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Guide to Mental Illness

Information Provided By The "National Institute Of Mental Health

  • GENERALIZED ANXIETY DISORDER

    • (GAD) is characterized by 6 months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. People with this disorder usually expect the worst; they worry excessively about money, health, family, or work, even when there are no signs of trouble. They are unable to relax and often suffer from insomnia. Many people with GAD also have physical symptoms, such as fatigue, trembling, muscle tension, headaches, irritability, or hot flashes. Fortunately, through research supported by the National Institute of Mental Health (NIMH), effective treatments have been developed to help people with GAD.

    How Common is GAD?

    About 3 to 4% of the U.S. population has GAD during the course of a year. GAD most often strikes people in childhood or adolescence, but can begin in adulthood, too. It affects women more often than men.

    What Causes GAD?

    Some research suggests that GAD may run in families, and it may also grow worse during stress. GAD usually begins at an earlier age and symptoms may manifest themselves more slowly than in most other anxiety disorders.

    What Treatments Are Available for GAD?

    Treatments for GAD include medications, cognitive-behavioral therapy, relaxation techniques, and biofeedback to control muscle tension. Successful treatment may include a medication called buspirone. Research into the effectiveness of other medications, such as benzodiazapines and antidepressants, is ongoing.

    Can People with GAD Also Have Other Physical and Emotional Illnesses?

    Research shows that GAD often coexists with depression, substance abuse, or other anxiety disorders. Other conditions associated with stress, such as irritable bowel syndrome, often accompany GAD. Patients with physical symptoms such as insomnia or headaches should also tell their doctors about their feelings of worry and tension. This will help the patient's health care provider to recognize that the person is suffering from GAD.

  • OBSESSIVE-COMPULSIVE DISORDER

    • People with(OCD) suffer intensely from recurrent, unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals such as handwashing, counting, checking, or cleaning are often performed in hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them markedly increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person’s life. OCD is often a chronic, relapsing illness. Fortunately, through research supported by the National Institute of Mental Health (NIMH), effective treatments have been developed to help people with OCD.

    How Common Is OCD?

    About 2% of the U.S. population has OCD in a given year. OCD typically begins during adolescence or early childhood; at least one-third of the cases of adult OCD began in childhood. OCD affects men and women equally. OCD cost the U.S. $8.4 billion in 1990 in social and economic losses, nearly 6% of the total mental health bill of $148 billion.

    What Causes OCD?

    There is growing evidence that OCD has a neurobiological basis. OCD is no longer attributed to family problems or to attitudes learned in childhood - for example, an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Instead, the search for causes now focuses on the interaction of neurobiological factors and environmental influences. Brain imaging studies using a technique called positron emission tomography (PET) have compared people with and without OCD. Those with OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness at all. In addition, PET scans show that in patients with OCD, both behavioral therapy and medication produce changes in the caudate nucleus, a part of the brain. This is graphic evidence that both psychotherapy and medication affect the brain.

    What Treatments Are Available for OCD?

    Treatments for OCD have been developed through research supported by the NIMH and other research institutions. These treatments, which combine medications and behavioral therapy (a specific type of psychotherapy), are often effective. Several medications have been proven effective in helping people with OCD: clomipramine, fluoxetine, fluvoxamine and paroxetine. If one drug is not effective, others should be tried. A number of other medications are currently being studied. A type of behavioral therapy known as “exposure and response prevention” is very useful for treating OCD. In this approach, a person is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts and then, is taught techniques to avoid performing the compulsive rituals and to deal with the anxiety.

    Can People With OCD Also Have Other Physical or Emotional Illnesses?

    OCD is sometimes accompanied by depression, eating disorders, substance abuse, attention deficit hyperactivity disorder, or other anxiety disorders. When a person also has other disorders, OCD is often more difficult to diagnose and treat. Symptoms of OCD can also coexist and may even be part of a spectrum of neurological disorders, such as Tourette’s syndrome. Appropriate diagnosis and treatment of other disorders are important to successful treatment of OCD.

  • PANIC DISORDER

    • is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions. As a result, the diagnosis of panic disorder is frequently not made until extensive and costly medical procedures fail to provide a correct diagnosis or relief. Many people with panic disorder develop intense anxiety between episodes, worrying when and where the next one will strike. Fortunately, through research supported by the National Institute of Mental Health (NIMH), effective treatments have been developed to help people with panic disorder.

    How Common Is Panic Disorder?

    In a given year, 1 to 2% of the U.S. population has panic disorder. Women are twice as likely as men to develop panic disorder. Panic disorder typically strikes in young adulthood. Roughly half of all people who have panic disorder develop the condition before age 24.

    What Causes Panic Disorder?

    The exact cause of panic disorder is unknown and is the subject of intense scientific investigation. Possible causes include heredity, other biological factors, stressful life events, and overreacting to normal bodily sensations. Some research suggests panic attacks occur when a “suffocation alarm mechanism” in the brain erroneously fires, falsely reporting that death is imminent.

    What Treatments Are Available for Panic Disorder?

    Treatment for panic disorder includes medications and a type of psychotherapy known as cognitive-behavioral therapy, which teaches people how to view panic attacks differently and demonstrates ways to reduce anxiety. NIMH is conducting a large-scale study to evaluate the effectiveness of combining these treatments. Appropriate treatment by an experienced professional can reduce or prevent panic attacks in 70% to 90% of people with panic disorder. Most patients show significant progress after a few weeks of therapy. Relapses may occur, but they can often be effectively treated just like the initial episode.

    Can People with Panic Disorder Also Have Other Physical and Emotional Illnesses?

    Research shows that panic disorder can coexist with other disorders, most often depression and substance abuse. About 30% of people with panic disorder use alcohol and 17% use drugs, such as cocaine and marijuana, in unsuccessful attempts to alleviate the anguish and distress caused by their condition. Appropriate diagnosis and treatment of other disorders such as substance abuse or depression are important to successfully treat panic disorder. Approximately 20% of people with panic disorder attempt suicide. It is not unusual for a person with panic disorder to develop phobias about places or situations where panic attacks have occurred, such as in supermarkets or other everyday situations. As the frequency of panic attacks increases, the person often begins to avoid situations where they fear another attack may occur or where help would not be immediately available. This avoidance may eventually develop into agoraphobia, an inability to go beyond known and safe surroundings because of intense fear and anxiety. People with panic disorder may also have irritable bowel syndrome, characterized by intermittent bouts of gastrointestinal cramps and diarrhea or constipation, or a relatively minor heart problem called mitral valve prolapse. In fact, panic disorder often coexists with unexplained medical problems such as chest pain not associated with a heart attack or chronic fatigue.

  • PHOBIAS

    • are persistent, irrational fears of certain objects or situations. Phobias occur in several forms; the fear associated with a phobia can focus on a particular object (specific phobia) or be a fear of embarrassment in a public setting (social phobia). People who have phobias are often so overwhelmed by their anxiety that they avoid the feared objects or situations. Specific phobias involve a fear of an object or situation, such as small animals, snakes, closed-in spaces, or flying in an airplane. Social phobia is the fear of being humiliated in a social setting, such as when meeting new people, giving a speech, or talking to the boss. Most people experience these fears with mild to moderate intensity, and the fear passes. For people with social phobia, however, the fear is extremely intrusive and can disrupt normal life, interfering with work or social relationships in varying degrees of severity. Fortunately, through research supported by the National Institute of Mental Health (NIMH), effective treatments have been developed to help people with phobias.

    How Common Are Phobias?

    Approximately 4 to 5% of the U.S. population has one or more clinically significant phobias in a given year. Specific phobias occur in people of all ages. The average age of onset for social phobia is between 15 and 20 years of age, although it can often begin in childhood.

    What Causes Phobias?

    Traumatic events often trigger the development of specific phobias, which are slightly more prevalent in women than men. Research shows that social phobia may have a hereditary component and occurs in women and men in equal proportions. However, men may seek treatment for social phobia more frequently than women.

    What Treatments Are Available for Phobias?

    Social phobia can be effectively treated with medications including, MAOIs, SSRIs, and high potency benzodiazepines. People with a specific form of social phobia called performance phobia have been helped by drugs called beta blockers. There is no proven drug treatment for specific phobias, but certain medications may help reduce symptoms of anxiety before one faces a phobic situation. A type of cognitive-behavioral therapy known as "exposure therapy" is also a very useful treatment for phobias. It involves helping patients become gradually more comfortable with situations that frighten them. Relaxation and breathing techniques are also helpful.

    Can People with Phobias Also Have Other Physical and Emotional Illnesses?

    People with phobias, particularly social phobia, may also have problems with substance abuse. Many people with social or a specific phobia become so anxious that they experience panic attacks, which are intense and unexpected bursts of terror accompanied by physical symptoms. As more situational panic attacks occur, people with phobias may take extreme measures to avoid situations where they fear another attack might happen or where help would not be immediately available. This avoidance, similar to that in many panic disorder patients, may eventually develop into agoraphobia, an inability to go beyond known and safe surroundings because of intense fear and anxiety. Appropriate diagnosis and treatment of other disorders are important to successful treatment of phobias.

  • POST-TRAUMATIC STRESS DISORDER

    (PTSD) is an extremely debilitating condition that can occur after exposure to a terrifying event or ordeal in which grave physical harm was threatened or occurred. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural or manmade disasters, car accidents, or military combat. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. Despite this avoidant behavior, many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Symptoms of PTSD also include emotional numbness and sleep disturbances (including insomnia), depression, and irritability or outbursts of anger. Feelings of intense guilt are also common. PTSD is diagnosed only if these symptoms last more than one month. Fortunately, through research supported by the National Institute of Mental Health (NIMH), effective treatments have been developed to help people with PTSD.

    How Common Is PTSD?

    About 4% of the population will experience symptoms of PTSD in a given year.

    When Does PTSD Strike?

    PTSD can develop at any age, including childhood. Symptoms of PTSD typically begin within 3 months following a traumatic event, although occasionally symptoms do not begin until years later. Once PTSD develops, the duration of the illness varies. Some people recover within 6 months while others may suffer much longer.

    What Treatments Are Available for PTSD?

    Treatment for PTSD includes cognitive-behavioral therapy, group psychotherapy, and medications (including antidepressants). Various forms of exposure therapy (such as systemic desensitization and imaginal flooding) have all been used with PTSD patients. Exposure treatment for PTSD involves repeated reliving of the trauma, under controlled conditions, with the aim of facilitating the processing of the trauma.

    Can People with PTSD Also Have Other Physical or Emotional Illnesses?

    People with PTSD can also have other psychological difficulties, particularly depression, substance abuse, or another anxiety disorder. The likelihood of treatment success is increased when these other conditions are appropriately diagnosed and treated, as well.

    Created on ... January 17, 2002

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