Diagnosing specific mental health problems and disorders is not always easy. The human mind is very complex. Even highly-trained and vastly experienced mental health professionals may occasionally experience some difficulties in pinning down a definitive diagnosis.

This is especially true in regard to co-occurring disorders. Also referred to as “dual disorders” or a “dual diagnosis,” a co-occurring disorder exists when a mental health condition is accompanied by at least one other disorder.

Co-occurring disorders are relatively common. It is often the case where the symptoms of one condition will present themselves while other conditions lie beneath the surface. This is the challenge for psychiatric professionals; to determine whether there are underlying issues that may be affecting or exacerbating what appears to be a particular mental illness.

For example, it is not uncommon for ADHD to be accompanied by anxiety or mood disorders; or Post Traumatic Stress Disorder (PTSD) to coexist with depression. The symptoms of these illnesses can play into each other, overlap or display themselves as a result of the other.

Such is the case with addictive disorders that are well-known for existing with other conditions. Many who struggle with depression or mood and anxiety disorders turn to substance abuse to relieve their symptoms.

Treating Co-occurring Disorders

To effectively treat co-occurring disorders, each condition must be isolated and addressed. Every patient has their own unique background and set of circumstances. Therefore a treatment plan must be tailored to meet the needs of each individual.

After initial evaluation and assessment, an “integrated” approach to counseling and psychotherapy is usually preferred when treating co-occurring disorders. This is where substance abuse counselors, psychotherapists and anyone else involved in the treatment process will coordinate efforts and share information regarding the patient’s condition, care and progress.

An integrated program for those with co-occurring disorders is usually administered in stages. Various avenues of treatment are incorporated into a comprehensive strategy that includes helping the patient understand their condition, establishing goals and guiding the patient toward the development of healthier behavior patterns. Group therapy and aftercare can also play an important role in an overall plan to help a co-occurring disorder sufferer heal.

 Mental health problems are the leading cause of disability in the U.S., costing our society countless hours of productivity each year.

The types of mental illnesses are wide-ranging and are classified according to symptoms and characteristics.  It is not always easy to pinpoint a specific mental disorder. This is in part due to similarities between some of the symptoms of various illnesses. Although many established treatment methods have proven to be effective, approaches to treatment are continuously evolving and depend upon circumstances and contributing factors that are unique to each individual.

The Most Prevalent Types of Mental Disorders

Nearly nine percent of Americans suffer from some form of depression, according to the Centers for Disease Control and Prevention (CDC). Depression falls into the “mood disorders” category and can range from relatively mild depression to potentially debilitating “major depression.”

Other mood disorders include manias and manic disorders — which are indicated by abnormally elevated moods and elation — and bipolar disorders, which carry symptoms such as fluctuations between mania and depression or “mood swings.”

Personality disorders are another common category of mental illness. These are indicated by unstable and socially abnormal behavior patterns and include disorders such as schizophrenia and obsessive compulsive disorder (OCD). Mental illnesses such as OCD and various phobias are often also categorized as anxiety disorders.

The statistics on mental illness in our society are sobering. But the good news is that expertise in the areas of OCD treatment, depression treatment and overall mental health treatment continues to advance. Innovations in research, medications, psychotherapy, behavior modification techniques and the advent of technology such as transcranial magnetic stimulation (TMS treatment) are resulting in increasingly positive results in the treatment of a wide spectrum of mental disorders.

It’s normal to occasionally become melancholy or to feel “down.” But when feelings of sadness or “emptiness” persist, there is a good chance deeper issues exist.

Depression in its various forms affects roughly one in 10 Americans, according to Center for Disease Control and Prevention (CDC) statistics. The number of people suffering from this sometimes debilitating mental health condition has been on a steady incline in recent years.

Why the Increase?

There are many factors that can be linked to the increase of depression cases in the U.S. These include financial struggles resulting from the recent economic downturn; the burdens on homeowners and their families due to the housing crisis; and the difficulty for many to find work in an extremely tight job market.

Depression Treatment Increasingly Effective

Depression can range from mild to severe. But the good news is that treatment has become more refined and has proven to be successful at every level. After thorough diagnosis, a treatment plan is tailored toward the individual and usually includes a combination of psychotherapy and antidepressant medications.

For milder forms of depression, counseling may be all that is required to get a patient back on their feet. But severe depression may take extensive therapy and a combination of medications to effectively treat. There are also other treatment options for severe depression, such as Transcranial Magnetic Stimulation or “TMS therapy,” which stimulates areas within the brain responsible for regulating moods.

As mental health professionals become more experienced in caring for those with depression, treatment methods continue to evolve. As a result, despite the troubling statistics, the light shines ever brighter at the end of the tunnel for depression sufferers.

Compulsive hoarding is by no means a new phenomenon. However, it has recently moved into the spotlight courtesy of several documentaries and television shows such as A&E’s “Hoarders” and TLC’s “Hoarding: Buried Alive.”

The exposure compulsive hoarding has gained as a result has been an eye-opener to many hoarders as well as to those around them. It has brought awareness to the fact that treatment is available to help people begin to unclutter their lives.

The Characteristics of a Hoarder

Compulsive hoarding affects roughly two million Americans, according to Psychology Today Magazine. Although it is argued in some circles that hoarding is a stand-alone disorder, it is most often placed within the category of obsessive compulsive disorders (OCD).

Generally, hoarders fear that throwing anything away will have negative repercussions on their lives. As a result, they collect and accumulate things that might have little or no real use.

Although the scene inside their dwelling might appear chaotic to others, many hoarders feel hanging onto items provides them with a certain amount of control and sense of organization. Hoarders feel a personal responsibility and connection to their possessions. If an item is lost or discarded, the fragile balance in their lives can be disrupted.

Getting Help

In treating compulsive hoarding, mental health professionals use an approach similar to that of OCD treatment. The foundation of treatment focuses on a combination of medication and psychotherapy. Specifically, behavioral therapies such as cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) are employed.

Some of the goals within behavioral therapy include diminishing the hoarder’s urge to save, and redirecting the distorted view of the importance they place on the items in question. Therapy also helps at decreasing a hoarder’s anxiety over discarding items and improving their judgment and decision-making capabilities.

Mental health centers across the country are home to experienced professionals who have successfully treated compulsive hoarders. Though treatment can be lengthy and at times difficult, it can provide a new lease on life for those struggling with this all-consuming disorder.

Over 45 million Americans have some form of mental illness. Roughly 25 percent of these individuals have disorders considered to be serious, according to a recent Substance Abuse and Mental Health Services Administration (SAMHSA) study. With the number of Americans suffering from mental illness and substance abuse problems on the rise, caregivers and treatment facilities throughout the country continue to work to meet increasing demands.

One way this troubling trend is being addressed is through the creation of comprehensive mental health treatment centers. In recent years more focus has been placed upon the consolidation of mental health services that were once spread throughout a city or region.

Mental Health Centers are All-Encompassing

Many of the newer mental health centers are universal in their offerings. They provide inpatient and outpatient services for a wide range of mental health issues and are staffed with a diverse array of experienced therapists and psychiatric specialists.

These types of facilities will often contain separate areas for children, adolescents and adults. ADHD treatment, adolescent depression treatment, eating disorder treatment and treatment for anxiety and bipolar disorders are among the services that can be performed under one roof.

Some mental health centers also contain short-term residential units, such as Lindner Center of Hope’s “Sibcy House” near Cincinnati, Ohio. Sibcy House staff members specialize in the diagnosis and treatment of those with complex mental disorders, addictive disorders and those who have experienced a mental health crisis.

The Lindner facility is also one of the few mental health centers in the country to offer both ECT and TMS treatment. Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are used in severe depression treatment and to address conditions for other types of treatment that have failed. These devices are located in Lindner’s new state-of-the-art Neuromodulation Center.

The centralization of services in modern-day mental health centers has been a positive development in a number of ways, including making treatment more accessible to patients and communication between caregivers more convenient. This is especially the case in situations where multiple modes of treatment may be necessary.

 

There is an overriding tendency within human nature to fear what we don’t understand. Throughout history, this “fear of the unknown” has shaped our perception in regard to those who suffer from mental illness.

Assumptions and judgments are formed about people with mental health issues often without any understanding of the causes, symptoms and treatment of a particular disorder. Moreover, people tend to believe that those who are mentally ill have a greater propensity toward displaying violent behavior.

However this is simply not the case. Numerous studies have shown those with mental disorders are no more likely than anyone else to commit violent acts. In fact, the mentally ill are more likely to be the victims of violent crimes than the perpetrators.

The Stigma Softens

In the past, the portrayal of those with mental illness in books, film and television were major contributors to the negative reaction that terms such as “mental disorder” and “schizophrenia” often received from the general public.

However, in more recent years, a greater effort has taken place to educate the public about mental illness.  These positive developments include:

  • Mental health centers with educational programs that raise public awareness  about the truths of  mental disorders, as well as addressing successful treatment modalities for OCD, ADHD, depression,  and eating disorders.
  • Organizations such as the National Institute of Mental Health (NIMH) that work with media and news organizations to raise awareness about mental illnesses.
  • TV shows and documentaries focusing on the lives and struggles of people with bipolar disorders, obsessive compulsive disorders and other illnesses.
  • The emergence of celebrities who are beginning to discuss their mental health issues in public forums.

By increasing exposure to the facts and attaching names and faces to various disorders, the stigma and stereotypes surrounding mental illness are gradually fading. All these factors contribute to encouraging those with mental illness and other mental health concerns feel empowered to discuss their issues and seek help.

In recent years, many high profile actors, politicians and athletes have opted to take the step of disclosing their battles with mental disorders to the general public.

In doing so, these people have elevated public awareness of conditions such as bipolar disorders, depression and attention deficit hyperactivity disorders (ADHD). In some cases, the decisions by these public figures to reveal their struggles have been the catalyst for everyday people to seek help for their own mental conditions.

Public Figures Reveal Mental Health Issues

After a stressful period in which she was caring for her cancer-stricken husband actor Michael Douglass, Catherine Zeta-Jones decided to check herself into a mental health treatment center. Zeta-Jones had reached a point where she was fluctuating between periods of joy and deep depression and knew she had to take additional action to address her condition. As a result of her decision to seek treatment, the famous actress discovered she had bipolar II disorder.

Not long ago, comedian and game show host Howie Mandel was officially diagnosed with obsessive compulsive disorder (OCD) and ADHD. After years of dealing with racing thoughts, an inability to sit still and obsessing over germs, Mandel decided to get help. After seeing improvements in his mental health with ADHD treatment and OCD treatment that included the use of psychotherapy and medication, Mandel is now a spokesman for these disorders and fights to diminish stigmas attached to them.

Mental health issues surrounding professional athletes have also come to the forefront. Reigning National League MVP Joey Votto of the Cincinnati Reds and boxer Mike Tyson both endured bouts of severe depression. Additionally, a Duke University study found that nearly half of all U.S. presidents have at some point battled mood disorders that include depression.

Mental illness is not something an individual should be embarrassed about or feel they have to keep secret. Numerous agencies and mental health centers offer treatment that allows individuals struggling with mental disorders to live normal and productive lives.

The subject of mental illness is still considered taboo in many social circles. It remains the “elephant in the room” that those who are suffers are reluctant to discuss.

Positive strides have recently taken place to make the public more aware of the wide range of mental health issues affecting many individuals around the globe. However, stigmas and stereotypes associated with mental illness continue to have destructive repercussions that cause sufferers to keep their problems hidden instead of seeking treatment.

Society and pop culture have sensationalized mental illness within movies, news stories, books and documentaries. Extreme cases of schizophrenia and personality disorders are depicted in movies and TV shows, causing a reflexive fear within people. Countless movies have portrayed deranged or psychotic characters as villains, agents of fear and purveyors of edge-of-your-seat thrills. Images such as these reinforce negative stereotypes placed upon those suffering from mental illness.

It isn’t difficult to understand why many who suffer from mental illnesses — whether it is depression, bipolar disorder, addictions or eating disorders — feel they will be judged if “exposed.”

Steps are being taken in an attempt to diminish stigmas surrounding mental illness. One method of garnering public attention is having celebrities shed some educational and positive light on the issues.

It is also important to publicize corrections regarding misinformation on mental health disorders. For instance, most people would probably be somewhat surprised to discover only three percent of those suffering from mental illness actually turn violent.

Additionally, mental health organizations are better educating the public about mental illnesses by expanding their roles and increasing publicity about their service offerings.

Written by Paul E. Keck Jr., M.D.,  president and CEO of Lindner Center of HOPE and a professor of psychiatry and neuroscience at the University of Cincinnati College of Medicine

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Abraham Lincoln, Virginia Woolf, Eugene O’Neill, Leo Tolstoy, Tennessee Williams, Winston Churchill, Charles Dickens, Carrie Fisher, Mike Wallace, Patty Duke, Demi Lovato, Catherine Zeta-Jones – all talented and gifted individuals, each has made unique contributions to society, are heroes to many and all have touched our lives in one way or another.

Is it surprising that these individuals have experienced a mental illness such as schizophrenia, bipolar disorder, obsessive compulsive disorder, and/or personality disorder? It shouldn’t be. Mental illness affects one in four individuals, and five of the top 10 causes of disability worldwide are due to psychiatric illness. They strike men and women in almost equal proportions and affect people of all ages, ethnic groups and socioeconomic levels.

Although we have never had better evidence-based treatment and more achievable recovery for most psychiatric disorders, substantial stigma still exists and creates barriers for people needing and seeking treatment. Massive improvement is also needed in reimbursement for mental health care. Though these illnesses are as devastating for families as cancer and heart disease, society perpetuates disparities in support for individuals and families faced with mental illness.

Through research, great advancements in genetics, diagnosis and treatments have been made. In addition, we continue to increase awareness about the nature of suicide and the co-occurrence of mental illness and addiction.

Mental illness can be an uncomfortable topic, but when people share their stories, awareness grows and compassion is cultivated. We have an opportunity, in our community, to be leaders in improving access to high-quality mental health services, not only for humanitarian reasons, but based on economic imperatives.

Enhancing the health and well-being of our communities depends on a collective effort. No one organization, business or advocate can do it alone. I commend the nationally well-known individuals who share their stories of hope and also thank the everyday heroes in our communities who also face the effects of mental illness.