Mental Health by the Numbers
Do you know someone who's suffering from a mental health condition? Probably: They're very common, affecting millions of Americans. Some disorders cause chronic mild discomfort while others can have devastating, even fatal consequences. The good news is that there are effective treatments available for each and every problem. Read on to learn about some of the most common mental health issues.
Forty million adults have anxiety disorders, making it the most common mental illness in the U.S. While anxiety disorders are very treatable, only around one third of sufferers actually receive help.
Generalized anxiety disorder (GAD) is one of the most common anxiety disorders, affecting 6.8 million adults. GAD symptoms include feeling easily fatigued, feeling restless or wound up, difficulty concentrating, and muscle tension. These symptoms donít go away on their own, and may get worse with time.
In a social anxiety disorder, which affects 15 million Americans, an individual can feel very anxious, self-conscious, and even nauseated about being around others. Individuals may also have a hard time making friends and maintaining relationships.
Anxiety disorders are often accompanied by a related condition like depression. Typically, anxiety disorders are treated with medication and/or psychotherapy. Medication options include:
- Benzodiazepines like clonazepam or diazepam: Because these have the potential for addiction, they are generally used for only a short period of time.
- Beta blockers: These help prevent sweating, trembling, and other physical symptoms of anxiety.
- Selective serotonin reuptake inhibitors: Also known as SSRIs, these medications are commonly used to treat depression and are thought to increase the amount of the brain chemical serotonin available.
A type of talk therapy called cognitive behavioral therapy (CBT) may also help. With CBT, the therapist and patient work to explore the relationship between the patientís thoughts and behaviors. The individual is taught how certain thoughts can contribute to symptoms, along with techniques to adjust unhealthy thought patterns. In a controlled environment, therapists also help patients confront and tolerate anxiety-producing situations.
Post-Traumatic Stress Disorder (PTSD)
People who have lived through a very traumatic event or situation may develop this disorder, which causes flashbacks, bad dreams, scary thoughts, emotional numbness, and anger. In severe cases, PTSD can interfere with patients' ability to work, care for themselves, and enjoy daily activities. Some 7.7 million Americans are affected and women are more likely to have it than men.
Symptoms can be triggered by the individualís own thoughts, although objects or situations that remind the person of the traumatic event also can be a trigger. Itís possible to have serious symptoms for a few weeks and then have them disappear, in which case it's called an acute stress disorder (ASD). If the symptoms continue for an extended period, it's considered PTSD, which may be accompanied by depression or substance abuse.
Psychotherapy is "far and away the most researched and most effective treatment for PTSD in the long-term," says Amy House, PhD, clinical psychologist and associate professor of psychiatry and health behavior at the Medical College of Georgia at Augusta University in Augusta, Georgia. "Medication may help reduce symptoms while the medication is being taken but have not been shown to be effective long-term treatments for PTSD, while psychotherapy has been shown to have long-lasting effects, [meaning] after the therapy is over."
Among the different kinds of psychotherapy are talk therapy and exposure therapy, in which the person learns to face and control their fear by being gradually exposed to whatever trauma they faced in a safe way.
Clinical depression, or major depressive disorder, affects about 14.8 million American adults and can develop at any age. More prevalent in women than men, it can take many forms, including:
- Persistent depressive disorder, which lasts for at least two years.
- Psychotic depression, which includes severe depression along with some form of psychosis, or the loss of contact with reality.
- Perinatal depression, a full-blown depression either during or after pregnancy, with feelings of overwhelming sadness, anxiety, and exhaustion.
Fortunately, even the most severe cases of depression often respond to treatments like cognitive behavioral therapy, interpersonal psychotherapy (a short-termó12 to 16 sessionótreatment that focuses on problems in how the individual interacts with others) and anti-depressant medication, says Victor M. Fornari, MD, director of the Division of Child and Adolescent Psychiatry in the Department of Psychiatry at the Zucker Hillside Hospital and Cohen Childrenís Medical Center in Glen Oaks, NY. In fact, "A combination of psychotherapy and antidepressants may be the most effective treatment."
While many people go on a diet to lose weight, sometimes restricting food intake leads to an eating disorder. Itís estimated that about half a million teens are struggling with some type of eating disorder. While it's most common among women and girls, about 15 percent of people with anorexia and bulimia, and 35 percent of those with a binge eating disorder, are male.
The most common eating disorders are anorexia, bulimia, and binge eating disorders. In anorexia, the person has a distorted picture of their body weight, feeling fat even when very thin. In an effort to lose or maintain weight, anorexics often severely limit their food intake and may become malnourished. Bulimics often eat very large amounts of food, feel out of control, and end up vomiting, fasting, and/or using laxatives and diuretics for weight control. People with a binge eating disorder eat exceptionally large portions and feel guilty about it, but do not purge afterwards.
Behavioral symptoms of an eating disorder include dieting (or eating excessively, in some cases), and exercising very intensely, while physical symptoms can include severe constipation, lethargy, mild anemia (when your blood doesn't carry enough oxygen to other parts of your body) and low blood pressure. Unfortunately, if untreated, eating disorders can be fatal.
Treatment may include therapy, medication under the supervision of a physician, joining a support group, and nutritional counseling. Those with severe symptoms may require hospitalization until medically stable.
Borderline Personality Disorder
About 1.6% of U.S. adults have borderline personality disorder (BPD), which is often characterized by unstable moods, along with difficulty with interpersonal relationships, behavior, and self-image. In BPD, intense anger, depression, and anxiety may last for a few hours at a time. "With BPD, a person can feel extremely intense emotions," as well as "Mood shifts that last from minutes to hours, rather than weeks to months," according to House.
The most widely available and effective treatment for BPD is dialectical behavior therapy (DBT), says House. "DBT involves individual therapy focused on building a life worth living and skills training (usually in a group format), along with between-session phone coaching with the therapist," House says. If DBT is not available, she says, the best option is to search out a clinician who specializes in borderline personality disorder and will employ another scientifically-based treatment, such as cognitive behavioral therapy.
Addiction is a deadly disease, particularly where drugs and alcohol are concerned. Alcohol and alcohol-related illnesses kill 88,000 people a year, while drug overdose, the leading cause of accidental death in the US, resulted in 47,055 deaths in 2014. Even if it's not deadly, addiction can also wreak havoc with sufferers' (and their loved ones') health and relationships.
Addiction can be treated with therapy, medications that control cravings and address symptoms, and popular 12-step programs. Some patients may need in-patient treatment, usually at a hospital or rehabilitation facility, to cope with withdrawal symptoms and/or adjust to life without substances.
There are a variety of resources for those who are trying to beat addiction. One helpful article is "Rethinking Drinking" from the National Institute on Alcohol Abuse and Alcoholism. For treatment resources to help those with a drug problem, visit the National Institute on Drug Abuse's Patients & Families section.
Victor Fornari, MD, reviewed this article.
Victor Fornari, MD. Email interview June 16, 2016.
Amy House. Email interview on June 20, 2016.
Peter Rosenquist, MD. Email interview on June 20, 2016.
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