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Mental Illness
Mental illnesses include such disorders as schizophrenia, bipolar
disorder, major depressive disorder, obsessive-compulsive disorder,
panic and other severe anxiety disorders, personality disorders, and
other severe and persistent mental illnesses that affect the brain.
These disorders can profoundly disrupt a person's thinking, feeling,
moods, ability to relate to others and capacity for coping with the
demands of life.
Mental illnesses can affect persons of any age, race, religion, or
income. Mental illnesses are not the result of personal weakness, lack
of character, or poor upbringing.
Mental illnesses are treatable. Most people with serious mental
illness need medication to help control symptoms, but also rely on
supportive counseling. self-help groups, assistance with housing,
vocational rehabilitation, income assistance and other community
services in order to achieve their highest level of recovery.
Here are some important facts about mental illness and recovery:
Mental illnesses are biologically based brain disorders. They cannot
be overcome through "will power" and are not related to a person's
"character" or intelligence.
Mental disorders fall along a continuum of severity. The most serious
and disabling conditions affect (2.6 – 5.4%) of adults (5 – 9%) of
children ages five to seventeen.
Mental disorders are the leading cause of disability (lost years of
productive life) in the world. By 2020, Major Depressive illness will
be the leading cause of disability in the world for women and
children.
Mental illnesses strike individuals in the prime of their lives, often
during adolescence and young adulthood. All ages are susceptible, but
the young and the old are especially vulnerable.
Without treatment the consequences of mental illness for the
individual and society are staggering: unnecessary disability,
unemployment, substance abuse, homelessness, inappropriate
incarceration, suicide and wasted lives; The economic cost of
untreated mental illness is very high in terms of money throughout the
world.
The best treatments for serious mental illnesses today are highly
effective; between 70 and 90 percent of individuals have significant
reduction of symptoms and improved quality of life with a combination
of pharmacological and psychosocial treatments and supports;
Early identification and treatment is of vital importance; By getting
people the treatment they need early, recovery is accelerated and the
brain is protected from further harm related to the course of illness.
Stigma erodes confidence that mental disorders are real, treatable
health conditions. We have allowed stigma and a now unwarranted sense
of hopelessness to erect attitudinal, structural and financial
barriers to effective treatment and recovery. It is time to take these
barriers down.
Treatment of Mental Illness :
Extraordinary advances have been made in the treatment of mental
illness. An understanding of what causes some mental health disorders
has led to greater sophistication in tailoring treatment to the
underlying basis of each disorder. As a result, many mental health
disorders can now be treated nearly as successfully as physical
disorders.
Most treatment methods for mental health disorders can be categorized
as either somatic or psychotherapeutic. Somatic treatments include
drug therapy and electroconvulsive therapy. Psychotherapeutic
treatments include individual, group, or family and marital
psychotherapy; behavior therapy techniques (such as relaxation
training or exposure therapy); and hypnotherapy. Most studies suggest
that for major mental health disorders, a treatment approach involving
both drugs and psychotherapy is more effective than either treatment
method used alone.
Psychiatrists are not the only mental health care professionals
trained to treat mental illness. Others include clinical
psychologists, social workers, nurses, and some pastoral counselors.
However, psychiatrists are the only mental health care professionals
licensed to prescribe drugs. Other mental health care professionals
primarily practice psychotherapy.
Drug Therapy :
Over the last 40 years, a number of psychoactive drugs have been
developed that are highly effective and widely used by psychiatrists
and other medical doctors. These drugs are often categorized according
to the disorder for which they are primarily prescribed. For example,
antidepressants are used to treat depression. Selective serotonin
reuptake inhibitors are the newest and most widely used class of
antidepressants. Other new classes of antidepressants are being
developed. Antipsychotic drugs, such as chlorpromazine, haloperidol,
and thiothixene, are helpful in treating psychotic disorders such as
schizophrenia. Newer antipsychotic drugs, such as clozapine,
risperidone, olanzapine, and quetiapine, are increasingly being used
because they have fewer side effects. Ant anxiety drugs, such as
clonazepam and diazepam, as well as selective serotonin reuptake
inhibitors (which are antidepressants), are used to treat anxiety
disorders, such as panic disorder and phobias. Mood stabilizers, such
as lithium, carbamazepine, and valproate, have been used with some
success to treat manic-depressive illness (bipolar disorder).
Electroconvulsive Therapy :
With electroconvulsive therapy, electrodes are attached to the head,
and a series of electrical shocks are delivered to the brain to induce
seizures. This therapy has consistently been shown to be the most
effective treatment for severe depression. Many people treated with
electroconvulsive therapy experience temporary memory loss. However,
contrary to its portrayal in the media, electroconvulsive therapy is
safe and rarely causes any other complications. The modern use of
anesthetics and muscle relaxants has greatly reduced any risk to the
person.
Psychotherapeutic Treatments:
In recent years, significant advances have been made in the field of
psychotherapeutic treatments. Psychotherapy, sometimes referred to as
"talk" therapy, works on the assumption that each person has within
himself the cure for his own suffering and that this cure can be
facilitated through a trusting, supportive relationship with a
psychotherapist. By creating an empathetic and accepting atmosphere,
the therapist often is able to help the person identify the source of
his problems and consider alternatives for dealing with them. The
emotional awareness and insight that the person gains through
psychotherapy often results in a change in attitude and behavior that
allows the person to live a fuller and more satisfying life.
Psychotherapy is appropriate in a wide range of conditions. Even
people who do not have a mental health disorder may find psychotherapy
helpful in coping with such problems as employment difficulties,
bereavement, or chronic illness in the family. Group psychotherapy,
couples' therapy, and family therapy are also widely used.
Most mental health professionals practice within one of five types of
psychotherapy: psychoanalysis, psychodynamic psychotherapy, cognitive
therapy, behavior therapy, or interpersonal therapy.
Psychoanalysis:
Is the oldest form of psychotherapy and was developed by Sigmund Freud
in the first part of the 20th century. The person typically lies on a
couch in the therapist's office 4 or 5 times a week and attempts to
say whatever comes into his mind, a practice called free association.
Much of the focus is on understanding how past patterns of
relationships repeat themselves in the present. The relationship
between the person and the therapist is a key part of this focus. An
understanding of how the past affects the present helps the person
develop new and more adaptive ways of functioning in relationships and
in work settings.
Psychodynamic psychotherapy, like psychoanalysis, emphasizes the
identification of unconscious patterns in current thoughts, feelings,
and behaviors. However, the person is usually sitting instead of lying
on a couch and attends only 1 to 3 sessions per week. In addition,
less emphasis is placed on the relationship between the person and
therapist.
Cognitive therapy:
Helps people identify distortions in thinking and understand how these
distortions lead to problems in their lives. The underlying premise is
that how people feel and behave are determined by how they interpret
experiences. Through the identification of core beliefs and
assumptions, people can begin to think in different ways about their
experiences, resulting in improvement in symptoms, behavior, and
feelings.
Behavior therapy:
Is related to cognitive therapy. Sometimes, a combination of the two,
known as cognitive-behavior therapy, is used. The theoretical basis of
behavior therapy is learning theory, which holds that abnormal
behaviors are due to faulty learning. Behavior therapy involves a
number of interventions that are designed to help the person unlearn
maladaptive behaviors while learning adaptive behaviors. Exposure
therapy is one example of a behavior therapy.
Interpersonal therapy:
Was initially conceived as a brief psychological treatment for
depression and is designed to improve the quality of a depressed
person's relationships. It focuses on unresolved grief, conflicts that
arise when people fill roles that differ from their expectations (such
as when a woman enters a relationship expecting to be a stay-at-home
mother and finds that she must also be the major provider for the
family), social role transitions (such as going from being an active
worker to being retired), and difficulty communicating with others.
The therapist teaches the person to improve aspects of interpersonal
relationships, such as overcoming social isolation and responding in a
less habitual way to others.
Hypnosis and Hypnotherapy :
Hypnosis and hypnotherapy are often used to manage pain and treat
physical disorders that have a psychological component. Hypnosis is
simply the induction of a trance or altered state of consciousness,
whereas hypnotherapy involves psychotherapeutic intervention in
conjunction with the hypnotic state. These techniques may promote
relaxation and thereby lower anxiety and reduce tension. For example,
hypnosis and hypnotherapy can help people with cancer who have anxiety
or depression in addition to pain.
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