Unit 5: Common Types 

of Mental Illness
Objectives

• In the end of this lecture, students must be able to:
1. Depression
2. Anxiety
3. Grief and loss
4. Eating disorder
DEPRESSION

• What Is Depression?
• Everyone occasionally feels blue or sad. But these feelings are usually
short‐lived and pass within a couple of days. When you have
depression, it interferes with daily life and causes pain for both you
and those who care about you. Depression is a common but serious
illness.
• Many people with a depressive illness never seek treatment. But the
majority, even those with the most severe depression, can get better
with treatment. Medications, psychotherapies, and other methods
can effectively treat people with depression.
Major depression

• severe symptoms that interfere with your ability to work, sleep,

study, eat, and enjoy life. An episode can occur only once in a
person’s lifetime, but more often, a person has several episodes.
• Some forms of depression are slightly different, or they may develop
under unique circumstances. They include:
• Psychotic depression
• Postpartum depression
• Seasonal affective disorder (SAD),
Psychotic depression

• Psychotic depression, which occurs when a person has severe

depression plus some form of psychosis, such as having disturbing
false beliefs or a break with reality (delusions), or hearing or seeing
upsetting things that others cannot hear or see (hallucinations).
Postpartum depression

• Postpartum depression, which is much more serious than the "baby

blues" that many women experience after giving birth, when
hormonal and physical changes and the new responsibility of caring
for a newborn can be overwhelming.

• It is estimated that 10 to 15 percent of women experience

postpartum depression after giving birth.
Seasonal affective disorder (SAD)

• Seasonal affective disorder (SAD), which is characterized by the 
onset of depression during the winter months, when there is less 
natural sunlight. 
• The depression generally lifts during spring and summer. 
• SAD may be effectively treated with light therapy, but nearly half of 
those with SAD do not get better with light therapy alone. 
• Antidepressant medication and psychotherapy can reduce SAD 
symptoms, either alone or in combination with light therapy.
Causes

• Most likely, depression is caused by a combination of genetic,

biological, environmental, and psychological factors.
• Depressive illnesses are disorders of the brain. Brain‐imaging
technologies, such as magnetic resonance imaging (MRI), have
shown that the brains of people who have depression look different
than those of people without depression.
• The parts of the brain involved in mood, thinking, sleep, appetite,
and behavior appear different. But these images do not reveal why
the depression has occurred. They also cannot be used to diagnose
depression.
Cont...Causes

• Some types of depression tend to run in families. However,

depression can occur in people without family histories of depression
too. Scientists are studying certain genes that may make some
people more prone to depression.

• Some genetics research indicates that risk for depression results from
the influence of several genes acting together with environmental or
other factors. In addition, trauma, loss of a loved one, a difficult
relationship, or any stressful situation may trigger a depressive
episode. Other depressive episodes may occur with or without an
obvious trigger.
 Signs & Symptoms

Persistent sad, anxious, or "empty" feelings
Feelings of hopelessness or pessimism
Feelings of guilt, worthlessness, or helplessness
Irritability, restlessness
Loss of interest in activities or hobbies once pleasurable, including sex
Fatigue and decreased energy
Difficulty concentrating, remembering details, and making decisions
Insomnia, early‐morning wakefulness, or excessive sleeping
Overeating, or appetite loss
Thoughts of suicide, suicide attempts
Aches or pains, headaches, cramps, or digestive problems that do not 
ease even with treatment.
Who Is At Risk?

• Major depressive disorder is one of the most common mental

disorders in the United States. Each year about 6.7% of U.S adults
experience major depressive disorder. Women are 70 % more likely
than men to experience depression during their lifetime.

• Non‐Hispanic blacks are 40% less likely than non‐Hispanic whites to

experience depression during their lifetime. The average age of
onset is 32 years old. Additionally, 3.3% of 13 to 18 year olds have
experienced a seriously debilitating depressive disorder.
Diagnosis

• "I started missing days from work, and a friend noticed that something
wasn't right. She talked to me about the time she had been really
depressed and had gotten help from her doctor.“

• Depression, even the most severe cases, can be effectively treated. The
earlier that treatment can begin, the more effective it is.

• The first step to getting appropriate treatment is to visit a doctor or

mental health specialist. Certain medications, and some medical
conditions such as viruses or a thyroid disorder, can cause the same
symptoms as depression. A doctor can rule out these possibilities by
doing a physical exam, interview, and lab tests. If the doctor can find no
medical condition that may be causing the depression, the next step is a
psychological evaluation.
Cont..Diagnosis

• The doctor may refer you to a mental health professional, who should
discuss with you any family history of depression or other mental
disorder, and get a complete history of your symptoms. You should
discuss when your symptoms started, how long they have lasted, how
severe they are, and whether they have occurred before and if so, how
they were treated. The mental health professional may also ask if you
are using alcohol or drugs, and if you are thinking about death or suicide.

• Other illnesses may come on before depression, cause it, or be a

consequence of it. But depression and other illnesses interact differently
in different people. In any case, co‐occurring illnesses need to be
diagnosed and treated.
Cont...Diagnosis

• Anxiety disorders, such as post‐traumatic stress

disorder (PTSD), obsessive‐compulsive disorder,
panic disorder, social phobia, and generalized
anxiety disorder, often accompany depression. PTSD
can occur after a person experiences a terrifying
event or ordeal, such as a violent assault, a natural
disaster, an accident, terrorism or military combat.

• People experiencing PTSD are especially prone to

having co‐existing depression.
Cont...Diagnosis

• Alcohol and other substance abuse or dependence may also

co‐exist with depression. Research shows that mood
disorders and substance abuse commonly occur together.

• Depression also may occur with other serious medical

illnesses such as heart disease, stroke, cancer, HIV/AIDS,
diabetes, and Parkinson's disease. People who have
depression along with another medical illness tend to have
more severe symptoms of both depression and the medical
illness, more difficulty adapting to their medical condition,
and more medical costs than those who do not have co‐
existing depression. Treating the depression can also help
improve the outcome of treating the co‐occurring illness.
Treatments

• Once diagnosed, a person with depression can be treated in several 
ways. The most common treatments are medication and 
psychotherapy.
How can I help a loved one who is 
depressed?
• If you know someone who is depressed, it affects you too. The most
important thing you can do is help your friend or relative get a
diagnosis and treatment. You may need to make an appointment and
go with him or her to see the doctor. Encourage your loved one to
stay in treatment, or to seek different treatment if no improvement
occurs after 6 to 8 weeks.
• To help your friend or relative
• Offer emotional support, understanding, patience, and 
encouragement.
• Talk to him or her, and listen carefully.
Cont...How can I help a loved one who is 
depressed?
• Never dismiss feelings, but point out realities and offer hope.
• Never ignore comments about suicide, and report them to your loved
one's therapist or doctor.
• Invite your loved one out for walks, outings and other activities. Keep
trying if he or she declines, but don't push him or her to take on too
much too soon.
• Provide assistance in getting to the doctor's appointments.
• Remind your loved one that with time and treatment, the depression 
will lift.
How can I help myself if I am depressed?

• If you have depression, you may feel exhausted, helpless, and hopeless. It
may be extremely difficult to take any action to help yourself. But as you
begin to recognize your depression and begin treatment, you will start to
feel better.
• To Help Yourself
• Do not wait too long to get evaluated or treated. There is research showing
the longer one waits, the greater the impairment can be down the road. Try
to see a professional as soon as possible.
• Try to be active and exercise. Go to a movie, a ballgame, or another event or 
activity that you once enjoyed.
• Set realistic goals for yourself.
• Break up large tasks into small ones, set some priorities and do what you can
as you can.
• Try to spend time with other people and confide in a trusted friend or
relative. Try not to isolate yourself, and let others help you.
Cont..How can I help myself if I am 
depressed?
• If you have depression, you may feel exhausted, helpless, and hopeless. It
may be extremely difficult to take any action to help yourself. But as you
begin to recognize your depression and begin treatment, you will start to
feel better.
• To Help Yourself
• Do not wait too long to get evaluated or treated. There is research showing
the longer one waits, the greater the impairment can be down the road. Try
to see a professional as soon as possible.
• Try to be active and exercise. Go to a movie, a ballgame, or another event or 
activity that you once enjoyed.
• Set realistic goals for yourself.
• Break up large tasks into small ones, set some priorities and do what you can
as you can.
• Try to spend time with other people and confide in a trusted friend or
relative. Try not to isolate yourself, and let others help you.
Cont...How can I help myself if I am 
depressed?
• Expect your mood to improve gradually, not immediately. Do not
expect to suddenly "snap out of" your depression. Often during
treatment for depression, sleep and appetite will begin to improve
before your depressed mood lifts.

• Postpone important decisions, such as getting married or divorced or

changing jobs, until you feel better. Discuss decisions with others
who know you well and have a more objective view of your situation.

• Remember that positive thinking will replace negative thoughts as

your depression responds to treatment.
• Continue to educate yourself about depression.
ANXIETY
What Are the Types of Anxiety Disorders?

• There are several recognized types of anxiety disorders, including:
• Panic disorder: People with this condition have feelings of terror that 
strike suddenly and repeatedly with no warning. Other symptoms of 
a panic attack include sweating, chest pain, palpitations (unusually 
strong or irregular heartbeats), and a feeling of choking, which may 
make the person feel like he or she is having a heart attack or "going 
crazy.“
Cont...What Are the Types of Anxiety Disorders?

• Social anxiety disorder: Also called social phobia, social anxiety 
disorder involves overwhelming worry and self‐consciousness about 
everyday social situations. The worry often centers on a fear of being 
judged by others, or behaving in a way that might cause 
embarrassment or lead to ridicule.
• Specific phobias: A specific phobia is an intense fear of a specific 
object or situation, such as snakes, heights, or flying. The level of fear 
is usually inappropriate to the situation and may cause the person to 
avoid common, everyday situations.
• Generalized anxiety disorder: This disorder involves excessive, 
unrealistic worry and tension, even if there is little or nothing to 
provoke the anxiety.
What Are the Symptoms of an Anxiety Disorder?

• Symptoms vary depending on the type of anxiety disorder, but general 
symptoms include:
• Feelings of panic, fear, and uneasiness
• Problems sleeping
• Cold or sweaty hands and/or feet
• Shortness of breath
• Heart palpitations
• An inability to be still and calm
• Dry mouth
• Numbness or tingling in the hands or feet
• Nausea
• Muscle tension
• Dizziness
What Causes Anxiety Disorders?

• The exact cause of anxiety disorders is unknown; but anxiety

disorders ‐‐ like other forms of mental illness ‐‐ are not the result of
personal weakness, a character flaw, or poor upbringing. As scientists
continue their research on mental illness, it is becoming clear that
many of these disorders are caused by a combination of factors,
including changes in the brain and environmental stress.
Cont..What Causes Anxiety Disorders?

• Like other brain illnesses, anxiety disorders may be caused by

problems in the functioning of brain circuits that regulate fear and
other emotions. Studies have shown that severe or long‐lasting stress
can change the way nerve cells within these circuits transmit
information from one region of the brain to another. Other studies
have shown that people with certain anxiety disorders have changes
in certain brain structures that control memories linked with strong
emotions. In addition, studies have shown that anxiety disorders run
in families, which means that they can at least partly be inherited
from one or both parents, like the risk for heart disease or cancer.

• Moreover, certain environmental factors ‐‐ such as a trauma or

significant event ‐‐ may trigger an anxiety disorder in people who
have an inherited susceptibility to developing the disorder.
How Common Are Anxiety Disorders?

• Anxiety disorders affect millions of adult Americans. Most anxiety

disorders begin in childhood, adolescence, and early adulthood.

• They occur slightly more often in women than in men, and occur
with equal frequency in whites, African‐Americans, and Hispanics.
How Are Anxiety Disorders Diagnosed?

• If symptoms of an anxiety disorder are present, the doctor will begin

an evaluation by asking you questions about your medical history and
performing a physical exam.

• Although there are no lab tests to specifically diagnose anxiety

disorders, the doctor may use various tests to look for physical illness
as the cause of the symptoms.
• If no physical illness is found, you may be referred to a psychiatrist,
psychologist, or another mental health professional who is specially
trained to diagnose and treat mental illnesses.

• Psychiatrists and psychologists use specially designed interview and

assessment tools to evaluate a person for an anxiety disorder.
• The doctor bases his or her diagnosis on the patient's report of the
intensity and duration of symptoms ‐‐ including any problems with
daily functioning caused by the symptoms ‐‐ and the doctor's
observation of the patient's attitude and behavior.

• The doctor then determines if the patient's symptoms and degree of

dysfunction indicate a specific anxiety disorder.
How Are Anxiety Disorders Treated?

• Fortunately, much progress has been made in the last two decades in
the treatment of people with mental illnesses, including anxiety
disorders. Although the exact treatment approach depends on the
type of disorder, one or a combination of the following therapies may
be used for most anxiety disorders:
• Medication: Drugs used to reduce the symptoms of anxiety disorders
include anti‐depressants and anxiety‐reducing drugs.
• Psychotherapy: Psychotherapy (a type of counseling) addresses the
emotional response to mental illness. It is a process in which trained
mental health professionals help people by talking through strategies
for understanding and dealing with their disorder.
Cont...How Are Anxiety Disorders Treated?

• Cognitive‐behavioral therapy: This is a particular type of

psychotherapy in which the person learns to recognize and change
thought patterns and behaviors that lead to troublesome feelings.
• Dietary and lifestyle changes.
• Relaxation therapy.
Can Anxiety Disorders Be Prevented?

• Anxiety disorders cannot be prevented; however, there are some 
things you can do to control or lessen symptoms:
• Stop or reduce consumption of products that contain caffeine, such 
as coffee, tea, cola, energy drinks, and chocolate.
• Ask your doctor or pharmacist before taking any over‐the‐counter 
medicines or herbal remedies. Many contain chemicals that can 
increase anxiety symptoms.
• Seek counseling and support if you start to regularly feel anxious with 
no apparent cause.
 GRIEF AND LOSS

• What are grief and loss?

• Grief is a natural response to loss. It might be the

loss of a loved one, relationship, miscarriage, pet,
job or way of life.

• Other experiences of loss may be due to children

leaving home, infertility and separation from friends
and family.

• The more significant the loss, the more intense the

grief is likely to be.
• Grief is expressed in many ways and it can affect every part of your 
life; your emotions, thoughts and behaviour, beliefs, physical health, 
your sense of self and identity, and your relationships with others. 

• Grief can leave you feeling sad, angry, anxious, shocked, regretful, 
relieved, overwhelmed, isolated, irritable or numb.
• Grief has no set pattern. Everyone experiences grief differently. Some 
people may grieve for weeks and months, while others may describe 
their grief lasting for years. 

• Through the process of grief however you begin to create new 
experiences and habits that work around your loss.
 What is grief? 
• Grief is a natural response
to loss. It’s the emotional
suffering you feel when
something or someone
you love is taken away. You
may associate grief with
the death of a loved one –
and this type of loss does
often cause the most
intense grief.
• But any loss can cause grief,
including:
A relationship breakup 
Loss of health 
Losing a job 
Loss of financial stability 
A miscarriage 
Death of a pet 
Loss of a cherished dream 
A loved one’s serious illness 
Loss of a friendship 
Loss of safety after a 
Getting through grief and loss

• Grief is something that takes time to work through. 

• While everyone finds their own way to grieve it is important to have 
the support of friends and family or someone else, and to talk about 
your loss when you need to.
What you can do to help yourself

• Don’t be afraid to ask for help.

• Talk to friends and family about how you are feeling, or consider 
joining a support group.

• Take care of your physical health. Grieving can be exhausting so it is 
important to eat a healthy diet, exercise and sleep.
Cont...What you can do to help yourself

• Manage stress – lighten your load by asking friends, family members 
or work colleagues to help you with some chores or commitments. 
Relaxation and gentle exercise can be helpful.

• Do things you enjoy, even if you don’t really feel like doing them.
How to help a person who is experiencing grief 
and loss

• Many people do not know what to say or do when trying to comfort 
someone who is grieving. However, often it is the simple offer of love 
and support that is the most important.
• Ask how they are feeling. Each day can be different for someone who 
is grieving; take the time to listen and understand what they are 
going through. 
Cont...How to help a person who is experiencing 
grief and loss

• Talk about everyday life too. Their loss and grief does not have to be 
the focus of all your conversations.
• Ask them how you can help. A few home cooked meals, doing the 
shopping, or perhaps offering to go walking or do something 
enjoyable with them can all help someone through their grief.
• Encourage them to get help if their grief does not seem to be easing 
over time.
Common grief reactions

• Reactions to loss, called grief reactions, vary widely from person to 
person and vary in the same person over time. 

• Not every person has the same set of grief reactions, but common 
ones include:
1. Feelings.
2. Thoughts.
3. Physical sensations.
4. Behaviors.
Feelings.

• Feelings. People who have experienced loss may experience a range

of feelings, including shock, numbness, sadness, denial, despair,
anxiety, anger, guilt, loneliness, depression, helplessness, relief, and
yearning. A grieving person may start crying after hearing a song or
comment that makes them think of the person who has died. Or that
person may cry for no apparent reason.
 Thoughts.

• Thoughts. Common thought patterns include disbelief, confusion,

disorientation, difficulty concentrating, preoccupation, and
hallucinations (briefly thinking that you see or hear the deceased
person).
 Physical sensations.

• Physical sensations. It is common for grief to cause physical sensations,

such as tightness or heaviness in the chest or throat, nausea or an upset
stomach, dizziness, headaches, physical numbness, muscle weakness or
tension, and fatigue. It may also cause vulnerability to illness.
 Behaviors
• Behaviors. When a person is grieving, it may be difficult to fall asleep or
stay asleep, and he or she may lose energy for enjoyable activities or
lose interest in eating or interacting socially.

• A grieving person may also become more irritable or aggressive. Other

common behaviors include restlessness, hyperactivity (excessive
activity), and listlessness (lack of interest, energy, or spirit).
The five stages of grief: 
•
• Denial: “This can’t be happening to me.” 

• Anger:“Whyis this happening? Who is to blame?” 

• Bargaining:“Make this not happen, and in return I will ____.” 

• Depression: “I’m too sad to do anything.” 

• Acceptance:“I’m at peace with what happened.” 
 Coping with Grief & Loss 

• Losing someone or something you love is very painful. 

• After a significant loss, you may experience all kinds of difficult and surprising 
emotions, such as shock, anger, and guilt. 

• Sometimes it may feel like the sadness will never let up. While these feelings can 
be frightening and overwhelming, they are normal reactions to loss. 

• Accepting them as part of the grieving process and allowing yourself to feel what 
you feel is necessary for healing. 

• There is no right or wrong way to grieve — but there are healthy ways to cope 
with the pain. 

• You can get through it! Grief that is expressed and experienced has a potential for 
healing that eventually can strengthen and enrich life. 
Coping with grief and loss tip 1

• Coping with grief and loss tip 1: 
• Get support 
• The single most importantfactor in healing from loss is having the 
support of other people.
• Even if you aren’t comfortable talking about your feelings under 
normal circumstances, it’s important to express them 
when you’re grieving. Sharing your loss makes the burden of grief 
easier to carry. Wherever the support comes from, accept it and do 
not grieve alone.
• Connecting to others will help you heal. 
Coping with grief and loss tip 2

• Coping with grief and loss tip 2: 
• Take care of yourself.
• When you’re grieving, it’s more important than ever to take care of 
yourself. 
• The stress of a major loss can quickly deplete your energy and 
emotional reserves. 
• Looking after your physical and emotional needs will help you get 
through this difficult time. 
EATING DISORDER

• Eating disorders are one of the unspoken secrets that affect many 
families. Millions of Americans are afflicted with this disorder every 
year, and most of them ‐‐ up to 90 percent ‐‐ are adolescent and 
young women.

• Rarely talked about, an eating disorder can affect up to 5 percent of 
the population of teenage girls.
Why are teenage and young adult women so 
susceptible to getting an eating disorder? 
• According to the National Institute of Mental Health, it is because 
during this period of time, women are more likely to diet ‐‐ or try 
extreme dieting ‐‐ to try to stay thin. 

• Certain sports (such as gymnastics) and careers (such as modeling) 
are especially prone to reinforcing the need to keep a fit figure, even 
if it means purging food or not eating at all.
There are three main types of eating disorders:

• Anorexia
• Bulimia
• Binge Eating Disorder
Anorexia

• Anorexia (also known as anorexia nervosa) is the name for simply 
starving yourself because you are convinced you are overweight. If 
you are at least 15 percent under your normal body weight and you 
are losing weight through not eating, you may be suffering from this 
disorder.
Bulimia

oBulimia (also known as bulimia nervosa) is characterized by excessive 
eating, and then ridding yourself of the food by vomiting, abusing 
laxatives or diuretics, taking enemas, or exercising obsessively. 

oThis behavior of ridding yourself of the calories from consumed food 
is often called "purging."
Binging

A person who suffers from this disorder can have it go undetected 
for years, because the person's body weight will often remain 
normal. 

"Binging" and "purging" behavior is often done in secret and with a 
great deal of shame attached to the behavior. It is also the more 
common eating disorder.
Eating disorders are serious problems and need to be diagnosed and 
treated like any medical disease. 

If they continue to go untreated, these behaviors can result in future 
severe medical complications that can be life‐threatening.
Treatment of eating disorders nearly always includes cognitive‐
behavioral or group psychotherapy. 

Medications may also be appropriate and have been found effective 
in the treatment of these disorders, when combined with 
psychotherapy.
If you believe you may be suffering from an eating disorder or know 
someone who is, please get help. 

Once properly diagnosed by a mental health professional, such 
disorders are readily treatable and often cured within a few months' 
time.
A person with an eating disorder should not be blamed for having it! 
The disorders are caused by a complex interaction of social, biological 
and psychological factors which bring about the harmful behaviors. 

The important thing is to stop as soon as you recognize these 
behaviors in yourself, or to get help to begin the road to recovery.
 References

Heller, N.R. & Gitterman, A. (2011). Mental Health and  
Social Problems. Routledge London.

Palmo, A. J., Weikel W. J. & Borsos D. P. (2011).   

Foundations of Mental Health  Counseling. 
Fourth Edition.

Sulaigah Baputty, Sabtu Hitam & Sujata Sethi (2008). 

Mental Health Nursing. Oxford University Press.