A mental illness, or mental disorder, is characterized by a significant alteration in thinking, emotion and/or behavior. Nearly 50% of adults suffer or will suffer from a mental illness during their lifetime. What illnesses are considered mental illnesses? How do they manifest? How to diagnose and treat them? Where are we in mental illness research? TipsForWomens interviewed Professor Pierre-Michel Llorca, professor of psychiatry and director of care at the FondaMental Foundation.
Mental illness: definition
A person is said to have a mental disorder when they have a major alteration in their cognitive state, the regulation of their emotions or their behavior. These symptoms may also be accompanied by a feeling of distress or functional problems in important areas.
What are the different mental illnesses?
There is an official classification of mental disorders by the World Health Organization (WHO). They are described in the Eleventh Revision of the International Classification of Diseases (ICD-11). The following are considered mental illnesses:
- Bipolar disorders;
- Schizophrenia ;
- The Depression ;
- Post-traumatic disorders;
- Anxiety disorders;
- Eating disorders;
- Disruptive dyssocial behaviors;
- Neurodevelopmental disorders.
According to the WHO, in 2019, one in eight people in the world (970 million people) had a mental disorder. Anxiety disorders and depressive disorders being the most common. This proportion increased significantly during the COVID-19 pandemic. In just one year, anxiety disorders increased by 26% and major depressive disorders by 28%. “It is estimated that anxiety disorders currently affect 15 to 20% of the population in Europe. These are the most common mental disorders and yet they are not considered as such by the general population. They suffer from poor social knowledge unlike other more severe and less common mental illnesses.notes Professor Pierre-Michel Llorca, professor of psychiatry and director of care at the FondaMental Foundation.
What are the symptoms of mental illness?
The symptoms will depend on the disease in question.
Symptoms of bipolar disorder
People with bipolar disorder alternate between depressive episodes and manic episodes. A depressive episode manifests itself as a low mood (sadness, irritability, feeling of emptiness), a loss of pleasure or interest in any activity, for most of the day, almost every day. A manic episode results in euphoria or irritability, increased activity or energy, racing thoughts, impulsive behavior, etc.
Symptoms of schizophrenia
Schizophrenia can manifest as recurrent delusions, hallucinations, disorganized thinking, extreme agitation. Patients with schizophrenia face persistent cognitive difficulties.
Symptoms of depression
A person who is in the middle of a depressive episode is in a gloomy mood (sadness, irritability, feeling of emptiness) and no longer takes any pleasure or no longer wants to do activities, whatever they may be. To speak of depression, the person must have these symptoms every day for at least two weeks. Other symptoms can be added to this state of sadness: difficulty concentrating, a feeling of excessive guilt, a lack of self-confidence, dark thoughts, sleep problems, great fatigue, etc.
Symptoms of post-traumatic stress disorder
Post-traumatic disorders appear after exposure to a serious or threatening event or series of events. Post-traumatic stress disorder can manifest itself in different ways:
- The person constantly relives the traumatic event (nightmares, intrusive memories);
- The person avoids places, activities or people that remind them of the event;
- The person feels threatened or in danger constantly.
These symptoms last at least several weeks and are very debilitating on a daily basis.
Symptoms of anxiety disorders
There are several types of anxiety disorders: generalized anxiety disorder (excessive worry), panic disorder (panic attacks), social anxiety disorder (excessive fear and worry in social situations), separation anxiety disorder (fear the idea of being separated from the people to whom we are attached) or even phobias (fear focused on a specific object, situation or activity).
Symptoms of eating disorders
Anorexia nervosa and bulimia nervosa are considered eating disorders. They result in abnormal eating behavior and an obsession with food, which is accompanied by significant concerns about weight gain and physical appearance.
Symptoms of dyssocial disruptive behavior
Disruptive dyssocial behaviors correspond to behavioral problems that are repeated (provocative acts, permanent disobedience, illegal behavior). These disorders generally appear during childhood.
Symptoms of neurodevelopmental disorders
Neurodevelopmental disorders are behavioral and cognitive disorders that appear during childhood (or even early childhood) and lead to significant difficulties in the acquisition and execution of specific intellectual, motor, language or social functions. Neurodevelopmental disorders include intellectual development disorder, autism spectrum disorder and attention deficit disorder with or without hyperactivity (ADHD).
What are the causes of mental illness?
The onset of mental illness may be linked to internal and external factors. The manifestation of a psychiatric disorder is usually the result of the complex interaction of several factors:
- genetics ;
- organic (physical factors);
- psychological ;
- environmental (stress, lifestyle, social and cultural factors).
Genetic factors could be involved in many mental disorders. Indeed, certain people are more at risk of developing this type of condition due to their genetic heritage. This increased risk, associated with external factors such as significant stress at work or in the private sphere, can lead to the development of mental illness.
In addition to genetics, several studies have highlighted the role of altered regulation of brain chemical messengers (neurotransmitters) in the appearance of mental disorders. Changes in the brain have already been observed in people with mental disorders, using magnetic resonance imaging (MRI) and positron emission tomography (PET). But it is not clear whether these changes in the brain are the cause or the consequence of the mental disorder.
How to diagnose them?
Some mental illnesses are easier to diagnose than others. But overall, people with mental illness suffer from diagnostic wandering. Clearly, the period from the appearance of the first symptoms to the date on which a diagnosis is made is often long. “Unlike other illnesses for which there are different biological or imaging tests to make the diagnosis, mental illnesses are diagnosed based on questioning the patient and those around him. So it may take time”, underlines the psychiatrist.
Also, some mental illnesses take longer to diagnose than others because the symptoms must be observed over a long period of time or early symptoms may suggest other illnesses. This is for example the case of bipolar disorder which often begins with a depressive episode. To speak of bipolar disorder, we must observe a juxtaposition over time of depressive moments and manic moments. “Patients with bipolar disorder often have to wait 8 to 10 years before being diagnosed”, signals Pr Llorca.
Another obstacle to diagnosis is that it is not easy, particularly for general practitioners, to clearly distinguish mental illness from the behavior of a healthy person. Thus, we often say of an anxious person that it is part of their character, we rarely consider anxiety as a mental disorder. And yet it is one. “Unfortunately, we tend to minimize the symptoms of anxiety, which delays the diagnosis and treatment of this disorder.regrets the professor of psychiatry.
To clarify the diagnosis, doctors base themselves on three points :
- The severity of the symptoms;
- The duration of symptoms;
- The effects of the symptoms on the person’s daily life.
What support ?
The treatment of mental illnesses is based on somatic treatments (medications, transcranial magnetic stimulation, vagus nerve stimulation, etc.) and psychotherapeutic treatments (psychotherapy, behavioral therapy techniques, etc.).
Treatment can be prescribed by a general practitioner or a psychiatrist.
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