We have all been mentally ill at one time or another, just as we have been physically ill at one time or another.Most mental illnesses are typically not severe and are extremely common.Problems of everyday life can bring about symptoms such as sadness, anxiety, irritability, and depression (Thio, p. 169).
Hospitalization – The majority (70-80%) of hospitalized mental patients can recover and live relatively normal lives with successful treatment.Violence – The great majority (about 90%) of mental patients are not prone to violence and criminality.Winter Blues – Typically viewed as depression caused by lack of sunshine and coldness; however, depression is actually more likely to strike people in the summer than winter. Depression is a very common occurrence.Autism – The rate of autism has risen 657% over the past decade, partly due to broader definitions of the disorder and the inclusion of mild symptoms that were not previously included (Thio, p. 170).
Studies have shown a “link between mental disorder and genetics, biochemical abnormalities, neuroanatomical abnormalities, and the structure and functioning of the brain” (Kinderman, 2005). A variety of mental health conditions – such as depression, bipolar disorder, and schizophrenia – have been linked to genetic heritability.There is a scientifically proven association between mental disorders and psychological issues, such as life-shaping experiences or circumstances, childhood sexual abuse, bullying, assault, and interpersonal conflict (Kinderman, 2005).Studies have also shown a connection between mental disorders and social factors, such as poverty and unemployment (Kinderman, 2005).
These are two broad categories of mental disorder that both show the same symptoms: hallucination, delusion, impaired judgment, and other behavioral disturbances (Thio, p. 171).Organic Disorders – Result from damage to the brain. Examples: tumor, head injury, viral meningitis, brain syphilis, lead poisoning, deterioration from old age, drug abuse, or other acute physical damageFunctional Disorders – Result from psychological and social factors.Examples: unpleasant childhood experiences, interpersonal conflict, social stress (Thio, p. 171)These two categories are differentiated by their underlying cause.
According to Freud, “Psychosis denies reality and tries to substitute something else for it; neurosis does not deny reality, it merely tries to ignore it” (Thio, p. 171).Psychosis – Loses touch with reality. Does not recognize they are mentally ill (Thio, p. 171).Neurosis – Inability to face reality. Worried, terrified, or obsessed about reality (Thio, p. 173).Personality Disorder – Too self-absorbed, unsociable, or antisocial (Thio, p. 174).
Schizophrenia is the most common type of psychosis. Symptoms of Schizophrenia include: Loss of touch with reality Problems or inability to attend work or school Inappropriate expression of emotions Withdrawal from others Unresponsiveness to surroundings Delusions of grandeur or persecution Hallucinations (Thio, p. 172)
Manic-Depressive Disorder -aka Bipolar Disorder - is another common type of psychosis. Manic-Depressive Disorder is characterized by a fluctuation between opposite extreme of mood:mania vs. depression (Thio, p. 172).Symptoms of mania include: elation, exuberance, confidence, or excitement, hyperactivity, and grandiose delusions (Thio, p. 172).Symptoms of depression include: overwhelming despair, delusions of worthlessness, and suicidal ideation (Thio, p. 173).
Anxiety reaction -- Examples: Apprehension, nervousness, panic sensation, phobiasObsession/Compulsion:Obsession – Bothersome interruptions of normal train of thought.Compulsion – Ritualistic actions and the need to perform them.Depressive reaction -- Examples: Sadness, dejection, self-deprecationPsychophysiologic Disorder aka Psychosomatic illness --Symptoms that have no physical or neurologic cause (Thio, p. 173-174).
Personality Disorder is characterized by:* Blatant disregard for society’s rules * Lack of conscience and compassion * Self-centered nonconformists (Thio, p. 174).
Social stigmatization can have a tremendous impact on the lives of people with mental disorders. According to the labeling theory, “stereotypes about the mentally ill become personally relevant for persons with a mental disorder. These beliefs may act as a self-fulfilling prophecy and lead to lowered self-esteem” (Box, et al., 2009).To disclose or not disclose … that is the question. Disclosure may lead to stigmatization and contribute negatively towards psychological well-being. However, nondisclosure reduces the availability of social supports and can contribute to additional psychological stressors and challenges (Box, et al., 2009).
Social causation:* Mental disorder caused by social stressors. * Most prevalent in lower-class people.Social selection:* Higher-class people shift towards lower-class as lower-class status is a consequence of mental disorder (Thio, p. 176-177)
* Gender roles influence gender difference in mental disorder.* Women are more likely to have depression, anxiety, posttraumatic stress disorder.* Men are more likely to have antisocial personality, paranoia, drug and alcohol disorders (Thio, p. 177).
* The elderly are the least likely to become mentally ill.* People aged 25-34 have the highest rate of mental illness.* Youth depression rates have increased significantly in recent decades (Thio, p. 178).
* Mild depression – SAD - (short-term)* Situational depression – MORE SAD -(intermediate)* Major Depression – SEVERE SADNESS -(long-term) (Thio, p. 178-179)
* Increased rates of psychiatric distress among American blacks, Hispanics, and Asians.* Minorities experience more social stress due to discrimination, poverty, and cultural conflict (Thio, p. 179-180).
* Increased rates of mental disorder in urban areas, particularly inner city.* Produces abundance of physical and social stressors. Examples: traffic, noise, crowding, social tension, lack of social support (Thio, p. 180)
* Geographic proximity to terror attack correlates with posttraumatic stress disorder occurrence and severity.* More exposure to media coverage of terror attack correlates with increased posttraumatic stress disorder occurrence and severity (Thio, p. 181).
Chapter 8Mental Disorder Part I: Mary Young Part II: Anne (Philamena) Casey
Popular Beliefs Myth #1: Mental illness is essentially incurable; most mental patients will never recover. Myth #2: The mentally ill are no longer stigmatized and are treated with respect and understanding. Myth #3: The mentally ill are mostly crazed, violent, and therefore dangerous. (MY)
Popular Beliefs (cont’d.) Reality #1: The majority of mental patients can recover and live relatively normal lives (Thio, p. 170). Reality #2: Most people, regardless of age and education, feel that the mentally ill are somehow dangerous, violent, unpredictable, or worthless (Thio, p. 184). Reality #3: The great majority (about 90%) of mental patients are not prone to violence and criminality. They are more likely to hurt themselves than others (Thio, p. 170). (MY)
Types of Mental Disorder Traditional Classification 1.) Organic Disorders 2.) Functional Disorders (MY)
Types of Mental Disorder (cont’d.) DSM-IV Classification The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Thio, p. 174) Each mental disorder is listed along with its defining symptoms/criteria. (MY)
Incidence of mental disorder is generally higher in modern industrial societies such as the United States, France and England. (Thio, p.181)
Lower incidence of mental disorder in traditional agricultural societies such as China and Nigeria. (Thio, p.181)
Many different mental disorders occur in only specific areas which are attributed to the specific culture of the area.
A current events impact on Mental Health. September 11th, 2001. Three to Five days following September 11th , approximately 44% of Americans experienced symptoms of PTSD (Post Traumatic Stress Disorder) such as irritability, difficulty sleeping etc. (Thio, p.181) Five to Nine weeks after September 11th, 10% of New Yorkers came down with symptoms of major depression. To provide perspective, the serious stress suffered by 2.7% to 11.2% of Americans was considered a significant public health problem. (Thio, p. 181) (Schlenger et al., 2002) PC
Societal Response to Mental Disorder In ancient Greece mental illness was viewed with awe. (Thio, p.182) In the middle ages, mental patients were portrayed by artists as the only ones in touch with reality (Thio, p. 183) In biblical times mental patients were perceived as demons and put to death. In 1600 Germany a man proclaimed to be God, his tongue was cut out, he was beheaded and his body was burned. (Thio, p. 183) In 1793 a revolutionary change in attitude toward mentally ill occurred in Paris, they were treated with respect or moral treatment. (Thio, p.183) By 1955 new alternatives to mental institutions began to emerge, these included hospitals, outpatient clinics, private clinics and community mental health clinics. (Thio, p.184) PC
Community responsibility for mental health services PC Reducing suicide rates requires a collective, concerted effort from all groups in society: health, social services, other professionals, communities and community leaders, voluntary and statutory agencies and organizations, parents, friends, neighbors, and individuals. (Horizon, 2007 p.54) Suicide is an issue which affects every element of our society. The frequent clustering of suicides leaves not just individuals bereaved – families, friends, neighbors, and colleagues – but also devastates entire communities, leaving a legacy of hurt, confusion, insecurity, and fear. (Horizon, 2007 p.54)
Mental health courts a misguided attempt PC People with mental illness are falling through the cracks of this country’s social safety net and are landing in the criminal justice system at an alarming rate. (Seltzer 2005, p.572) Adults with mental illnesses are arrested for the same behavior twice as often as people who do not have a mental illness. (Seltzer 2005, p.573) Half of all arrests of people with mental illnesses are for nonviolent crimes such as trespassing or disorderly conduct. (Seltzer 2005, p.577)
PC Courts can hospitalize the mentally ill against their will for an indefinite period of time. Insanity defense , if judged insane sent to an institution , if judged sane is sent to prison.
References for Part I Bos, A., Kanner, D., Muris, P., Janssen, B., & Mayer B. (2009). Mental illness stigma and disclosure: Consequences of coming out of the closet. Issues in Mental Health Nursing, 30(8), 509-513. doi:10.1080/01612840802601382. Kinderman, P. (2005). A psychological model of mental disorder. Harvard Review of Psychiatry, 13(4), 206-207. doi:10.1080/10673220500243349. Thio, Alex. (2010). Deviant Behavior (10th ed.). Boston: Pearson. (MY)
References Part II (2008). Remarks by Mary McAleese, President of Ireland : Made at the International Association of Suicide Prevention XXIV Biennial Conference, August 31, 2007, Irish National Events Centre, Killarney, Co. Kerry, Ireland. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 29(1), 53-55. doi:10.1027/0227-5910.29.1.53. Seltzer, T. (2005). Mental health courts: A misguided attempt to address the criminal justice system's unfair treatment of people with mental illnesses. Psychology, Public Policy, and Law, 11, 570-586. Thio, A. (2010). Deviant behavior. Boston: Allyn & Bacon. PC