TYPES OF MENTAL HEALTH PROBLEMS

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In 2019, 301 million people were living  with an anxiety disorder including 58 million children and adolescents  (1).  Anxiety disorders are characterised by excessive fear and worry  and related behavioural disturbances. Symptoms are severe enough to result in significant distress or significant impairment in  functioning. There are several different kinds of anxiety disorders,  such as: generalised anxiety disorder (characterised by excessive  worry), panic disorder (characterised by panic attacks), social anxiety disorder (characterised by excessive fear and worry in  social situations), separation anxiety disorder (characterised by  excessive fear or anxiety about separation from those individuals to  whom the person has a deep emotional bond), and others. Effective psychological treatment exists, and depending on  the age and severity, medication may also be considered.

In  2019, 280 million people were living with depression, including 23  million children and adolescents (1). Depression is different from usual  mood fluctuations and short-lived emotional responses to challenges in  everyday life.  During a depressive episode, the person experiences depressed mood (feeling sad, irritable,  empty) or a loss of pleasure or interest in activities, for most of the  day, nearly every day, for at least two weeks. Several other symptoms  are also present, which may include poor concentration, feelings of excessive guilt or low self-worth,  hopelessness about the future, thoughts about dying or suicide,  disrupted sleep, changes in appetite or weight, and feeling especially  tired or low in energy. People with depression are at an increased risk of suicide. Yet, effective psychological  treatment exists, and depending on the age and severity, medication may  also be considered. 

In  2019, 40 million people experienced bipolar disorder (1).  People with  bipolar disorder experience alternating depressive episodes with periods  of manic symptoms.  During a depressive episode, the person experiences  depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities,  for most of the day, nearly every day.  Manic symptoms may include  euphoria or irritability, increased activity or energy, and other  symptoms such as increased talkativeness, racing thoughts, increased self-esteem, decreased need for sleep,  distractibility, and impulsive reckless behaviour.  People with bipolar  disorder are at an increased risk of suicide. Yet effective treatment  options exist including psychoeducation, reduction of stress and strengthening of social functioning, and  medication.

The  prevalence of PTSD and other mental disorders is high in  conflict-affected settings (3). PTSD may develop following exposure to  an extremely threatening or horrific event or series of events. It is  characterised by all of the following: 1) re-experiencing the traumatic event or events in the present (intrusive memories,  flashbacks, or nightmares); 2) avoidance of thoughts and memories of the  event(s), or avoidance of activities, situations, or people reminiscent  of the event(s); and 3) persistent perceptions of heightened current threat. These symptoms persist for at least  several weeks and cause significant impairment in functioning. Effective  psychological treatment exists. 

Schizophrenia  affects approximately 24 million people or 1 in 300 people worldwide  (1). People with schizophrenia have a life expectancy 10-20 years below  that of the general population (4).   Schizophrenia is characterised by  significant impairments in perception and changes in behaviour.  Symptoms may  include persistent delusions, hallucinations, disorganised thinking,  highly disorganised behaviour, or extreme agitation.  People with  schizophrenia may experience persistent difficulties with their cognitive functioning.   Yet, a range of  effective treatment options exist, including medication,  psychoeducation, family interventions, and psychosocial rehabilitation.  

In  2019, 14 million people experienced eating disorders including almost 3  million children and adolescents (1). Eating disorders, such as  anorexia nervosa and bulimia nervosa, involve abnormal eating and  preoccupation with food as well as prominent body weight and shape concerns. The symptoms or behaviours result in  significant risk or damage to health, significant distress, or  significant impairment of functioning. Anorexia nervosa often has its  onset during adolescence or early adulthood and is associated with premature death due to medical complications or  suicide.  Individuals with bulimia nervosa are at a significantly  increased risk for substance use, suicidality, and health complications.  Effective treatment options exist, including family-based treatment and cognitive-based therapy.

40  million people, including children and adolescents, were living with  conduct-dissocial disorder in 2019 (1). This disorder, also known as  conduct disorder, is one of two disruptive behaviour and dissocial  disorders, the other is oppositional defiant disorder.  Disruptive behaviour and dissocial disorders are  characterised by persistent behaviour problems such as persistently  defiant or disobedient to behaviours that persistently violate the basic  rights of others or major age-appropriate societal norms, rules, or laws. Onset of disruptive and dissocial  disorders, is commonly, though not always, during childhood. Effective  psychological treatments exist, often involving parents, caregivers, and  teachers, cognitive problem-solving or social skills training.

Neurodevelopmental disorders are behavioural and cognitive disorders, that? arise during the developmental period, and involve significant  difficulties in the acquisition and execution of specific intellectual,  motor, language, or social functions.

Neurodevelopmental  disorders include disorders of intellectual development, autism spectrum  disorder, and attention deficit hyperactivity disorder (ADHD) amongst  others. ADHD is characterised by a persistent pattern of inattention  and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social  functioning.  Disorders of intellectual development are characterised by  significant limitations in intellectual functioning and adaptive  behaviour, which refers to difficulties with everyday conceptual, social, and practical skills  that are performed in daily life. Autism spectrum disorder (ASD)  constitutes a diverse group of conditions characterised by some degree  of difficulty with social communication and reciprocal social interaction, as well as persistent restricted,  repetitive, and inflexible patterns of behaviour, interests, or  activities.

Effective treatment options exist including  psychosocial interventions, behavioural interventions, occupational and  speech therapy. For certain diagnoses and age groups, medication may  also be considered.

At  any one time, a diverse set of individual, family, community, and  structural factors may combine to protect or undermine mental health.  Although most people are resilient, people who are exposed to adverse  circumstances – including poverty, violence, disability, and inequality – are at higher risk. Protective and risk  factors include individual psychological and biological factors, such as  emotional skills as well as genetics.  Many of the risk and protective  factors are influenced through changes in brain structure and/or function.