Common Disorders and How to Find Them

When you’re mentally ill, people seem to think that you should know something is wrong, but that’s the nature of the beast; you might know something isn’t right, but that doesn’t mean you know what’s wrong either. It’s tough when your mind hates you; bad friends you can drop, you can leave your abusive ex-boy/girlfriend (please do, there are resources that can help), but you and your mind are stuck together. Stressful times like exams and holidays can bring out issues you didn’t even know were there. So if you’re concerned that you may be affected by a mental disorder, or even if you find them interesting and want to know a bit more, read on….*Disclaimer: this article is not a replacement for the advice of a medical professional or doctor, and it should not be used for such a purpose. If any of the following applies to you in any way, please consult your doctor, GP or the Student Health Centre as soon as possible.

Anxiety

Summary; Everyone worries, everyone gets stressed; it’s when it inhibits your ability to function that you have to consider if it is something more serious.  This is one of the more common disorders in students, affecting 1 in 9 people in Ireland. I could write an article about this in its own right; there are 6 main types of anxiety disorders, each with their own quirks and presentations. Generalized anxiety disorder, anxiety attacks (panic disorder), obsessive-compulsive disorder, phobia, social anxiety disorder, and post-traumatic stress disorder. It’s thought to be related to dysfunction in serotonin, GABA and noradrenaline levels.General symptoms for anxiety include;

• restlessness
• a sense of dread
• feeling constantly 'on edge'
• difficulty concentrating
• irritability
• impatience
• being easily distracted

As with many mental disorders, there can be physical symptoms too.

• dizziness
• drowsiness and tiredness
• pins and needles
• irregular heartbeat (palpitations)
• muscle aches and tension
• dry mouth
• excessive sweating
• shortness of breath
• stomach ache
• nausea
• diarrhoea
• headache
• painful or missed periods
• difficulty falling or staying asleep (insomnia)

Diagnosis; Chatting to your doctor. They might order some blood tests to rule out physical issues, and they might ask you questions where you give your answers on a scale (e.g. How often do you feel this way? Where 1 is every day and 7 is never). If they are concerned, they may refer you to a psychiatrist and/or counsellor for more specialised help.Treatment; Cognitive behavioural therapy, counselling and medication are the most commonly used treatments for anxiety. Exercise also helps.

Eating Disorders

Summary; Anorexia Nervosa, Bulimia Nervosa, Binge eating disorder (compulsive over eating), Purge eating disorder, orthorexia and night eating syndrome.  Alterations in dopamine, acetylcholine, and reward systems in the brain are implicated in bulimia and anorexia.Symptoms; these vary between disorders, here is a brief overview.Anorexia is an inability to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level. It incorporates an intense fear of weight gain or being "fat", and in extreme cases loss of menstrual periods.Bulimia consists of repeated episodes of bingeing and purging. Purging after a binge, typically by self-induced vomiting, abuse of laxatives, diet pills, diuretics, excessive exercise, or fasting are common, along with frequent dieting.Orthorexia is an obsession with eating a healthy diet.Diagnosis; speaking to your GP, maybe getting blood tests to rule out other causes for fluctuating weight before being referred to a specialist/psychiatrist.Treatment; Psychotherapy and CBT are used. Nutritional counselling is one of the most important parts and can help develop a diet plan to maintain a healthy weight. Medication may also be used in conjunction with other methods.

Depression

Summary; it’s one of the most common disorders in the western world, with almost 20% of people being affected by it. When the symptoms last longer than 2-4 weeks, it’s time to check in with the doctor.Symptoms;

• Feeling sad, anxious or bored
• Low energy, feeling tired or fatigued
• Under-sleeping or over-sleeping, waking frequently during the night
• Poor concentration, thinking slowed down and becoming more indecisive
• Loss of interest in hobbies, family or social life
• Low self-esteem and feelings of guilt
• Aches and pains with no physical basis, e.g. chest, head or tummy pain  associated with anxiety or stress
• Loss of interest in living, thinking about death, suicidal thoughts
• Massive weight gain/ loss

Diagnosis; Talk to your doctor. They may ask you a few questions and ask you to rate your response on a scale, as with anxiety. If they are concerned, they may refer you to a psychiatrist and/or counsellor for more specialised help.Treatment; Cognitive behavioural therapy, counselling, antidepressants and exercise are used. The most effective treatment tends to be a combined approach of at least 2 of the above.

Sleep Disorders

Issues with sleep disorders can affect every part of your life; your grades, friendships, relationships, mood, concentration and more. They are also quite common among college students (Who hasn’t pulled an all-nighter, or stayed up all night cramming/ stressing for a test?) As with everything on this list, there are different types…

• Insomnia - a hard time falling or staying asleep.
• Sleep apnoea - breathing interruptions during sleep.
• Restless legs syndrome - a tingling or prickly sensation in the legs.
• Narcolepsy - daytime "sleep attacks"

Diagnosis; depends on the disorder. Speak to your GP, you may be referred to a specialist, or do a sleep study, where they keep you in overnight and monitor your regular sleeping habits.Treatment; Depends on the type of sleep disorder. CBT, medication or surgery may be good to alleviate any underlying conditions that may be affecting your ability to sleep. Good sleep hygiene is also key to treating these disorders. Examples would include;

• Using the bed for sleep and sex only (no television watching or reading in bed)

• Avoiding caffeine, especially late in the day and activities that will get you stimulated and upset late in the day; practising relaxation techniques before bedtime
• Exercising each day
• Maintaining a regular schedule for sleep. Try to avoid naps, they throw you off.
• If you can’t sleep, get up and do something until you feel sleepy; staying in bed and watching the clock is NOT helpful.

Schizophrenia

Summary; this is one of the most well-known disorders, thanks to featuring in many movies/TV shows. Unfortunately, it’s also one of the most misunderstood. There are estimated to be 23 million people worldwide who are affected, and symptoms usually develop from late teens to mid-twenties.   There are many theories on the neurological causes of schizophrenia, although it is thought to be related to a deficit of glutamate and/or increased dopamine.Symptoms; Symptoms for schizophrenia are divided into 3 types.Positive; delusions, hallucinations, thought/movement disorders and disorganized speechNegative; seeming flat, in facial expression, tone and mood, reduced feelings of pleasure, social withdrawal, and low energyCognitive; forgetting things immediately after being told (working memory deficits), trouble focusing and paying attention, loss of executive function (the ability to understand information and use it to make decisions).Diagnosis; There is no specialised test for schizophrenia, and it’s notoriously difficult to diagnose. Again, speaking to your GP, where you may be referred to a psychiatrist to evaluate. Displaying 2 or more positive symptoms for a month or more is usually a good bench mark (although if the hallucinations are especially extreme, one symptom may be enough).Treatment; Medication, counselling, job training and social rehabilitation to help people function better.

Seasonal Affective Disorder (SAD)

Summary; Season Affective Disorder (SAD) is a condition where people who usually have ‘normal’ mental health throughout the year experience depressive symptoms at the same time/season each year. Contrary to popular belief, it is not necessarily tied to winter, although it’s more common to see it in winter months.Symptoms; in addition to the symptoms of depression, people with SAD may experience other symptoms based on what time of year they are affected.Winter symptoms; oversleeping or difficulty waking up in the morning, nausea, and a tendency to over eat, often with a craving for carbohydrates, which leads to weight gainSpring/Summer symptoms; insomnia, decreased appetite and weight loss, and agitation or anxietyDiagnosis; it’s classified as a subset of major depressive disorder, so speak to your GP. Early intervention as the seasons are changing makes a big difference.Treatment; antidepressants, CBT, ionized air administration (releasing charged particles into the sleeping environment) and light therapy are used. Light therapy consists of simulating sun light, either by reflecting it off windows, programming your computer of getting a light box.

Bipolar

Summary; despite the misconception that people with bipolar cycle rapidly back and forth between mania and depression, most are more depressed more often than they are manic. In fact, mania can be so mild it goes unnoticed. Dopamine, noradrenaline and glutamate are implicated in the manic phase. Around 40,000 people in Ireland have bipolar.Symptoms; the depressive symptoms are the same as the ones listed above for depression. The symptoms of mania are as follows;

• feeling very happy, elated or euphoric (overjoyed)
• talking very quickly
• feeling full of energy
• feeling full of self-importance
• feeling full of great new ideas and having important plans
• being easily distracted
• being easily irritated or agitated
• being delusional, having  hallucinations and disturbed or illogical thinking
• not feeling like sleeping
• not eating
• doing pleasurable things that often have disastrous consequences, such as spending large sums of money on expensive and sometimes unaffordable items.

There are 5 main states of bipolar;Severe mania -> hypomania -> normal -> mild to moderate depression -> severe depressionDiagnosis; Speak to your GP where you may be referred to a Psychiatrist. They’ll ask about your mood, maybe even give you a questionnaire.Treatment; CBT, medication, self-care. Sleep deprivation can trigger a manic episode, so give yourself time to sleep properly and take care of yourself. Bipolar people are more likely to have substance abuse issues, so getting support for any other underlying issues is crucial to successful management. Borderline Personality disorderSummary; the hallmarks of this disorder are a long history of unstable relationships, abandonment issues, unstable sense of self and emotional dysregulation. It’s like being on an emotional rollercoaster, and unfortunately for those affected, they can’t get off. It occurs in approximately 1-3% of people worldwide.Symptoms;

• Markedly disturbed sense of identity
• Frantic efforts to avoid real or imagined abandonment and extreme reactions to such
• Splitting ("black-and-white" thinking, someone’s motivations are either all good or all bad, there is no middle ground)
• Severe impulsivity
• Intense or uncontrollable emotional reactions that often seem disproportionate to the event or situation
• Unstable and chaotic interpersonal relationships
• Self-damaging behaviour
• Distorted self-image
• Dissociation
• Anger issues

It presents differently in males than females (men with the disorder are more likely to have anger issues or explosive tempers), although the disorder is more commonly diagnosed in women.Diagnosis; speaking to a professional, either a doctor or counsellor. This condition is particularly comorbid with other mental disorders, and is sometimes discovered in the treatment of something else.Treatment; Dialectical behavioural Therapy (DBT) is a modified form of CBT, and has been shown to be one of the most effective treatments. It focuses on increasing emotional regulation by learning to identify events that trigger episodes and giving people tools to cope with them to avoid unhealthy reactions. Counselling, medication and psychotherapy are also used.If you are in anyway concerned that you may have any of the disorders above, you can contact the following;Student Health Centre; 021 4902311Student Counselling Service; 021 490 3565Samaritans; 116 123 (free number to call, open 24/7, 365 days a year).Any advice given in the above article is purely that, advice, and should not be taken as a replacement for professional medical advice or consultation. Consult your GP in addition to the aforementioned services.