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What is mental illness? Mental illness is a term that refers to all the different types of mental disorders, including disorders of thought, mood or behavior. These disorders cause distress and result in a reduced ability to function psychologically, socially, occupationally or interpersonally. People who have a mental illness might have trouble handling such things as daily activities, family responsibilities, relationships, or work and school responsibilities. You can have trouble with one area or all of them, to a greater or lesser degree. And you can have more than one type of mental illness at the same time. How is the classification of mental illnesses evolving? Today, we classify mental disorders based on the symptoms a person experiences and the clinical features of the illness. As time goes by and we gain a clearer understanding of how specific genes interact with illness or specific behaviors, we may be able to develop a much more sophisticated classification system that is directly linked to a biologic cause, rather than just symptoms. Some disorders with similar symptoms and clinical features are very different in terms of their underlying biology. To treat them similarly simply because they share the same symptoms may not be appropriate. We suspect, for example, that there are different types of schizophrenia, with different causes, and that they possibly respond differently to different treatments. What are the classes of mental illness? Our evolving understanding of genetics and how the brain works may eventually change how we classify mental illnesses. For the time being, we think of several main classes of mental illness:
Do all mental illnesses have a biological basis — a problem with the brain's chemistry? No, not all of them. We know that many serious mental illnesses do have a strong biological basis. But that's not the entire story. Some people, for example, might have an inherited, biological tendency to develop depression. They can experience serious depression even though no specific event triggers it. Others, however, have no known inherited tendency for depression. But if something happens, such as the death of a loved one, it can trigger major depression. We don't yet know if the underlying neurochemical aspects of these two depressive reactions are the same. In other words, one person may have a mental illness because of their nature — their genetic vulnerabilities, their neurochemical functioning. And another person may have a mental illness because of nurture — an environmental cause that perhaps then alters their neurochemistry. Most of the time, however, it's probably a complex interaction of both nature and nurture. With so many medications available to treat depression and other illnesses, is psychotherapy still a good option? Yes, there is still a major role for psychotherapy in treating mental illnesses. Among the many forms of psychotherapy are brief therapy, cognitive-behavioral therapy, psychodynamic therapy, and family or couples therapy. Psychotherapy remains a very important part of treatment for many individuals and often is the treatment of choice. Medication might be all that some people need to restore their brain chemistry to a more normal state. But for others, medication, although effective, doesn't alter the way they cope with the stress that might have contributed to their illness. Psychotherapy and education can help change coping behaviors and offer strategies to help understand and modify risk factors for illness. Very often, a combination of medication and psychotherapy is most effective. And in some cases, medication is entirely ineffective and psychotherapy alone can help.
Are mental illnesses more common these days? More people seek help today than in the past. But is that because more people are ill? Or is it because now it's more acceptable to seek help, and help is more readily available? Also, the world is more complicated and fast-paced than it once was. Does this change in environment contribute to increased mental illness? We don't know the answers to those questions. Are mental illnesses simply whatever a culture or society defines them as? Behaviors that are approved of or frowned upon can vary greatly from culture to culture. But research shows a somewhat surprising consistency in the prevalence of serious mental illnesses across all cultures. Schizophrenia, for instance, occurs in about 1 percent of all populations worldwide. Major depression also has a consistent prevalence in countries around the world. This information supports the idea that serious mental illnesses have a biological basis common to all humans. How does stress affect mental health? Going through a stressful event doesn't mean you'll develop depression or an anxiety disorder, but it can increase your risk of developing a mental disorder. Stress runs the gamut, from daily hassles, such as traffic jams and financial worries, to major life events, such as the breakup of a relationship or the death of a loved one. People who have experienced depression in the past are more vulnerable to depression after a major loss. Some people sink into a depression after major life events, while others seem to sail through them and even experience personal or spiritual growth. People with an active, problem-solving style are less likely to experience depression than those with a passive, emotion-focused style. A positive coping style that helps manage stress includes:
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