ORLANDO, Fla. – When it comes to mental health, there are many illnesses that cover a variety of symptoms someone can be diagnosed with. We wanted to get a better idea of what some of the most common conditions are, so we sat down with Dr. Zishan Khan, a psychiatrist with Mindpath Health.
“One of the most common reasons why people come to see us, or any psychiatrists for that matter, is involving mood disorders and anxiety,” said Khan. “So that would include depression, as well as the subsets like major depressive disorder, dysthymia, and things like that, as well as various anxiety disorders, generalized anxiety, social anxiety, panic disorder, PTSD, and OCD and all those other subsets.”
“You will also, you know, get the patients that come in for maintenance, have bipolar, schizophrenia,” Khan said. “Obviously, in an acute situation, those patients would probably go to an inpatient facility to stabilize first, but then on an outpatient basis, they can be maintained with their medication. And so those are kind of the most common disorders, although there’s still many others that we see patients for.”
Here are the most common conditions, and how they may manifest.
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- Several disorders fall under anxiety disorders, including social phobias, specific phobias, panic disorders, OCD and PTSD
- Can lead to significant impairment in daily life
- Can lead to physical signs of panic like rapid heartbeat and sweating
- Leads to abnormal responses to situations, or uncontrollable responses
- Anxiety can be related to specific phobias or be more generalized
“Everyone has anxiety, anxiety is a good thing, in certain respects, because it’s what keeps you from walking onto a street when there’s oncoming traffic,” said Khan. “So some level of anxiety is important for everyone to have.
“However, if it gets to a problematic level, where it’s affecting daily functioning, that’s when it becomes an issue. And so with anxiety disorders, you know, people might have generalized anxiety, which is more of a general ruminating intrusive thoughts that they have throughout the day, a lot of times people will worry about things, too, at a level that tends to be a little extreme. They can potentially catastrophize you know, think the worst-case scenario, things like that.
“Panic disorder, as you can imagine, you experience symptoms of panic, which can resemble almost like a heart attack, chest pain, rapid heart rate, difficulty breathing, diaphoresis, where it’s excessive sweating, feeling like the room around you is spinning or closing on on you. Now, these episodes tend to be short-lived, everyone has a variance with how long their panic attacks lasts. But it can, it can last up to, you know, 15-20 minutes. However, even once the panic attack itself has subsided, that doesn’t mean that their anxiety is gone. And so that’s obviously very problematic as well,” Khan said.
SOCIAL ANXIETY DISORDER
- Intense, persistent fear of being watched or judged
- Can inhibit going to work, school, partaking in everyday life activities
- Can present physically with blushing, sweating, trembling, racing heart, stomachaches, difficulty making eye contact
“You know, we all experience some level of nervousness when we’re about to meet a new person, or go on a blind date or something like that. However, in individuals with social anxiety, they have an intense fear of being judged,” said Khan. “They scrutinize every single thing they might say or do, constantly worried how other people are perceiving them, and they oftentimes get very uncomfortable in large crowds in settings where they’re are not fully aware of what may happen. And then on top of that, sometimes they even get uncomfortable in situations around people that they do know, you know, family members, ‘I’m going to be overwhelmed during Thanksgiving, because I’m going to be around a bunch of family members I don’t normally see but I do know them.’ So we’re going to be nervous about that.”
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- An anxiety disorder
- Recurrent thoughts, images or impulses that are intrusive and unwanted and cause anxiety
- Compulsions are time-consuming and distressing repetitive rituals in response to an obsessive thought, like ordering things in a precise way, excessive cleaning or handwashing, compulsive counting or repeatedly checking locks
- Person spends at least an hour a day on these tasks but gets no pleasure out of them, perhaps only slight relief
- Treatments are cognitive behavioral therapy and medications
“OCD is characterized by obsessive, intrusive thoughts that people have. And in response to that, they tend to do compulsive acts in order to kind of relieve the tension and the anxiety that they feel from those obsessive thoughts that they’re having. So that’s another common anxiety disorder,” said Khan.
POST-TRAUMATIC STRESS DISORDER
- Condition that can develop after a traumatic/terrifying event
- Often causes lasting and frightening thoughts and memories of the event like flashbacks or nightmares
- Can be triggered at any time
- Can lead to angry outbursts, difficulty sleeping, feeling tense or being easily startled
- In children, can present as bed-wetting, being unusually clingy, being unable to talk, or acting out the event in playtime
“PTSD, you see that a lot,” said Khan. “And you know, classically you imagine, you know, a war veteran, or someone who’s experienced some major trauma that’s reliving it, experiencing flashbacks, things like that. But even smaller ‘trauma’, I say that in quotes, because you know, that what might seem kind of miniscule for me might be a big deal for someone else. And so, these traumatic moments, whether it’s a major car accident, something that happened to you while you were at the grocery store, where you relive that moment, you have flashbacks of it, maybe even some nightmares, or hyper-vigilance, certain things that remind you of that moment, and keep you from being able to function normally, that’s also something that can be associated with anxiety.”
- Lowering of mood, loss of interest and enjoyment, reduced energy, social withdrawal, changes in eating and sleeping patterns
- Not just feeling sad, people may be irritable or apathetic
- Causes severe symptoms that affect how you feel, think, and handle daily activities
- Symptoms can lead to increased risk of suicidal thoughts or behaviors
- Genetic, biological, environmental and psychological factors play a role
- Treatments can vary widely from person to person
“You have lower levels of certain neurotransmitters which are chemicals in the brain that basically help regulate emotions such as serotonin, norepinephrine, dopamine, those are the most common. And that’s why it’s not as simple as like, ‘just snap out of it,’” said Khan.
“What oftentimes happens is, you know, with people with major depression, it’s a long-term condition that has trended before the pandemic. It tends to be more prolonged, more intense in terms of its level of symptoms, you have difficulty sleeping, difficulty concentrating, decreased desire to do certain things that normally cause pleasure and happiness in you, feelings of being worthless, hopeless, helpless, all those,” Khan said.
“However, with people who develop feelings of depression or sadness in response to life changes, that is not necessarily major depression. And it might even feel that way where it’s very intense and stuff, but you oftentimes look at the time period as well. For the most part, with major depressive disorder, you would have the symptoms consistently, for at least two weeks, it’s something that oftentimes gets progressively worse as well.”
- Previously referred to as manic depression
- Person will have episodes of mania and then depression, very high highs and low lows
- Can go between not needing nearly any sleep to sleeping too much, excessive interest in activities to no interest at all, feeling able to handle many tasks to none at all, etc.
- May or may not experience psychotic symptoms
- Cause is unknown but genetics play a part although environmental factors can trigger episodes
“A lot of people have a misconception that any sort of mood swings is bipolar. And that is just not simply the case,” said Khan. “With bipolar disorder, the mood swings that are extreme in terms of their level of anger, level of euphoria, level of depression, whatever’s coming up, but there’s other symptoms that are along for the ride. They’re displaying risk-taking behavior, they’re drinking a lot more all of a sudden, or, ‘Wow, she just went on a binge this weekend and had intimate relations with multiple people, that’s just not like her.’”
“Someone might have the impulse to like, buy and purchase things that they normally wouldn’t. I’m not talking about, ‘oh, I just went and bought a bunch of clothes,’ like, ‘I just bought a bunch of stuff that I really can’t afford,’ things like that,” Khan said. “Another very key component to mania tends to be decreased sleep. With mania in particular, you have the disrupted sleep, but you’re not even sleeping at all. You don’t have tiredness, you don’t have that. So those are the types of things that I look for when it comes to someone coming in with potential bipolar disorder.”
- Involve distorted awareness and thinking like having hallucinations or delusions
- One example is schizophrenia, which is not a split personality, but rather an illness where a person cannot tell what’s real from what’s imagined
- Leads to psychotic episodes where a person loses touch with reality, and often a sudden change in personality and behavior
“When it comes to schizophrenia, first off the barebones, a person tends to experience psychotic symptoms, which could include auditory hallucinations, visual hallucinations, as well as delusional thought, which are fixed false beliefs, where they’re concerned that someone’s spying on them, the government’s out to get them, those types of delusional thoughts are very common. And with the auditory hallucinations, sometimes they can be as severe as command hallucinations, which are essentially you know, these voices telling you that you should do this, you should hurt yourself, you should yell at this person, things like that,” said Khan.
“With multiple personality disorders, also known as dissociative identity disorder, what happens oftentimes, is it’s the result of a severe trauma,” Khan said. “And what happens is that in response to that trauma, the person develops certain symptoms or behaviors in order to cope with that trauma. This is a neurological condition that they’re experiencing, where they oftentimes will have a different personality, a different way of talking, a different identity completely. That’s why it’s called dissociative identity disorder, because I might have the identity of a child or a female or someone named Tom or something like that. And they present that way, but all of it is a response to their trauma and their difficulty with coping with it.”
- Common misconceptions are this is a choice; it’s a serious and often fatal illness
- Extreme emotions, attitudes and behaviors surrounding weight and food
- Include anorexia nervosa, bulimia nervosa and binge eating amont the most common
If you feel you or a loved one may be experiencing some of these symptoms, there’s a screening tool to help get you started on the Mental Health America website.
Need help? We have a list of mental wellness programs and services that can help, in some cases regardless of your ability to pay, in our Mental Health section.
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