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Understanding Mental Illness

Mental illnesses refer to disorders generally characterized by dysregulation of mood, thought, and/or behavior. Mood disorders are among the most pervasive of all mental disorders and include major depression, in which the individual commonly reports feeling, for a time period of two weeks or more, sad or blue, uninterested in things previously of interest, psychomotor retardation or agitation, and increased or decreased appetite since the depressive episode ensued.(APA, 2016)

The Center for Disease Control (CDC) characterizes mental illness as:

The term mental health is commonly used in reference to mental illness. However, knowledge in the field has progressed to a level that appropriately differentiates the two. Although mental health and mental illness are related, they represent different psychological states.

Mental health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” It is estimated that only about 17% of U.S adults are considered to be in a state of optimal mental health. There is emerging evidence that positive mental health is associated with improved health outcomes.

Mental illness is defined as “collectively all diagnosable mental disorders” or “health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.” Depression is the most common type of mental illness, affecting more than 26% of the U.S. adult population. It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease.4

Evidence has shown that mental disorders, especially depressive disorders, are strongly related to the occurrence, successful treatment, and course of many chronic diseases including diabetes, cancer, cardiovascular disease, asthma, and obesity and many risk behaviors for chronic disease; such as, physical inactivity, smoking, excessive drinking, and insufficient sleep.

Common Issues:

Antisocial personality disorder: exploitative interactions with others; disdain for following social rules often leading to impulsive criminal acts, lack of empathy or remorse, and thrill  seeking.

Anxiety disorders: persistent problems of anxiety and worry either in response to a specific object (a phobia), a specific situation (social phobia or agoraphobia), sudden bouts of intense anxiety (panic attacks), or post traumatic stress syndrome.

Affective disorders: uncontrolled and persistent intense emotions—either depression (including eating and sleeping problems, apathy, fatigue, and thoughts of suicide or hopelessness) or swings of mood from extreme elation to depression.

Cognitive disorders: severe problems in memory or judgment caused by brain damage in such conditions as Alzheimer’s disease, stroke, and traumatic brain injury.

Schizophrenia: inability to function due to incoherent thought; withdrawal from social relationships; hallucinations; and delusions.

Substance use disorders: excessive use of chemicals (for example, alcohol, marijuana, heroin) that jeopardizes health, social, or occupational functioning or that involves tolerance (need for larger doses) or withdrawal (physical symptoms after stopping intake).

Mental Health Indicators

In the health care and public health arena, more emphasis and resources have been devoted to screening, diagnosis, and treatment of mental illness than mental health. Little has been done to protect the mental health of those free of mental illness. Researchers suggest that there are indicators of mental health, representing three domains. These include the following:

  • Emotional well-being
    • such as perceived life satisfaction, happiness, cheerfulness, peacefulness.
  • Psychological well-being
    • such as self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one’s environment, spirituality, self-direction, and positive relationships.
  • Social well-being
    • social acceptance, beliefs in the potential of people and society as a whole, personal self-worth and usefulness to society, sense of community.

The former surgeon general notes that there are social determinants of mental health as there are social determinants of general health that need to be in place to support mental health. These include adequate housing, safe neighborhoods, equitable jobs and wages, quality education, and equity in access to quality health care.

Frequent Mental Distress:

Frequent mental distress is defined based on the response to the following quality of life question, ‘‘Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?’’ Frequent mental distress is identified as a report of 14 or more days of poor mental health in the past 30 days.

  • 9.4% of U.S. adults experienced Frequent Mental Distress (FMD) for the combined periods 1993-2001 and 2003-2006.
  • The Appalachian and the Mississippi Valley regions had high and increasing FMD prevalence, and the upper Midwest had low and decreasing FMD prevalence during this same time period.

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Keyes CLM. Social well–being. Soc Psychol Quart 1998;61:121–140.
Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:617–627.
Murray CJL, Lopez AD. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Geneva, Switzerland;World Health Organization, 1996.
Ryff CD, Keyes CLM. The structure of psychological well–being revisited. J Pers Soc Psychol 1995;69:719–727.
Ryff CD. Happiness is everything, or is it? Explorations on the meaning of psychological well–being. J Pers Soc Psychol 1989;57:1069–1081.
U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services; Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.
World Health Organization. Strengthening Mental Health Promotion. Geneva, World Health Organization (Fact sheet no. 220), 2001.

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