Types of Disorders

     

1. Psychotic Disorders

Schizophrenia is a chronic, severe, and disabling brain disorder that has affected people throughout history. About 1 percent of Americans have this illness.

People with the disorder may hear voices other people don't hear. They may believe other people are reading their minds, controlling their thoughts, or plotting to harm them. This can terrify people with the illness and make them withdrawn or extremely agitated.

People with schizophrenia may not make sense when they talk. They may sit for hours without moving or talking. Sometimes people with schizophrenia seem perfectly fine until they talk about what they are really thinking.

Families and society are affected by schizophrenia too. Many people with schizophrenia have difficulty holding a job or caring for themselves, so they rely on others for help.

Treatment helps relieve many symptoms of schizophrenia, but most people who have the disorder cope with symptoms throughout their lives. However, many people with schizophrenia can lead rewarding and meaningful lives in their communities. Researchers are developing more effective medications and using new research tools to understand the causes of schizophrenia. In the years to come, this work may help prevent and better treat the illness.

The symptoms of schizophrenia fall into three broad categories: positive symptoms, negative symptoms, and cognitive symptoms.

Positive Symptoms

Positive symptoms are psychotic behaviors not seen in healthy people. People with positive symptoms often "lose touch" with reality. These symptoms can come and go. Sometimes they are severe and at other times hardly noticeable, depending on whether the individual is receiving treatment. They include the following:

Hallucinations are things a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. "Voices" are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices. The voices may talk to the person about his or her behavior, order the person to do things, or warn the person of danger. Sometimes the voices talk to each other. People with schizophrenia may hear voices for a long time before family and friends notice the problem.

Other types of hallucinations include seeing people or objects that are not there, smelling odors that no one else detects, and feeling things like invisible fingers touching their bodies when no one is near.

Delusions are false beliefs that are not part of the person's culture and do not change. The person believes delusions even after other people prove that the beliefs are not true or logical. People with schizophrenia can have delusions that seem bizarre, such as believing that neighbors can control their behavior with magnetic waves. They may also believe that people on television are directing special messages to them, or that radio stations are broadcasting their thoughts aloud to others. Sometimes they believe they are someone else, such as a famous historical figure. They may have paranoid delusions and believe that others are trying to harm them, such as by cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. These beliefs are called "delusions of persecution."

Thought Disorders are unusual or dysfunctional ways of thinking. One form of thought disorder is called "disorganized thinking." This is when a person has trouble organizing his or her thoughts or connecting them logically. They may talk in a garbled way that is hard to understand. Another form is called "thought blocking." This is when a person stops speaking abruptly in the middle of a thought. When asked why he or she stopped talking, the person may say that it felt as if the thought had been taken out of his or her head. Finally, a person with a thought disorder might make up meaningless words, or "neologisms."

Movement Disorders may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic. Catatonia is a state in which a person does not move and does not respond to others. Catatonia is rare today, but it was more common when treatment for schizophrenia was not available.

"Voices" are the most common type of hallucination in schizophrenia.

Negative Symptoms

Negative symptoms are associated with disruptions to normal emotions and behaviors. These symptoms are harder to recognize as part of the disorder and can be mistaken for depression or other conditions. These symptoms include the following:

  • "Flat affect" (a person's face does not move or he or she talks in a dull or monotonous voice)
  • Lack of pleasure in everyday life.
  • Lack of ability to begin and sustain planned activities.
  • Speaking little, even when forced to interact.
People with negative symptoms need help with everyday tasks. They often neglect basic personal hygiene. This may make them seem lazy or unwilling to help themselves, but the problems are symptoms caused by the schizophrenia.

Cognitive Symptoms

Cognitive symptoms are subtle. Like negative symptoms, cognitive symptoms may be difficult to recognize as part of the disorder. Often, they are detected only when other tests are performed. Cognitive symptoms include the following:

  • Poor "executive functioning" (the ability to understand information and use it to make decisions)
  • Trouble focusing or paying attention.
  • Problems with "working memory" (the ability to use information immediately after learning it).

Cognitive symptoms often make it hard to lead a normal life and earn a living. They can cause great emotional distress.

 

2. Bipolar Disorders

Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes-from extreme highs (e.g., mania) to extreme lows (e.g., depression).

Major depressive disorder (unipolar depression) is reported to be the most common mood disorder. It may manifest as a single episode or as recurrent episodes. The course may be somewhat protracted—up to 2 years or longer—in those with the single-episode form. About three out of four patients experience recurrences throughout life, with varying degrees of residual symptoms between episodes. Bipolar disorders (previously called manic-depressive psychosis) consists of at least one hypomanic or manic episode. Most bipolar disorder patients experience episodes of both polarity. Manias predominate in men, depression and mixed states in women. A person may sometimes develop milder, short-lived periods of hypomania rather than full-blown mania (bipolar II disorder).

 

3. Depressive Disorders

There are several forms of depressive disorders. The most common are major depressive disorder and dysthymic disorder.

Major Depressive Disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.

Dysthymic Disorder, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Double Depression: Sometimes there is an insidious onset of depression dating back to late childhood or the teens. When one or more major depressive episodes add on top of these low levels of depression individuals are then suffering from what is commonly called as “double depression”. This pattern, commonly referred to as double depression, is seen in about 20 to 25 percent of persons with major depressive disorder. A return to the low-grade depressive pattern usually takes place following recovery from superimposed major depressive episodes.

Some forms of depressive disorder exhibit slightly different characteristics than those described above, or they may develop under unique circumstances. However, not all scientists agree on how to characterize and define these forms of depression. They include:

Psychotic Depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.

Postpartum Depression, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

Seasonal Affective Disorder (SAD), which is characterized by the onset of a depressive illness during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.

 

4. Anxiety

Anxiety Disorders affect about 40 million American adults age 18 years and older (about 18%) in a given year, causing them to be filled with fearfulness and uncertainty. Unlike the relatively mild, brief anxiety caused by a stressful event (such as speaking in public or a first date), anxiety disorders last at least 6 months and can get worse if they are not treated. Anxiety disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse. In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder.

Effective therapies for anxiety disorders are available, and research is uncovering new treatments that can help most people with anxiety disorders lead productive, fulfilling lives. If you think you have an anxiety disorder, you should seek information and treatment right away.

Categories of anxiety disorders include

  • Panic Disorder:

    Panic disorder consists of recurrent episodes of panic attacks which are unexpected and unpredictable.

    A panic attack is defined as a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

  1. Palpitations, pounding heart, or accelerated heart rate
  2. Sweating
  3. Trembling or shaking
  4. Sensations of shortness of breath or smothering
  5. Feeling of choking
  6. Chest pain or discomfort
  7. Nausea or abdominal distress
  8. Feeling dizzy, unsteady, lightheaded, or faint
  9. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  10. Fear of losing control or going crazy
  11. Fear of dying
  12. Paresthesias (numbness or tingling sensations)
  13. Chills or hot flushes
 
  • Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD), Obsessions are defined as recurrent, persistent thoughts, images, or impulses that are experienced as intrusive and inappropriate. Compulsions are repetitive behaviors (e.g., checking locked doors or gas jets, handwashing) or mental acts (e.g., counting, repeating words) that the person feels driven to perform in response to an obsession or according to rigid rules. As a rule, the person recognizes that the obsessions or compulsions are excessive or unreasonable.

 
  • Post-traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is defined in as a constellation of symptoms in response to a stressor. The symptoms persist for at least 1 month and include reexperiencing a traumatic event such as having nightmares, numbed feeling, and symptoms of an increased level of arousal and avoidance of stimuli associated with the event.

 
  • Social Phobia

Social phobia (or social anxiety disorder), social phobia is a persistent, irrational fear accompanied by a compelling desire to avoid situations in which a person might act in a humiliating or embarrassing way while under the scrutiny of others. The person recognizes the fear as excessive or unreasonable. Common social phobias involve fears of speaking or eating in public, urinating in public lavatories, writing in front of others, or saying foolish things in social situations.


 
  • Tab Specific Phobia

Specific phobias such as fear of spiders, heights, traveling in air-plane etc. One such type is Agoraphobia which is defined as a fear and avoidance of being in places or situations from which escape might be difficult or in which help might not be available in the event of sudden incapacitation. As a result of such fears, the agoraphobic person avoids travel outside the home or requires accompaniment when away from home. Moderate cases may cause some constriction in lifestyle, while severe cases of agoraphobia may result in the person being completely housebound or unable to leave home unaccompanied..

 
  • Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD), in which excessive anxiety and worry (apprehensive expectation), occurrs for several days in a span of at least 6 months, about a number of events or activities (such as work or school performance). The person finds it difficult to control the worry. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children.

  1. Restlessness or feeling keyed up or on edge
  2. Being easily fatigued
  3. Difficulty concentrating or mind going blank
  4. Irritability
  5. Muscle tension
  6. Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
 

5. Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder, ADHD, is one of the most common mental disorders that develop in children. Children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. If untreated, the disorder can have long-term adverse effects into adolescence and adulthood.

Signs & Symptoms

Symptoms of ADHD will appear over the course of many months, and include: nattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age.

Children who have symptoms of inattention may:

  • Be easily distracted, miss details, forget things, and frequently switch from one activity to another.
  • Have difficulty focusing on one thing.
  • Become bored with a task after only a few minutes, unless they are doing something enjoyable.
  • Have difficulty focusing attention on organizing and completing a task or learning something new
  • Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities.
  • Not seem to listen when spoken to.
  • Daydream, become easily confused, and move slowly.
  • Have difficulty processing information as quickly and accurately as others.
  • Struggle to follow instructions.

Children who have symptoms of hyperactivity may:

  • Fidget and squirm in their seats.
  • Talk nonstop.
  • Dash around, touching or playing with anything and everything in sight.
  • Have trouble sitting still during dinner, school, and story time.
  • Be constantly in motion.
  • Have difficulty doing quiet tasks or activities.

Children who have symptoms of impulsivity may:

  • Be very impatient.
  • Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences.
  • Have difficulty waiting for things they want or waiting their turns in games.
  • Often interrupt conversations or others' activities.

How is it diagnosed?

If ADHD is suspected, the diagnosis should be made by a professional with training in ADHD. This includes child psychiatrists, psychologists, developmental/behavioral pediatricians, behavioral neurologists, and clinical social workers. After ruling out other possible reasons for the child’s behavior, the specialist checks the child’s school and medical records and talks to teachers and parents who have filled out a behavior rating scale for the child. A diagnosis is made only after all this information has been considered.

Treatment

Effective treatments for ADHD are available, and include behavioral therapy and medications.

 


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