A mental illness can be defined as a health condition that changes a person’s thinking, feelings, or behavior (or all three) and that causes the person distress and difficulty in functioning. As with many diseases, mental illness is severe in some cases and mild in others. Individuals who have a mental illness don’t necessarily look like they are sick, especially if their illness is mild. Other individuals may show more explicit symptoms such as confusion, agitation, or withdrawal. There are many different mental illnesses, including depression, schizophrenia, attention deficit hyperactivity disorder (ADHD), autism, and obsessive-compulsive disorder, PTSD and others. Each illness alters a person’s thoughts, feelings, and/or behaviors in distinct ways.
Not all brain diseases are categorized as mental illnesses. Disorders such as epilepsy, Parkinson’s disease, and multiple sclerosis are brain disorders, but they are considered neurological diseases rather than mental illnesses. Interestingly, the lines between mental illnesses and these other brain or neurological disorders is blurring somewhat. As scientists continue to investigate the brains of people who have mental illnesses, they are learning that menta illness is associated with changes in the brain’s structure, chemistry, and function and that mental illness does indeed have a biological basis. This ongoing research is, in some ways, causing scientists to minimize the distinctions between mental illnesses and these other brain disorders.
Many people feel that mental illness is rare, something that only happens to people with life situations very different from their own, and that it will never affect them. Studies of the epidemiology of mental illness indicate that this belief is far from accurate. In fact, the surgeon general reports that mental illnesses are so common that few U.S. families are untouched by them.
Mental Illness- Who Has It?
Even if you or a family member has not experienced mental illness directly, it is very likely that you have known someone who has. Estimates are that at least one in four people is affected by mental illness either directly or indirectly. Consider the following statistics to get an idea of just how widespread the effects of mental illness are in society:
•According to recent estimates, approximately 20 percent of Americans, or about one in five people over the age of 18, suffer from a diagnosable mental disorder in a given year.
•Four of the 10 leading causes of disability—major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder—are mental illnesses.
•About 3 percent of the population has more than one mental illness at a time.
•About 5 percent of adults are affected so seriously by mental illness that it interferes with their ability to function in society.
•Approximately 20 percent of doctors’ appointments are related to anxiety disorders such as panic attacks.
•Eight million people have depression each year.
•Two million Americans have schizophrenia disorders, and 300,000 new cases are diagnosed each year.
Mental illness is not uncommon among children and adolescents. Approximately 12 million children under the age of 18 have mental disorders. The National Mental Health Association has compiled some statistics about mental illness in children and adolescents:
•Mental health problems affect one in every five young people at any given time.
•An estimated two-thirds of all young people with mental health problems are not receiving the help they need.
•Less than one-third of the children under age 18 who have a serious mental health problem receive any mental health services.
•As many as 1 in every 33 children may be depressed. Depression in adolescents may be as high as 1 in 8.
•Suicide is the third leading cause of death for 15- to 24-years-olds and the sixth leading cause of death for 5- to 15-year-olds.
•Between 118,700 and 186,600 youths in the juvenile justice system have at least one mental illness.
•Of the 100,000 teenagers in juvenile detention, an estimated 60 percent have behavioral, cognitive, or emotional problems.
·Schizophrenia is rare in children under age 12, but it occurs in about 3 of every 1,000 adolescents.
Each mental illness has its own characteristic symptoms. However, there are some general warning signs that might alert you that someone needs professional help. Some of these signs include:
•Marked personality change,
•Inability to cope with problems and daily activities,
•Strange or grandiose ideas,
•Prolonged depression and apathy,
•Marked changes in eating or sleeping patterns,
•Thinking or talking about suicide or harming oneself,
•Extreme mood swings—high or low,
•Abuse of alcohol or drugs, and
•Excessive anger, hostility, or violent behavior.
A person who shows any of these signs should seek help from a qualified health professional.
Mental Illness Diagnosis
To be diagnosed with a mental illness, a person must be evaluated by a qualified professional who has expertise in mental health. Mental health professionals include psychiatrists, psychologists, psychiatric nurses, social workers, and mental health counselors. Family doctors, internists, and pediatricians are usually qualified to diagnose common mental disorders such as depression, anxiety disorders, and ADHD. In many cases, depending on the individual and his or her symptoms, a mental health professional who is not a psychiatrist will refer the patient to a
psychiatrist. A psychiatrist is a medical doctor (M.D.) who has received additional training in the field of mental health and mental illnesses. Psychiatrists evaluate the person’s mental condition in coordination with his or her physical condition and can prescribe medication. Only psychiatrists and other M.D.s can prescribe medications to treat mental illness.
Unlike some disease diagnoses, doctors can’t do a blood test or culture some microorganisms to determine whether a person has a mental illness. Maybe scientists will develop discrete physiological tests for mental illnesses in the future; until then, however, mental health professionals will have to diagnose mental illnesses based on the symptoms that a person has. Basing a diagnosis on symptoms and not on a quantitative medical test, such as a blood chemistry test, a throat swab, X-rays, or urinalysis, is not unusual. Physicians diagnose many diseases, including migraines, Alzheimer’s disease, and Parkinson’s disease based on their symptoms alone. For other diseases, such as asthma or mononucleosis, doctors rely on analyzing symptoms to get a good idea of what the problem is and then use a physiological test to provide additional information or to confirm their diagnosis.
When a mental health professional works with a person who might have a mental illness, he or she will, along with the individual, determine what symptoms the individual has, how long the symptoms have persisted, and how his or her life is being affected. Mental health professionals often gather information through an interview during which they ask the patient about his or her symptoms, the length of time that the symptoms have occurred, and the severity of the symptoms. In many cases, the professional will also get information about the patient from family members to obtain a more comprehensive picture. A physician likely will conduct a physical exam and consult the patient’s history to rule out other health problems.
Mental health professionals evaluate symptoms to make a diagnosis of mental illness. They rely on the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; currently, the fourth edition), published by the American Psychiatric Association, to diagnose a specific mental illness. For each mental illness, the DSM-IV gives a general description of the disorder and a list of typical symptoms. Mental health professionals refer to the DSM-IV to confirm that the symptoms a patient exhibits match those of a specific mental illness. Although the DSM-IV provides valuable information that helps mental health professionals diagnose mental illness, these professionals realize that it is important to observe patients over a period of time to understand the individual’s mental illness and its effects on his or her life.
In Mental Illness 101-Part II, we will look further into mental illness and look at risk factors for having mental illness.