Psychology Online

Mental disorder

Synonyms in a broader sense

Mental illness, mental abnormality, mental illness, vulg .: mental illness

Definition of terms and general information

The term "Mental disorder“Is the current term in specialist circles for diseases of the human psyche. It was chosen because it is assumed that there is less (dis) valuation inherent in it than terms such as “illness” or “illness” and in order to avoid the stigmatization of those affected that often occurred in the past.

On the following pages, however, the terms “mental illness”, “mental abnormality” and “mental illness” are used without making any judgment.

The human psyche is difficult to grasp in its entirety, and accordingly it is also difficult to clearly define disorders of the psyche. One reason for this may be that a considerable part of these disturbances eludes the observer or examiner because it takes place “inside” the person concerned, in contrast to the somatic, i.e. H. Physical, medicine generally lacks "measured values" to objectify such disorders.

The delicate definition of what is psychologically “normal” also plays a role to a considerable extent, which is largely shaped by the ideas and tolerance of the respective society. For this reason, psychiatry, the discipline of modern medicine that deals with mental disorders, has a not inconsiderable intersection with the social sciences.

definition

A mental disorder is the term used to describe significant abnormalities in the experience and behavior of those affected, which can appear as disorders of perception, thought processes, actions and feelings. To decide whether such abnormalities are of disease value and consequently require treatment, the question of the ability of those affected to care for themselves (suitability for everyday use) and their exposure to symptoms is often used.

frequency

Mental disorders are generally common, some studies assume that every second person at some point in life will show at least mild symptoms of a psychological problem. The frequency of disorders requiring treatment is given for Germany as about 1/10. A mental disorder is one of the most frequent treatment occasions for general practitioners and a reason for (temporary) occupational disability.

causes

Science has identified many influencing factors for the development of a mental disorder, one speaks of a "multifactorial genesis". It is hardly possible to structure these influencing factors systematically without gaps and areas of overlap. The following list is therefore more of an exemplary nature.

Physical causes: Metabolic disorders (e.g. Hypothyroidism or Hyperthyroidism), Brain damage e.g. B. by accident, diseases or infections of the brain such as Alzheimer's disease or Meningitis, Poisoning (alcohol, drugs), disorders of the messenger metabolism in the brain, storage diseases such as M. Wilson.

„Mental causes": Traumatic experiences (PTSD) z. B. Experience of violence, serious illness, stressful life events.

Genetic causes: For a number of mental disorders a familial accumulation has been proven in recent years, which suggests the occurrence of hereditary risk factors.

Symptoms

The symptoms and severity of mental disorders are diverse, they can express themselves very subtly and remain largely hidden from the viewer or appear massive and represent a heavy burden for those affected and their surroundings. To illustrate the wide range of psychiatric symptoms, an exemplary collection of symptoms is given here:

Disorders of consciousness, orientation and attention: twilight states, sleepiness, sleepwalking, disorientation in relation to oneself, the local environment, the current situation and temporal contexts, limitation of perception, absent-mindedness.

Memory disorders: impairment of short and / or long-term memory, amnesias, false memories such as déjà vu experiences.

Intelligence disorders: Reduced intellectual performance, either from birth or as part of aging or disease processes (dementia).

Thought disorders: disorders of the thought process such as slowing down, brooding, inhibition of thinking, debauchery of thoughts, thought leaps up to incoherence.

Delusion: misjudgments of reality, to which those affected persistently and convincingly hold on and cannot be corrected from the outside. These include delusions of persecution, delusions of jealousy, delusions of guilt or delusions of grandeur. Patients with delusional disorders reinterpret perceptions or experiences (delusional perception) and occasionally construct complex "delusional systems" that are confusing for the outsider, but conclusive for those affected, in which they live as if in a second, subjective reality.

Perceptual disorders: Sham perceptions (hallucinations) in the area of seeing, hearing, smelling, tasting, feeling. Change in the intensity of perception (everything appears paler or more colorful, clearer or more blurred on the patient).

Ego disturbances: I disturbances express themselves in difficulties to separate oneself from one's surroundings. Patients have the feeling that their thoughts are being entered, withdrawn or read from outside, they feel controlled or experience themselves, parts of themselves or the environment as changed, "strange" and strange.

Mood and drive disorders: Mood disorders can manifest themselves through increased or decreased expressions of sensations such as joy or sadness or through their complete absence (numbness). Increased or reduced "deflection" (change of mood, influencing) of the mood from the outside can also be typical for certain psychological disorders.

Anxiety and obsessive-compulsive disorders: These include increased, e. Fears of certain or indefinite situations that appear to be nonsensical, for example fear of spiders (arachnophobia), fear of space and space, fear of illness (hypochondria). Constraints often result from e.g. Partly unconscious fears and express themselves in the exercise of gestures, rituals and actions (compulsive actions) or thoughts (obsessive thoughts), which the patient himself judges as nonsensical. These include compulsory cleaning, compulsory counting or compulsory checks.

Nocturnal panic attacks can be very stressful for those affected. Find out all the important information about this at: Nocturnal panic attacks - what's behind them?

Common clinical pictures

In anticipation of a detailed description in the respective sub-chapter, a brief overview of common mental disorders and their symptoms follows:

Depressive disorders: Depressive clinical pictures are expressed in a markedly depressed mood that is not appropriate to the circumstances and listlessness of the patient. Patients feel sad, uncomfortable, and unable to change anything about this situation. Clinically, a distinction can be made between a. Mixed images with manic or delusional disorders (see depression, Pregnancy depression)

Manic disorders: In contrast to depressive disorders, manic disorders express themselves through an inappropriately cheerful, carefree mood of the patient. Those affected show an aimless thirst for action, are filled with nonsensical, but perceived as positive ideas and are not infrequently conspicuous through rampant and self-damaging behavior such as excessive party or squandering money. Relatively common are mixed images in which manic and depressive phases alternate, and thought processes and content in the context of mania can also assume a delusional character (see mania)

Schizophrenic clinical pictures: Symptoms of schizophrenic disorders include a. Ego disorders and delusional misunderstanding of reality, hallucinations, sleep and thought disorders or perceived emptiness. The schizophrenic disorders are divided according to cause or predominant symptom pattern (see schizophrenia)

Addictions and drug disorders: Drug abuse is linked to mental disorders in two ways: firstly, a number of substances have been shown to trigger mental illnesses, and secondly, it has been proven that some mental disorders lead to an increased “susceptibility” to substance abuse.

Furthermore, “non-material” addictions are also counted among the addictions, such as shopping, gambling or sex addiction (see Addiction).

Anxiety and Obsessive-Compulsive Disorders: Anxiety disorders include, for example, phobias (object or situation-related fears, e.g. spider phobia, claustrophobia); this spectrum also includes hypochondria (excessive fear of illness) or panic attacks. Obsessive-compulsive disorders are often based on fears of a concrete or abstract danger, which those affected try to avoid by compulsively performing rituals (e.g. compulsory control, cleaning or counting (see fear and Obsessive-compulsive disorder)

Diagnosis

The diagnosis of mental disorders rests on two pillars:

An initially carried out, conscientious somatic (= physical) examination and questioning serves to exclude physical illnesses as the basis of the mental disorder. The blood test provides information such as B. on underlying metabolic disorders, diagnostic imaging (computer or magnetic resonance tomography) on infections or shrinking processes of the brain.
The further essential part of the diagnosis is the psychiatric anamnesis (survey of the medical history with a focus on the patient's psyche). This includes extensive inquiries into the patient's life story, questions about character traits, attitudes and feelings as well as observing the behavior of the person concerned in conversation with the aim of capturing their personality as completely as possible. This type of history-taking has to be carried out very carefully, takes a lot of time and can be a heavy burden for the examiner and patient.

It can be difficult to assign individual symptoms to specific clinical pictures, not least because of the overlapping areas between individual mental disorders. An important "tool" in the allocation and summary of symptom pictures are the so-called "Classification manuals“The World Health Organization and the American Psychiatric Association (ICD and DSM, respectively). These establish criteria for making the diagnosis of a specific mental disorder, for example the type and duration of the abnormality or combination with other symptoms. Such a classification objectifies the diagnosis and helps to differentiate between differential diagnoses.

therapy

If the mental disorder is based on a physical illness, the therapy of this is usually decisive and can lead to success.

In the therapy of non-physically caused mental disorders there are different ones psychotherapeutic and medicinal procedures alone or in combination for use. Which psychotherapeutic methods (e.g. psychoanalysis, behavioral or gestalt therapy) are chosen depends on the type of disorder to be treated and, last but not least, the therapist's experience and qualifications.

A large number of specific and highly effective active ingredients are available for drug therapy of psychological disorders, most of which alleviate the symptoms of the respective disorder by influencing the neurotransmitter balance in the brain. Unfortunately this Medication It is not uncommon for significant side effects such as drowsiness, lack of emotion or weight gain, so that drug therapy demands a great deal of consistency from the patient in implementing it and should be monitored by experienced therapists.

Depending on the severity of the symptoms, a psychosocial care give patients help in coping with everyday life.

forecast

The prognosis of a mental disorder is very different, so it is difficult to give general information. What is important, however, is the fact that a large number of mental disorders tend to become chronic if left untreated and, according to estimates, at most half of all disorders requiring treatment even come into contact with auxiliary facilities. On the other hand, through an optimal interaction of z. B.Psychotherapy, drug therapy and psychosocial care of the patient often ensure a good treatment success even in the case of serious mental disorders, which is often measured by the reintegration of those affected into a regular everyday life and their ability to care for themselves.