Mental Disorders

Despite the fact that it’s the 21st century, there is still significant stigma attached to mental illness. The derogatory term “mentally ill” is often associated only with the most serious conditions, such as schizophrenia and bipolar disorder.

However, the DSM – the Diagnostic and Statistical Manual of Mental Disorders – actually lists a wide range of psychiatric conditions, including everything from primary insomnia to nicotine dependence. Yet most people would never regard someone who’s been having trouble sleeping for the past month or a 2-pack-a-day smoker as having a “mental disorder”.

Mental disorders are quite prevalent; they affect far more people than you might think. Granted, some disorders, like acute stress disorder, last for only a few days to a few weeks and then subside. Some mental disorders are recurring – which is often the case with disorders like major depression. But some, like schizophrenia, typically last a lifetime – even with treatment.

Despite all the advances of science, we still don’t know exactly what causes the vast majority of mental disorders. In most cases it is believed to be a combination of factors including genetics, environmental influences such as childhood trauma, for example, and imbalances in brain chemistry. Some believe that spiritual factors may also play a role.

The traditional treatment of most mental disorders usually involves psychotropic medication, psychotherapy, or a combination of both. Lifestyle changes – such as getting regular exercise, practicing meditation and / or yoga, using relaxation techniques, making dietary changes, or taking certain supplements are also often beneficial- at least to some degree.

With regards to both our understanding and treatment of mental disorders, we’ve certainly made significant progress in the past century. It wasn’t really that long ago that individuals with serious mental illness were treated inhumanely – subject to horrific treatment such as witch hunts, imprisonment, exorcism, barbaric medical procedures, and even human sacrifice.

We still have a long way to go and much to learn, however. Hopefully there will come a day when mental illness is not only truly understood, but advances in science will allow even those on the most severe end of the spectrum to live completely normal, happy lives with treatment – or better yet - to be cured from their illness entirely.

Current Categories of Mental Disorders

Following is a brief overview of the current categories of mental disorders listed in the DSM.

For more information about certain disorders, click on the links below. It should be noted that many categories of disorders include related disorders that are “NOS” (not otherwise specified – e.g. depressive disorder NOS), “due to a general medical condition” (e.g. psychotic disorder due to brain injury), or “substance-induced” (e.g. cocaine-induced mood disorder).

Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence

This category of disorders is quite large. It includes all disorders for which the initial diagnosis typically occurs at some point in childhood or adolescence. However, even though they are listed in this category, some of these disorders, such as ADHD, may not be identified and diagnosed until the individual is an adult.

• Mental Retardation
  • Learning Disorders
  • Reading Disorder
  • Mathematics Disorder
  • Disorder of Written Expression
• Motor Skills Disorder
  • Developmental Coordination Disorder
• Communication Disorders
  • Expressive Language Disorder
  • Mixed Receptive-Expressive Language Disorder
  • Phonological Disorder
  • Stuttering
• Pervasive Developmental Disorders
  • Autistic Disorder
  • Rett’s Disorder
  • Asperger’s Disorder
  • Childhood Disintegrative Disorder
• Attention-Deficit and Disruptive Behavior Disorders
  • ADHD
  • Conduct Disorder
  • Oppositional Defiant Disorder
• Feeding and Eating Disorders of Infancy or Early Childhood
  • Pica
  • Rumination Disorder
  • Feeding Disorder of Infancy or Early Childhood
• Tic Disorders
  • Tourette’s Disorder
  • Chronic Motor or Vocal Tic Disorder
  • Transient Tic Disorder
• Elimination Disorders
  • Encopresis
  • Enuresis
• Other Disorders of Infancy, Childhood, or Adolescence
  • Separation Anxiety Disorder
  • Selective Mutism
  • Reactive Attachment Disorder
  • Stereotypic Movement Disorder

Cognitive Disorders

This category of disorders is characterized by serious impairments in memory and / or cognitive functioning. Common symptoms may include disorientation, confusion, hallucinations or other types of perceptual disturbances, speech or language problems, forgetfulness or memory loss, and difficulties initiating or planning normal tasks. The primary disorders in this category include:

• Delirium
• Dementia - The types of dementia that is diagnosed is based on the underlying cause, such as Vascular Dementia or Dementia due to HIV. Dementia of the Alzheimer’s Type is diagnosed only when other causes for the dementia have been ruled out.
• Amnestic Disorder

Mental Disorders Due to a General Medical Condition

The mental disorders listed in this category are believed to be caused by a specific medical condition. In other words, the symptoms (e.g. changes in personality, catatonia, mania, sleep problems, etc.) are directly due to the person’s medical condition and would not otherwise be present.

Substance-Related Disorders

The disorders in this category pertain to the effects and use of alcohol, street drugs and other frequently abused drugs or substances, medications, and toxic substances (e.g. antifreeze, rat poison, or paint fumes).

• Substance Dependence
• Substance Abuse
• Substance Intoxication
• Substance Withdrawal
• Substance-Induced Mental Disorders

Psychotic Disorders

Psychotic disorders are diagnosed when someone essentially loses touch with reality. Symptoms typically include hallucinations and / or delusions, but may also include severely disorganized speech or behavior, and in some instances, catatonic symptoms. The primary disorders in this category include:

• Schizophrenia
• Schizophreniform Disorder
• Schizoaffective Disorder
• Delusional Disorder
• Brief Psychotic Disorder
• Shared Psychotic Disorder (“Folie a Deux”)

Mood Disorders

The disorders listed in this category primarily involve a serious disturbance in mood, including depression, mania, hypomania, or mixed mood symptoms. The primary disorders in this category include:

• Major Depressive Disorder
• Dysthymic Disorder
• Bipolar I Disorder
• Bipolar II Disorder
• Cyclothymic Disorder

Anxiety Disorders

Anxiety disorders are characterized by excessive or intense worry or dread, and / or irrational fears. The primary disorders in this category include:

• Generalized Anxiety Disorder
• Panic Disorder (with or without Agoraphobia)
• Obsessive-Compulsive Disorder
• Social Phobia (often referred to as Social Anxiety Disorder)
• Specific Phobias
• Posttraumatic Stress Disorder and Acute Stress Disorder

Somatoform Disorders

Disorders in this category are diagnosed when a patient complains of distressing and significant somatic problems that have no clear medical basis, or their concern is excessive. There may be several different somatic issues, or just one or two that keeps recurring. The complaints involve pseudoneurological, sexual, pain, or gastrointestinal symptoms. The primary disorders in this group include:

• Somatization Disorder
• Undifferentiated Somatoform Disorder
• Conversion Disorder
• Pain Disorder
• Hypochondriasis
• Body Dysmorphic Disorder

Factitious Disorder

This disorder involves faking or intentionally causing symptoms in order to take on the role of someone who is sick. It is different from Malingering, in which the person’s motivation is external gain of some sort.

Dissociative Disorders

Individuals diagnosed with mental disorders in this category have problems with understanding who they are (i.e. identity disturbances), the way they perceive their surroundings, their memory, and / or their consciousness. The primary disorders include:

• Dissociative Amnesia
• Dissociative Fugue
• Dissociative Identity Disorder (formerly known as “Multiple Personality Disorder”)
• Depersonalization Disorder

Sexual and Gender Identity Disorders

This category encompasses disorders related to sexual desire, response (or lack thereof), fantasies, behaviors, and urges, and gender issues. The primary subcategories include:

• Sexual Dysfunctions
  • Hypoactive Sexual Desire Disorder
  • Sexual Aversion Disorder
  • Female Sexual Arousal Disorder
  • Male Erectile Disorder
  • Female Orgasmic Disorder
  • Male Orgasmic Disorder
  • Premature Ejaculation
  • Dyspareunia
  • Vaginismus
• Paraphilias
  • Exhibitionism
  Fetishism
  • Frotteurism
  Pedophilia
  • Sexual Masochism
  • Sexual Sadism
  • Transvestic Fetishism
  • Voyeurism
• Gender Identity Disorders

Eating Disorders

Eating disorders are characterized by significant disturbances in a person’s eating habits and behaviors. The two disorders in this category are:

• Anorexia Nervosa
• Bulimia Nervosa

Sleep Disorders

As the name implies, disorders in this category are characterized by serious disturbances in a person’s sleep or sleep patterns, or unusual behaviors that occur while sleeping. The primary disorders include:

• Primary Insomnia
• Primary Hypersomnia
• Narcolepsy
• Breathing-Related Sleep Disorder
• Circadian Rhythm Sleep Disorder
• Nightmare Disorder
• Sleep Terror Disorder
• Sleepwalking Disorder

Impulse-Control Disorders (not classified elsewhere)

These disorders involve problems with controlling impulses and urges. They include:

• Intermittent Explosive Disorder
• Kleptomania
• Pyromania
• Pathological Gambling
• Trichotillomania

Adjustment Disorders

An adjustment disorder is diagnosed when a person’s emotional or behavioral reaction to a stressful situations (e.g. a breakup with a girlfriend) goes beyond what would normally be expected under the circumstances. Adjustment disorder subtypes distinguish how the problematic symptoms manifest:

• Adjustment Disorder with Depressed Mood
• Adjustment Disorder with Anxiety
• Adjustment Disorder with Disturbance of Conduct
• Adjustment Disorder with Mixed Disturbance of Emotions and Conduct

Personality Disorders

Personality disorders are characterized by maladaptive patterns of viewing oneself and the world, relating to others, and coping with life in general. They include:

• Paranoid Personality Disorder
• Schizoid Personality Disorder
• Schizotypal Personality Disorder
• Antisocial Personality Disorder
• Borderline Personality Disorder
• Histrionic Personality Disorder
• Narcissistic Personality Disorder
• Avoidant Personality Disorder
• Dependent Personality Disorder
• Obsessive-Compulsive Personality Disorder
• Personality Disorder NOS

If you (or someone you love) are experiencing unusual symptoms that suggest the possibility of a mental disorder, talk to your primary doctor or set up an appointment with a psychiatrist, psychologist, or other mental health professional for an evaluation. Once an accurate diagnosis is made you can explore and discuss the best treatment options with your healthcare provider.