Other Illnesses

Alzheimer’s disease, which affects more than 5 million Americans, is a brain disorder that over time destroys a person’s memory and ability to learn, reason, make judgments, communicate and perform daily activities. The disease usually begins after age 60, with the risk going up with age. It is estimated that about half of the population 85 and older has Alzheimer’s; therefore, it is not an inevitable part of aging. Rarer forms of the disease can occur earlier in life. The brains of people with Alzheimer’s are characterized by having clumps, called amyloid plaques, and tangled fibers, called neurofibrillary tangles, but what causes them remains an active area of research. Genetics and aspects of aging may play a role in creating the brain changes that most likely cause the disease symptoms. As Alzheimer’s progresses, individuals may experience changes in personality and behavior, including anxiety, suspiciousness, agitation, delusions and hallucinations. Disease course varies with each individual, but the average person lives 8 to 10 years after diagnosis. No cure currently exists for Alzheimer’s and drugs have variable effectiveness, but considerable research about the disease is leading to new approaches to drugs. Effective care and support has been shown to improve the quality of life for people with Alzheimer’s and their caregivers.

This disorder affects from 1.4% to 5.9% of adults in the US. It is characterized by pervasive instability in moods, interpersonal relationships, and self-image, in addition to marked impulsivity. There is a high rate of self-injury without suicidal intent, a significant incidence of attempted suicides, and a 10% suicide rate. This disorder has a strong genetic component with environmental factors, such as an invalidating or abusive environment, increasing the risk of developing this disorder. A variety of treatments specifically designed for BPD have been shown by research to be effective. Click here to learn more and support BPD research.

Conduct disorder is diagnosed in childhood or adolescence and is evidenced by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. Diagnostic indicators typically fall into four categories: aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules.

The essential feature of the Dissociative Disorders is a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. The disturbance may be sudden or gradual, transient or chronic. The following disorders are included in this section:

- Dissociative Identity Disorder, previously referred to as Multiple Personality Disorder (MPD) is characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

- Dissociative Amnesia is characterized by an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness.

- Dissociative Fugue is characterized by sudden, or unexpected travel away from home or one’s customary place of work, accompanied by an inability to recall one’s past and confusion about personal identity or the assumption of a new identity.

- Depersonalization Disorder is characterized persistent or recurrent feelings of detachment from oneself, such as feeling one is in a dream. However, the person experiencing these feelings remains reality-oriented during the occurrence. The possibility of other mental disorders, substance abuse or a general medical condition must be ruled out. The disorder must also cause significant distress or impairment in areas of functioning, such as work or family life.

Source: APA, Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition, Washington, D.C. APA 1994

There are three major types of eating disorders--anorexia nervosa, bulimia nervosa, and binge-eating disorder (this has not yet been approved as a formal psychiatric diagnosis). An eating disorder involves serious disturbances in eating behavior, and is a medical illness. These disorders typically develop during adolescence or early adulthood, and often occur with other psychiatric disorders like depression or anxiety disorders. An estimated 0.5 - 3.7 percent of females develop anorexia, an estimated 1.1 percent to 4.2 percent of females have bulimia nervosa, and between 2 percent and 5 percent of Americans develop binge-eating disorder at some point in their lives.

Fragile X syndrome is the most common inherited cause of mental retardation. The full mutation appears in approximately 1 in 3600 males and 1 in 4000 to 6000 females. Males are typically more severely impacted than females. Fragile X syndrome may cause significant intellectual disability, a variety of physical and behavioral characteristics, and physical manifestations. Some of the behavioral characteristics associated with Fragile X Syndrome may include learning difficulties, autistic behaviors, attention deficit disorders, and speech disturbances.

Parkinson's disease is a chronic, progressive brain disorder classified as a motor system disorder. It is often diagnosed around age 60, with patients experiencing tremors or trembling, balance difficulties, muscle stiffness, and slowness of movement (also called bradykinesia). Other symptoms may include dementia, depression, anxiety, constipation, urinary difficulties and sleep disturbances, with symptoms worsening over time. There are approximately 1.5 million people in the U.S. living with Parkinson's Disease, with about 60,000 new cases diagnosed each year. Parkinson's appears to result from an interplay of genetic and environmental factors--some with Parkinson's appear to have a gene mutation which increases susceptibility to environmental and other factors. It is not currently possible to predict who will get Parkinson's, or to prevent it. Parkinson's is associated with a loss of brain cells which produce the brain chemical dopamine--this discovery led to the development of an important drug treatment in 1970 called levodopa. Levodopa significantly improves mobility, and enables relatively normal functioning. However, as the disease progresses, larger doses are required. Additionally, levodopa also has severe side effects for some people. As a result, other drugs have been developed to lessen these side effects. Other drugs have been developed to work in conjunction with Levodopa. Targeted surgery may be used as a rare treatment (not cure) for severe Parkinson's disease or for those who do not respond to medications, and may help in alleviating specific symptoms rather than all the symptoms associated with Parkinson's. An alternative treatment to targeted surgery is deep brain stimulation (DBS), which involves implanting an electrode in the brain which emits electrical pulses to stimulate the brain and block brain signals that result in symptoms of Parkinson's. Early results of this treatment look very promising, particularly in relieving tremors. Research continues in other areas to find the cause or causes of Parkinson's disease, better treatments and an eventual cure.

Premenstrual dysphoric disorder (PMDD) affects approximately 5 percent of women of reproductive age. The exact cause of PMDD is not known, though several theories have been proposed. One theory states that women who experience PMDD may have abnormal reactions to normal hormone changes that occur with each menstrual cycle. Any woman can develop PMDD, however, those with a history of mood disorders or postpartum depression may be at an increased risk.
The primary symptoms that distinguish PMDD is the onset and duration of PMDD symptoms -- with symptoms appearing during the week before and disappearing within a few days after the onset of menses -- and the level by which these symptoms disrupt daily living tasks. Symptoms of PMDD are so severe that women have an impaired level of functioning at home, at work, and in interpersonal relationships during this symptomatic time period (this diminished level of functioning is generally in great contrast with the same woman's interactions and abilities at other times during the month.). Symptoms can include anger, agitation, heart palpitations, visual disturbances, appetite changes, headache, nausea, forgetfulness, vomiting, painful menstruation, fluid retention, etc.

Schizoaffective disorder is a major psychiatric disorder that is quite similar to schizophrenia. Essentially, people with this illness experience symptoms of both schizophrenia and affective disorders (either bipolar disorder or depression). The criteria include a period in which the affective disorder is active concurrently with two of the major symptoms of schizophrenia (such as delusions and hallucinations) are also present. Additionally, the person must experience delusions or hallucinations for a period of two weeks in the absence of any mood disorder. About 1 in every 200 people develops schizoaffective disorder during his or her life. The disorder can affect all aspects of daily living, including work, social relationships, and self-care skills. People with schizoaffective disorder may experience hallucinations and delusions, depression, low motivation, an inability to experience pleasure, and poor attention. It can be hard for the person with the disorder to distinguish between reality and fantasy. The serious nature of the symptoms of schizoaffective disorder sometimes requires patients to be hospitalized at times for treatment.
Antipsychotic medications do not cure the disorder, but they can reduce symptoms and help prevent relapses. Antidepressant medications and mood stabilizing medications are also used to treat affective symptoms (depressive or manic symptoms) in schizoaffective disorder.

Schizotypal personality disorder has symptoms similar to schizophrenia, but not as severe. It is primarily characterized by peculiarities of thinking, odd beliefs, and eccentricities of appearance, behavior, interpersonal style, and thought. Individuals with this disorder often seek isolation from others. They sometimes believe they have extra sensory abilities or that unrelated events relate to them in some important way. They generally engage in eccentric behavior and have difficulty concentrating for long periods of time. Their speech is often overly elaborate and difficult to follow. They may talk to themselves, dress inappropriately, and are very sensitive to criticism.

Seasonal Affective Disorder is a mood disorder associated with the seasons. The most common type of SAD is called winter depression. It usually begins in late fall or early winter and goes away by summer. It is caused by a biochemical imbalance in the hypothalamus due to the shortening of daylight hours and the lack of sunlight in winter. As many as 6 of every 100 people in the United States may experience winter depression. A less common type of SAD, known as summer depression, usually begins in the late spring or early summer. SAD is more common in women than in men, and as may be expected, is more common in northern geographic regions. Symptoms may include sleep disturbances, lethargy, overeating, weight gain, depression, anxiety, irritability and decreased sex drive. Light therapy has proven effective in up to 85 percent of diagnosed cases. The non-sedative selective serotonin reuptake inhibitor (SSRI) medications are effective in alleviating the depressive symptoms of SAD and combine well with light therapy.

Many people believe that those who abuse drugs, alcohol or cigarettes are morally weak or have criminal tendencies, and that abusers or addicts should be able to stop their addiction if they simply change their behavior. While substance abuse starts when an individual makes a choice to take a drug or drink the alcohol, addiction actually changes the brain of users and makes it harder for the person to stop. Also, it is believed that people with mental illness may take drugs, alcohol and cigarettes in an effort to self-medicate their depression, anxiety or their altered mental state. At some point, changes occur in the brain that can turn drug abuse into addiction, a chronic, relapsing illness. Those addicted to drugs suffer from a compulsive drug craving and usage, and cannot quit by themselves. A variety of approaches are used in treatment programs to help patients deal with these compulsive cravings and possibly avoid drug relapse. Through treatment tailored to individual needs, patients can learn to control their condition and live relatively normal lives. Current research into understanding drug abuse helps in understanding how to prevent use in the first place--it is better to not start at all than to enter rehabilitation if addiction occurs.

Suicide accounts for more than 30,000 deaths in the United States annually, and while it is sometimes characterized as a response to a single event or set of circumstances, it is almost always a complication of a psychiatric illness. Mood disorders account for 60% of cases, with major depression being the most common. Researchers believe that both depression and suicidal behavior can be linked to decreased serotonin in the brain. Scientists have learned that serotonin receptors in the brain increase their activity in persons with major depression and suicidality, which explains why selective serotonin reuptake inhibitors, or SSRIs have been found effective in treating depression. Currently, studies are underway to examine to what extent medications like SSRIs can reduce suicidal behavior.

Tourette Syndrome (TS) is a neurological brain disorder with the age of onset between the ages of 2 and 15. Males are 3 to 4 times more likely to have TS than females. It is diagnosed by the presence of multiple motor and/or vocal tics, classified as simple or complex, which last more than one year. People with TS all have involuntary movements, while only some have vocalizations. Symptoms vary by individual and can range from mild to severe, with most in the mild range. Comorbid or co-occurring conditions may include learning disabilities, attentional problems (ADHD/ADD, impulsiveness and oppositional defiant disorder), and obsessive compulsive behaviors. Research indicates that TS may result from abnormal activity of the neurotransmitter dopamine and its receptors. Other neurotransmitters such as serotonin may also be involved. The majority of people with TS do not require medication, as they are not significantly disabled by it. However, if symptoms interfere with daily functioning, medications may be helpful. These can include clonazepam (Klonopin), clonidine (Catapres), fluphenazine (Prolixin, Permitil), haloperidol (Haldol), pimozide (Orap), and risperidone (Risperdal). Psychotherapy may be beneficial for assisting with coping skills, and some behavior therapies may help in substituting one tic for another more acceptable one.