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Agoraphobia Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
With agoraphobia, you fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line or being in a crowd. The anxiety is caused by fear that there’s no easy way to escape or seek help if intense anxiety develops. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to fear another attack and avoid the place where it occurred.
People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fears can be so overwhelming that you may feel unable to leave your home.
Agoraphobia treatment can be challenging because it usually means confronting your fears. But with talk therapy (psychotherapy) and medications, you can escape the trap of agoraphobia and live a more enjoyable life. (Source: Mayo Clinic)
Alzheimer’s Disease 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.
Alzheimer’s is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases. (Source: alz.org)
Antisocial Personality Disorder Antisocial personality disorder, sometimes called sociopathy, is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others. People with antisocial personality disorder tend to antagonize, manipulate or treat others harshly or with callous indifference. They show no guilt or remorse for their behavior. (Source: Mayo Clinic)
Anxiety Disorders Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships. There are several different types of anxiety disorders. Examples include generalized anxiety disorder, panic disorder, and social anxiety disorder. (Source: National Institute of Mental Health)
Asperger Syndrome Asperger syndrome is one of several previously separate subtypes of autism that were folded into the single diagnosis autism spectrum disorder (ASD) with the publication of the DSM-5 diagnostic manual in 2013.
Asperger syndrome was generally considered to be on the “high functioning” end of the spectrum. Affected children and adults have difficulty with social interactions and exhibit a restricted range of interests and/or repetitive behaviors. Motor development may be delayed, leading to clumsiness or uncoordinated motor movements. Compared with those affected by other forms of ASD, however, those with Asperger syndrome do not have significant delays or difficulties in language or cognitive development. Some even demonstrate precocious vocabulary – often in a highly specialized field of interest.
The following behaviors are often associated with Asperger syndrome. However, they are seldom all present in any one individual and vary widely in degree:
- limited or inappropriate social interactions
- “robotic” or repetitive speech
- challenges with nonverbal communication (gestures, facial expression, etc.) coupled with average to above average verbal skills
- tendency to discuss self rather than others
- inability to understand social/emotional issues or nonliteral phrases
- lack of eye contact or reciprocal conversation
- obsession with specific, often unusual, topics
- one-sided conversations
- awkward movements and/or mannerisms (Source: autismspeaks.org)
Attention Deficit Disorder (ADD) / Attention Deficit Hyperactivity Disorder (ADHD) ADD is officially called Attention-Deficit/Hyperactivity Disorder, or AD/HD (American Psychiatric Association, 1994), although most lay people, and even some professionals, still call it ADD or A.D.D. (the names given in 1980) or ADHD . The disorder’s name has changed as a result of scientific advances and the findings of careful field trials; researchers now have strong evidence to support the position that AD/HD [ A.D.D. or ADHD ] [as we will refer to the disorder throughout the remainder of this Briefing Paper] is not one specific disorder with different variations. In keeping with this evidence, AD/HD [ A.D.D. OR ADHD ] is now divided into three subtypes, according to the main features associated with the disorder: inattentiveness, impulsivity, and hyperactivity. The three subtypes are:
- AD/HD [ A.D.D. OR ADHD ] Predominantly Combined Type,
- AD/HD [ A.D.D. OR ADHD ] Predominantly Inattentive Type, and
- AD/HD [ A.D.D. OR ADHD ] Predominantly Hyperactive-Impulsive Type.
These subtypes take into account that some children with AD/HD [ A.D.D. OR ADHD ] have little or no trouble sitting still or inhibiting behavior, but may be predominantly inattentive and, as a result, have great difficulty getting or staying focused on a task or activity. Others with AD/HD [ A.D.D. OR ADHD ] may be able to pay attention to a task but lose focus because they may be predominantly hyperactive-impulsive and, thus, have trouble controlling impulse and activity. The most prevalent subtype is the Combined Type. These children will have significant symptoms of all three characteristics. (Source: add-adhd.org)
Autism Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome.
ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art.
Autism appears to have its roots in very early brain development. However, the most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age. Autism Speaks continues to fund research on effective methods for earlier diagnosis, as early intervention with proven behavioral therapies can improve outcomes. Increasing autism awareness is a key aspect of this work and one in which our families and volunteers play an invaluable role. (Source: autismspeaks.org)
Avoidant Personality Disorder People with avoidant personality disorder experience long-standing feelings of inadequacy and are extremely sensitive to what others think about them. These feelings of inadequacy lead to the person to be socially inhibited and feel socially inept. Because of these feelings of inadequacy and inhibition, the person with avoidant personality disorder will seek to avoid work, school and any activities that involve socializing or interacting with others. (Source: Psych Central)
Bipolar Disorder Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.
There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.
- Bipolar I Disorder— defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.
- Bipolar II Disorder— defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.
- Cyclothymic Disorder (also called cyclothymia)— defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
- Other Specified and Unspecified Bipolar and Related Disorders— defined by bipolar disorder symptoms that do not match the three categories listed above. (Source: National Institute of Mental Health)
Borderline Personality Disorder Borderline personality disorder (BPD) is a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships. A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days.
Some people with BPD also have high rates of co-occurring mental disorders, such as mood disorders, anxiety disorders, and eating disorders, along with substance abuse, self-harm, suicidal thinking and behaviors, and suicide.
While mental health experts now generally agree that the label “borderline personality disorder” is very misleading, a more accurate term does not exist yet. (Source: National Institute of Mental Health)
Brain Disorder Brain disorders include any conditions or disabilities that affect your brain. This includes those conditions that are caused by illness, genetics, or traumatic injury. (Source: healthline.com)
Catatonia Catatonia is a syndrome—typically episodic, with periods of remission—characterized by the presence of a variety of behavioral and motoric traits. Accurate, prompt diagnosis of catatonia is crucial for preventing morbidity and death in a variety of settings (including emergency medical, psychiatric, neurologic, medical, obstetric, and surgical ones) and for instituting effective interventions.
Individuals with catatonia often cannot provide a coherent history; however, collateral sources can often relate relevant historical information. Family members can confirm the presence of typical primary features of catatonia, including immobility, stupor, posturing, rigidity, staring, grimacing, and withdrawal. (Source: Medscape)
Catatonic Schizophrenia The predominant clinical features seen in the catatonic subtype of schizophrenia involve disturbances in a person’s movement. Affected people may exhibit a dramatic reduction in activity, to the point that voluntary movement stops, as in catatonic stupor. Alternatively, activity can dramatically increase, a state known as catatonic excitement.
Other disturbances of movement can be present with this subtype. Actions that appear relatively purposeless but are repetitively performed, also known as stereotypic behavior, may occur, often to the exclusion of involvement in any productive activity.
Patients may exhibit an immobility or resistance to any attempt to change how they appear. They may maintain a pose in which someone places them, sometimes for extended periods of time. This symptom sometimes is referred to as waxy flexibility. Some patients show considerable physical strength in resistance to re-positioning attempts, even though they appear to be uncomfortable to most people.
Affected people may voluntarily assume unusual body positions, or manifest unusual facial contortions or limb movements. This set of symptoms sometimes is confused with another disorder called tardive dyskinesia, which mimics some of these same, odd behaviors. Other symptoms associated with the catatonic subtype include an almost parrot-like repeating of what another person is saying (echolalia) or mimicking the movements of another person (echopraxia). Echolalia and echopraxia also are seen in Tourette’s Syndrome. (Source: Psych Central)
Chronic Homelessness Under the Department of Housing and Urban Development’s new definition, a chronically homeless individual is someone who has experienced homelessness for a year or longer, or who has experienced at least four episodes of homelessness in the last three years (must be a cumulative of 12 months), and has a disability. A family with an adult member who meets this description would also be considered chronically homeless. (Source: National Alliance to End Homelessness)
Cognitive Behavioral Therapy (CBT) Cognitive behavioral therapy (CBT) focuses on exploring relationships among a person’s thoughts, feelings and behaviors. During CBT a therapist will actively work with a person to uncover unhealthy patterns of thought and how they may be causing self-destructive behaviors and beliefs.
By addressing these patterns, the person and therapist can work together to develop constructive ways of thinking that will produce healthier behaviors and beliefs. For instance, CBT can help someone replace thoughts that lead to low self-esteem (“I can’t do anything right”) with positive expectations (“I can do this most of the time, based on my prior experiences”).
The core principles of CBT are identifying negative or false beliefs and testing or restructuring them. Oftentimes someone being treated with CBT will have homework in between sessions where they practice replacing negative thoughts with more realistic thoughts based on prior experiences or record their negative thoughts in a journal.
Studies of CBT have shown it to be an effective treatment for a wide variety of mental illnesses, including depression, anxiety disorders, bipolar disorder, eating disorders and schizophrenia. Individuals who undergo CBT show changes in brain activity, suggesting that this therapy actually improves your brain functioning as well.
Cognitive behavioral therapy has a considerable amount of scientific data supporting its use and many mental health care professionals have training in CBT, making it both effective and accessible. More are needed to meet the public health demand, however. (Source: National Alliance on Mental Illness)
Consumer A mental health consumer (or mental health patient) is a person who is obtaining treatment or support for a mental disorder, also known as psychiatric or mental illness. The term was coined by people who use mental health services in an attempt to empower those with mental health issues, usually considered a marginalized segment of society. The term suggests that there is a reciprocal contract between those who provide a service and those who use a service and that individuals have a choice in their treatment and that without them there could not exist mental health providers. (Source: Wikipedia)
Co-occurring The coexistence of both a mental health and a substance use disorder is referred to as co-occurring disorders. (Source: Substance Abuse and Mental Health Services Administration)
Comorbidity The occurrence of two disorders or illnesses in the same person, either at the same time (co-occurring comorbid conditions) or with a time difference between the initial occurrence of one and the initial occurrence of the other (sequentially comorbid conditions). (Source: National Institute on Drug Abuse)
Cultural Competence Cultural competence in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs. (Source: National Center for Cultural Competence)
Delusion A fixed false belief that is resistant to reason or confrontation with actual fact: a paranoid delusion. (Source: Dictionary.com)
Delusional Disorder Delusional disorder, previously called paranoid disorder, is a type of serious mental illness called a “psychosis” in which a person cannot tell what is real from what is imagined. The main feature of this disorder is the presence of delusions, unshakable beliefs in something untrue or not based on reality. People with delusional disorder generally experience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, however, the situations are either not true at all or highly exaggerated. If the delusions could not happen in reality (aliens, television broadcasting your thoughts) then a person might be considered delusional with bizarre-type delusions. (Source: WebMD)
Dementia 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. (Source: alz.org)
Department of Health and Human Services The United States Department of Health and Human Services (HHS), also known as the Health Department, is a cabinet-level department of the U.S. federal government with the goal of protecting the health of all Americans and providing essential human services. Its motto is “Improving the health, safety, and well-being of America”. Before the separate federal Department of Education was created in 1979, it was called the Department of Health, Education, and Welfare (HEW). (Source: Wikipedia)
Dependent Personality Disorder Dependent personality disorder is characterized by a long-standing need for the person to be taken care of and a fear of being abandoned or separated from important individuals in his or her life. This leads the person to engage in dependent and submissive behaviors that are designed to elicit care-giving behaviors in others. The dependent behavior may be see as being “clingy” or “clinging on” to others, because the person fears they can’t live their lives without the help of others. (Source: Psych Central)
Depersonalization-Derealization Disorder Persistent and recurrent episodes of depersonalization or derealization or both cause distress and problems functioning at work or school or in other important areas of your life. During these episodes, you are aware that your sense of detachment is only a feeling, and not reality.
The experience and feelings of the disorder can be difficult to describe. Worry about “going crazy” can cause you to become preoccupied with checking that you exist and determining what’s actually real. (Source: Mayo Clinic)
Depression Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks. (Source: National Institute of Mental Health)
Dissociative Amnesia Dissociative amnesia occurs when a person blocks out certain information, usually associated with a stressful or traumatic event, leaving him or her unable to remember important personal information. With this disorder, the degree of memory loss goes beyond normal forgetfulness and includes gaps in memory for long periods of time or of memories involving the traumatic event.
Dissociative amnesia is not the same as simple amnesia, which involves a loss of information from memory, usually as the result of disease or injury to the brain. With dissociative amnesia, the memories still exist but are deeply buried within the person’s mind and cannot be recalled. However, the memories might resurface on their own or after being triggered by something in the person’s surroundings. (Source: WebMD)
Dissociative Disorder Dissociative disorders are characterized by an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder.
It’s estimated that 2% of people experience dissociative disorders, with women being more likely than men to be diagnosed. Almost half of adults in the United States experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes.
The symptoms of a dissociative disorder usually first develop as a response to a traumatic event, such as abuse or military combat, to keep those memories under control. Stressful situations can worsen symptoms and cause problems with functioning in everyday activities. However, the symptoms a person experiences will depend on the type of dissociative disorder that a person has.
Treatment for dissociative disorders often involves psychotherapy and medication. Though finding an effective treatment plan can be difficult, many people are able to live healthy and productive lives. (Source: National Alliance on Mental Illness)
Dissociative Fugue Dissociative Fugue is one or more episodes of amnesia in which the inability to recall some or all of one’s past and either the loss of one’s identity or the formation of a new identity occur with sudden, unexpected, purposeful travel away from home.
Specific symptoms include:
- The predominant disturbance is sudden, unexpected travel away from home or one’s customary place of work, with inability to recall one’s past.
- Confusion about personal identity or assumption of a new identity (partial or complete).
- The disturbance does not occur exclusively during the course of Dissociative Identity Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. (Source: Psych Central)
Dissociative Identity Disorder Dissociative Identity Disorder, formerly referred to as Multiple Personality Disorder, is a condition wherein a person’s identity is fragmented into two or more distinct personalities. Sufferers of this rare condition are usually victims of severe abuse.
Dissociative Identity Disorder (DID) is a severe condition in which two or more distinct identities, or personality states, are present in—and alternately take control of—an individual. The person also experiences memory loss that is too extensive to be explained by ordinary forgetfulness.
DID is a disorder characterized by identity fragmentation rather than a proliferation of separate personalities. The disturbance is not due to the direct psychological effects of a substance or of a general medical condition, yet as this once rarely reported disorder has become more common, the diagnosis has become controversial. (Source: Psychology Today)
DSM-V The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) is the product of more than 10 years of effort by hundreds of international experts in all aspects of mental health. Their dedication and hard work have yielded an authoritative volume that defines and classifies mental disorders in order to improve diagnoses, treatment, and research. (Source: American Psychiatric Association)
Early Intervention Addresses a condition early in its manifestation.
- Is of relatively low intensity
- Is of relatively short duration (usually less than one year)
- Has the goal of supporting well being in major life domains and avoiding the need for more extensive mental health services
- May include individual screening for confirmation of potential mental health needs. (Source: Riverside University Health System)
Eating Disorder Eating disorders — such as anorexia, bulimia, and binge eating disorder – include extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males. (Source: National Eating Disorders Association)
Electroconvulsive Therapy (Electroshock Therapy) Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. It often works when other treatments are unsuccessful. (Source: Mayo Clinic)
EMDR (Eye Movement Desensitization and Reprocessing) EMDR is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma.
EMDR is a set of standardized protocols that incorporates elements from many different treatment approaches. EMDR integrates strengthening resources the client already possesses as well as learning new ways to reduce distress. EMDR facilitates the shift of the traumatic issue from short-term to long-term memory, where typically memories are stored. Clients report an instant shift toward wellbeing, a sense of release, a feeling of peace and acceptance, and a deep appreciation for their own strength after EMDR therapy.
Research has identified EMDR an effective therapy for Post-Traumatic Stress Disorder. Although PTSD is often associated with life events such as war, rape, natural disaster, and witnessing a violent death or crime, such symptoms can also result from recurring memories of childhood abuse, a traumatic car accident, loss of a loved one through death or divorce, or the experience of life threatening illness.
In addition, it is also successful using EMDR in the treatment of the following:
- Anxiety Disorders
- Disturbing Memories
- Stress Reduction
- Sexual, Emotional and/or Physical Abuse
- Panic Attacks
Evidence-Based Practice The most common definition of Evidence-Based Practice (EBP) is … “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”
EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Source: Duke University Medical Center Library)
Family-Driven Care Family-driven means families have a primary decision making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes:
- Choosing culturally and linguistically competent supports, services, and providers;
- Setting goals;
- Designing, implementing and evaluating programs;
- Monitoring outcomes; and
- Partnering in funding decisions. (Source: National Federation of Families for Children’s Mental Health)
Generalized Anxiety Disorder Generalized anxiety disorder is characterized by persistent, excessive, and unrealistic worry about everyday things.
People with the disorder, which is also referred to as GAD, experience excessive anxiety and worry, often expecting the worst even when there is no apparent reason for concern. They anticipate disaster and may be overly concerned about money, health, family, work, or other issues. GAD is diagnosed when a person finds it difficult to control worry on more days than not for at least six months and has three or more symptoms. (Source: Anxiety and Depression Association of America)
Health Insurance Portability and Accountability Act (HIPAA) A US law designed to provide privacy standards to protect patients’ medical records and other health information provided to health plans, doctors, hospitals and other health care providers. Developed by the Department of Health and Human Services, these new standards provide patients with access to their medical records and more control over how their personal health information is used and disclosed. They represent a uniform, federal floor of privacy protections for consumers across the country. State laws providing additional protections to consumers are not affected by this new rule. HIPAA took effect on April 14, 2003. (Source: MedicineNet.com)
Histrionic Personality Disorder Individuals with Histrionic Personality Disorder exhibit excessive emotionalism–a tendency to regard things in an emotional manner–and are attention seekers. People with this disorder are uncomfortable or feel unappreciated when they are not the center of attention. Behaviors may include constant seeking of approval or attention, self-dramatization, theatricality, and striking self-centeredness or sexual seductiveness in inappropriate situations, including social, occupational and professional relationships beyond what is appropriate for the social context. They may be lively and dramatic and initially charm new acquaintances by their enthusiasm, apparent openness, or flirtatiousness. They commandeer the role of “the life of the party”. Personal interests and conversation will be self-focused. They use physical appearance to draw attention to themselves. Emotional expression may be shallow and rapidly shifting. Their style of speech is excessively impressionistic and lacking in detail. They may do well with jobs that value and require imagination and creativity but will probably have difficulty with tasks that demand logical or analytical thinking. The disorder occurs more frequently in women though that may be because it is more often diagnosed in women than men. (Source: Psychology Today)
Intensive Outpatient Programming (I.O.P.) An intensive outpatient program (IOP) is a kind of treatment service and support program used primarily to treat eating disorders, depression, self harm and chemical dependency that does not rely on detoxification. IOP operates on a small scale and does not require the intensive residential or partial day services typically offered by the larger, more comprehensive treatment facilities. (Source: Wikipedia)
Juvenile Detention Juvenile detention, as part of the juvenile justice continuum, is a process that includes the temporary and safe custody of juveniles whose alleged conduct is subject to court jurisdiction who require a restricted environment for their own and the community’s protection while pending legal action. Juvenile detention may range from the least restrictive community based supervision to the most restrictive form of secure care.
The critical components of juvenile detention include:
- Screening to ensure appropriate use of detention,
- Assessment to determine the proper level of custody, supervision and placement,
- Policies that promote the safety, security and well being of juveniles and staff,
- Services that address immediate and/or acute needs in the educational, mental, physical, emotional and social development of juveniles. (Source: National Partnership for Juvenile Services)
Managed Care Managed Care is a health care delivery system organized to manage cost, utilization, and quality. (Source: Medicaid.gov)
Managed Health Care Plan Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan’s network. How much of your care the plan will pay for depends on the network’s rules.
Plans that restrict your choices usually cost you less. If you want a flexible plan, it will probably cost more. There are three types of managed care plans:
- Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
- Preferred Provider Organizations (PPO) usually pay more if you get care within the network. They still pay part of the cost if you go outside the network.
- Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care. (Source: MedlinePlus)
Manic-Depressive Disorder See Bipolar Disorder
Mental Disorder A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.
Mental Health Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood. (Source: MentalHealth.gov)
Mental Illness A mental illness is a condition that affects a person’s thinking, feeling or mood. Such conditions may affect someone’s ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis. (Source: National Alliance on Mental Illness)
Mental Retardation (Intellectual Disability) Mental retardation (MR) is a condition diagnosed before age 18, usually in infancy or as a young child, that includes below-average general intellectual function, and a lack of the skills necessary for daily living. When onset occurs at age 18 or after, it is called dementia, which can coexist with an MR diagnosis. Intelligence level as determined by individual standard assessment is below 70, and the ability to adapt to the demands of normal life is impaired. This is important because it distinguishes a diagnosis of MR from individuals with low IQ scores who are able to adapt to the demands of everyday life. Education, job training, support from family, and individual characteristics such as motivation and personality can all contribute to the ability of individuals with MR to adapt.
Other behavioral traits associated with MR (but not deemed criteria for an MR diagnosis) include aggression, dependency, impulsivity, passivity, self-injury, stubbornness, low self-esteem, and low frustration tolerance. Some may also exhibit mood disorders such as psychotic disorders and attention difficulties, though others are pleasant, otherwise healthy individuals. Sometimes physical traits, like shortness in stature and malformation of facial elements, can set individuals with MR apart, while others may have a normal appearance.
Mental retardation affects about 1 percent to 3 percent of the population. (Source: Psychology Today)
Multiple Personality Disorder See Dissociative Disorder
Narcissistic Personality Disorder Narcissistic personality disorder is a mental disorder in which people have an inflated sense of their own importance, a deep need for admiration and a lack of empathy for others. But behind this mask of ultraconfidence lies a fragile self-esteem that’s vulnerable to the slightest criticism. (Source: Mayo Clinic)
National Alliance on Mental Illness (NAMI) NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. (Source: National Alliance on Mental Illness)
Neurobiology Neurobiology is the study of cells of the nervous system and the organization of these cells into functional circuits that process information and mediate behavior.
It is a subdiscipline of both biology and neuroscience.
Neurobiology differs from neuroscience, a much broader field that is concerned with any scientific study of the nervous system. (Source: ScienceDaily)
Neuropsychiatry When used to refer to a scientific field, neuropsychiatry is the integrated study of psychiatric and neurologic disorders. This definition of neuropsychiatry does not connote a particular type of educational background or professional training; instead, it refers broadly and inclusively of the work performed any basic or clinical scientist, educator, clinician, public policy maker, or other individual that seeks to advance our understanding of the neurological bases of psychiatric disorders, the psychiatric manifestations of neurological disorders, and/or the evaluation and care of persons with neurologically based behavioral disturbances. In other words, one’s work can be neuropsychiatric regardless of whether one is trained as a neuropsychiatrist.
When used to refer to a medical subspecialty, neuropsychiatry is one of the two historically separate but parallel clinical disciplines that comprise the medical subspecialty known currently as Behavioral Neurology & Neuropsychiatry. (Source: American Neuropsychiatric Association)
Nonverbal Learning Disorder Nonverbal learning disorders (NLD) is a neurological syndrome consisting of specific assets and deficits. The assets include early speech and vocabulary development, remarkable rote memory skills, attention to detail, early reading skills development and excellent spelling skills. In addition, these individuals have the verbal ability to express themselves eloquently. Moreover, persons with NLD have strong auditory retention. Four major categories of deficits and dysfunction also present themselves:
- Motoric- lack of coordination, severe balance problems, and difficulties with graphomotor skills.
- Visual-Spatial-Organizational- lack of image, poor visual recall, faulty spatial perceptions, difficulties with executive function* and problems with spatial relations.
- Social- lack of ability to comprehend nonverbal communication, difficulties adjusting to transitions and novel situations, and deficits in social judgment and social interaction.
- Sensory- sensitivity in any of the sensory modes: visual, auditory, tactile, taste or olfactory. (Source: nldline.com)
Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over. (Source: National Institute on Mental Health)
Obsessive-Compulsive Personality Disorder OCPD is a type of “personality disorder” with these characteristics:
- Rigid adherence to rules and regulations
- An overwhelming need for order
- Unwillingness to yield or give responsibilities to others
- A sense of righteousness about the way things “should be done” (Source: International OCD Foundation)
Oppositional Defiant Disorder A behavior disorder characterized by a persistent pattern of defiant, disobedient, and hostile behavior towards authority figures; a frequent loss of temper, arguing, becoming angry or vindictive, or other negative behaviors. (Source: National Library of Medicine)
Panic Disorder Panic disorder occurs when you experience recurring unexpected panic attacks. The DSM-5 defines panic attacks as abrupt surges of intense fear or discomfort that peak within minutes. People with the disorder live in fear of having a panic attack. You may be having a panic attack when you feel sudden, overwhelming terror that has no obvious cause. You may experience physical symptoms, such as a racing heart, breathing difficulties, and sweating.
Most people experience a panic attack once or twice in their lives. The American Psychological Association reports that 1 out of every 75 people might experience a panic disorder. Panic disorder is characterized by persistent fear of having another panic attack after you have experienced at least one month (or more) of persistent concern or worry about additional panic attacks (or their consequences) recurring. (Source: healthline.com)
Paranoid Personality Disorder People with paranoid personality disorder are generally characterized by having a long-standing pattern of pervasive distrust and suspiciousness of others. A person with paranoid personality disorder will nearly always believe that other people’s motives are suspect or even malevolent.
Individuals with this disorder assume that other people will exploit, harm, or deceive them, even if no evidence exists to support this expectation. While it is fairly normal for everyone to have some degree of paranoia about certain situations in their lives (such as worry about an impending set of layoffs at work), people with paranoid personality disorder take this to an extreme — it pervades virtually every professional and personal relationship they have. (Source: Psych Central)
Parity Mental health parity describes the equal treatment of mental health conditions and substance use disorders in insurance plans. When a plan has parity, it means that if you are provided unlimited doctor visits for a chronic condition like diabetes then they must offer unlimited visits for a mental health condition such as depression or schizophrenia. (Source: National Alliance on Mental Illness)
Pervasive Developmental Disorder (PDD) The diagnostic category of pervasive developmental disorders (PDD) refers to a group of disorders characterized by delays in the development of socialization and communication skills. Parents may note symptoms as early as infancy, although the typical age of onset is before 3 years of age. Symptoms may include problems with using and understanding language; difficulty relating to people, objects, and events; unusual play with toys and other objects; difficulty with changes in routine or familiar surroundings, and repetitive body movements or behavior patterns. Autism (a developmental brain disorder characterized by impaired social interaction and communication skills, and a limited range of activities and interests) is the most characteristic and best studied PDD. Other types of PDD include Asperger’s Syndrome, Childhood Disintegrative Disorder, and Rett’s Syndrome. Children with PDD vary widely in abilities, intelligence, and behaviors. Some children do not speak at all, others speak in limited phrases or conversations, and some have relatively normal language development. Repetitive play skills and limited social skills are generally evident. Unusual responses to sensory information, such as loud noises and lights, are also common. (Source: National Institute of Neurological Disorders and Stroke)
Personality Disorders Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors that are unhealthy and inflexible. The behaviors cause serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and problems. They often have stormy relationships with other people.
The cause of personality disorders is unknown. However, genes and childhood experiences may play a role.
The symptoms of each personality disorder are different. They can mild or severe. People with personality disorders may have trouble realizing that they have a problem. To them, their thoughts are normal, and they often blame others for their problems. They may try to get help because of their problems with relationships and work. Treatment usually includes talk therapy and sometimes medicine. (Source: MedlinePlus)
Postpartum Depression You may have postpartum depression if you have had a baby within the last 12 months and are experiencing some of these symptoms:
- You feel overwhelmed. Not like “hey, this new mom thing is hard.” More like “I can’t do this and I’m never going to be able to do this.” You feel like you just can’t handle being a mother. In fact, you may be wondering whether you should have become a mother in the first place.
- You feel guilty because you believe you should be handling new motherhood better than this. You feel like your baby deserves better. You worry whether your baby can tell that you feel so bad, or that you are crying so much, or that you don’t feel the happiness or connection that you thought you would. You may wonder whether your baby would be better off without you.
- You don’t feel bonded to your baby. You’re not having that mythical mommy bliss that you see on TV or read about in magazines. Not everyone with postpartum depression feels this way, but many do.
- You can’t understand why this is happening. You are very confused and scared.
- You feel irritated or angry. You have no patience. Everything annoys you. You feel resentment toward your baby, or your partner, or your friends who don’t have babies. You feel out-of-control rage.
- You feel nothing. Emptiness and numbness. You are just going through the motions.
- You feel sadness to the depths of your soul. You can’t stop crying, even when there’s no real reason to be crying.
- You feel hopeless, like this situation will never ever get better. You feel weak and defective, like a failure.
- You can’t bring yourself to eat, or perhaps the only thing that makes you feel better is eating.
- You can’t sleep when the baby sleeps, nor can you sleep at any other time. Or maybe you can fall asleep, but you wake up in the middle of the night and can’t go back to sleep no matter how tired you are. Or maybe all you can do is sleep and you can’t seem to stay awake to get the most basic things done. Whichever it is, your sleeping is completely screwed up and it’s not just because you have a newborn.
- You can’t concentrate. You can’t focus. You can’t think of the words you want to say. You can’t remember what you were supposed to do. You can’t make a decision. You feel like you’re in a fog.
- You feel disconnected. You feel strangely apart from everyone for some reason, like there’s an invisible wall between you and the rest of the world.
- Maybe you’re doing everything right. You are exercising. You are taking your vitamins. You have a healthy spirituality. You do yoga. You’re thinking “Why can’t I just get over this?” You feel like you should be able to snap out of it, but you can’t.
- You might be having thoughts of running away and leaving your family behind. Or you’ve thought of driving off the road, or taking too many pills, or finding some other way to end this misery.
- You know something is wrong. You may not know you have a perinatal mood or anxiety disorder, but you know the way you are feeling is NOT right. You think you’ve “gone crazy.”
- You are afraid that this is your new reality and that you’ve lost the “old you” forever.
- You are afraid that if you reach out for help people will judge you. Or that your baby will be taken away. (Source: Postpartum Progress)
Postpartum Psychosis Postpartum Psychosis is a rare illness, compared to the rates of postpartum depression or anxiety. It occurs in approximately 1 to 2 out of every 1,000 deliveries, or approximately .1 -.2% of births. The onset is usually sudden, most often within the first 2 weeks postpartum. (Source: Postpartum Support International)
Posttraumatic Stress Disorder Posttraumatic stress disorder, or PTSD, is a serious potentially debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening events. Research has recently shown that PTSD among military personnel may be a physical brain injury, specifically of damaged tissue, caused by blasts during combat. (Source: Anxiety and Depression Association of America)
Psychiatry Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. (Source: American Psychiatric Association)
Psychosis Most people think of psychosis as a break with reality. In a way it is. Psychosis is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t. These disruptions are often experienced as seeing, hearing and believing things that aren’t real or having strange, persistent thoughts, behaviors and emotions. While everyone’s experience is different, most people say psychosis is frightening and confusing.
Psychosis is a symptom, not an illness, and it is more common than you may think. In the U.S., approximately 100,000 young people experience psychosis each year. As many as three in 100 people will have an episode at some point in their lives. (Source: National Alliance on Mental Illness)
Psychotropic Drug Any drug capable of affecting the mind, emotions, and behavior. Some legal drugs, such as lithium for bipolar disorder, are psychotropic. Many illicit drugs, such as cocaine, are also psychotropic. Also known as psychodynamic drug. (Source: MedicineNet.com) (Click here for a list of psychotropic medications on Wikipedia)
Recovery Recovery from mental disorders and/or substance abuse disorders is a process of change through which individuals:
- Improve their health and wellness
- Live a self-directed life
- Strive to achieve their full potential (Source: mentalhealth.gov)
Residential Treatment Residential psychiatric care is a positive alternative to the less productive route that typically starts with a hospital stay. After managing the acute crisis that triggers the admission, hospitals usually do not offer patients enough structure, despite the fact that the majority of people with serious psychiatric disorders do best with a high degree of structure. (Source: American Residential Treatment Association)
Resilience Resilience is that ineffable quality that allows some people to be knocked down by life and come back stronger than ever. Rather than letting failure overcome them and drain their resolve, they find a way to rise from the ashes. Psychologists have identified some of the factors that make someone resilient, among them a positive attitude, optimism, the ability to regulate emotions, and the ability to see failure as a form of helpful feedback. Even after misfortune, resilient people are blessed with such an outlook that they are able to change course and soldier on. (Source: Psychology Today)
Schizoid Personality Disorder Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy away from interaction with others. They also have a limited range of emotional expression. (Source: Mayo Clinic)
Schizophrenia Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling. (Source: National Institute of Mental Health)
Schizotypal Personality Disorder People with schizotypal personality disorder are often described as odd or eccentric and usually have few, if any, close relationships. They generally don’t understand how relationships form or the impact of their behavior on others. They may also misinterpret others’ motivations and behaviors and develop significant distrust of others. (Source: Mayo Clinic)
Selective Serotonin Reuptake Inhibitors (SSRI) Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They can ease symptoms of moderate to severe depression, are relatively safe and typically cause fewer side effects than other types of antidepressants do. (Source: Mayo Clinic)
Serious Emotional Disturbance (SED) Many terms are used to describe emotional, behavioral or mental disorders. Usually, people with such disorders are categorized as having a serious emotional disturbance. The Individuals with Disabilities Act defines a person with emotional disturbance as a person exhibiting one or more of the following characteristics over a long period of time and to a degree that adversely affects the person’s performance. One characteristic is an inability to learn, which cannot be explained by intellectual, sensory, or health factors.
Another characteristic of emotional disturbance is an inability to build or maintain satisfactory interpersonal relationships with peers. Other characteristics include inappropriate types of behavior or feelings under normal circumstances, a general pervasive mood of unhappiness or depression, or a tendency to develop physical symptoms or fears associated with personal problems.
The causes of emotional disturbance have not been adequately determined. Although various factors have been suggested as possible causes, research has not shown any to be the direct cause of behavior problems. (Source: The Arc Western Wayne County)
Serious Mental Illness Severe mental illness is often defined by its length of duration and the disability it produces. These illnesses include disorders that produce psychotic symptoms, such as schizophrenia and schizoaffective disorder, and severe forms of other disorders, such as major depression and bipolar disorder.
Illnesses that produce distortions of perception, delusions, hallucinations, and unusual behaviors are sometimes called thought disorders. Because the symptoms reflect a loss of contact with perceived reality, the disorders are also sometimes known as psychotic disorders.
Severe mental illnesses are treatable, and with proper treatment and management of the illness, people with these disorders can experience recovery. (Source: Behavioral Health Evolution)
Social Anxiety Disorder Social anxiety disorder can wreak havoc on the lives of those who suffer from it. This disorder is not simply shyness that has been inappropriately medicalized.
Symptoms may be so extreme that they disrupt daily life. People with this disorder, also called social phobia, may have few or no social or romantic relationships, making them feel powerless, alone, or even ashamed.
- About 15 million American adults have social anxiety disorder
- Typical age of onset: 13 years old
- 36 percent of people with social anxiety disorder report symptoms for 10 or more years before seeking help
Although they recognize that the fear is excessive and unreasonable, people with social anxiety disorder feel powerless against their anxiety. They are terrified they will humiliate or embarrass themselves. (Source: Anxiety and Depression Association of America)
Special Education Special Education programs are designed for those students who are mentally, physically, socially and/or emotionally delayed. This aspect of “delay,” broadly categorized as a developmental delay, signify an aspect of the child’s overall development (physical, cognitive, scholastic skills) which place them behind their peers. Due to these special requirements, students’ needs cannot be met within the traditional classroom environment. Special Education programs and services adapt content, teaching methodology and delivery instruction to meet the appropriate needs of each child. These services are of no cost to the family and are available to children until they reach 21 years of age. (States have services set in place for adults who are in need of specialized services after age 21.)
The Individuals with Disabilities Act (IDEA) defines Special Education as “specially designed instruction, at no cost to the parents, to meet the unique needs of a child with a disability,” but still, what exactly is Special Education? Often met with an ambiguous definition, the umbrella term of Special Education broadly identifies the academic, physical, cognitive and social-emotional instruction offered to children who are faced with one or more disabilities. (Source: Teach.com)
Stigma Three out of four people with a mental illness report that they have experienced stigma. Stigma is a mark of disgrace that sets a person apart. When a person is labelled by their illness they are seen as part of a stereotyped group. Negative attitudes create prejudice which leads to negative actions and discrimination. (Source: Healthy WA)
Strength-Based Treatment Strengths-based approach moves the focus away from deficits of people with mental illnesses (consumers) and focuses on the strengths and resources of the consumers. (Source: US National Library of Medicine)
Suboxone® (buprenorphine and naloxone) Sublingual Film (CIII) is a prescription medicine indicated for treatment of opioid dependence and should be used as part of a complete treatment plan to include counseling and psychosocial support. (Source: Suboxone.com)
Substance Abuse Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. (Source: World Health Organization)
Substance Abuse and Mental Health Services Administration (SAMHSA) The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities. (Source: Substance Abuse and Mental Health Services Administration)
Therapy Treatment Among psychologists and other mental health professionals, including psychiatrists, psychiatric nurse practitioners, and clinical social workers, the term may refer specifically to psychotherapy (sometimes dubbed “talking therapy”). (Source: Wikipedia)
VIVITROL® (naltrexone for extended-release injectable suspension) is a prescription injectable medicine used to treat alcohol dependence. You should stop drinking before starting VIVITROL. Prevent relapse to opioid dependence after opioid detox. You must stop taking opioids or other opioid-containing medications before starting VIVITROL. (Source: Vivitrol.com)