Urban Healthcare Initiative Program
AGING / DEMENTIA / DEPRESSION / DYING
WHAT IS MENTAL ILLNESS
National Alliance of Mental Illness (NAMI) recognizes that other organizations have drawn distinctions between what diagnoses are considered “mental health conditions” as opposed to “mental illnesses.” We intentionally use the terms “mental health conditions” and “mental illness/es” interchangeably.
A mental illness is a condition that affects a person’s thinking, feeling, behavior or mood. These conditions deeply impact day-to-day living and may also affect the ability to relate to others. If you have — or think you might have — a mental illness, the first thing you must know is that you are not alone. Mental health conditions are far more common than you think, mainly because people don’t like to, or are scared to, talk about them. However:
1 in 5 U.S. adults experience mental illness each year
1 in 20 U.S. adults experience serious mental illness each year
1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year
50% of all lifetime mental illness begins by age 14, and 75% by age 24
A mental health condition isn’t the result of one event. Research suggests multiple, linking causes. Genetics, environment and lifestyle influence whether someone develops a mental health condition. A stressful job or home life makes some people more susceptible, as do traumatic life events. Biochemical processes and circuits and basic brain structure may play a role, too.
None of this means that you’re broken or that you, or your family, did something “wrong.” Mental illness is no one’s fault. And for many people, recovery — including meaningful roles in social life, school and work — is possible, especially when you start treatment early and play a strong role in your own recovery process.
When it comes to mental illness, biological/medical factors can contribute, but environmental and other factors play a role as well. A mental imbalance may very well be the result of a medical condition or medication reaction. Therefore it is important to consult your physician to rule out medical factors which may affect the individual mental state.
TO learn more details about the various “conditions of mental illness” go to www.nami.org
CONDITIONS OF MENTAL ILLNESS:
Attention Deficit Hyperactivity Disorder (ADHD)
Borderline Personality Disorder
Posttraumatic Stress Disorder
WHAT ARE DEPRESSION AND ANXIETY DISORDERS
What is Depression
Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.
Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression.
Depression involves recurrent, severe periods of clear-cut changes in mood, thought processes and motivation lasting for a minimum of two weeks. Changes in thought processes typically include negative thoughts and hopelessness. Depression also involves affects sleep/energy, appetite or weight.
Could it be depression?
Being unhappy isn’t the same as being depressed. Depression is a term often used loosely to describe how we feel after a bad week at work or when we’re going through a breakup. But major depressive disorder — a type of depression — is much more complicated. There are specific symptoms that determine whether it’s depression or the sadness we all sometimes experience in life.
Determining if persistent, unshakable dark feelings are a result of depression can be the first step toward healing and recovery. Read through these warning signs to see if it’s time for you to see a mental health professional.
Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:
- Changes in sleep
- Changes in appetite
- Lack of concentration
- Loss of energy
- Lack of interest in activities
- Hopelessness or guilty thoughts
- Changes in movement (less activity or agitation)
- Physical aches and pains
- Suicidal thoughts
Learn more about depression at:
Depression - Causes, Diagnosis, and Treatments
Depression does not have a single cause. It can be triggered by a life crisis, physical illness or something else—but it can also occur spontaneously. Scientists believe several factors can contribute to depression:
- Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These changes may lead to depression.
- Genetics. Mood disorders, such as depression, tend to run in families.
- Life circumstances. Marital status, relationship changes, financial standing and where a person lives influence whether a person develops depression.
- Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
- Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) can mimic depressive disorder. Some medications can also cause symptoms of depression.
- Drug and alcohol misuse. Adults with a substance use disorder are at significantly higher risk for experiencing a major depressive episode. Co-occurring disorders require coordinated treatment for both conditions, as alcohol can worsen depressive symptoms.
To be diagnosed with depressive disorder, a person must have experienced a depressive episode lasting longer than two weeks. The symptoms of a depressive episode include:
- Loss of interest or loss of pleasure in all activities
- Change in appetite or weight
- Sleep disturbances
- Feeling agitated or feeling slowed down
- Feelings of low self-worth, guilt or shortcomings
- Difficulty concentrating or making decisions
- Suicidal thoughts or intentions
Although depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After an assessment rules out medical and other possible causes, a patient-centered treatment plans can include any or a combination of the following:
- Psychotherapy including cognitive behavioral therapy, family-focused therapy and interpersonal therapy.
- Medications including antidepressants, mood stabilizers and antipsychotic medications.
- Exercise can help with prevention and mild-to-moderate symptoms.
- Brain stimulation therapies can be tried if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.
- Light therapy, which uses a light box to expose a person to full spectrum light in an effort to regulate the hormone melatonin.
- Alternative approaches including acupuncture, meditation, faith and nutrition can be part of a comprehensive treatment plan.
What is Anxiety Disorder
We all experience anxiety. For example, speaking in front of a group can make us anxious, but that anxiety also motivates us to prepare and practice. Driving in heavy traffic is another common source of anxiety, but it helps keep us alert and cautious to avoid accidents. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.
Anxiety disorders are the most common mental health concern in the United States. Over 40 million adults in the U.S. (19.1%) have an anxiety disorder. Meanwhile, approximately 7% of children aged 3-17 experience issues with anxiety each year. Most people develop symptoms before age 21.
Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening. People typically experience one or more of the following symptoms:
- Feelings of apprehension or dread
- Feeling tense or jumpy
- Restlessness or irritability
- Anticipating the worst and being watchful for signs of danger
- Pounding or racing heart and shortness of breath
- Sweating, tremors and twitches
- Headaches, fatigue and insomnia
- Upset stomach, frequent urination or diarrhea
Types of Anxiety Disorders
Types Of Anxiety Disorders
There are many types of anxiety disorders, each with different symptoms. The most common types of anxiety disorders include:
Generalized Anxiety Disorder (GAD)
GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.
Social Anxiety Disorder
More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.
This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset. Many people will go to desperate measures to avoid an attack, including social isolation.
We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.
Other anxiety disorders include:
- Selective mutism
- Separation anxiety disorder
- Substance/medication-induced anxiety disorder, involving intoxication or withdrawal or medication treatment
Anxiety Disorder - Cause, Diagnosis, and Treatment
Scientists believe that many factors combine to cause anxiety disorders:
- Genetics. Studies support the evidence that anxiety disorders “run in families,” as some families have a higher-than-average amount of anxiety disorders among relatives.
- Environment. A stressful or traumatic event such as abuse, death of a loved one, violence or prolonged illness is often linked to the development of an anxiety disorder.
Physical symptoms of an anxiety disorder can be easily confused with other medical conditions, like heart disease or hyperthyroidism. Therefore, a doctor will likely perform an evaluation involving a physical examination, an interview and lab tests. After ruling out an underlying physical illness, a doctor may refer a person to a mental health professional for evaluation.
Using the Diagnostic and Statistical Manual of Mental Disorders (DSM) a mental health professional is able to identify the specific type of anxiety disorder causing symptoms as well as any other possible disorders that may be involved. Tackling all disorders through comprehensive treatment is the best recovery strategy.
Different anxiety disorders have their own distinct sets of symptoms. This means that each type of anxiety disorder also has its own treatment plan. But there are common types of treatment that are used.
- Psychotherapy, including cognitive behavioral therapy
- Medications, including antianxiety medications and antidepressants
- Complementary health approaches, including stress and relaxation techniques
Anxiety disorders can occur along with other mental health conditions, and they can often make related conditions worse. So, talk with a mental health care professional if you are experiencing anxiety and any of the following:
- Substance Use
- Attention Deficit Hyperactivity Disorder (ADHD)
- Eating Disorders
- Trouble Sleeping
What is Dementia?
Dementia is the loss of mental functions such as thinking, memory, and reasoning that is severe enough to interfere with a person’s daily functioning. Dementia is not a disease itself, but rather a group of symptoms that are caused by various diseases or conditions.
Is dementia different than Alzheimer’s?
DEMENTIA is a term that is often associated with the cognitive decline of aging. However, issues other than Alzheimer’s can cause dementia. Other common causes of dementia are Huntington’s Disease, Parkinson’s Disease and Creutzfeldt-Jakob disease.
Normal aging vs dementia
Alzheimer’s disease and other dementias are not a part of normal aging. Almost 40 percent of people over the age of 65 experience some form of memory loss. When there is no underlying medical condition causing this memory loss, it is known as “age-associated memory impairment,” which is considered a part of the normal aging process. Brain diseases like Alzheimer’s disease and other dementias are different.
For more information: www.alzheimer.ca/
Normal Aging vs Dementia
Dementia is not normal aging. It is characterized by multiple cognitive deficits with memory impairments as a frequent early symptom.
For more information: www.alzheimer.ca
What is Alzheimer’s Disease?
The most common form of dementia, Alzheimer’s disease is irreversible and destroys brain cells, causing thinking ability and memory to deteriorate. Alzheimer’s disease is not a normal part of aging.
What is Alzheimer’s disease?
Dr. Alois Alzheimer first identified the disease in 1906. He described the two hallmarks of the disease: “plaques,” which are numerous tiny, dense deposits scattered throughout the brain that become toxic to brain cells at excessive levels, and “tangles,” which interfere with vital processes, eventually choking off the living cells. When brain cells degenerate and die, the brain markedly shrinks in some regions.
The image below shows that a person with Alzheimer’s disease has less brain tissue (right) than a person who does not have the disease (left). This shrinkage will continue over time, affecting how the brain functions.
For the stages of Alzheimer’s Disease: http://www.alzheimer.ca/en/
The Effects of Alzheimer’s
Alzheimer’s disease is a fatal disease that eventually affects all aspects of a person’s life: how they think, feel, and act. Each person is affected differently. It is difficult to predict symptoms, the order in which they will appear, or the speed of their progression.
The following are some of the changes you may expect as the disease progresses.
Cognitive and functional abilities: a person’s ability to understand, think, remember and communicate will be affected. This could impact a person’s ability to make decisions, perform simple tasks, or follow a conversation. Sometimes people lose their way, or experience confusion and memory loss, initially for recent events and eventually for long-term events.
Emotions and moods: a person may appear apathetic and lose interest in favorite hobbies. Some people become less expressive and withdrawn.
Behaviour: a person may have reactions that seem out of character. Some common reactions include repeating the same action or words, hiding possessions, physical outbursts and restlessness.
Physical abilities: the disease can affect a person’s coordination and mobility, to the point of affecting their ability to perform day-to-day tasks such as eating, bathing and getting dressed.
Living Will Palative Care
The goal of care for people who are dying focuses on helping them enjoy as good a quality of life as possible. This may include relieving suffering; helping people stay as well as they can; and helping them achieve goals that are important to them before they die. This care is often provided by a mix of professionals, including those skilled in palliative care. These professionals will want to ensure that everyone affected by a terminal condition (including families and carers) knows about the choices they have and what support is available to them at this difficult time.