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July 2011
Mental Disorder

The term “mental disorder” refers to a condition in which there is a substantial change in someone’s behavior, emotions, thinking, or general psychological state, which becomes very different from the usual. This condition can affect an individual’s ability to function in one or more areas of their daily lives. There are a number of different categories of mental disorders which reflect changes in mood, thinking, behavior, or personality.

Over the last several decades, there has been a great deal of progress made in understanding the origins of mental disorders. We now know that a single factor, except in an unusual situation, is not likely to be the cause of a mental disorder.  Rather, we must take into account a variety of factors which include genetic influences, family environment, economic factors, and general living circumstances.  It is clear that certain individuals may have an inherited disposition which interacts with a particular environmental stress to produces the onset of the disorder.  An example of this includes the influence of any kind of unusual stress on an individual with an inherited vulnerability to depression.

Mental disorders are very common and can affect children, adolescents, adults, and the elderly.  Most people who have mental disorders continue to function in most aspects of their lives even though the illness may cause difficulty in certain aspects of daily life.  

There are many myths about the origins of mental disorders.  These myths include the idea that mental disorders occur because of a moral weakness, or because of not living up to certain values or standards in society.  Along with the myths about the causes of mental disorders, there are also myths that suggest these are not real illnesses and that therefore, there are no treatments.  A wide range of effective treatments is now available, which include those which address changes in brain chemistry, such as a variety of medications as well as interventions which focus on the development of social skills. Psychotherapy treatments are focused on exploring through a therapeutic conversation the patient’s psychological situation to gain better understanding of causes of stress and to learn more adaptive ways of dealing with stressful thoughts, feelings, or situations.  

Treatments for mental disorders may be provided by a variety of clinicians.  These include psychiatrists, who are medical doctors with additional specialized training in the diagnosis and treatment of mental illnesses.  Clinical psychologists, and specially trained social workers, nurses, or counselors may have expertise in a specific area such as treating people suffering from drug abuse or alcoholism.  When these resources are available, and if the illness is severe, a team of individuals may be involved in treatment.  In many locations, because of a lack of available individuals with specialized training in mental disorder diagnosis and treatment, primary care clinicians may be the individuals responsible for providing care.

In order to provide care in the most effective way, the clinician must learn, not only what the specific symptoms are that the patient is experiencing, but also learn more about who is the person who has the disorder.  This would include such information as the individual’s upbringing, family life, living situation, work situation, and typical ways of dealing with stress.  In addition, it is important to understand how an individual’s cultural, spiritual, religious, and family beliefs play a role in the patient’s ability to address problems they face.  Sensitivity to cultural,  spiritual, and religious influences are of particular importance in treatment of mental disorders since patterns of thinking, feeling, and responding may be very typical in the culture of the patient but may not be signs of mental illness.  

Unfortunately, in many parts of the world there are substantial gaps in the availability of clinicians or clinical settings for the specific treatment of mental disorders.  In these situations, the patient or a family members may contact a primary care clinician or, in the situation in which the problem occurs in a child, the appropriate individual at the child’s school.

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