Mental Health

Mental Health

Mental health includes our emotional, psychological, and social well-being.

It affects how we think, feel and act as we cope with life. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Mental illnesses are serious disorders which can affect your thinking, mood, and behavior. There are many causes of mental disorders. Your genes and family history may play a role. Your life experiences, such as stress or a history of abuse, may also matter. Biological factors can also be part of the cause. Mental disorders are common, but treatments are available.

ADHD and ADD: Differences, Types, Symptoms, and Severity

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders. ADHD is a broad term, and the condition can vary from person to person. There are an estimated 6.4 million diagnosed children in the United States, according to the Centers for Disease Control and Prevention.

The condition is also known as attention deficit disorder (ADD), though this is considered an outdated term. The American Psychiatric Association released the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in May 2013. The DSM-5 changed the criteria necessary to diagnose someone with ADHD.

Keep reading to learn more about the types and symptoms of ADHD.

There are three types of ADHD:

  1. Inattentive

This is what is typically referred to when someone uses the term ADD. This means a person shows enough symptoms of inattention (or easy distractibility) but isn’t hyperactive or impulsive.

2. Hyperactive-Impulsive

This type occurs when a person has symptoms of hyperactivity and impulsivity but not inattention.

3. Combined

This type is when a person has symptoms of inattention, hyperactivity, and impulsivity.

The three primary symptoms are:

inattention
hyperactivity
impulsiveness

With each set of symptoms, there are a number of criteria that a child will need to meet in order to be diagnosed. The number of criteria needed for a diagnosis can vary by age. Children up to age 16 must show six or more symptoms. Anyone over the age of 17 only needs five.

Symptoms have to be present for at least six months and must be inappropriate for a child’s developmental level.

Inattention

Inattention, or trouble focusing, is one symptom of ADHD. A child can be diagnosed as inattentive if the child:

  • is easily distracted
  • is forgetful, even in daily activities
  • fails to give close attention to details in school work or other activities, including
  • making careless mistakes
  • has trouble keeping attention on tasks or activities
  • ignores a speaker, even when spoken to directly
  • does not follow instructions, fails to finish schoolwork or chores, and loses focus or is easily side-tracked
  • has trouble with organization
  • dislikes and avoids tasks that require long periods of mental effort, such as homework
  • loses vital things needed for tasks and activities (e.g., books, keys, wallet, phone)

Hyperactivity and Impulsivity

A child can be diagnosed as hyperactive or impulsive if the child:

  • excessively talks
  • has severe difficulty waiting for their turn
  • squirms in their seat, taps their hands or feet, or fidgets
  • gets up from a seat when remaining seated is expected
  • runs around or climbs in inappropriate situations
  • is unable to quietly play or take part in leisure activities
  • blurts out an answer before a question has been finished
  • intrudes on and interrupts others constantly

Adult ADHD

Adults with ADHD have typically had the disorder since childhood, but it may not be diagnosed until later in life. An evaluation usually occurs at the prompting of a peer, family member, or co-worker who has observed problems at work or in relationships.

Adults can be diagnosed with any of the three subtypes of ADHD. Adult ADHD symptoms can be somewhat different from those experienced by children because of the relative maturity of adults, as well as physical differences between adults and children.

Severity

The symptoms can range from mild to severe, depending on a person’s unique physiology and environment. Some people experience mild inattentiveness or hyperactivity when they perform a task they don’t enjoy, but they have the ability to focus on tasks they like. Others may experience more severe symptoms. These can have a negative impact in school, at work, and in social situations.

Symptoms seem to be more severe in unstructured group situations (for example, on the playground) than in more structured situations where rewards are given (in the classroom). Other conditions, such as depression, anxiety, or a learning disability may worsen symptoms. Some people report that symptoms go away with age. For example, an adult with ADHD who was hyperactive as a child may find that they’re now able to remain seated or curb some impulsivity

Most people feel anxious or depressed at times. Losing a loved one, getting fired from a job, going through a divorce, and other difficult situations can lead a person to feel sad, lonely, scared, nervous, or anxious. These feelings are normal reactions to life’s stressors.

But some people experience these feelings daily or nearly daily for no apparent reason, making it difficult to carry on with normal, everyday functioning. These people may have an anxiety disorder, depression, or both.

It is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder. The good news is that these disorders are both treatable, separately and together.

Read on to find out more about the co-occurrence of anxiety and depression and how they can be treated.

Depression

Depression is a condition in which a person feels discouraged, sad, hopeless, unmotivated, or disinterested in life in general. When these feelings last for a short period of time, it may be a case of “the blues.”

But when such feelings last for more than two weeks and when the feelings interfere with daily activities such as taking care of family, spending time with friends, or going to work or school, it’s likely a major depressive episode.

Major depression is a treatable illness that affects the way a person thinks, feels, behaves, and functions. Depression is one of the most common mental disorders in the United States. In 2014, around 15.7 million adults age 18 or older in the U.S. had experienced at least one major depressive episode in the last year, which represented 6.7 percent of all American adults. At any point in time, 3 to 5 percent of adults suffer from major depression; the lifetime risk is about 17 percent. As many as 2 out of 100 young children and 8 out of 100 teens may have serious depression.

Screen yourself or a loved one for depression.

Types of Depression

Three main types of depressive disorders—major depression, persistent depressive disorder, and bipolar disorder—can occur with any of the anxiety disorders.

Major depression involves at least five of these symptoms for a two-week period. Such an episode is disabling and will interfere with the ability to work, study, eat, and sleep. Major depressive episodes may occur once or twice in a lifetime, or they may recur frequently. They may also take place spontaneously, during or after the death of a loved one, a romantic breakup, a medical illness, or other life event.

Some people with major depression may feel that life is not worth living and some will attempt to end their lives.

Persistent depressive disorder, or PDD, (formerly called dysthymia) is a form of depression that usually continues for at least two years. Although it is less severe than major depression, It involves the same symptoms as major depression, mainly low energy, poor appetite or overeating, and insomnia or oversleeping. It can manifest as stress, irritability, and mild anhedonia, which is the inability to derive pleasure from most activities.

People with PDD might be thought of as always seeing the glass as half empty.

Bipolar disorder, once called manic-depression, is characterized by a mood cycle that shifts from severe highs (mania) or mild highs (hypomania) to severe lows (depression).

During the manic phase, a person may experience abnormal or excessive elation, irritability, a decreased need for sleep, grandiose notions, increased talking, racing thoughts, increased sexual desire, markedly increased energy, poor judgment, and inappropriate social behavior.

During the depressive phase, a person experiences the same symptoms as would a sufferer of major depression. Mood swings from manic to depressive are often gradual, although occasionally they can occur abruptly. Learn more about bipolar disorder.

Depression and Anxiety Disorders: Not the Same

Depression and anxiety disorders are different, but people with depression often experience symptoms similar to those of an anxiety disorder, such as nervousness, irritability, and problems sleeping and concentrating. But each disorder has its own causes and its own emotional and behavioral symptoms.

Many people who develop depression have a history of an anxiety disorder earlier in life. There is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.

Read more information about depression from the National Institute of Mental Health.

Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships. There are several different types of anxiety disorders. Examples include generalized anxiety disorder, panic disorder, and social anxiety disorder.

Signs and Symptoms

Generalized Anxiety Disorder

People with generalized anxiety disorder display excessive anxiety or worry for months and face several anxiety-related symptoms.

Generalized anxiety disorder symptoms include:

  • Restlessness or feeling wound-up or on edge
  • Being easily fatigued
  • Difficulty concentrating or having their minds go blank
  • Irritability
  • Muscle tension
  • Difficulty controlling the worry
  • Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)

Panic Disorder

People with panic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom.

Panic disorder symptoms include:

  • Sudden and repeated attacks of intense fear
  • Feelings of being out of control during a panic attack
  • Intense worries about when the next attack will happen
  • Fear or avoidance of places where panic attacks have occurred in the past

Social Anxiety Disorder

People with social anxiety disorder (sometimes called “social phobia”) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others.

Social anxiety disorder symptoms include:

  • Feeling highly anxious about being with other people and having a hard time talking to them
  • Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others
  • Being very afraid that other people will judge them
  • Worrying for days or weeks before an event where other people will be
  • Staying away from places where there are other people
  • Having a hard time making friends and keeping friends
  • Blushing, sweating, or trembling around other people
  • Feeling nauseous or sick to your stomach when other people are around

Evaluation for an anxiety disorder often begins with a visit to a primary care provider. Some physical health conditions, such as an overactive thyroid or low blood sugar, as well as taking certain medications, can imitate or worsen an anxiety disorder. A thorough mental health evaluation is also helpful, because anxiety disorders often co-exist with other related conditions, such as depression or obsessive-compulsive disorder.

Risk Factors

Researchers are finding that genetic and environmental factors, frequently in interaction with one another, are risk factors for anxiety disorders. Specific factors include:

  • Shyness, or behavioral inhibition, in childhood
  • Being female
  • Having few economic resources
  • Being divorced or widowed
  • Exposure to stressful life events in childhood and adulthood
  • Anxiety disorders in close biological relatives
  • Parental history of mental disorders
  • Elevated afternoon cortisol levels in the saliva (specifically for social anxiety disorder)

 

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