9/11 – Never Forget.
We changed forever 20 years ago today. And so did the world of mental health, resources, professions, and motive to emerge ourselves into it. PTSD, depression, substance abuse disorders, and anxiety disorders all gained a new definition and intensity to them. This day is solemn and remindful of how important it is to take the step needed to care for our mental health. Everyone has a different story from this day. A Body & Mind Health Services, LLC and our community support every single one of these with care, love and support.
Here are the new definitions, criteria, and examples of what these mental health struggles may look like.
The etiology of PTSD is characterized by genetic risk, greater amygdala activation, and diminished activation of regions of the medial prefrontal cortex. PTSD is also described by childhood exposure to trauma, greater reactivity to signals of threat, and Mowrer’s two-factor model of conditioning. These characteristics are commonalities with other anxiety disorders. The severity and type of trauma, the hippocampus, and coping all influence how PTSD is caused and expressed. The severity and type of trauma varies. Examples include directly witnesses violence versus indirect exposure and trauma caused by human versus natural disasters. The types of trauma will result in different severities of PTSD. The hippocampus is the central role in autobiographical memories and has greater activation in PTSD. People who cope with trauma by trying to avoid it may be more likely to develop PTSD. Dissociation is a form of avoidance by keeping a person from confronting memories. 15% of people with PTSD use dissociation.
Two major depressive disorders are major depressive disorder and persistent depressive disorder. Major depressive disorder is a sad mood or loss of interest and pleasure with at least 5 symptoms present. Persistent depressive disorder is an individual having a depressed mood for at least 2 years and 1 year for children or adolescents. The epidemiology of depressive disorders suggests that depression is common with prevalence over 10% that varies by culture and gender. The consequences of these depressive disorders is their high comorbidly rate and risk for other disorders. Major depressive disorder is a sad mood or loss of interest and pleasure with at least 5 symptoms present. Symptoms include sleeping too much or too little, psychomotor retardation or agitation, poor appetite and weight loos, or increased appetite and weight gain, loss of energy, feelings of worthlessness or excessive guilt, difficulty concentrating, thinking, or making decisions, or recurrent thoughts of death or suicide. These symptoms are present nearly every day, most of the day, and for at least two weeks and are distinct from and more severe than a normative response to significant loss. Major depressive disorder I is episodic where symptoms tend to dissipate over time and recurrent where once depression occurs, future episodes are likely. Among people with a first depressive episode 15% report persistent depressive symptoms and 50% report at least one additional episode. Major depressive disorder II is useful to consider depression symptoms as a continuum of severity and patients may present with quite varied symptom presentations. Persistent depressive disorder is an individual having a depressed mood for at least 2 years and 1 year for children or adolescents. Two symptoms must also be present such as poor appetite or overeating, sleeping too much or too little, low energy, poor self-esteem, trouble concentrating or making decisions, or feelings of hopelessness. These symptoms must also not clear for more than 2 months at a time and bipolar disorder must not be present.
In 2018, nearly 32 million people over the age of 12 in the U.S. used an illicit substance in the past month. Substance use disorder is more common in men than women but the gap in narrowing with differences in use across culture, race, and ethnicity. They are amongst the most stigmatized disorders and influenced by a number of factors that include neurobiological, social, cultural, environmental, and psychological however, they are not solely due to a moral failing or personal choice. Two symptoms that are often a part of severe substance use disorder are tolerance and withdrawal. Tolerance is when larger doses of the drug are needed to produce the desired effect as the effects of the drug decrease if the usual amount is taken. Withdrawal is negative physical and psychological effects from stopping substance use such as muscle pain, twitching, sweats, vomiting, diarrhea, and insomnia. The DSM-5 criteria for substance use disorder involves the problematic pattern of use that impairs functioning with two or more symptoms within a 1-year period. These failure to meet obligations, continuing to use even in situations where it is physically dangerous, repeated relationship problems, continuing to use despite problems caused by the substance, tolerance, withdrawal, the substance is taken for longer time or greater amounts than intended, efforts to reduce or control substance use do not work, much time is spent trying to get the substance, social events, hobbies, and/or work are given up or reduced, and strong craving to use the substance.
The DSM-5 anxiety disorders include the most common psychological disorders of specific phobias, social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder. Specific phobias and social anxiety are the most common. Anxiety disorders are the 10th leading cause of disability worldwide reported in 2015 and 28% of people report anxiety symptoms in their lifetime. The clinical description for anxiety disorder is a disorder with symptoms that interfere with important areas of functioning or causes marked distress, are not caused by a drug or a medical condition and are persistent for at least 6 months or at least 1 month for panic disorder. The fears and anxieties are distinct from the symptoms of another anxiety disorders.