We now know that many disorders are physiological, not psychological
By the numbersWho are the mentally ill? They are our neighbors, friends, family — and us. Put five people in a room and one has suffered from a mental illness in the past year. One in five adults (46 million Americans) experiences mental illness each year. One in 17 suffers serious mental illness such as schizophrenia, major depression or bipolar disorder.One in 10 children lives with a serious mental or emotional disorder. The rate of mental illness is more than twice as high among those aged 18 to 25 (29.9 percent) than among those 50 and older. Less than one-third of adults and half of children with a diagnosable mental disorder receives mental health care in a given year. Half of all lifetime cases of mental illness begins by age 14, three-quarters by 24. More than 50 percent of students 14 and older with a mental disorder drop out of high school — the highest dropout rate of any disability group. 24 percent of state prisoners and 21 percent of local jail prisoners have a recent history of mental illness. 70 percent of children in juvenile justice systems have at least one mental disorder. The annual economic, indirect cost of mental illness in the U.S. is about $79 billion, mostly in lost productivity. Adults living with serious mental illness die 25 years earlier than other Americans, largely due to treatable medical conditions. An estimated 8.7 million American adults had serious thoughts of suicide in the past year. Of them, 2.5 million made suicide plans, and 1.1 million attempted suicide.
Sources: Substance Abuse and Mental Health Services Administration, National Alliance on Mental Illness, National Institute of Health, U.S. Department of Health and Human Services, National Center for Mental Health and Juvenile Justice
Major mental illnessesMental illness refers to a wide range of disorders that affect mood, thinking and behavior. More common ones include: Attention-deficit/hyperactivity disorder: Characterized by inattention, hyperactivity and impulsivity. Strong scientific evidence indicates ADHD is a biologically based disorder. Research also suggests a strong genetic basis. Bipolar disorder (formerly known as “manic-depressive disorder”): A major mood disorder in which a person experiences episodes of depression and mania (extreme irritability or euphoria). Likely caused by an imbalance of neurotransmitters or hormones. Trauma and major loss may play roles.Major depression (known as clinical depression): A combination of depressed mood, poor concentration, insomnia, fatigue, appetite disturbances, excessive guilt and suicidal thoughts. Depression is twice as common in women for reasons not fully understood. Likely caused by biological differences in the brain along with trauma or major loss. Post-traumatic stress disorder: Severe or repeated exposure to trauma can affect the brain in a way that makes a person feel like the event is happening again and again. Can induce anxiety, sleeplessness, anger or substance abuse. PTSD can affect everyone from survivors of sexual trauma and natural disasters to emergency and rescue personnel and military veterans. Generalized anxiety disorder: A severe, chronic, exaggerated worrying about everyday events. Likely caused by genetics, brain chemistry and environmental stresses. Obsessive-compulsive disorder: Obsessions are intrusive, irrational thoughts or impulses that repeatedly well up in a person's mind. Compulsions are repetitive rituals such as handwashing, counting, checking, hoarding or arranging. Evidence suggests that OCD is caused by a chemical imbalance in the brain. People whose brains are injured also can develop OCD. Panic disorder: Feelings of terror that strike suddenly and repeatedly with no warning. Symptoms include sweating, chest pain and irregular heartbeats. More common in women. Brain abnormalities, family history, major life stress and abuse of drugs and alcohol may play roles. Schizophrenia: A group of severe brain disorders in which people interpret reality abnormally. May result in hallucinations, delusions and disordered thinking and behavior. Likely caused by differences in the brain, genetic vulnerability and environmental factors that occur during a person's development. Personality disorders Borderline personality disorder: Characterized by unstable moods, interpersonal relationships, self-image and behavior. Antisocial personality disorder: A person's thinking and relating to others are abnormal and destructive, such as disregard for right and wrong, lying and behaving violently. Narcissistic personality disorder: Characterized by an inflated sense of self-importance and a deep need for admiration. Personality disorders are thought to be caused by genetic and environmental factors. Sources: National Alliance on Mental Illness, Mayo Clinic, WebMD
First in a seriesThe mentally ill are under pressure and scrutiny like never before. Mental health budgets have been slashed. State inpatient beds are at historic lows. Emergency rooms and jails are the new front lines of care. In the wake of mass shootings — and would-be school shooters such as Alice Boland — some want registration of the severely ill. But there is promise for change. State funding may increase. Research is showing these illnesses are based in flawed physiology, not character flaws. And many who suffer are challenging the stereotypes that affect them. The Post and Courier is examining these issues in a series of stories over the next few months. We start with the stigma and its undercurrent of shame.
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Biology of change
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