Breaking the stigmas on mental disease

In the month of October, we acknowledge many things, from Breast Cancer to LGBTQ awareness to German American Day and everything in between. The week of Oct. 10, the world acknowledges World Mental Health Day, an international holiday focused on raising awareness of mental diseases. This national holiday also serves to provide the differences between each diagnosis because, unfortunately, many mental diseases are commonly and casually misused.

“People often have misconceptions [about mental diseases] because they have a small amount of information on these diseases and what they really are,” Karl Backman, NSU’s psychiatrist for Student Counseling Services said. “Furthermore, people tend to self-diagnose themselves due to exaggerated influences of the media.”

People often assume that someone with a mental disease will be unintelligent and dangerous, when in reality they are very intelligent people ― Abraham Lincoln and Isaac Newton reportedly suffered mental illnesses and were both intelligent and non-violent. Most of these beliefs stem from pop culture and media portrayal, which tend to overgeneralize symptoms of mental disease for publicity purposes and even sometimes use it in a comical sense. As a result, uninformed people make incorrect assumptions of what a mental disease really is and what is used to classify them.

“When it comes to identifying clinical symptoms, there are certain criteria that have to be met in order to diagnose someone with a particular disease,” Backman said. “These symptoms can be found in the DSM-5.”

The DSM-5 outlines the strict criteria that clinicians and researchers must use to diagnose and classify mental disorders, which is important because it not only makes identifying symptoms easier but also distinguishes a temporary mood from an actual disease.

To further understand the differences between frequently commercialized mental diseases and how they are psychological defined, read below.

OCD

What people think it means: People often only associate obsessive-compulsive disorder with the fear of germs, which is actually a phobia. This perception disregards the fact that someone suffering from this mental illness also has a compulsion. It is also commonly thought that because you have a tendency to want to double check something, for example, leaving the stove on, that automatically means that you have OCD.

Timothy Razza, assistant professor in the College of Psychology, said,“It is rare that we find a source of media that conveys OCD correctly because it comes down to what is going to attract people to watch.”

 

What it really is: “Obsessive compulsive disorder is not just someone who likes to have things nice and neat,” Razza said. “What defines it are two core symptoms: obsessive thoughts and compulsive behaviors.”

OCD is only diagnosed when the compulsion is a repeated obsession that interferes with the normal function of daily life. So in the case of germs, the obsession is wanting to be clean, and as a result, there is a compulsion to constantly wash hands. Having to stop and wash your hands every five minutes interferes with completing your daily tasks because you are consumed by the thought of being dirty. Hence, “clean freaks” do not have OCD.

ADD/ADHD

What people think it means: There is not a clear understanding of the difference between these two mental disorders, and for that reason, they are often described and displayed on television as a child who is extremely active and out of control. References to these diseases on television are usually humorous, and characters habitually refer to any hyper episode as a result of their “ADHD” flaring up.

What it really is: ADD is attention deficit disorder, and ADHD is attention deficit hyperactivity disorder, both of which can be found in children and adults. The main difference between these two disorders is that ADD is the appearance of an attention disorder without hyperactivity. A patient can be diagnosed with ADD with or without hyperactivity.

“People tend to use ADD to mean both [forms], but in reality, it is [exhibited by] someone with attention deficit who does not have symptoms of impulsion or hyperactivity,” Razza said.

People can have an inability to pay attention or sit still for numerous reasons, such as lack of sleep, hypoglycemia, head injury and everyday events that can cause someone to feel a sense of irritability.  Neither of these factors qualify as reason enough to diagnose someone with ADD or ADHD.

Every hyper child is not experiencing ADHD. This mental disease is only diagnosable when their hyperactivity interferes with their everyday functions and ability to learn.

Depression

What people think it means: There is a tendency for people to say they are depressed, but they forget that feeling sad is an emotion that many people feel as a result of an event, and a temporary mood change does not satisfy the requirements of a depressive diagnosis.

What it really is: Depression is diagnosed only if the patient displays a severity of several of the following symptoms: a persistent sad and or empty mood, pessimism, feeling guilty and/or worthless, loss of interest in things that previously brought pleasure, fatigue, a change in sleeping patterns, a change in appetite and increased thoughts of suicide over a period of at least two weeks.

“The duration, intensity and interference with major functions are the key components to what define a major depressive episode,” Razza said.

Anxiety

What people think it means: The common misconception about anxiety is that having an anxiety disorder means that you have a phobia, when, in reality, a phobia is only one type of anxiety. The less-common forms of anxiety include generalized anxiety disorder and social anxiety disorder.

What it really is: Feeling anxious in stressful situations is normal, but when the person is in a constant state of fear that persists or increases over time and constricts them from performing daily functions, that makes it a disorder.

“The difference between a disorder and sub-clinical anxiety is the interference of functioning,” Razza said. “So even individuals who [claim to] have phobias, it would not be diagnosed as a phobia if that phobia is not something that he or she experiences on a daily basis.”

If you think back to the earlier years of the human population, we have adapted to learn emotions such as fear, and these emotions are directed towards things that can potentially cause us harm. These fears protect us and, ultimately, like in the past, further our chances of survival. For example, if a person is afraid of the color blue, and the person is afraid to go outside because the sky is bluer than white that day, then that would be a phobia. Not leaving home would exclude this person from social interaction, proper social growth and proper thinking because they are so consumed by the anxiety of their particular fear.

Bipolar disorder

What people think it means: People associate bipolar disorder with being crazy and exhibiting two completely opposite and consecutive personalities, when in actuality, bipolar disorder is a disease centered on mood, not personality. Moodiness does not indicate bipolar disorder.

What it really is: Bipolar disorder, also commonly known as manic-depressive disorder, results in discrete shifts in mood, interests and ability to carry out simple day-to-day functions.

“Bipolar disorder is not split personality, and we cannot label someone bipolar just because they experience mood changes,” Razza said.

Bipolar disorder is a combination of separate episodes that are manic or major depressive. These episodes do not have to be close together or take place on the same day, but rather have a drastic effect; the individual must be extremely excited and delusional or filled with depressive actions. Mood disorders are misunderstood and confused with anxiety disorders because it’s not understood that mood disorders happen in episodes, while anxiety disorders happen constantly when in the presence of a particular trigger.

Eating Disorders

What people think it means: Eating disorders are often bashed because people think that if someone has an eating disorder, then he or she automatically has an obsession with being thinner and, therefore, starves themselves to ensure that outcome. The truth is, an eating disorder is much more complex than that, and there is more than one type of eating disorder.

What it really is: The two major types of eating disorders are anorexia nervosa, which is the act of constricting food intake, and bulimia nervosa, which is the act of binge eating followed by forced regurgitation.

“The biggest problem is many people do not understand the concept of binging,” Razza said. “When someone forces themselves to vomit, we are talking about compensatory behaviors out of fear.”

People often think that someone with an eating disorder is starving him or herself, but it can be that they are taking other precautions to prevent weight gain or encourage weight loss, such as taking pills, using dietary products and eating low-calorie foods. Although movies make jokey references to women and anorexia, it is no joking matter, and keep in mind that just because someone does not want to gain weight does not mean they have a disorder.

PTSD

What people think it means: People often associate PTSD with the effects of serving in a war. Although it is commonly portrayed on television and in novels as a disease common among veterans, veterans are not the only people who can experience symptoms of PTSD, and war is not the only factor that can trigger it.

What it really is:  “It is true that a big part of what [scientists] have learned about PTSD stems from combat situations in the military,” Razza said. “But still, someone can experience and be diagnosed with PTSD following any type of traumatic experience.”

PTSD symptoms are a result of individual experience, and for that reason, the definition of a traumatic experience varies from person to person. Some of the most common are war, natural disasters, abuse and rape and/or sexual assault, but that is not to say that everyone who experiences these events will develop PTSD.

The biggest misconception about mental disease is that we should examine the disease rather than the individual person. Although the DSM-5 outlines criteria for diagnosis, patients are examined case-by-case, meaning that even if some mental illness symptoms are present, it may not be cause enough for an official diagnosis if the person is deemed healthy otherwise.

Media may be a growing form of communication, but keep in mind that not everything you see on television or read in a blog is true. Use this World Mental Healthy Day to educate yourself about the various mental illnesses.

For more information on mental diseases visit nimh.nih.gov/health/topics/ for an outline of all mental disorders. If you think you might be suffering from one, contact NSU’s Student Services at 954-424-6911 or 954-262-7050.

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