In today’s scenario of fast-paced life, lots of competition, workload and a person living a stressful life which may lead to mental diseases and disorders.

Let’s understand in detail about mental diseases and disorders and know about the treatment that can be done for curing mental diseases and disorders.   

TYPES OF MENTAL DISEASES AND DISORDERS

Mental diseases are also called as mental health disorders. Mental diseases can be organic or functional in origin.

Organic mental disease is caused due to brain damage from head injuries, tumours or diseases like Meningitis(inflammation of membranes surrounding the brain and spinal cord), Syphilis at the final stage(infection through sex), or Encephalitis(infection of the brain).

Functional mental illness is psychological in origin. Most cases of mental diseases fall into the functional group.

Several factors usually unite to produce a psychological disorder. Among the important influences that may predispose a person to a psychological disorder are heredity, constitution, the structure of personality, mode of upbringing, education & cultural background.

Precipitating factors may be:-

• Psychological as frustration, losses, a conflict between an individual’s personal needs and restrictions placed on the activity by the community.
• Physical as after brain damage. 
• Physiological as prolonged sleep, marked weight loss, effects of drugs or effects of endocrine changes. 

Mental diseases and disorders are mainly anxiety disorders, mood disorders, psychotic disorders, eating disorders, personality disorders, neurodevelopmental disorders, trauma and stress-related disorders.

Mental diseases and disorders are classified into four types of mental health disorders.

• A– Psychoneurotic disorders
• B– Psychotic disorders
• C– Psychosomatic( Psychophysiological) disorders
• D– Personality disorders 

A–Psychoneurotic disorders

A group of mental disorders caused by unresolved internal conflicts, in which no observable loss of contact with reality and judgement is present.

The patient often realises that some of his emotions, thoughts or impulses to act are strange & unintelligible but he is unable to control them.

1 Anxiety

Anxiety is an excited state associated with the expectancy of danger. The patient seeks a means of escape, so the defences are up. Anxiety is a normal response to threats directed towards one’s body, possessions, way of life, loved ones, or cherished values.

Normal anxiety motivates the individual to useful action and plays an important role in beneficial changes & personality growth.

Excessive anxiety not only makes a person unhappy but has a detrimental effect on his performance.

Anxiety can be expressed either as agitation and tension or apathy and listlessness. Severe, disorganizing anxiety is called Panic.

The patient may complain of tension and fatigue(lack of energy) accompanied by sweating, palpitation(increased heartbeat), tachycardia(abnormal heartbeat), anorexia(eating disorder), insomnia(lack of sleep), sexual dysfunction and loss of weight.

2- DEPRESSIVE 

Depression is an inhibited, pessimistic state associated with irrevocable loss. The patient sees no means of escape from his condition, so his defences are down.

Mild depression manifests itself by a loss of pleasurable interest in the usual affairs of life.

A person does his work and meets his obligations but spontaneity is lacking and fatigue(feeling of tiredness or lack of energy) is excessive. 

In more severe depression the patient falls physically ill. He is gloomy, helpless & hopeless. The patient may believe things are as bad as he feels & he may have Delusions(fixed beliefs). 

Insomnia( lack of sleep) is a prominent symptom. In all depression danger of suicide is present. Depression is considered to be caused by biochemical dysfunction, trauma, living conditions and other external factors.

Depression is caused by Serotonin and catecholamine and it’s not the only hormone mediated.

Research suggests that depression doesn’t spring from simply having too much or too little of certain brain chemicals. Rather there are many possible causes of depression including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications and medical problems. It’s believed that several of these forces interact to bring on depression.

For example, if a person is diagnosed with cancer, he will not only be depressed because of the biochemical levels but also due to monitory, disease-related stress.

3- DISSOCIATIVE REACTION 

It is a process of disconnecting from one’s thoughts, feelings, memories or sense of identity.
Gross disorganisation of personality resulting from an overwhelming sense of anxiety.

4- CONVERSION REACTION

Conversion of anxiety into symptoms of dysfunction of various organs or parts of the body
The emotional conflict, instead of being experienced consciously is converted into physical symptoms involving voluntary muscles or special sense organs. Blindness, deafness, paralysis or other neurological symptoms may occur.

5- PHOBIC REACTION

The principal symptom of phobic reaction is anxiety. In the phobias, the patient fixes his anxiety on a given object or situation which he then can avoid. A phobia is a specific fear apparently out of proportion to the stimulus.

The most commonly encountered phobic reactions are Agoraphobia( fear of open places), Claustrophobia(fear of being closed in), Aerophobia(fear of high places) and Aquaphobia(fear of water).

6- Obsessive-compulsive reaction

Anxiety is manifested by unwanted but insistent and repetitive thoughts (Obsession) or urges to perform an act(compulsion) the patient has no voluntary control over these thoughts or acts.

For example, the patient can not turn off a tap without turning it several times opening and closing, to make sure that it is properly turned off.

B–Psychotic disorders

 A group of mental disorders in which the disturbance is of such magnitude that personality disintegration takes place.

These are more severe forms of mental illness. Psychotic individuals usually suffer from hallucinations(a false perception of sense) and/or delusions(fixed beliefs).

1-  Schizophrenic reaction

Schizophrenia is a name for a group of disorders characterised by a progressive disintegration of emotional stability, judgement, and contact with an appreciation of reality.

The essential features of the illness are:

a) Thought disorder

The vagueness of thinking, disconnection of thoughts, and new interest in vague, abstract theories or beliefs.

Thought block — the patient starts to answer a question but stops speaking suddenly as if second thoughts have swayed his decision.

The patient’s conversion veers off at a tangent and the conclusions cannot be understood. 

The patient coins words or phrases that only he understands. In its extreme form, the patient’s statements are incomprehensible.

Delusions are often encountered in schizophrenic patients. 

b) Emotional disorder

The patient’s train of thought and emotions felt or expressed at the same time are disorderly. The patient may laugh or grin for no apparent reason or when grave matters are being discussed. The patient may have a fixed grin or remain inert regardless of external circumstances.

c) Perceptual disorder

Misinterpretation and hallucinations(false perception) are common in schizophrenia.
In PPD(irrational & obsessive distrust of others} misinterpretation is common, innocent errors are interpreted as malicious, and words spoken by others take on a double meaning.

d) Disturbance of volition

A general lessening of willpower is evident in many cases. The patient complains of an inability to make decisions or to act of his own volition.

There may be marked inactivity, the patient staying in bed or lying down wherever he happens to be at the time, showing no apparent awareness of the need to turn up for meals.

Forms of schizophrenia

a) Simple schizophrenia  

Characterized by slow onset in adolescence or early adult life, the major symptom is the loss of emotional response, loss of drive and gradual withdrawal from social situations proceed slowly. The illness may begin with hypochondriacal complaints (unduly worried about serious illness) but typical signs of schizophrenia-like hallucinations and delusions are not usually seen.

b) Hebephrenic schizophrenia

Thought disorder is the prominent feature of this form of illness, which is common in young people. Often proceeded by depersonalisation and apathy, there is a slow progressive vagueness of thinking and in later stages, delusions & hallucinations develop. Speech incoherent, bed wetting and silliness of response and action often predominate.

c) Catatonic schizophrenia

There are two distinct phases in this form. The commonest of these is Stupor but the most striking stage is Catatonic excitement
In milder cases of stupor, the patient speaks and moves very slowly and may show obedience.
In more severe cases the patient is generally unresponsive but may refuse physical attempts to help him. Food is refused and bed-clothes are soiled. In advanced cases, the patient may maintain an awkward posture for hours at a time, apparently undistressed by the inevitable severe muscular fatigue.

In Catatonic excitement, the patient shows mild uninhibited behaviour with an excessive amount of mobility, and restlessness, continuing for long periods. No sleep is obtained, and food is refused. Patient in these states often shows violent destructive behaviour.

d) Paranoid schizophrenia 

The prominent feature of this form of schizophrenia is the appearance of paranoid delusions. It commonly starts in middle life or later. 

This type is also slowly progressive, the paranoid delusions being accompanied later by hallucinations. Other varieties of thought disorders and affective changes are usually absent.

As the illness develops after the personality is fully formed, deterioration is rarely marked.

Superficially the patient appears to carry on his pattern of life as before. He may seek help to deal with those whom he believes are responsible for his persecution.

2-  Paranoid reaction

The term refers to the development of firmly held delusions without disturbance of thinking, volition or behaviour.

Hallucinations are usually not present.

It is not considered to be a schizophrenic illness.

A suspicious husband may falsely accuse his wife of infidelity which she denies angrily, he then interprets her response as anger at being found out. The patient may blame others for his failures.

3-  Puerperal psychosis

These do not differ in their essential nature from comparable psychoses seen apart from the puerperium. The commonest forms are affective disorders, notably depression, sometimes with suicide and infanticide as complications, and severe persistent states of anxiety with intense manifestation.

Puerperal psychoses usually occur within one year of delivery. A great majority of them occur within three months and are usually of relatively short duration and good prognosis.

The additional psychological stresses and challenges of pregnancy and labour with the emotional significance of childbirth and motherhood are some of the aetiological factors.

4- Affective disorders

This is a combination of misery and malaise, which occurs either spontaneously or exceeds in duration and intensity the normal reaction to any disaster or misfortune. The three main affective disorders are depression, mania and hypomania, and psychoneuroses and psychosis.

The patient’s mood is characterised by dejection and unhappiness withdrawal of interest from the outside world, indecision and often subjective difficulty in thinking, feeling of guilt may be intense. There may be some delusions including convictions of impoverishment or hypochondriacal for example patient may believe that he is financially ruined. 

The symptoms of outstanding importance are:

• Disturbance of sleep rhythm with early morning waking 

• Loss of appetite and weight

• Constipation and dyspepsia( indigestion, discomfort or pain in the upper abdomen)

Depression

Depression appearing spontaneously is often called Endogenous when it follows external events that are regarded as precipitated called Reactive. Such distinction is however rarely clear-cut. There are two main types:-

1-Bipolar Disorder

2-Involutional psychotic

Bipolar disorder is characterised by a great degree of loss of judgement and separation from reality and is more likely to be accompanied by delusions and hallucinations. Phases of normality or exaltation and elation may alternate with phases of depression.

Involutional melancholia occurs characteristically at the junction of the middle and later thirds of life and is apt to be particularly severe. Agitation is a predominant feature of the illness and may be expressed by repeated complaints of bodily or mental suffering with wringing of the hands, restlessness and lamentation( passionate expression of grief or sorrow). Hypochondriacal ideas and delusions of impoverishment are common. Suicide is a real danger.

Mania and hypomania

Just as depression is a combination of misery and malaise, so mania is a combination of elation and energy which can progress to exhaustion and disaster.

Hypomania is the milder form of illness. there is an elevation of mood and acceleration and extension of the stream of thought, with the fight of ideas and inexhaustible energy.

Such patients are restless and excitable, cannot sleep, often will not be bothered with food and must always be busy. They launch innumerable talks, never finishing any of them.

In more severe cases, complete physical collapse from lack of sleep and nourishment may follow. The severest form of the disorder is mania wherein the patient is uncontrollably excited while the flight of ideas and pressure of thoughts may render him incoherent.

Psychoneuroses and psychosis

Psychosis is a more severe form whereas Psychoneuroses is a mild form of mental illness

Psychoneuroses – a disorder of mental function whereby patients are abnormally emotionally vulnerable or upset but retain touch with external reality at least partially. 

Subconscious ideas are attained only through symbolic expression in some physical or mental disturbance eg. paralysis or a temporary loss of memory.

This physical or mental disorder depends only on mental causes eg. anxiety states, obsessive-compulsive states or hysteria.

Psychosis – a form of mental illness, whether acute or chronic, that interferes with the patient’s understanding and appreciation of what is going on in the world about him.

Psychosis is grossly disorganised, subconscious ideas are verbally expressed, view of reality distorted, behaviour abnormal and may regress to an infantile level.

Unlike the psychotic individual, the unstable individual usually realises he is ill and keen to get well, he is cooperative and unlikely to need care in an institution.

C — PSCHOMATIC DISORDERS 

These disorders are psychophysiological, organic dysfunctions in which emotional factors are considered to play a causative or contributory role. Physical symptoms dominate the clinic picture.

(i) Skin reaction: Urticaria, pruritus, angioedema, eczema.

(ii) Musculoskeletal reaction: Backache, muscle cramps and myalgias.

(iii) Respiratory reaction: Bronchial spasm and hiccoughs.

(iv) Cardiovascular reaction: Paroxysmal tachycardia, dyspnoea and hypertension.

(v) Gastrointestinal reaction: Peptic ulcer, indigestion, ulcerative colitis, constipation, pylorospasm, irritable colon, obesity due to compulsive eating and anorexia nervosa ( food aversion, self-induced, which attempts to serve as a solution of psychic conflicts ).

(vi) Genitourinary reaction: Menstrual disturbances, dysuria, urgency.

(vii) Nervous fatigue: Weakness, irritability, headache, blurred vision, poor concentration & insomnia.

D — PERSONALITY DISORDERS

Disorders characterised by developmental defects in personality structure with minimal subjective anxiety and distress.

In most instances, these disorders are manifested by lifelong behaviour patterns rather than mental or emotional symptoms.

The person with such disorders rarely seeks help because of his anxiety or discomfort, more often he is referred by a family or society with whom he is unable to live in harmony. He is unable to maintain emotional equilibrium and independence under stress.

(i) Inadequate Personality 

These persons show inadaptability, poor judgement, lack of physical and emotional stamina, irresponsibility and social incompatibility.

(ii) Schizoid Personality 

Inherent traits are avoidance of close relations with others and the inability to express ordinary aggressive feelings.  These qualities result in aloofness, emotional detachment, fearfulness and avoidance of competition.

(iii) Cyclothymic Personality

Such Individuals are characterised by apparent warmth, friendliness superficial generosity and enthusiasm for competition. They tend to have alternate periods of elation and sadness. 

(iv) PPD

They have many schizoid personality traits and tend to be suspicious, envious, extremely jealous and stubborn. 

(v) Emotionally unstable Personality

The individual reacts excitably and ineffectively under minor stress. Guilt, anxiety and hostility disturb his relationship with others.

(vi) Passive-aggressive Personality

These individuals tend to depend on others. They are indecisive, stubborn and inefficient. Some throw tantrums and are destructive in behaviour. 

(vii) Compulsive Personality

Such individuals show chronic, excessive concern with standards of conscience. They are often inhibited and overly conscientious, with a great work capacity but unable to relax.

(viii) Antisocial Personality

These individuals are always in trouble not learning from experience or punishment. They have no loyalties and lack a sense of responsibility.

(ix) Dissocial Personality 

These individuals disregard the usual social codes but have strong loyalties. They have always lived in an abnormal environment.

(x) Sexual Deviation

In this person, a satisfaction of sexual impulse is sought through such expressions as homosexuality, exhibitionism and sadism ( including rape, sexual assault, and  mutilation )

(xi) Addiction

An addictive behaviour is engaging in the same activity despite knowing the drawbacks. Addiction can be with anything for example nowadays mobile addiction is very common. Here we are discussing about the most harmful addiction.

(a) Alcoholism: The harmful effects of excessive ingestion of alcohol. Many people with alcohol-using disorders ultimately suffer a disintegration of personality. The alcoholic squanders money, loses feelings of affection and responsibility, and is touchy, irritable and critical.

(b) Drug Dependence: This can lead to an individual wasting his life away and losing interest in work and family.

TREATMENT OF MENTAL DISEASES AND DISORDERS

Psychiatry

Psychiatry is that branch of medicine that is primarily concerned with disorders of thought, feeling and behaviour. 

Mild psychiatric disorders are relatively common and such patients are usually treated in general practice.

Patients with severe mental illness are often referred for specialist advice to a psychiatrist.

During the past years, several important advances in the treatment of mental illness by non-drug therapies have been made. But, it must be emphasised that all methods of treatment involve a psychological approach to the patient.

Non-drug Therapy

Non-drug therapy is classified into three types

(a) Psychotherapy

Psychotherapy is essentially a psychological form of treatment in which an attempt is made to reduce or abolish the maladaptive facets of the personality that disturb the patient emotionally.

The therapy can be:

• Superficial, in which immediate problems are investigated.

• Short-term, in which the approach may be deeper but involves only one aspect of the patient’s personality.

• Deep therapy, in which early experiences and feelings are investigated.

• Analytical approach, in which it may be necessary to investigate the patient’s experiences at all stages of development from infancy.

Psychotherapy can be given in several different settings depending on the needs of the patient.

The settings are:

• Individual analysis, in which the patient communicates with the therapist in private.

• Group psychotherapy, in which a group of patients communicate together in the presence of the therapist.

• Family therapy, in which the patient and members of the immediate family meet the therapist together at one time. 

Psychotherapy requires technique and training and the therapist has to be well adept in both.

(b) Electroconvulsive therapy (E.C.T)

E.C.T. is one of the simplest and most effective methods of treatment for selected patients. It is most widely used for the treatment of severe depressive states and schizophrenia (in combination with phenothiazines)

The most important side effect of E.C.T. is memory disturbance.

Techniques of E.C.T 

I don’t want to go into detail about the techniques of E.C.T.

In this technique, before treatment, the patient is asked to take no food for five hours.  

Improvement is usually noticeable after two treatments but it is generally after four or five E.C.T that the patient himself acknowledges feeling better. 

(c) Prefrontal Leucotomy

This is a surgical operation in which the white matter of the prefrontal areas is sectioned to reduce mental distress in psychological disorders.

Leucotomy is only considered as a last resort when all other forms of treatment have been given an adequate trial and failed. Typically, it is used to treat severe chronic obsessional neurosis, chronic tension states and chronic anxiety states. In some cases, it is used to treat chronic or frequently recurrent depressive illness and schizophrenia, though less commonly.

Complications of leucotomy include post-operative epilepsy, haemorrhage, and personality changes such as loss of social sense and tact.

Drug Therapy

It’s advisable to consult your psychiatrist before taking any drug. 

Psychotropic drugs have effects on the mind or psychological state of the individual to whom it is administered.

Other drugs like anxiolytic, mood-regulating, antidepressant and neuroleptic are used for a specific action. 

SUM UP

It’s always better to remain healthy and fit and live a stress-free life. Consult your doctor as soon as you find any symptoms of mental diseases and disorders.

This information about mental diseases and disorders is just for your knowledge and not medical advice.