreme behaviors, like an extreme reduction of food intake or overeating, or obsessions about body weight or shape. The three most identified eating disorders are anorexia nervosa, bulimia nervosa and binge eating. Females are affected at a dramatically higher rate than their male counterparts. Most eating disorders appear during adolescence and early adulthood. They frequently appear with other mental illnesses, like depression, substance abuse or anxiety disorders. Physical health problems are prevalent in those with eating disorders and may lead to heart complications, kidney failure and death.

Anorexia:

Characterized by emaciation, distorted body image, unwillingness and fear of maintaining a healthy body weight. Obsession with eating, food and weight control that results in compulsive behaviors like repeated weighing, portioning food and extremely limited caloric intake. Physical complications can include osteoporosis, thinning hair, anemia, muscle loss, low blood pressure and internal body temperature decrease.

• An estimated .5 to 3.7 percent of U.S. females are affected in any given year
• Treatment is most effective using various types of psychotherapy, including individual, group, and family. There are three identifiable components to treating anorexia:
  • Restoring one to a healthy weight
  • Treating the psychological issues that contribute to the eating disorder
  • Reducing/ eliminating behaviors and thoughts that lead to anorexia, thereby preventing relapse

Bulimia:

Classified by patterns of extreme food intake (binge-eating), followed by purging in the form of vomiting, use of laxatives or diuretics, fasting or extreme exercise. A bulimic may maintain normal body weight, but fear gaining weight, or are unhappy with their body size or shape. Co-existing issues are often present, and include depression, anxiety or substance abuse. Physical problems include electrolyte imbalances, gastrointestinal problems and oral health issues.

• An estimated 1.1 to 4.2 percent of U.S. females are affected in any given year
• Treatment may include nutritional counseling and psychotherapy, specifically cognitive behavioral therapy, and/or medication

Binge Eating:

Characterized by recurrent binge-eating behaviors during which a person feels a loss of control that results in feelings of guilt, shame and distress. Binge eaters are often overweight or obese, which results in physical problems like hypertension and cardiovascular disease.

• Surveys estimate that between two and five percent of U.S. adults are affected in a given six month period
• Treatment may include appetite suppressant medications, cognitive behavioral therapy and group counseling

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is one of the most common mental disorders in children and teens, affecting between three to five percent of children, though it also affects 4.1 percent of adults in a given year. Characteristics of ADHD include symptoms of inattention, hyperactivity and impulsivity. The distractibility, poor concentration and lack of behavioral control can affect a person in school, in social relationships and at home. ADHD often co-occurs with other disorders, most commonly learning disabilities and conduct disorder (extremely aggressive behavior), but also with anxiety, depression or bipolar disorder. The median age onset is seven, with symptoms sometimes lasting into adolescence and adulthood. Treatment may include medication, behavioral therapy and emotional counseling.

Autism Spectrum Disorders (ASDs)

ASDs cause significant impairment in thinking, feeling, language and the ability to relate to others. ASDs range in severity; autism is the most debilitating, Asperger’s syndrome the least. Though the severity of symptoms vary, all affected by an ASD experience discrepancies in social interaction, verbal and non-verbal communication, repetitive behaviors and interests, and uncommon responses to normal sensory experiences. Early intervention is essential to reducing symptoms and increasing a child’s ability to develop. The prevalence of autism is often debated due to differences in definitions, study methods and diagnostic criteria. Most ASDs develop in early childhood and are often diagnosed by age three. Autism is nearly four times more common in boys than girls; however, girls with autism often have more severe symptoms. Treatment should begin immediately after diagnosis and should be highly individualized; behavioral therapy, medication or dietary restrictions may be used separately or in conjunction in order to manage the ASD.

Substance Abuse (25)

In a 2003 National Household Survey on Drug Abuse (NHSDA) report on substance abuse or dependence in metropolitan and non-metropolitan areas, substance abuse and dependence were defined based on the DSM-IV as:

Abuse: of a substance if he or she is not dependant on that substance and reports one or more of the following symptoms in the past year:

• Recurrent use resulting in failure to fulfill major obligations at school, work or home
• Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile)
• Recurrent substance-related legal problems
• Continued use despite having persistent or recurrent social or interpersonal problems

Dependence: on a substance if he or she reports three or more of the following symptoms in the past year:

• Tolerance: discovering less effect with same amount used (needing more to become intoxicated)
• Withdrawal (characteristic of withdrawal associated with the type of drug)
• Using more or for longer periods than intended
• Desire to or unsuccessful efforts to cut down or control substance abuse
• Considerable time spent in obtaining or using the substance or recovering from its effects
• Important social, work or recreational activities given up or reduced because of use
• Continued use despite knowledge of problems caused by or aggravated by use