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What is a Mental Health Condition/Disorder?


"1 in 5 Adults Have a Mental Illness"

Most of us have heard the alarming statistics regarding declining mental health in America. I know as a study of psychology both in high school and college, I heard many times that "1 in 5" American adults have a mental illness. What I did not know was that that statistic speaks for all of American adults in any given year. Throughout a lifetime, fifty percent of Americans will meet the criteria of a mental health condition. FIFTY PERCENT! That means of all the people we know, about half of them have (at one point in their lives) suffered from symptoms severe enough to meet the criteria of a diagnosable mental health condition. These statistics are alarming.


50 Percent of Americans

Fifty percent of Americans meet the criteria of a mental disorder at some point in their life. This means that half of the nation has had significant behavioral or psychological conflict or dysfunction not caused by a reasonable situation that has led to clinically significant distress to the person suffering from the symptoms. Of those fifty percent, half meet this criteria by the time they are fourteen years old.


To understand what these statistics mean, we have to understand what a mental health condition is. To be a diagnosable mental health condition, such a condition must meet the criteria of a condition listed in the most current version of the Diagnostic and Statistical Manual of Mental Disorders. The newest edition is the fifth edition as of 2013. This is also referred to as the DSM-5. The DSM-5 lists a plethora of mental disorders. These disorders are divided into diagnoses and further specified depending on the symptoms.

Mental Disorders of the DSM-5

  • Neurodevelopmental Disorders - Autism Spectrum, "Retardation", Communication Disorders, and Motor Disorders (such as Torrette syndrome and other movement disorders)

  • Schizophrenia Spectrum and other psychotic disorders - Schizophrenia, Schizoaffective disorder, Delusional Disorder, and Catatonia.

  • Bipolar and related disorders - Bipolar 1, Bipolar 2, and "other specified/unspecified" Bipolar and related disorders.

  • Depressive Disorders - Major Depressive Disorder, Disruptive Mood Dysregulation Disorder (DMDD), Premenstrual Dysphoric Disorder, Dysthymia, and "other specified/unspecified" depressive disorders.

  • Anxiety Disorders - Phobias, Separation Anxiety Disorder, Panic Disorder, Agoraphobia, Social Anxiety Disorder, Separation Anxiety Disorder, Selective Mutism, Generalized Anxiety Disorder, and "other specified/unspecified" anxiety disorders.

  • Obsessive-Compulsive and related disorders - Excoriation Disorder, Hoarding Disorder, Substance-/Medication-induced obsessive-compulsive and related disorders, Trichotillomania, Body Dysmorphic Disorder, and "other specified/unspecified" obsessive-compulsive and related disorders.

  • Trauma- and stressor-related disorders - Post-traumatic Stress Disorder (PTSD), Acute Stress Disorder, Reactive Attachment Disorder (RAD), Dis-inhibited Social Engagement Disorder, and Adjustment Disorder.

  • Dissociative Disorders - Depersonalization/Derealization Disorder, Dissociative Amnesia, and Dissociative Idenitity Disorder.

  • Somatic symptom and related disorders - Illness Anxiety Disorder, Conversion Disorder (Functional Neurological Symptom Disorder), Psychological Factors Affecting Other Medical Conditions, Factitious Disorder, and "other specified/unspecified" somatic and related disorders.

  • Feeding and Eating Disorders - Pica, Rumination Disorder, Binge Eating Disorder (BED), Bulimia Nervosa, Anorexia Nervosa, Avoidant/Restrictive Food Intake Disorder, and "other specified/unspecified" feeding or eating disorders.

  • Sleep-Wake Disorders - Insomnia Disorder, Hyper-somnolence Disorder, and Narcolepsy.

  • Breathing-Related Sleep Disorders - Obstructive Sleep Apnea Hypopnea, Central Sleep Apnea, Circadian Rhythm Sleep-Wake Disorders, and Parasomnia Disorders, Sleep-Related Hypo-ventilation and "other specified/unspecified" breathing related disorders.

  • Sexual Dysfunctions - Delayed Ejaculation, Erectile Disorder, Female Orgasmic Disorder, Female Sexual Arousal Disorder, Genito-Pelvic Pain Disorder, Male Hypoactive Sexual Desire Disorder, Premature (Early) Ejaculation, Substance/Medication-Induced Sexual Dysfunction, and "other specified/unspecified" sexual disorders.

  • Disruptive, Impulse-Control, and Conduct Disorders - Oppositional Defiant Disorder, Intermittent Explosive Disorder, Conduct Disorder, Antisocial Personality Disorder, Pyromania Kleptomania, and "other specified/unspecified" disruptive, impulse, and/or conduct disorders.

  • Substance-Related and Addictive Disorders - Substance-Related Disorders, Alcohol-Related Disorders, Caffeine-Related Disorders, Cannabis-Related Disorders, Hallucinogen-Related Disorders, Inhalant-Related Disorders, Oppioid-Related Disorders, Sedative-/Hypnotic-/Anxiolytic-Related Disorders, Stimulant-Related Disorders, Tobacco-Related Disorders, and Gambling Disorder, Other (or unknown) Substance-Related Disorders.

  • Personality Disorders

  1. Cluster A - Paranoid Personality, Disorder Schizoid Personality Disorder, and Schizotypal Personality Disorder.

  2. Cluster B - Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder, and Narcissistic Personality Disorder.

  3. Cluster C - Avoidant Personality Disorder, Dependent Personality Disorder, and Obsessive-Compulsive Personality Disorder (not to be confused with OCD).

  4. "Other specified/unspecified" personality disorders.

  • Paraphillic Disorders - Voyeuristic Disorder, Exhibitionistic Disorder, Frotteuristic Disorder, Sexual Masochism Disorder, Sexual Sadism Disorder, Pedophilic Disorder, Fetishistic Disorder, Transvestic Disorder, and "other specified/unspecified" Paraphilic Disorders.

  • "Other" Mental Disorders - Other specified/unspecified mental disorders or mental disorders due to a medical condition.


What a list! It seems like the sheer number of disorders means it's likely that people would meet the criteria of at least one, right? Not so. Each mental disorder has a long list of criteria that a person must meet before they are diagnosed with that disorder. Many people who seek help may be treated for "symptoms" rather than a disorder because they do have the symptoms, but they do not meet the criteria.


The definition of a mental disorder is its own criteria:

  • A) a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual

  • B) is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom

  • C) must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one

  • D) a manifestation of a behavioral, psychological, or biological dysfunction in the individual

  • E) neither deviant behavior (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual

What does all that mean?

This basically means that a person's symptoms have a proven clinically significant behavioral/psychological syndrome/pattern. This significant impact must be associated with distress, disability, or a significant risk or suffering that has increased since the onset. The symptoms must not be expected culturally for the situation. The deviance in behavior or psychological well-being cannot just be cultural, religious, sexual, or another outside factor. It has to cause significant dysfunction in the individual.


In the coming blogs, we will discuss more specific criteria as well as the vague wording that is involved in a lot of the DSM-5.


One subsection of mental disorder was not listed in this blog, but is still listed in the DSM-5: Gender Dysphoria. The month of June was dedicated to #PrideMonth and discussed the changes and history of diagnostic criteria and treatment of the LGBTTQQIAAP community based on their conflict with social and religious norms despite Criteria E of mental disorders - "Neither deviant behavior (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual". Also discussed is the most recent statistics affecting the community and how allies, counselors, authority figures, parents, and schools can all help increase wellness and safety.


Send any questions or requests to faith.stevens@fourpillarscounseling.com


-Faith







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