Common Disorders

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer’s is the most common type of dementia.
Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

If you or your loved one is experiencing any of the signs and symptoms below, make an appointment with a physician to discuss options:

• Memory loss that disrupts daily life
• Challenges in planning or solving problems
• Difficulty completing familiar tasks at home, at work or at leisure
• Confusion with time or place
• Trouble understanding visual images and spatial relationships
• New problems with words in speaking or writing
• Misplacing things and losing the ability to retrace steps
• Decreased or poor judgment
• Withdrawal from work or social activities
• Changes in mood and personality

Major depressive disorder is a medical condition that adversely impacts one’s thoughts, feelings and behavior. Depression is one of the most disabling disorders in the world.

Symptoms of depression include the following:

• Sadness
• Irritability (especially in children and men)
• Despair
• Hopelessnessc
• Worthlessness
• Physical pain
• Co-occurring anxiety
• Suicidal thoughts

Depression interferes with one’s ability to work, concentrate, sleep, eat, socialize and enjoy activities that he or she once enjoyed. Depression strikes those that have a combination of genetic predispositions with environmental and social vulnerabilities.

Fact and Figures (American Foundation for Suicide Prevention)

• More Americans suffer from depression in a given year (24 million) than heart disease (17 million), cancer (12 million) and HIV/AIDS (1 million).
• 15% of the population will suffer from clinical depression at some point during their lifetime.
• 30% of all clinically depressed patients attempt suicide; half of them ultimately die by suicide.
• Every day, approximately 105 Americans take their own life.
• 60% of suicide victims suffer from depression.
• Between 1980 and 1996, the suicide rate for African-American males aged 15-19 doubled.
• Depression is among the most treatable of psychiatric illnesses. Almost all patients receiving psychiatric treatment attain some relief from their symptoms.
• Risk factors for suicide include hopelessness, suicidal thoughts, depression, impulsive or aggressive behavior, bipolar disorder, anxiety disorders, drug and/or alcohol abuse and previous suicide attempts, with the risk increased if there is situational stress and access to firearms.

Depression in children & adolescents is often similar to that in adults. But there are some differences that can be attributed to the child’s developmental stages. Instead of talking about how they feel, children and adolescents with depression may have the following symptoms:

• Irritable mood
• Low frustration tolerance (get upset easily)
• Temper tantrums
• Physical complaints (headaches and stomach aches)
• Limited participation in social activities

One can diagnose the different types of depression using the following criteria:

Major Depression (MDD)

• 2 weeks of continuous change in mood
  • Either irritable mood, depressed mood, or loss of interest must be present
• Plus at least 5 other symptoms
  • Appetite change, weight loss, sleep change, activity level change, energy level decrease, feeling worthless or excessive guilt, decreased concentration, suicidal thoughts
• Plus difficulty functioning at work, school, or at home
  • 2% in children; 4-8% in adolescents
  • Male: Female Ratio – childhood 1:1, adolescence 1:2
  • Risk increases by 2-4x after puberty, particularly in females

It is important to consider Bipolar Disorder when discussing Pediatric Depression. Bipolar disorder is when individuals have at least one manic or hypomanic episode. They also usually have episodes of depression. You can differentiate bipolar disorder in children (without manic presentation) with certain indicators such as family history of bipolar disorder, psychotic symptoms, history of medication induced mania/hypomania.

It is also important to consider Seasonal Affective Disorder when discussing Pediatric Depression. Children with Seasonal Affective Disorder have symptoms of depression during the seasons with less daylight (fall and winter). This should be differentiated from depression triggered by school stress, because both coincide with the school calendar year.

It is important to recognize and treat depression, because there can be severe consequences if depression is untreated. Suicide attempts & completion are among the most significant & devastating consequences of depression. 3.4% of people with depression commit suicide. 60% of those who commit suicide suffered from MDD or another mood disorder. In addition, untreated depression, may affect the development of the child’s emotional, cognitive, & social skills, & may interfere with family relationships.

And finally, there is a high risk of substance abuse (including smoking cigarettes), legal problems, exposure to negative life events, physical illness, early pregnancy, and poor performance at work or school.

Generalized anxiety disorder (GAD) is characterized by excessive worry and anxiety that are difficult to control and that cause significant distress and impairment.

Patients with GAD may have severe physical symptoms and other symptoms such as:

• Headaches
• Difficulty concentrating
• Poor sleep
• Mild heart palpitations
• Dizzines
• Stomach pain

Excessive worry leads to difficulty completing important taks at work and in social situations. GAD has a life time prevalence 4.1% in U.S. adult population (Source: Up to Date).

People experience traumatic events in which their life is in danger. Examples of traumatic life events include physical / sexual abuse, being robbed at gunpoint, witnessing a friend murdered, or enduring military combat.
Post-traumatic stress disorder (PTSD) is an anxiety disorder characterized by re-experiencing the traumatic event by, avoiding situations that remind you of the event, and heighted aw.

The symptoms associated with PTSD include:

• Intrusive thoughts
• Nightmares and flashbacks of past traumatic events
• Avoidance of reminders of trauma
• Hypervigilance (i.e, frequently being “on guard”)
• Sleep disturbance

These symptoms also cause functional impairment in social and occupational functioning. The lifetime prevalence of PTSD ranges from 6.8 to 12.3 percent in the general adult population in the United States (Source: Up to Date).

Panic Disorder is an anxiety disorder characterized by discrete episodes of intense fear that begin abruptly and last for several minutes to an hour.

Patients also often present with physical symptoms of a panic attack such as:

• Chest pain
• Shortness of breath
• Feeling of doom
• Heart palpitations
• Dizziness
• Nausea and vomiting
• Fear like you are losing control

In panic disorder, patients experience recurrent, unexpected panic attacks, worry about future attacks, and avoidance of situations that could trigger an attack. Panic Disorder has a lifetime prevalence of 4.7% in U.S. adult population (Source: Up to Date).

Schizophrenia is a chronic and serious mental illness. It is the classic example of a mental illness involving psychosis, which literally means “a break with reality.” It is estimated to occur in about 1% of the population (that is, 1 in every 100 persons). The age of onset of schizophrenia is usually earlier in males (late teens to mid-20s) than in females (mid-20s to mid-30s). The prognosis varies among individuals, but about half of affected persons will experience a significant decline in their ability to work and function socially. Common symptoms of schizophrenia include the following:

• Hallucinations (usually auditory or visual)
• Delusions (usually paranoid or grandiose)
• Decreased emotional expressiveness
• Decrease in motivation
• Social withdrawal
• Disorganized thoughts (speech that “does not make sense”)
• Disorganized behavior

Schizophrenia is not cured, but can be managed with the help of healthcare professionals. Treatment includes medications (primarily anti-psychotics) as well as psychotherapy and social programs that help affected individuals improve their reality testing and boost their ability to function. For further information about schizophrenia and resources, see the National Alliance for the Mentally Ill (NAMI).