HomeTable of ContentsOnline Pre-Test1. OverviewPurposeTraining Objectives2. Context for ChangeMental Health ProgramStrategic Plan OverviewGuiding Principlesof ServicePeople ServedMental Health/Illness Defined3. FL Mental HealthSystem's ServicesOutreach: Info. ServicesOutreach: Screening& ReferralScreening ActivitiesReferral ActivitiesMental HealthAssessmentService Planning& Delivery4. Overview of MentalIllnesses & ResourcesAnxiety DisordersGeneralized AnxietyObsessive CompulsivePanic DisordersPost-Traumatic StressSocial PhobiaAnxiety Disorder ResourcesBipolar DisorderDementiaAlzheimer's Disease5. Resource Listings: State &District Health Contacts6. TANF SAMFProgram OverviewOnline Post-TestGlossaryPrinter-Friendly Version
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General Mental Health Conditions and Resources
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Download Anxiety Disorders Information (PDF Format - 130K)
Anxiety disorders are illnesses that cause people to feel frightened, distressed, and uneasy for no apparent reason. If untreated, anxiety disorders can affect a person's productivity and quality of life.
How Common are Anxiety Disorders?
Anxiety disorders are the most common mental health condition in America. More than 19 million people are affected by anxiety disorders yearly.
It is estimated that anxiety disorders cost the U.S. 46.6 billion dollars in direct and indirect costs in 1990 and one third of the nation's total mental health bill of $148 billion is spent on anxiety disorders.
Five types of anxiety disorders have been identified.
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Generalized Anxiety Disorder (GAD)
This disorder causes people to worry about everyday life and ordinary occurrences. The condition usually lasts for over six months. People with this disorder often expect the worst to happen although this often is not the case. People can have problems sleeping, muscle tension, headaches, and nausea.
How Common is Generalized Anxiety Disorder (GAD)?
About 2.8% of Americans experience GAD (four million people have GAD in a year). GAD most often occurs when people are children or adolescents. It can also begin in adulthood. More women are affected than men.
What Are the Symptoms of General Anxiety Disorders?
Other symptoms are:
What Causes GAD?
GAD is thought to run in families. The symptoms of GAD get worse during times of stress.
What Treatments Are Available for General Anxiety Disorders?
Most general anxiety disorders respond to medication and psychotherapy. Medications are usually very effective, although the medication may take several weeks to take affect. Behavior therapy using relaxation techniques is also helpful. Exposure to the feared object or situation is carefully planned so the person can learn to control the anxious responses. This approach is called desensitization. Cognitive-behavioral therapy helps people understand their patterns of thinking so they can react differently to situations that cause anxiety.
Psychodynamic therapy is based on the concept that symptoms result from unconscious mental conflict and the meaning to this conflict must be resolved in order to control the anxiety.*
*Adapted from "Public Information, Anxiety Disorders," American Psychiatric Association, Joint Commission on Public Affairs, 1400 K St., N.W., Washington, DC, 20005, 1993.
This disorder causes people to do repeated activities, have unwanted thoughts of terror or a sense of fear that seem impossible to control. How Common is Obsessive-Compulsive Disorder (OCD)? About 2.3% of Americans or 3.3 million people have OCD every year. OCD affects about the same number of men and women. OCD usually starts in early childhood or adolescence. Obsessive compulsive disorders cost the US economy over 8.4 billion dollars in 1990 from social and economic losses. About 6% of all mental health services are for treatment of OCD. Symptoms of this disorder often occur in early childhood. What Are Some of the Symptoms of Obsessive Compulsive Disorder?
What Causes OCD? Growing research findings show that OCD has a neurological (nerves) basis. People with OCD reveal certain patterns of brain activity than people who do not have OCD. What Treatments Are Available for Obsessive-Compulsive Disorder? Medications and behavioral therapy have proven to be very effective for people who have obsessive-compulsive disorders. A type of behavioral therapy called "exposure and response prevention" has been shown to be useful for treating OCD. People are voluntarily and deliberately exposed to whatever causes the person to have the obsessive thoughts, and then the person is taught to avoid performing the compulsive rituals and deal with the anxiety.* *Adapted from "Anxiety Disorders Education Campaign, Obsessive Compulsive Disorders," National Mental Health Association, 1998.
*Excerpted from National Institute of Mental Health, "Facts about Obsessive-Compulsive Disorders," 1999.
These disorders cause people to have panic attacks, unexplained feelings of terror that hit without warning, and may include physical symptoms of pain, sweating, and fear of dying. How Common Are Panic Disorders? Annually, about 1.7 Americans or 2,4 million people have panic disorders. Women are twice as likely as men to have panic disorders. Panic disorder usually hits when someone is in young adulthood. Roughly half of all people who have panic disorder develop the condition before 24 years of age.* *Adapted from "Anxiety Disorders Education Campaign, Panic Disorder," National Mental Health Association, 1998. What Are the Symptoms of Panic Disorders? The panic attack is an overwhelming fear of being in danger (great anxiety) and physical symptoms can include:
*Adapted from "Public Information, "Anxiety Disorders," American Psychiatric Association, Joint Commission on Public Affairs, 1400 K St., N.W., Washington, DC, 20005, 1993. What Causes Panic Disorder? Heredity, stress, and situations that aggravate normal reactions to catastrophic events are all believed to be a part of panic disorders. Some research has shown that panic attacks occur when a "false alarm" in the brain goes off indicating that death or injury may occur. The exact causes of panic disorders are not known. What Treatments Are Available for Panic Disorders? Treatment for panic disorders include medication and a type of therapy called "cognitive-behavioral therapy" which teach people how to see panic attacks differently and shows them ways to reduce anxiety. Appropriate treatment by an experienced therapist or doctor can reduce or prevent panic attacks in 70% to 90% of people with panic disorders.* *Adapted from "Anxiety Disorders Education Campaign, Panic Disorder," National Mental Health Association, 1998.
Post-Traumatic Stress Disorder This disorder causes people to have flashbacks or strong emotions that are usually in reaction to a traumatic situation, such as physical or mental abuse, war, disasters, child or domestic abuse or other emotionally intense situations. Nightmares, depression, and intense emotional reactions are common. How Common Is Post-Traumatic Stress Disorder (PTSD)? Up 5.3 million Americans or 3.6 of Americans have PSTD annually. About 30% of men and women have spent time in war zones. One million war veterans developed PTSD after Vietnam. Post-traumatic stress disorder can develop at any age, even childhood. Symptoms usually start about three months after a traumatic event. For many physically or emotionally abused children or adults, the disorder can be triggered by another traumatic event or something that reminds the person of the trauma. The severity and duration of the illness varies widely.* *Adapted from "Anxiety Disorders Education Campaign, Post-Traumatic Stress Disorder," National Mental Health Association, 1998 What Are the Symptoms of Post-Traumatic Stress Disorders? People with PTSD re-experience the trauma that triggered the severe personal reaction. This can happen through:
*Health Guide, Brain Center, Clinical Tools, 1998. What Causes Post-Traumatic Stress Disorder (PTSD)? The causes of PTSD are believed to be due in part to a biochemical imbalance in the brain. PTSD alters several brain functions. Abnormalities have been detected in brain chemicals that assist with coping mechanisms, behavior, memory, and learning. Brain imaging studies have recently shown altered metabolism and blood flow in people with PTSD.* *Excerpted from National Institute of Mental Health, "Facts about Post-Traumatic Stress Disorders," 1999. What Treatments Are Available for Post-Traumatic Stress Disorders? Medications such as antidepressants and therapy have proven to be very successful for people with PSTD.
This disorder causes extreme and overwhelming fear of something that is usually not a real danger. Many people may limit their interactions with people and become homebound. How Common Is Social Phobia? About 3.7 % of Americans or about 5.3 million people have social phobia in a year. Women are more likely to have social phobia than men and the disorder typically begins in childhood or early adolescence and rarely develops after 25 years of age.* *Adapted from "Anxiety Disorders Education Campaign, Social Phobia," National Mental Health Association, 1998 What Are the Symptoms of Social Phobia? People with social phobia have a persistent, intense and chronic fear of being evaluated by others and being embarrassed or humiliated. Some symptoms of social phobia are:
What Causes Social Phobia? Research has not identified any causes of social phobia to date. Some experts have suggested that social phobia may be caused by biochemical factors within the brain. What Treatment Is Available for Social Phobia? Research by National Mental Health (NIMH) and other institutions have found that medication is extremely effective in balancing social phobia. Therapy is also successful by "exposure therapy" where the person is gradually made more comfortable with situations that frighten them. Biofeedback and stress management therapy are also effective for social phobia treatment.* *Excerpted from National Institute of Mental Health, "Facts about Social Phobia," 1999.
Anxiety Disorders Association of America
11900 Parklawn Drive, Suite 100
National Self-Help Clearinghouse
National Mental Health Association
Healthy Place Anxiety Disorders Education Program National Institute of Mental Health 6001 Executive Boulevard, Rm 8184, MSC 9663 Betheseda, MD 20892-9663 (301)443-4513 www.nimh.nih.gov/anxiety
Bipolar Disorder (Also Known as Manic Depression) Download Bipolar Disorder Information (PDF Format - 50K) People with bipolar disorder have an illness in which moods swing from deep depression to almost euphoria (often called mania). How Common is Bipolar Disorder? Manic depression or bipolar disorder affects nearly one person in 100 over the course of people's lifetimes. Over four million people in America have been diagnosed as having a bipolar disorder. Bipolar disorder is a serious mood disorder that affects a person's ability to function in every day activities. It affects an individual's ability to work, interact with friends and family, and affects interpersonal relationships.* *Excerpted from National Institute of Mental Health, "Facts about Bipolar Disorder (Manic Depression)," 1999. What Are the Symptoms of Bipolar Disorder? Bipolar disorders (moods) come and go. There are times when people feel "normal" moods and then the illness may swing from one extreme of depression to the other extreme of mania. Symptoms for the Manic Phase include:
*Adapted from "Public Information, "Bipolar Disorder," American Psychiatric Association, Joint Commission on Public Affairs, 1400 K St., N.W., Washington, DC, 20005, 1993. Symptoms for the Depressed Phase include:
What Causes Bipolar Disorder? Bipolar disorder is thought to be genetic. More than 80% of people with bipolar disorder have a family member who has either depression or bipolar disorder which is up to 20 times higher than the general population. Times of stress can bring on times of illness and increase the likelihood that the episode will continue. What Treatment Is Available for Bipolar Disorder? Medications and therapy has proven to be very effective. Lithium has been the drug of choice for many people although the medication works well for some people and not for others. Research has found that many people will stop taking their medication when they are feeling well or having a manic episode. Many people may be hospitalized during manic or depressive stages. Resources
DEPRESSION/Awareness, Recognition, and Treatment (D/ART)
National Mental Health Association
National Depressive and Manic-Depressive Association
Mental Health Sanctuary
Stanley Foundation Bipolar Network
Dementia Download Dementia Information (PDF Format - 130K) Dementia is a disorder that interferes with normal activities due to memory loss. Alzheimer's accounts for most of the cases of dementia in the United States (50-85%). Among people of Asian and African-American descent, and persons over 85 years of age, dementia is often due to hypertension or stroke. How Common is Dementia? The number of people affected by dementia increases steadily as people grow older. It has been estimated that over 47% of people over 85 years old have dementia. Dementia is also common among people who live in institutionalized settings. Over one-third to one-half of all residents of nursing homes are thought to have dementia. What Are the Symptoms of Dementia? Many people miss the early signs of dementia. Memory loss is the easiest way to detect signs of dementia but other symptoms can include depression, lack of interest in activities that were previously of interest, lack of housekeeping or self care, or delirium. Sometimes, taking too many medications or a combination of certain medications can seem like dementia. People can also have dementia if they are not well which would suggest that a thorough physical examination should be conducted to make sure people are not physically ill. What Causes Dementia? Dementia can be caused by physical illness, especially from a stroke or high blood pressure. As the brain ages, some of the neurological connections seem to function slower or not transmit well. The loss of a loved one, changes in living environment, and changes in a person's health are all important factors to consider when screening for dementia. Alzheimer's disease, which is one of the most common forms of dementia, is covered in the following section. It can also play an important role in how a person sees him or her self. What Treatment Is Available for Dementia? After ruling out physical health reasons for dementia, some medications can assist people in maintaining their memory. Support groups and reminders and support groups are also helpful. Some people may be depressed as they realize they are losing some of their memory capacity. Counseling and therapy can alleviate some of the stress for the person with dementia and family members.
Resources
DEPRESSION/Awareness, Recognition, and Treatment D/ART)
National Mental Health Association
Download Alzheimer's Disease Information (PDF Format - 48K) What is Alzheimer's Disease? Alzheimer's Disease is a progressive disorder that slowly kills nerve cells in the brain. The disease affects memory and the ability to think logically. In its severest stages, Alzheimer's can make usually simple chores such as dressing, bathing, and eating hard for people with the disease. How Common is Alzheimer's Disease? The illness affects over four million Americans. At least one in 20 adults over 65 years of age have the disease and one study found that over 47% of elders over 85 years of age have Alzheimer's disease. What Are the Symptoms of Alzheimer's Disease? At first people have small personality changes and memory loss. They may seem more tired, upset or anxious. As the disease worsens, people will have difficulty making decisions, taking care of themselves and often become angry with people trying to help them. Driving can become hazardous yet people will often still want to drive. They forget where they are going, names of loved ones and they may become very suspicious of loved ones who are trying to help them. In the later stages of Alzheimer's disease, some individuals lose physical coordination, depression, need help with dressing and feeding and are often dependent for all physical care. Other symptoms can include:
What Causes Alzheimer's Disease? Research on Alzheimer's has found that all people with the disease develop changes in the brain called "plaques" and neurological "tangles" that develop as brain cells die. The reason for the premature death of brain cells has not been learned yet. What Treatments Are Available for Alzheimer's Disease? The important first step is to find a doctor who is familiar with Alzheimer's. The doctor can be a primary health care doctor, a neurologist, or a psychiatrist who has an interest in geriatrics (the study of working with elder persons), Psychiatric medication may help with some of the depressive symptoms. There are support groups for family members and there are several groups that can provide information and support for people with Alzheimer's and their family members.* *Adapted from "Public Information, "Alzheimer's Disease," American Psychiatric Association, Joint Commission on Public Affairs, 1400 k St., N.W., Washington, DC, 20005, 1993.
Resources
Alzheimer's Association
Alzheimer's Disease Education and Referral Center (ADEAR)
Alzheimer's Disease Research and the American Health Assistance Foundation
American Association of Retired Persons
American Geriatric Society
National Council of Senior Citizens
National Council on the Aging
National Institute on Aging
Depression Download Depression Information (PDF Format - 57K) Depression is a serious medical illness that affects over 17 million Americans annually. The estimated financial costs of depression in missed days at work, medical expenses and premature death are 43 million dollars a year. What is Depression? Depression has a variety of symptoms but the most common one is a deep feeling of sadness. People with depression often feel tired, have no energy, feel hopeless and overwhelmed by everything. Emotional and physical withdrawal are not unusual for people with depression. Depression seems to hit about midlife for many people, from age 24 to 44 years of age. One in four women and one in ten men are likely to experience depression at some time in their life.* *Adapted from "Public Information, "Clinical Depression," American Psychiatric Association, Joint Commission on Public Affairs, 1400 K St., N.W., Washington, DC, 20005, 1993. What Are the Symptoms of Depression? Depression symptoms can include:
What Causes Depression? Research has shown that depression is often caused by several factors:
What Treatments Are Available for Depression? Depression is the most treatable mental health condition. Most people (80 - 90%) respond very well to antidepressant medication and therapy can assist in raising people's self esteem. Short-term therapy has been shown to be very effective. Depression screenings are available year round at 1-800-269-1014. "I felt so low that I'd stay in bed for days. Just got up to eat and go to the bathroom and most of the time I was exhausted after that. Sleep was something I did either a lot of or none at all!"
Resources
National Foundation for Depressive Illness
DEPRESSION/Awareness, Recognition, and Treatment D/ART)
National Mental Health Association
National Council of Senior Citizens
National Council on the Aging
National Self-Help Clearinghouse
Depression and Related Affective Disorders Association (DRADA)
Schizophrenia Download Schizophrenia Information (PDF Format - 45K) Schizophrenia is a disease of the brain. It has diagnosable symptoms and signs. It can be inherited and gets better with medication and therapy and gets worse without treatment. What is Schizophrenia? Schizophrenia is a disorder of the brain that affects one out of every one hundred people. It is a life-long illness that interferes with the ability to think clearly, manage emotions, know what is real, make decisions, and relate to others.* *Adapted from "Schizophrenia is Real," National Mental Health Association, 1998. Over 2.5 million people have schizophrenia. 75% of these persons respond well to newer medications although they may not receive the medications due to the cost. Both men and women seem to have the disease at the same frequency. It is estimated that one-third to one-half of all homeless people are schizophrenic. At least 50% of all people with schizophrenia receive inappropriate or no treatment at all. What are the Types of Schizophrenia? People who have catatonic schizophrenia may be withdrawn, mute and have negative symptoms. Many people have rigid, immobile or stiff muscles. People who have disorganized schizophrenia usually experience extreme confusion and have incoherent speech. Some people may not have delusions or hallucinations. People who have paranoid schizophrenia have extreme feelings of suspicion, persecution or grandiose ideas. People who have residual schizophrenia do not have delusions or hallucinations but often are not interested in activities and may have a lack of motivation. People who have schizoaffective disorder have both the symptoms of schizophrenia and major depression. What are the Symptoms of Schizophrenia? Symptoms can come and go but usually develop slowly over months or years. Schizophrenia symptoms often appear between 13 to 25 years of age. The disease may come and go with periods of remission and relapse. Behaviors that are early warning signs of schizophrenia include:
The symptoms of schizophrenia are usually divided into two categories: positive and negative symptoms. Positive symptoms of schizophrenia include:
Negative Symptoms refer to emotional flatness or lack of expression, an inability to start and finish things speech that is brief and a lack of pleasure in life. What Causes Schizophrenia? There are several causes that can cause schizophrenia. They are:
What Treatments Are Available for Schizophrenia? Recent medical and medication advancements have changed the way many people with schizophrenia can be treated now. Medications and assertive community-based supports and services that recognize when people are starting to feel worse from schizophrenia have revolutionized the way people with schizophrenia are treated now. Therapy for the person and family members can be helpful. Side effects from medication must be monitored carefully as well. Resources
Schizophrenia Anonymous
National Alliance for Research on Schizophrenia and Depression
National Self-Help Clearinghouse
National Mental Health Association
National Alliance for the Mentally Ill
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The following list of mental health conditions describe symptoms and commonly used treatments. Please remember that these are general labels for informational purposes only. They are not meant to diagnose a mental health condition or mental illness.
"I was always a worrier. But it got worse when I had kids. I was so afraid of them getting hurt, I wouldn't let them go to school or outside to play since I knew they'd get hurt.
"Getting dressed in the morning was tough because I had a routine and if I deviated from that routine, I'd have to get dressed again. I knew the rituals didn't make sense but I couldn't seem to overcome them until I got therapy."
"I was sitting in a chair when I felt like my heart was going to explode. They rushed me to the hospital but the doctor said it was a panic attack!"
"My fear would happen in any social situation. I would be anxious even before I left the house and it would escalate as I got closer to a party. I felt like I had the flu. My heart would pound and I thought I'd throw up!"
"My husband started forgetting things. He'd go into a room and forget what he'd gone to get. He went out of doors and got lost. A policeman had to help him home. I couldn't figure out what was going on until the doctor told me he had dementia.
Mary Smith was 72 years old when her husband, John, began noticing she was forgetting things. She would become angry for no apparent reason. Pots would be left on the stove burning while Mary was doing other things.
"My job was awful so I'd try to avoid it so I lost my job which made me more depressed. I finally saw my doctor
after my wife said she couldn't take it anymore. She was right, she shouldn't have because once I started taking medication and talking to other people about the depression, I realized I wasn't so badly off after all!"
