Anxiety Disorders

In my post about panic disorder, I described fear as an emotion that elicits the "fight-or-flight" response of the autonomic nervous system. In anxiety, unlike fear, there is no activation of the fight-or-flight response. Anxiety is a long-term response oriented towards future events rather than imminent danger. Short-lived, low levels of anxiety can be good because they help prepare a person for upcoming activities such as an exam or sports event. However, long-term high-intensity anxiety creates a state of chronic over-arousal that can lead to physical troubles such as reduced immune response (i.e. susceptibility to disease) and increased blood pressure, as described in my post about the biological effects of stress.

Somatic Symptom and Related Disorders

Somatic symptoms are medical complaints that arise from mental illness. In my experience, such symptoms are shrugged off by the general public as "oh, that's not a real symptom, it's just somatic." Well, let me tell you: the symptoms feel very real to the suffering individual.(Something I learned in my work at a suicide hotline and my own intensive outpatient therapy is that what you feel is a real feeling, regardless of what others say.) And sometimes (in fact, maybe a lot of the time) symptoms are due to a "real" medical problem caused by the mental illness. Read my post about the physiological effects of anxiety if you don't believe me.

Depression - an overview

Depression is a surprisingly common mental health issue, affecting 17% of Americans at some point throughout their lifetimes. Depressions almost always are a result of a stressful life event, though not all of these depressions are severe enough or long enough in duration to be considered a mood disorder. 

Hoarding and Body Dysmorphic Disorders

Obsessive compulsive disorder (discussed in a previous post) is grouped in a DSM-5 category called "obsessive compulsive and related disorders." Other disorders included in this category are hoarding, body dysmorphic, trichotillomania (hair picking), and excoriation (skin picking) disorders. 

Upon publication of the DSM-5, there were a lot of ignorant people laughing at the "new" disorder "hoarding," and giving it as an example of how the DSM-5 encourages over-diagnosis of "normal" individuals. Such people do not understand the dire nature of this disorder. An individual with hoarding disorder finds it extremely distressful to discard objects, regardless of their actual value. These objects fill up their living spaces, leading to impairment of the individual's ability to live a healthy, functional life. 

Obsessive Compulsive Disorder

Most people are familiar with obsessive compulsive disorder as is popularized in many TV shows and movies. My favorite is Monk, a TV show about Adrian Monk, an investigator who works with the San Francisco police department. Due to Monk's severe OCD (along with other disorders), he was forced into retirement as a detective with the San Francisco PD. The show is unflinching about the negative effects of Monk's disorder, but of course it introduces humor into his predicament. 

According to the DSM-5, obsessions are "recurrent and persistent thoughts, urges, or images" that are intrusive and cause distress. The individual attempts to ignore the obsessions, but is generally unable to. Compulsions are repetitive behaviors - such as hand washing, checking, praying, counting, or word repetition - that the individual feels compelled to perform in order to reduce anxiety and distress.

Post Traumatic Stress Syndrome - the Basics

I think we all have some idea of what we think PTSD is, but it turns out PTSD isn't as clear-cut as I thought.

Apparently, when PTSD was first introduced into the DSM, the diagnostic criteria required a traumatic event "outside the range of usual human experience" that would cause "significant symptoms of distress in almost anyone." That fits pretty well with my own perception of PTSD. Rape, war, torture, violent experiences...these all fit into that description. PTSD is a normal response to an abnormal stressor. 

Does the DSM-5 encourage overmedication?

Oh, the irony of life - I clicked on a link to read an article by Dr. Allen Frances (chair of the DSM-IV task-force and author of Saving Normal: An Insider's Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life) - and I was forced to wait through a 15 second advertisement on a psychiatric medication. This is exactly the type of thing Dr. Frances complains about. People have "too much" access to information that they are not trained to understand. Dr. Frances urges the public to beware self-overdiagnosis. (This could also be referred to as cyberchondria.) 

Clinical Mental Health Diagnosis - Psychological Assessment

In my post about the biological assessment of mental health diagnosis, I mentioned that there are three ways a clinician can focus a mental health assessment: biological, psychodynamic, and behavioral. In this post I will discuss the psychodynamic and behavioral assessments of patients. 

I'm not sure what a psychological assessment feels like to the clinician, but I have been through several assessments as a patient. Some of them have been very grueling and embarrassing - my 2 hour long assessment for dialectical behavioral therapy comes to mind. Generally, the mental health worker will ask a series of questions to determine personality (am I maladaptive?), social context (am I from an abusive family? caring for an sick family member? a bullied teen?), and culture (I'm a WASC) .

Clinical Mental Health Diagnosis - Biological Assessment

One of the most difficult tasks for mental health workers is to clinically assess and diagnose mental illnesses - especially when comorbidity (having more than one mental illness) is so common. It usually begins with a psychological assessment through tests, observation, and interviews so the clinician can catalog the symptoms. Then the DSM-5 is consulted to give the diagnosis. 

A clinician may focus the assessment in three ways - biological, psychodynamic, and behaviorally. 

The Definition of Abnormal

Well, my first week of Abnormal Psychology is through. We've read chapters 1-2 of our textbook, Abnormal Psychology by James N Butcher.

Chapter 1 was mainly about defining "abnormal" in the sense of "abnormal psychology." This is a lot more difficult than you might imagine.