Welcome to Mental Health (which is, when you stop to think about it, an oxymoron)! Subject matter to be covered includes mood disorders, somatoform disorders, psychotic disorders, personality disorders and finally, defense mechanisms.
Again, this information is meant to supplement and NOT replace your text books and/or lecture material. Good Luck!
MOOD DISORDERS
Depression is extremely common, affecting up to twenty percent of the population at some point during their life. It is relatively easy to treat, with up to eighty percent of those treated reporting significant improvement. Unfortunately, many people who are depressed do not present themselves for treatment.
Depression and mania are classified as mood disorders. They have also been known as Affective Disorders. They can occur separately or in combination. Depression can range from mild to moderate to severe. It can be acute or chronic in nature.
Criteria for a Major Depressive Disorder include:
1. Depressed Mood such as feeling sad, empty, or tearful.
2. Lack of interest in or not deriving pleasure from
most activities.
3. Weight loss or gain of over 5% of body weight.
4. Insomnia or hypersomnia.
5. Agitation or psychomotor retardation.
6. Lack of energy.
7. Feelings of worthlessness or guilt.
8. Difficulty in concentration and/or decision making.
9. Thoughts, plans or attempts of suicide or
preoccupation with death.
Criteria for a Manic episode include:
A. Seven days or more of uncharacteristically
elevated,irritable, grandiose or expansive mood.
B. Concurrent with number 1, three or more other symptoms
(see below) are present in a significant degree. Four
if the mood disturbance is irritable in the absence of
significantly elevated, grandiose or expansive mood.
Symptoms include:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep.
3. Excessive talking.
4. Flight of ideas.
5. Distractibility.
6. Psychomotor agitation or increased goal-directed
activity.
7. Hedonistic and risk-taking behavior.
C. The episode is not A Mixed Episode.
D. The episode is severe, including danger to oneself
or others, psychotic symptoms, or significant
deterioration in social, relationship, or vocational
spheres.
E. The symptoms are not due to a general medical
condition or an exogenous substance.
Included in Mood Disorders are:
Major Depressive Disorder is characterized by two weeks or more of depressed mood or loss of interest plus at least four additional symptoms.
Dysthymic disorder is characterized by two years or more of depressed mood most of the time in addition to additional symptoms of depression but less than the four required to meet the criteria for Major Depressive Episode.
Bipolar Disorder is characterized by one of more Manic or Mixed Episodes accompanied by a Major Depressive Episode.
Cyclothymic Disorder is characterized by two years or more of frequent periods of manic symptoms falling short of the criteria for a Manic Episode and depressive symptoms falling short of the criteria for a Major Depressive Episode.
Mood Disorder due to a Generalized Medical Condition is a pronounced and long lasting mood disturbance that is the result of a general medical condition.
Substance Abuse Mood Disorder is a pronounced and long lasting mood disturbance caused by a drug or toxin.
SOMATOFORM DISORDERS
Somatoform Disorders are those conditons that are suggestive of a physical disorder but upon examination cannot be accounted for by a medical disorder, an exogenous substance or other mental disorder.
These disorders are usually presented in general medical settings as the patients presume them to be of somatic origin.
To warrant the diagnosis of Somatoform Disorder, the symptoms must cause significant impairment or distress.
Somatization Disorder was formerly called hysteria. Primarily affecting women, it generally has its onset in adolescence or early adulthood and lasts for years. Its symptoms usually include a combination of pain, pseudoneurological, digestive and sexual complaints.
Undifferentiated Disorder is a milder form of Somatization disorder lasting at least six months.
Conversion Disorder is characterized by unexplained sensory motor deficits which are judged to be psychogenic.
Pain Disorder is diagnosed when the primary symptom is pain and psychological factors are presumed to be important in the etiology, maintenance or exacerbation of the condition.
Hypochondriasis is the fear illness in the absence there of or exaggeration of symptoms or bodily sensations into serious illness.
Body Dysmorphic disorder refers to a preoccupation with a presumed or exaggerated physical defect.
PSYCHOTIC DISORDERS
The Psychotic Disorders are characterized by hallucinations, delusions, personality disorganization, loss of ego boundaries and/or the inability to meet the ordinary demands of life.
Most habituated criminals are Dx by both prosecution and defense as having either antisocial or borderline or both. Since this was obviously scientific fact and not "paid expert witness syndrome", States had to respond with "legal definations of sanity" vs "legal definitions of insanity".
Schizophrenia
People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. They sometimes hear voices, talk to themselves, or respond to imaginary fears.
Schizophreniform Disorder
This disorder is marked by delusions, hallucinations, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior, and negative symptoms (i.e., affective flattening, alogia, or avolition).
Schizoaffective Disorder (SAD)
An individual with SAD experiences some symptoms of schizophrenia as well as symptoms of a mood disorder, such as depression or mania.
PERSONALITY DISORDER
The diagnosis of Personality Disorder is used to identify individuals with consistent and long lasting patterns of deviation from societal norms which remain inflexible in spite of distress and maladaptation.
Paranoid Personality Disorder is evidenced by pervasive distrust and suspiciousness of others.
Schizoid Personality Disorder is evidenced by social isolation and emotional constriction.
Schizotypal Personality Disorder is evidenced by social unease, eccentric behavior patterns and cognitive and/or perceptual experiences that cannot be consentually validated.
Antisocial Personality Disorder is evidenced by the violation of the rights of others or society.
Borderline Personality Disorder is evidenced by impulsive behavior and unstable social relationships, affect and sense of self and identity.
Histronic Personality Disorder is characterized by attention seeking and marked emotionality.
Narcissistic Personality Disorder is characterized by self centeredness, attention seeking, grandiosity and a lack of empathy.
Avoidant Personality Disorder is characterized by social constriction, extreme avoidance of negative self evaluation and low self esteem.
Dependent Personality Disorder is characterized by a clinging and submissive social relationship style and the persistant desire to have one's needs taken care of by others.
Obsessive-Compulsive Personality Disorder is characterized by the continued need to maintain control, order, neatness, cleanlinss, and/or perfectionism.
DEFENSE MECHANISMS
Psychoanalysis and psychodynamic theory have described the process by which we protect ourselves from awareness of our undesired and feared impulses. Defense Mechanisms are our way of distancing ourselves from a full awareness of unpleasant thoughts, feelings and desires, as well as "knowing" or "believing".
Defense mechanisms represent an unconscious mediation by the ego of id impulses which are in conflict with the wishes and needs of the ego and/or superego. By altering and distorting one's awareness of the orignial impulse, one makes it more tolerable.
However, while defense mechanisms are used in an attempt to protect oneself from unpleasant emotions, they often result in equally harmful problems. Below are some of the more common defense mechanisms.
Compartmentalization is a process of separating parts of the self from awareness of other parts and behaving as if one had separate sets of values. An example might be an honest person who cheats on their income tax return and keeps their two value systems distinct and unintegrated while remaining unconscious of the cognitive dissonance.
Compensation is the process of psychologically counterbalancing perceived weaknesses by emphasizing strength in other areas. The "I'm not a fighter, I'm a lover" philosophy can be an example of compensation. The Napoleonic complex is another example of compensation.
Denial is the refusal to accept reality and to act as if a painful event, thought or feeling did not exist. It is considered one of the most primitive of the defense mechanisms because it is characteristic of very early childhood development.
Displacement is the redirecting of thoughts, feelings, and impulses from an object that gives rise to anxiety to a safer, more acceptable one. Being angry at the instructor and kicking the dog can be an example of displacement.
Fantasy, when used as a defense mechanism, is the channeling of unacceptable or unattainable desires into imagination. This can protect ones self esteem as when educational, vocational or social expectations are not being met, one imagines success in these areas and wards off self condemnation.
Intellectualization is the use of cognitive approach without the attendant emotions to suppress and attempt to gain mastery over the perceived disorderly and potentially overwhelming impulses. An example might be an individual, who when told they had a life threatening disease, focuses exclusively on the statistical percentages of recovery and is unable to cope with their fear and sadness.
Projection is the attribution of one's undesired impulses onto another. thus, an angry spouse accuses the partner of hostility.
Rationalization is the cognitive reframing of ones perceptions to protect the ego in the face of changing realities. Thus, the promotion one wished fervently for and didn't get becomes "a dead end job for brown nosers and yes men".
Reaction Formation is the converting of wishes or impulses that are perceived to be dangerous into their opposites. A woman who is furious at her child and wishes her harm might become overly concerned and protective of the child's health.
Regression is the reversion to an earlier stage of development in the face of unacceptable impulses. For an example, an adolescent who is overwhelmed with fear, anger and growing sexual impulses might become clinging and begin thumb sucking or bed wetting.
Repression is the blocking of unacceptable impulses from consciousness.
Sublimation is the channeling of unacceptable impulses into more acceptable outlets.
Undoing is the attempt to take back behaviors or thoughts that are unacceptable.An example of undoing would be excessively praising someone after having insulted them.
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