Guest Author - Lisa Angelettie M.S.W.
Acute Stress Reaction
By definition, acute stress disorder is a result of a traumatic event in which the person experienced or witnessed an event that involved threatened or actual serious injury or death and responded with intense fear and helplessness.
Adjustment disorder refers to a psychological disturbance that lasts six months or less. Adjustment disorders are caused by specific sources of stress, such as severe personal crisis (divorce, death of loved one, recent abuse) or major unexpected negative events (tornado or fire destroys a person's home). The usual symptoms mimic depression, anxiety, or sleep disorder; however the disturbance disorder is short-term and can usually be treated with counseling or mild short-term medication. If the problem persists past six months, the person may have a more permanent problem, such as a genuine mood or sleep disorder.
Agoraphobia is a form of anxiety disorder. The word is an English adoption of the Greek words agora and phobia. Literally translated as "a fear of the marketplace". A common misconception is that agoraphobia is a fear of open spaces. This is, though, most often not the case since people suffering from agoraphobia usually are not afraid of the open spaces themselves, but of public spaces or of situations often associated with these spaces. The Greek word agora should be interpreted rather as a crowded marketplace than just an open space -- this makes the common combination of agoraphobia and claustrophobia less conflicting. Some people who suffer from agoraphobia fear social gatherings where help in an emergency might not be readily available. Others are comfortable seeing visitors, but only in a defined space they feel in control of. Such a person may live for years without leaving his or her home, while happily seeing visitors and working, as long as they can stay within their safety zone.
An agoraphobic may experience severe panic attacks during situations where they feel trapped, insecure, out of control, or too far from their personal comfort zone. During severe bouts of anxiety, the agoraphobic is confined not only to their home, but to one or two rooms and they may even become bedbound until their over-stimulated nervous system can quiet down, and their adrenaline levels return to a more normal level.
Agoraphobics are often extremely sensitised to their own bodily sensations, sub-consciously over-reacting to perfectly normal events. To take one example, the exertion involved in climbing a flight of stairs may be the cause for a fullblown panic attack, because it increases the heartbeat and breathing rate, which the agoraphobic interprets as the start of a panic attack instead of a normal fluctuation.
Agoraphobia can be successfully treated in many cases through a very gradual process of graduated exposure therapy combined with cognitive therapy and sometimes anti-anxiety or antidepressant medications.
One example of a case of agoraphobia from modern literature is the character of Boo Radley from Harper Lee's prize-winning novel To Kill a Mockingbird.
Alcoholism is a dependency on alcohol characterized by craving (a strong need to drink), loss of control (being unable to stop drinking despite a desire to do so), physical dependence and withdrawal symptoms, and tolerance (increasing difficulty of becoming drunk).
Amnesia is a condition in which memory is disturbed. The causes of amnesia are organic or functional. Organic causes include damage to the brain, through trauma or disease, or use of certain (generally sedative) drugs. Functional causes are psychological factors, such as defense mechanisms. Hysterical post-traumatic amnesia is an example of this. Amnesia may also be spontaneous, in the case of transient global amnesia. This global type of amnesia is more common in middle-aged to elderly people, particularly males, and usually lasts less than 24 hours.
Amnesia can be temporary. As someone recovers, older memories will generally return first. The memories of the event that caused the amnesia are often never recalled.
Treatment varies according to the type of amnesia and the cause of the problem. Sufferers of amnesia should seek medical attention.
Anorexia nervosa is an eating disorder characterized by voluntary starvation and exercise stress. Anorexia nervosa is a complex disease, involving psychological, sociological and physiological components. A person who is suffering from anorexia is referred to as 'anorexic' or (less commonly) 'anorectic'. The term is frequently but incorrectly shortened to anorexia, which simply refers to the medical symptom of lost appetite.
Antisocial Personality Disorder
Antisocial personality disorder (APD), or dissocial personality disorder, is a personality disorder which is often characterised by antisocial and impulsive behaviour. APD is generally (if controversially) considered to be the same as, or similar to, the disorder known as psychopathic or sociopathic personality disorder. Approximately 3% of men and 1% of women have some form of antisocial personality disorder (source: DSM-IV). The word antisocial is often misused to refer to someone with social anxiety.
Attention-Deficit Disorder (ADD, ADHD)
Attention-deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed mental disorders among children, and may be diagnosed in adults, where it is often referred to as Adult attention-deficit disorder (AADD) if symptoms were present in childhood. Current theory holds that approximately 30% of children diagnosed retain the disorder as adults.
Autism is classified as a neurodevelopmental disorder that manifests itself in markedly abnormal social interaction, communication ability, patterns of interests, and patterns of behavior. Although the specific etiology of autism is unknown, genetic factors appear to be important. To diagnose the condition a list of psychiatric criteria as well as a series of standardized clinical tests may be used. Physiologically, autism may lack readily visible differences, but it is linked to abnormal biological and neurochemical development of the brain. A complete physical and neurological evaluation will typically be part of determining a diagnosis of autism. Some now speculate that autism is in fact several distinct conditions that manifest themselves in similar ways rather than a single diagnosis.
By definition, autism must manifest delays in "social interaction, language as used in social communication, or symbolic or imaginative play," with "onset prior to age 3 years." (DSM-IV) The ICD-10 also says that symptoms must "manifest before the age of three years." There have been large increases in the reported incidence of autism, for reasons that are heavily debated in the scientific community.
There are cases of autistic children who have improved their social and other skills to the point where they can fully participate in mainstream education and social events, but there are lingering concerns that an absolute cure from autism is impossible with current technology since it involves aspects of neurological brain structure determined very early in development. However, some autistic children and adults who are able to communicate at a functional level are opposed to attempts to cure their condition.
Avoidant Personality Disorder
Avoidant personality disorder (sometimes abbreviated APD or AvPD), or anxious personality disorder, is a personality disorder characterised by a pervasive pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to negative evaluation. People with avoidant personality disorder often consider themselves to be socially inept or personally unappealing, and avoid social interaction for fear of being ridiculed or humiliated.
Avoidant personality disorder usually is first noticed in early adulthood, and is associated with rejection during childhood by parents and peers. Whether the rejection is due to the extreme interpersonal monitoring attributed to people with the disorder is still an open question.
Bibliomania is the obsessive purchase or collecting of books to the point where social relations or health are damaged. One of many obsessive-compulsive psychological disorders associated with books, bibliomania is frequently characterized by the collecting of books which have no use to the collector nor any great instrinsic value to a genuine book collector. The purchase of multiple copies of the same book and edition, for example, or the accumulation of books beyond possible capacity of use or enjoyment, are frequent symptoms of bibliomania.
The term "bibliomania" is also used of a more selective but (in some opinions) excessive accumulation of books. These bibliomanes are also obsessed with the hunt, but greater discrimination, resources, and talent lend a patina of respectability to the higher class of bibliomane.
Great collectors of books, like other people who sacrifice their immediate personal interests and society to a particular drive or ambition, may serve the greater good. They assemble libraries of rare or valuable manuscripts and books, but are nonetheless considered bibliomanes in so far as they are driven to collect beyond what are deemed normal bounds.
Other abnormal or condemned behaviour involving books include book-eating (bibliophagy), compulsive book-stealing, book-burying, and book-burning.
Binge eating disorder
Binge eating disorder is a medical syndrome in which, according to currently accepted definitions, people:
• feel their eating is out of control;
• eat what most people would think is an unusually large amount of food;
• eat much more quickly than usual during binge episodes;
• eat until so full they are uncomfortable;
• eat large amounts of food, even when they are not really hungry;
• eat alone because they are embarrassed about the amount of food they eat;
• feel disgusted, depressed, or guilty after overeating.
Binge eating also takes place in another eating disorder called bulimia nervosa. Persons with bulimia nervosa, however, usually purge, fast, or do strenuous exercise after they binge eat. Purging means vomiting or using a lot of diuretics (water pills) or laxatives to keep from gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, means exercising for more than an hour just to keep from gaining weight after binge eating. Purging, fasting, and overexercising are dangerous ways to try to control your weight.
While binge eating is similar in nature, it is different than being a compulsive overeater.
Bipolar disorder is a condition that causes extreme shifts in mood, energy, and functioning. In most populations it affects around 1 percent of the population. Men and women are equally likely to develop this often-disabling illness. The disorder typically emerges in adolescence or early adulthood and affects sufferers throughout their lifespan.
Although traditionally thought of as an adult disorder, there is now recognition that children also suffer from bipolar disorder. There are no definite known causes. Scientists believe that Bipolar Disorder may be caused by a combination of biological and psychological factors. Most commonly the onset of this disorder can be linked to stressful life events. Cycles, or episodes, of depression, mania, or "mixed" manic and depressive symptoms typically recur and may become more frequent, often disrupting work, school, family, and social life.
The "kindling" theory suggests that persons who are genetically prone (toward bipolar) experience a series of stressful events, each of which lowers the threshold at which mood changes occur. Then at some point these mood changes occur spontaneously. The person then "becomes bipolar". This might explain why the cause of bipolar is difficult to pinpoint but is somehow related to genetics and environment.
Body Dysmorphic Disorder
Body dysmorphic disorder (BDD) is a mental disorder which involves a disturbed body image. The central feature of BDD is that persons who are afflicted with it are excessively dissatisfied with their body because of a perceived physical defect. An example would be a man who is extremely worried that his nose is too big, although other people don't notice anything unusual about it.
Borderline Personality Disorder
Borderline personality disorder (BPD) is a personality disorder characterised by extreme 'black and white' thinking, mood swings, emotional reasoning, disrupted relationships and difficulty in functioning in a way society accepts as normal.
The name comes from the DSM-IV-TR; the ICD-10 in Europe has an equivalent called Emotionally Unstable Personality Disorder. Psychiatrists describe borderline personality disorder as a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity.
Originally thought to be at the "borderline" between psychosis and neurosis, people with BPD suffer from a disorder of emotion regulation. While less well-known than schizophrenia or bipolar disorder (manic-depression), BPD is more common, affecting two percent of adults, mostly young women. There is a high rate of self-injury without suicidal intent, as well as a significant rate of suicide attempts and completed suicide in severe cases.
In some instances people with BPD kill themselves by accident in a case of self-injury that goes too far. Patients often need extensive mental health services, and they account for 20 percent of psychiatric hospitalizations. With help, however, many will improve over time and are eventually able to lead productive lives.
Bulimia nervosa, an eating disorder more commonly known as bulimia, is a psychological condition in which the subject engages in recurrent binge eating followed by intentionally doing one or more of the following in order to compensate for the intake of the food and prevent weight gain:
• inappropriate use of laxatives, enemas, diuretics or other medication
• excessive exercising
A person is classified as having bulimia when he or she feels incapable of controlling the urge to binge, even during the binge itself, when he or she consumes a larger amount of food than a person would normally consume at one sitting, and when such behavior occurs at least twice per week for three months.
Claustrophobia is an anxiety disorder that involves the fear of enclosed or confined spaces. Claustrophobes may suffer from panic attacks in situations such as being in elevators, trains or aircraft. Conversely, people who are prone to having panic attacks will often develop claustrophobia. If a panic attack occurs while they are in a confined space then they will be unable to escape the situation.
Claustrophobes may also fear being in crowds.
Claustrophobia can be treated in similar ways to other anxiety disorders, with a range of treatments including cognitive behavior therapy and the use of antidepressant medication.
Popularly, claustrophobia is considered to be the opposite of agoraphobia, or a "fear of open spaces". This is an oversimplification, however: agoraphobia can also be characterized as a "fear of public spaces", and so a crowded city square might trigger claustrophobics and agoraphobics alike.
Clinical depression is a health condition of depression with mental and physical components reaching criteria generally accepted by clinicians.
Although nearly any mood with some element of sadness may colloquially be termed a depression, clinical depression is more than just a temporary state of sadness. Symptoms lasting two weeks or longer in duration, and of a severity that they begin to interfere with daily living, can generally be said to constitute clinical depression. Using DSM-IV-TR terminology, someone with a major depressive disorder can, by definition, be said to be suffering from clinical depression.
Clinical depression affects about 16%1 of the population on at least one occasion in their lives. The mean age of onset, from a number of studies, is in the late 20s. About 2 times as many females as males report or receive treatment for clinical depression, though this imbalance is shrinking over the course of recent history; this difference seems to completely disappear after the age of 50 - 55, when most females have passed the end of menopause. Clinical depression is currently the leading cause of disability in the US as well as other countries, and is expected to become the second leading cause of disability worldwide (after heart disease) by the year 2020, according to the World Health Organization5.
Conduct disorder is a pattern of repetitive behavior where the rights of others or the social norms are violated. Possible symptoms are overt aggressive behavior, bullying, physical aggression, cruel behavior toward people and pets, destructive behavior, lying, truancy, vandalism and stealing.
After the age of 18, a conduct disorder may develop into antisocial personality disorder.
Cyclothymia is a mild mood disorder which is sometimes seen as more of a personality trait than an illness. Cyclothymia is characterised by repetitive periods of mild depression followed by periods of normal or slightly elevated mood. A percentage of cyclothymics go on to develop full-blown bipolar disorder (normally bipolar II type) at some stage in their lives, while others suffer from forms of depression or other more severe mood disorders.
Some researchers have theorized that cyclothymia is common among creative and high-achieving people, with the idea being that cyclothymics come up with new ideas during their brief high periods, and then grind doggedly through the work necessary to achieve that new idea during their lengthy low periods. Historically, cyclothymia has been associated with various ethnic groups, including the Scots. See James Boswell's London Journal, 1762-1763, for some observations about the Scottish character and "moodiness". Winston Churchill was cyclothymic.
Delusional disorder is a psychiatric diagnosis denoting a mental illness that involves holding one or more non-bizarre delusions in the absence of any other significant psychopathology (signs or symptoms of mental illness). In particular a person with delusional disorder has never met any other criteria for schizophrenia and does not have any marked hallucinations, although tactile (touch) or olfactory (smell) hallucinations may be present if they are related to the theme of the delusion.
A person with delusional disorder can be quite functional and does not tend to show any odd or bizarre behaviour except as a direct result of the delusional belief.
It is worth noting that the term paranoia was previously used in psychiatry to denote what is now called 'delusional disorder'. The modern psychiatric use of the word paranoia is subtly different but now rarely refers to this specific diagnosis.
Delusional disorder may typically be one of the following types:
• Erotomanic Type (see erotomania): delusion that another person, usually of higher status, is in love with the individual.
• Grandiose Type: delusion of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person (e.g. see Jerusalem syndrome)
• Jealous Type: delusion that the individual's sexual partner is unfaithful (see delusional jealousy).
• Persecutory Type: delusion that the person (or someone to whom the person is close) is being malevolently treated in some way.
• Somatic Type: delusions that the person has some physical defect or general medical condition (for example, see delusional parasitosis).
A diagnosis of 'mixed type' or 'unspecified type' may also be given if the delusions fall into several or none of these categories.
Dementia (from Latin demens) is progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging. Particularly affected areas may be memory, attention, language and problem solving, although particularly in the later stages of the condition, affected persons may be disoriented in time (not knowing what day, week, month or year it is), place (not knowing where they are) and person (not knowing who they are). Symptoms of dementia can be classified as either reversible or irreversible depending upon the etiology of the disease, although dementia, by definition, is irreversible and will eventually result in death. Dementia is a non-specific term that encompasses many disease processes just as fever is attributable to many etiologies.
Affected persons may also show signs of psychosis, depression and delirium. Early symptoms often consist in changes in personality, or in behavior. Often dementia can be first evident during an episode of delirium. There is a higher prevalance of eventually developing dementia in individuals who experience an acute episode of confusion while hospitilized.
Dementia can affect language, comprehesion, motor skills, short term memory, ability to identify commonly used items, reaction time, personality traits, and executive functioning.
Dependent Personality Disorder
Dependent personality disorder (DPD) is a personality disorder that is characterised by a pervasive psychological dependence on other people. The difference between a 'dependent personality' and a 'dependent personality disorder' is somewhat subjective, which makes a diagnosis sensitive to cultural influences such as gender role expectations.
Dissociative Identity Disorder
n psychiatry, Dissociative Identity Disorder (DID) is the current name of the condition formerly listed in the Diagnostic and Statistical Manual of Mental Disorders as Multiple Personality Disorder (MPD) and Multiple Personality Syndrome. The International Statistical Classification of Diseases and Related Health Problems continues to list it as Multiple Personality Disorder. Multiple Personality Disorder should not be confused with schizophrenia.
According to standard American textbooks in clinical psychology, Dissociative Identity Disorder is a psychological condition characterized by the use of dissociation as a primary defense mechanism. A chronic reliance on dissociation as a means of defending against stressors in the environment causes the individual to experience their psyche/identity as disconnected or split into distinct parts.
Dysthymia, or dysthymic disorder, is a form of the mood disorder of depression characterised by a lack of enjoyment/pleasure in life that continues for at least six months. It differs from clinical depression in the severity of the symptoms. While dysthymia usually does not prevent a person from functioning, it prevents full enjoyment of life. Dysthymia also lasts much longer than an episode of major depression. Dysthymia may or may not respond to traditional anti-depressant medication and to other forms of therapy. Dysthymic individuals are often perceived as being 'dour' and humourless or as martinets.
Many times a stressful or overwhelming situation, like having a first baby (Postpartum depression), will throw a dysthymic individual into a major depression. When a major depressive episode occurs on top of dysthymia, the condition is referred to as double depression.
An exhibitionist is a person who practises exhibitionism as a psychological alteration of the human behaviour that neither implies the need to exhibit the genitalia or buttocks nor alterations of the psychiatric condition of the individual (although sometimes this occurs, see below).
In this type of exhibitionism the individual shows a tendency to an extravagant behaviour and the need to captivate the attention of others. The person can act in several forms, by competing to be the "first", adhering to a particular fashion, ostentation (in different forms), showing him/herself in a pre-determined form, posing, being bombastic, etc. In this type of exhibitionism the above-mentioned forms can appear isolated or as a group of manifestations. People showing this type of personality are sometimes called extravagant instead of exhibitionist. Generally this type of exhibitionism does not have legal implications, unless the individual shows an aggressive or criminal behaviour.
Female Sexual Arousal Disorder
Female sexual arousal disorder is the condition of decreased interest in sexual intercourse, sexual activity, and sexual contact in females. Loss of interest in sex occurs most commonly in women as they age. There are strong evolutionary reasons to support the notion that females should have a lessened interest in sexual activities once they are no longer of child-bearing age. Natural selection may demand that women who can no longer reliably produce healthy children would therefore have a diminished interest in sexual activities.
Gender identity disorder
Gender identity disorder is a condition where a person who has been assigned one gender (usually at birth on the basis of their sex, but compare intersexual) but identifies as belonging to another gender, or does not conform with the gender role their respective society prescribes to them. It is a psychiatric term for what is widely known by terms like transsexuality, transgender and (subject to debate, but full-fledged GID is present in at least some cases) transvestism or cross-dressing.
This feeling usually is reported as "having always been there", although in many cases it seems to appear in adolescence or even in adulthood, and has been reported by some as intensifying over time. Since many cultures strongly disapprove of cross-gender behaviour, it often results in significant problems, for example a severe identity crisis. Also, social problems are likely to occur if a society does not accept cross-gender behaviour. In many cases discomfort is also reported as stemming from feeling like one's body is "wrong" or meant to be different.
Generalized Anxiety Disorder
General anxiety disorder or generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by uncontrollable worry about everyday things. The frequency, intensity, and duration of the worry are disproportionate to the actual source of worry, and such worry often interferes with daily functioning. GAD sufferers often uncontrollably worry over things such as their job, their finances, and the health of themselves and their family. However, GAD sufferers can also constantly abnormally worry over more mundane things such as deadlines for appointments, keeping the house clean, and whether or not their workspace is properly organized. For a diagnosis of GAD to be made, worry must be present more days than not for at least six months.
Physical symptoms of GAD can include: cold, clammy hands; hypertension; difficulty swallowing; gastrointestinal discomfort and diarrhea; jumpiness; muscle tension; nausea; and sweating. GAD sufferers also easily become tired and have trouble sleeping. They also tend to be irritable and complain about feeling "on edge".
GAD can be difficult to diagnose, because it often lacks the more telltale signs of other anxiety disorders, such as with panic disorder. GAD can also occur alongside other anxiety disorders, as well as alongside depressive disorders and substance abuse.
Grief, Bereavement, Loss
Grief is a multi-faceted response to loss. Although conventially focussed on the emotional response to loss, it also has a physical, cognitive, behavioural, social and philosophical dimensions. Common to human experience is the death of a loved one. While the terms are often used interchangeably, bereavement often refers to the state of loss, and grief to the reaction to loss. Losses can range from loss of employment, pets, status, a sense of safety, order, possessions, to the loss of the people nearest to us. Our response to loss is varied and researchers have moved away from "cookie cutter" views of grief, that is that people move through an orderly and predicatable series of responses to loss to one that considers the wide variety of responses that are influenced by personality, family, culture and spiritual and religious beliefs and practices.
Mental Health Terms Glossary H-Z