This section is designed to provide education about common mental illnesses. Please note that anyone seeking a proper diagnosis should receive a thorough assessment from a trained mental health professional.
Anxiety is our brain’s “threat detection system”. It is how we identify and prepare for trouble. Anxiety can take the form of worry, nervousness, stress, fear, or even physical symptoms such as muscle tension, headaches, or an upset stomach. Anxiety itself is a natural, healthy emotion; unhealthy anxiety is disproportionate to the actual danger posed by the situation, and causes significant distress and impairment. Anxiety disorders are categorized by the root cause of the anxiety:
Agoraphobia: the fear of going into situations in which the person feels a loss of control, and worries that escape might not be possible or help might not be available. Common fearful situations are transportation (e.g. planes, buses, cars), being in open spaces (parking lots, bridges), being in enclosed spaces (shops, movie theaters, traffic), being in a line or in crowds, or being outside of the home alone.
Generalized Anxiety Disorder: experienced as chronic worry and stress across a broad range of subjects. People with GAD often describe themselves as “worry warts”, have difficulty unwinding, feel tense and/or irritable, find themselves exhausted due to stress, or have difficulty falling asleep due to being unable to stop their mind from worrying.
Panic Attacks: a powerful surge of intense fear or physical discomfort, typically lasting from 5-15 minutes. Common symptoms are heart palpitations, chest tightness, shortness of breath or choking, sweating, chills or heat flashes, nausea, shaking, dizziness, numbness or tingling sensations, derealization (feeling unreal or dream-like), or even fears of passing out or dying. Panic attacks often feel very frightening (a literal feeling of panic and loss of control), but pose no medical risk to one’s health.
Panic Disorder: some people who experience recurrent panic attacks develop an overwhelming fear of triggering another attack. This can lead to constantly scanning their bodies for sensations of an impending panic attack, developing a hypersensitivity to feared physical sensations (elevated heart rate, feeling out of breath), and avoiding situations or places that they fear could trigger another attack.
Specific Phobias: one of the most well-known anxiety disorders, phobias stem from an intense fear of a specific object or situation. This might be experienced as a powerful fear of heights, spiders, or even clowns! These situations are typically avoided at all costs, or create overwhelming anxiety if encountered.
Social Anxiety Disorder: sometimes called “social phobia”, this disorder is caused by a powerful fear of embarrassment, rejection, or humiliation around other people. Because of this, the person with social anxiety will often experience intense feelings of anxiety, shyness, or awkwardness, or avoid social situations altogether.
Performance Anxiety: a sub-type of social anxiety disorder that stems from ”performing” in front of other people. This person may generally feel comfortable in most social situations, but might experience intense anxiety from public speaking, playing an instrument in front of an audience, or participating in a sport with spectators.
ADHD is very well-known, but often misunderstood. ADHD is neurodevelopmental disorder characterized by persistent difficulties with inattention and/or hyperactivity-impulsivity. ADHD is commonly associated with some of the following symptoms:
An inability to sustain attention
Frequent careless mistakes
Problems with organization
Trouble following instructions
Easily distracted by external stimuli
Patterns of forgetfulness
These symptoms must be caused by a general inability to maintain attention or self-control, not due to outside stressors: symptoms of ADHD are often confused with other issues that create difficulties with concentration, such as stress, anxiety, or depression. The causes of ADHD are complex, but are believed to be due to an under-development in the parts of the brain responsible for “executive function”, aka the parts of the brain that dictate where attention and mental resources should be focused. Due to the difficult nature of diagnosing ADHD, one should seek a thorough assessment from a mental health professional.
“Being bipolar” is often mistakenly used to describe moodiness or irritability, but true bipolar disorder is a serious medical condition that can have a significant impact on a person’s life. Bipolar disorder is diagnosed when a person reports having “episodes” of mania and depression. “Episodes” are not simply changes in mood from one minute the next (i.e. mood swings), but distinct periods of abnormal moods that last days or weeks at a time.
Mania: persistently elevated or irritable mood, along with increased motivation or energy, lasting for over 7 days. Typically associated with unusually high self-esteem or grandiosity, decreased need for sleep (feels rested after only a few hours), more talkative than usual (might feel pressured, aka unable to stop), racing thoughts, distractibility, or engaging in unusual impulsive behavior (going on shopping sprees, gambling binges, drug/alcohol use, sexual promiscuity). Manic behavior often feels uncontrollable and can cause significant harm to one’s life. Severe manic episodes can even cause delusional beliefs or hallucinations, and may require that the individual be hospitalized to become stabilized.
Hypomania: similar symptoms to Mania, but hypomanic episodes tend to be shorter (4 days or more), less intense, and are not associated with delusionality or hallucinations. Hypomanic episodes are can still be quite destructive, however, as they are less obvious than manic episodes and therefore will often go untreated for longer.
Depression: see below.
Bipolar disorder is sometimes confused with other disorders that can cause mood swings and racing thoughts, such as anxiety or trauma. Accurate diagnosis of Bipolar disorder is very important, as standard anti-depressant and anti-anxiety medications (SSRIs) can actually cause Bipolar symptoms to become worse.
Depression is one of the most common and well-known mental illnesses today, but that does not detract from the serious impact that it can have on one’s life. Depression is not simply “having the Blues” - it’s a self-reinforcing pattern of negative emotions, thoughts, and behaviors that can be very difficult to escape from. Depression is typically characterized by the following symptoms:
Feelings of sadness, emptiness, or hopelessness
Diminished interest and enjoyment in most, or all, activities
Significant changes in appetite (eating too much or too little)
Significant changes in sleep patterns (sleeping too much or too little)
Feeling physically restless or slowed down
Fatigue or loss of loss of energy nearly every day
Feeling worthless, guilty, or like a burden on others
Difficulties concentrating or making decisions
Thoughts of death or suicide (even if there is no intent or desire to hurt oneself)
Depression is often accompanied with feelings of helplessness, hopelessness, negative thoughts about oneself, or negative thoughts about the world. Depression can also be very isolative: people with depression tend to withdraw from social relationships, or hide the full extent of their feelings from others.
Eating disorders typically stem from an unhealthy relationship with food or one’s body-image. Eating disorders tend to be associated with one or more of the following issues:
Severe food restriction due to a fear of gaining weight
Bingeing: episodes of uncontrollable eating, often accompanied by feelings of shame and embarrassment
Purging: methods to eliminate the calorie intake of food after it has been eaten, such as by vomiting, use of diuretics, or excessive exercise
Beyond the psychological distress, eating disorders can also cause significant risks to one’s health and physical well-being. Because of this, eating disorders should be treated by well-trained practitioners who are experienced in this area.
Obsessive-Compulsive Disorder is a commonly misunderstood problem that often goes unrecognized. People with OCD are typically portrayed as being germapobic, tidy, and anal-retentive, but OCD is far more complicated than most people realize. OCD is characterized by the following symptoms:
Obsessions: unpleasant and unwanted intrusive thoughts/urges/images that cause distress. These thoughts/urges/images are so uncomfortable that the persona will actively try to ignore, avoid, or eliminate them.
Compulsions: repetitive behaviors (e.g. hand washing, ordering, checking) or mental routines (e.g. praying, counting, repeating words or phrases) that the person feels compelled to perform in order to eliminate the anxiety caused by an obsessive thought or to obey a strict set of internal rules. These behaviors or mental routines are designed to reduce anxiety, but are irrational or clearly excessive for the situation.
OCD is driven by the presence of thoughts that are “sticky” and difficult to ignore. For this reason, intrusive thoughts tend to take on content that one finds uncomfortable, scary, or disturbing - the thoughts that we find the most difficult to dismiss. Another common feature is a strong difficulty with uncertainty (“did I really turn the stove off?”) - a common nickname for OCD is “the doubting disease”, because OCD can make you question your own memory or senses. Compulsions are strategies to find some relief or reassurance for the anxiety, but are like scratching a poison ivy rash: the itch just keeps coming back stronger. People with OCD can experience a wide range of symptoms, but these can grouped into common themes or “subtypes”:
Contamination: fears of becoming contaminated by germs, dirt, or otherwise becoming “unclean”
Symmetry: ordering, repeating, and counting
Checking: checking and re-checking to make sure that something is okay or “safe”. Stoves, lights, or locks are common subjects of checking behaviors
Harm: intrusive and unwanted thoughts of accidentally hurting others (e.g. while driving) or of losing control and intentionally committing violence
Sexual orientation or gender identity: obsessive thoughts that you might actually be of a different sexual orientation or gender identity than you wish to be
Scrupulosity: constant worries about having done something immoral or committed a sin
Health: excessive fears of having something wrong with one’s health
Relationship: constant rumination, checking, and reassurance-seeking to alleviate doubts about one’s relationship
Hoarding: difficulty parting with possessions, regardless of their value, due to feeling a need to save them and experiencing distress when discarding them, resulting in accumulating substantial clutter
Schizophrenia is a severe mental disorder in which the a person may experience delusions, hallucinations, bizarre thought processes, problems with concentration and motivation, mood issues, and more. Schizophrenia is typically begins between the ages of 16-30, and is a chronic condition. Thankfully, research has shown that early intervention can reduce long-term worsening of symptoms. Medication management is typically a very important component of treatment, and long-acting injectibles have been developed that can maintain a therapeutic level of medication in a person for weeks to months at a time.
The label of “Substance Use Disorder” can be used to describe any kind of unhealthy drug or alcohol use, not just addiction. Many people experience temporary periods in which their use of drugs/alcohol becomes problematic, even if they do not go on to develop a physical dependency and full-blown addiction. Some symptoms of substance abuse are:
Habitually consuming more of a drug or alcohol than one originally intended
Difficulty cutting back or controlling drug/alcohol use
Dedicating a significant amount of time to drug/alcohol use
Experiencing cravings (strong desires for the drug/alcohol)
Use of the drug/alcohol resulting in problems fulfilling obligations at work, school, or home
Continuing to use the drug/alcohol despite negative consequences
Cutting back on other activities in favor of drug/alcohol use
Using drugs/alcohol in situations where it is physically dangerous to do so
Developing a significant tolerance to the drug/alcohol
Experiencing withdrawal symptoms if you attempt to stop using the drug/alcohol
The most commonly recommended treatments for Substance Use Disorders are 12-step support groups like AA and NA, however a wide variety of therapeutic approaches and medications are available.
Trauma is a defined as an event that is so frightening, dangerous, or shocking that it leaves a lasting impact on our minds and bodies. Witnessing or being victim of a crime, abuse, accident, or natural disaster, being involved in combat, or being a first responder can all cause trauma. The most common source of trauma events in the general population are motor vehicle accidents and sexual assaults. Frequent reactions to trauma are: feelings of anxiety, sadness, or anger, difficulty concentrating or sleeping, continually thinking about the event, social withdrawal, feeling jumpy or hypervigilant, and physical symptoms like headaches, stomach pain, or tiredness. Some (but not all) who experience a traumatic event go on to develop PTSD (see below).
Post-Traumatic Stress Disorder (PTSD): while most people who’ve experienced trauma may have a period of time where they have difficulty coping, PTSD is a disorder in which a person’s brain can get “stuck” in a traumatized state. It is typically associated with some form of intrusive memories, such as vivid flashbacks or dreams, avoidance of things that remind the person of the trauma, negative changes in how one thinks about themselves or the world, and changes in physical and emotional reactions such as becoming easily startled, angered, or engaging in self-destructive behaviors. PTSD is associated with a heightened fight or flight response, where the brain and body can become easily triggered to flee or fight when feeling threatened. PTSD is often accompanied by high levels of shame and guilt, and many people attempt to hide their symptoms. Thankfully, effective treatments for PTSD have been developed, and anyone who suspects that they or a loved one might have PTSD should talk with a professional experienced with trauma.