Facts About Specific Diagnoses
In the U.S., mental disorders are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).
Major (or Clinical) Depression
More than 17 million American have a diagnosis of clinical depression.
Not everyone experiences clinical depression in the same way. Different people have different symptoms. Symptoms of clinical depression include:
- a persistent sad, anxious or empty mood;
- sleeping too little or too much;
- reduced appetite and weight loss, or increase appetite and weight gain;
- loss of interest or pleasure in activities once enjoyed;
- restlessness or irritability (in children or adolescents this may be perceived as "acting out");
- persistent physical symptoms that don't respond to treatment (such as headaches, chronic pain or constipation and digestive disorders);
- difficulty concentrating, remembering or making decisions;
- fatigue or loss of energy;
- feeling guilty, hopeless or worthless; and
- thoughts of death or suicide.
Bipolar disorder (also know as manic depression) is a mental illness involving episodes of extreme highs (mania or hypomania) and lows (depression). In most cases, the person's mood swings from excessively high or euphoric and/or irritable to sad and hopeless and then back again with periods of normal mood in between. Sometimes, however, a person experiences both states at the same time (mixed episodes).
At least 2 million Americans have a diagnosis of bipolar disorder.
Mania can last up to four months if untreated. The symptoms of mania include:
- increased energy, activity, restlessness, racing thoughts and rapid talking;
- denial that anything is wrong, excessive high or euphoric feelings;
- extreme irritability and distraction;
- decreased need for sleep;
- unrealistic beliefs in one's ability and powers;
- uncharacteristically poor judgment;
- unusual sexual drive;
- abuse of drugs, particularly cocaine, alcohol and sleep medications; and
- provocative, intrusive or aggressive behavior.
Symptoms of depression include:
- persistent sadness, anxiety or emptiness;
- feelings of hopelessness or pessimism;
- feelings of guilt, worthlessness or helplessness;
- loss of interest or pleasure in usually enjoyed activities, including sex;
- decreased energy, a feeling of fatigue or of being slowed down;
- difficulty concentrating, remembering or making decisions;
- restlessness or irritability;
- sleep disturbances;
- loss of appetite and weight, or weight gain;
- chronic pain or other persistent bodily symptoms that are not caused by a physical disease; and
- thoughts of and attempts at suicide.
Anxiety disorders cause people to feel anxious a lot of the time, making everyday situations extremely uncomfortable. Or, people may experience occasional instances of anxiety that are so terrifying and intense that they may cause the person to feel immobilized.
Often, symptoms of depression accompany anxiety disorders.
In any given year, approximately 40 million American adults aged 18 and older, or about 18.1 percent of people in this age group, are diagnosed with an anxiety disorder.
The various types of anxiety disorders include: Generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, phobias.
Generalized anxiety disorder is characterized by at least six months of persistent and excessive anxiety and worry about a number of events and activities. People who have it also experience at least some of the following:
- Inability to relax
- Inability to fall asleep or stay asleep
- Trembling or irritability
- Twitching or muscle tension
- Sweating or hot flashes
- Lightheadedness or breathlessness
- Going to the bathroom frequently
- Fatigue or lack of concentration
Panic disorders exist when someone has persistent panic attacks, which are feelings of terror that strike suddenly and without warning and build to a peak within about ten minutes (although, in some cases, they may last for as long as an hour). In addition, the person develops intense concern between attacks, worrying about when another one will occur. Symptoms of a panic attack may include:
- Trembling or shaking
- Shortness of breath or a feeling of choking or smothering
- Chest pain or discomfort
- Nausea or abdominal distress
- Dizziness or lightheadedness
- Sense of unreality
- Fear of losing control or "going crazy"
- Fear of dying
- Chills or hot flashes
- Tingling in the hands
- Pounding heart
Obsessive Compulsive Disorder (OCD)
Obsessive Compulsive Disorder, or OCD, causes people to have intrusive, unwanted thoughts or obsessions that last more than one hour a day or cause them to become distressed. Even though people who have them recognize that these obsessions or compulsions are unreasonable, they are unable to stop them.
Obsessions are persistent ideas, thoughts, impulses or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress.
Compulsions are repetitive behaviors, such as hand washing or checking, or mental acts, such as praying or counting. The goal of these behaviors or acts is to reduce anxiety or distress, rather than to provide pleasure or gratification.
In most cases, the person feels driven to perform the compulsion in order to reduce the distress that accompanies an obsession or to prevent some dreaded event or situation.
Post-traumatic Stress Disorder (PTSD)
Post-traumatic Stress Disorder can develop in anyone who has experienced a severe crisis, agony or torment. This includes victims or witnesses of a violent crime, a natural or man-made disaster, and persons involved in military combat. Sometimes the symptoms of PTSD are short-lived and resolve quickly. Other times, symptoms persist for months or years.
People with PTSD re-experience their trauma in some way. Most often, they develop intrusive, recurrent and distressful memories and repeated nightmares about the experience. Some people may lapse into a trance and re-enact the traumatic event.
People with PTSD also develop immediate emotional distress when they encounter a situation or condition that resembles or symbolizes their past traumatic experience. They avoid thinking about or doing anything that reminds them of the experience, and they experience persistent symptoms of increased anxiety, watchfulness or vigilance about what is happening in their surroundings. They may have an exaggerated startle response, a hard time falling or staying asleep and trouble concentrating.
Phobias are the most common psychiatric illness in women and the second most common in men over 25. There are three main groups.
Specific phobias case intense fear of a particular object or situation that is actually relatively safe. People who suffer from specific phobias are aware that their fear is irrational, but they still experience severe anxiety and even a panic attack at the thought of facing the object or situation. Examples of specific phobias include persistent fear of dogs, insects or snakes, driving a car, heights, tunnels or bridges, thunderstorms or flying.
Social phobias cause fear and anxiety of being humiliated or embarrassed in front of other people. It can be related to feelings of inferiority and low self-esteem and can drive someone to drop out of school, avoid making friends and remain unemployed.
Agoraphobia causes people to suffer anxiety about being in places or situations from which they find it difficult or embarrassing to leave or escape. Examples include being in a room full of people or in an elevator. In extreme cases, a person with agoraphobia may be afraid to leave his or her house, and remain housebound for months or even years.
Schizophrenia is a disorder which can affect how a person thinks, feels and acts. It is a disease that can make it difficult for a person to tell the difference between real and imagined experiences, to think logically, to express normal emotional responses or to behave appropriately in social situations.
Each year, schizophrenia affects about 2.4 million American adults, or 1.1 percent of people aged 18 and over.
Symptoms vary from person to person. They may develop slowly over months or years or appear very suddenly.
Initial symptoms, which usually begin to appear in late adolescence or early adulthood, may include mild feelings of tension, an inability to sleep or concentrate, or a loss of interest in school, work and friends. As the disorder intensifies, the individual may experience more disabling symptoms such as delusions, hallucinations, disordered speech and thoughts or a lack of motivation.
A personality disorder may exist when the way an individual consistently perceives him- or herself is out of sync with others that it causes difficulty in forming and sustaining relationships and coping with the normal stresses of daily living. As a result, the individual often feels very unhappy and distressed.
An estimated 30.8 million American adults (14.8 percent) meet standard diagnostic criteria for at least one personality disorder.
Personality disorders are generally grouped into three clusters, Cluster A, B and C, each with their own set of behaviors and symptoms.
Cluster A Disorders include: Paranoid Personality Disorder, Schizoid Personality Disorder and Schizotypal Personality Disorder.
Paranoid Personality Disorder is characterized by interpreting the actions of others as deliberately threatening or demeaning and believing others will harm, exploit or deceive, even if no objective evidence exists to support that belief.
Schizoid Personality Disorder is characterized by withdrawal and detachment from others and emotional distance.
Schizotypal Personality Disorder is characterized by discomfort around others and difficulty forming relationships.
Cluster B Disorders include: Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder and Narcissistic Personality Disorder.
Antisocial Personality Disorder is characterized by acting out conflict, ignoring normal rules of behavior, deceit and manipulation.
Borderline Personality Disorder is characterized by unstable and intense personal relationships, problems with self-image and marked impulsive and moody behavior.
Histrionic Personality Disorder is characterized by highly emotional behavior and attempts to do something dramatic to draw attention.
Narcissistic Personality Disorder is characterized by an exaggerated sense of one’s importance.
Cluster C Disorders include: Avoidant Personality Disorder, Dependent Personality Disorder and Obsessive-Compulsive Personality Disorder.
Avoidant Personality Disorder is characterized by feelings of inadequacy, hypersensitivity to rejection or negative evaluations, and inhibited social situations.
Dependent Personality Disorder is characterized by the belief that one cannot function without the help of others accompanied by submissiveness and clinging in an attempt to get others to take care of and make decisions.
Obsessive-Compulsive Personality Disorder is characterized by a preoccupation with orderliness, perfection and control.
A person who has both an alcohol or drug problem and an emotional/psychiatric has a co-occurring disorder. These individuals typically need treatment for both disorders.
It has been estimated that 37 percent of people who abuse alcohol and 53 percent of those who abuse drugs have at least one serious mental illness. Conversely, it has been estimated that 29 percent of all people diagnosed as having a serious mental illness abuse either alcohol or drugs.
Childhood Mental Illness
Approximately one in 10 children has a serious mental or emotional disorder.
Anxiety symptoms and disorders are the most common type of mental health disorder in children. They usually affect children between the ages of 6 and 11.
Autism spectrum disorders have been estimated to affect approximately one in 150 children.
Attention deficit-hyperactivity disorder (ADHD) has been diagnosed in an estimated 4.4 million youths between the ages of 4 and 17, according to the U.S. Centers for Disease Control (CDC). As of 2003, an estimated 2.5 million youth are on medication for ADHD.