Types of mental health issues

Posted by Nurse Linda in Life After Paralysis on May 20, 2019 # Health

Mental health is a quality of general well-being where people recognize their own potential, cope with the typical stressors of life, work productively, and contribute to the community. It is meeting the challenges of life, the ups and downs. It is living productively for yourself and others.

Sometimes, there are challenges in life that greatly affect our mental health. These can come from all sorts of situations such a loss of a loved one, work, or living situation. We typically think of challenges coming from disappointing situations, but they can come from happy events as well. A new baby, marriage, or promotion at work can lead to challenges of thinking about if our capabilities will match the challenge. For many people, a challenge can be an extreme change in the way our bodies function.

This month, May is designated as mental health month. My blogs have focused on a variety of topics concerning mental health. There are some mental health challenges that are typically discussed but often people do not really understand what they are. Some mental health issues are caused by a chemical imbalance or genetic link. These include bipolar disorder, schizophrenia, depression, and generalized anxiety disorder.

Bipolar disorder, which is also known as manic depressive disorder, is unusual changes in mood, energy, activity levels, and the ability to carry out day-to-day tasks. It is typically seen in individuals whose mental status shifts from extreme highs to extreme lows.

There are four types of bipolar disorder. Bipolar I Disorder consists of extreme manic or hyperactive energy lasting for seven days. This phase is so extreme that hospitalization may be required. It is followed by two weeks of depression. Sometimes the mania and depression episodes are mixed.

Bipolar II Disorder is like Bipolar I but with less extreme behavior. The third, Cyclothymic Disorder, are episodes of high activity followed by depression lasting for two years, one year in children. The fourth type of Bipolar disorder is a variation of the manic and depressive stages.

Individuals with bipolar disorder in the manic phase often think they can do many things all at once. They might feel really great about themselves, have trouble keeping on task until completion because their mind is moving so fast and can get agitated because they can’t keep up to their own expectations. They may have difficulty sleeping or self-calming. Sometimes, they may even talk fast.

In the depressive phase, the person is often tired, may sleep too much or too little. They might become self-critical and sad. They might not find joy in anything they do or with what is going on around them. Sometimes, they might become suicidal.

Schizophrenia affects how a person thinks, feels and behaves. The individual will appear as if they have lost touch with reality. It is not what is depicted on TV.

There are types of schizophrenia that include positive, negative and cognitive symptoms. Positive symptoms can be hallucinations (hearing or seeing something that is not there), delusions (thoughts not based on reality), thought disorders (dysfunctional ways of thinking), movement disorders (unusual body movements.

Negative symptoms of schizophrenia are reduced emotions and vocalizations, “Flat affect” (reduced expression of emotions via facial expression or voice tone), lack of finding pleasure in life, struggling to start and sustain activities, and a reduced amount of talking.

Cognitive symptoms are difficulty in focusing, remembering and thinking such as making decisions. These can be very subtle to quite noticeable.

Depression is unhappiness or sadness that affects how you feel, think, and handle daily activities, such as sleeping, eating, or working. Everyone becomes depressed or sad about things depending on the situation, however, depression is not diagnosed unless the symptoms last for over two weeks. Depression can be difficult to diagnose because the symptoms can be vague in some people.

A persistent depressive disorder is a depression that lasts for two years. Psychotic depression includes delusions and/or hallucinations. Hormonal changes and fatigue can affect a person as in postpartum depression. Seasonal affective disorder (SAD) develops in some people in the darker winter months when natural sunlight is not plentiful.

There are common symptoms of depression. Not every symptom will be experienced by a person with depression. Some people might have a few symptoms, others will have several. The level of intensity of the symptoms is different for everyone based on their own interpretations. Symptoms of depression can be:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Generalized anxiety disorder is excessive anxiety or worry about activities or events. The worry is concentrated around everyday events. The diagnosis is not made until symptoms last six months or longer. Symptoms may include some or all of the following:

  • Having trouble controlling their worries or feelings of nervousness
  • Knowing that they worry much more than they should
  • Feeling restless and have trouble relaxing
  • Having a hard time concentrating
  • Being easily startled
  • Having trouble falling asleep or staying asleep
  • Feeling easily tired or tired all the time
  • Having headaches, muscle aches, stomach aches, or unexplained pains
  • Having a hard time swallowing
  • Trembling or twitching
  • Being irritable or feel “on edge”
  • Sweating a lot, feeling light-headed or out of breath
  • Having to go to the bathroom a lot

These are extreme mental health disorders. Why some people have these concerns and others do not is not fully understood. Chemical imbalances and genetics play a role. But in families, even though some will develop the disorder, others will not.

The good news for mental health concerns is that treatment is available. If you suspect you are having issues, you should first check with your healthcare provider who can do an in-office screening. They can recommend the appropriate treatment. Although you might be suspicious that you have a specific mental health concern, they will be able to streamline the diagnostic process to make sure you get started on the right path to enhance your mental health. Treatments include medication and therapy.

Psychologists and psychiatrists specialize in different diagnostic categories. Therapy is directed in different frameworks. Connecting with the right person for your condition as well as for your personality is a positive step in recovery.

People with chronic issues like spinal cord injury are susceptible to depression and anxiety due to adjustments to injury but not bipolar disorder or schizophrenia disorders. That does not mean anyone is exempt, but no one should be expecting these two mental health issues as a consequence of SCI.

In our society, some people tend to focus on the weaknesses of others. Unfortunately, this includes making fun of mental health issues. You might hear name calling if someone has a lot of energy or acts differently. That does not mean the targeted person even has these issues. It is an unfortunate problem in society to have to put others down by using negative connotations. Therefore, it is good to know what these issues are, so we can all be aware.

Next week, we will examine destructive health behaviors that people often use as adaptive techniques. When we have the knowledge, we can start to change behaviors.

Pediatric Consideration: As with all diagnosis, mental health issues are becoming more evident in the pediatric population. Health care issues that were thought to be just in older adults are being seen in younger and younger age groups, especially as healthcare advances.

Children and adolescents with spinal cord injury and other chronic disease have what is considered an adult issue. They deal with adapting to significant life changes with less life experience to do so. Parents and adolescents that are able to communicate as adults should ask for mental health screening. Depression in children is diagnosed more frequently as assessments become fine-tuned to the needs of pediatric individuals. Assessing mental health should be encouraged, just as assessing a blood pressure or other measurement.

Family therapy is significant for children. Parents need to be able to decide when to step in and when to let the child or adolescent make decisions on their own. As a parent, you need to be involved in the healthcare of your child regardless of their age. Let your child have choices but direct them to positive outcomes. Sometimes a mental health professional can see the dynamics more clearly.

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- Nurse Linda

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.