DEPRESSIVE DISORDERS

These includes disruptive mood dysregulation disorder,major depressive disorder(including major depressive episode),persistent depressive disorder(dysthymia), substance/medication induced depressive disorder, premenstrual dysphoric disorder,depressive disorder due to another medical condition, other depressive disorder and unspecified depressive disorder.The common feature of all these disorders is the presence of sadness,emptiness or irritable mood, accompanied by somatic and cognitive changes that significantly affects the individual’s capacity to function.

 

A depressive disorder is an illness that involves the body,moods and thoughts of a person. Through co-ordination of these 3 major aspects, the body undergoes a process of disposition. The changes can either be temporary or permanent.

Almost everyone has experienced depression, at least in it’s milder and more temporary forms.Loosing something or experiencing pain,whether it’s mild or severe serves as the most inevitable parts of our lives.Our bodies totally reacts to a different kind of abnormality.We suddenly feel mirthless, discouraged and apathetic about our own lives.The future seems so unclear and the splintering motion distorts every thought we have.

A research was conducted by (Seligman,1991).He stated that 25-30% of college students experience mild depression but the feelings usually fades with time in correspondence with the events that has taken place. (Oakley and Jenkins,1992)  argued that the frequency intensity and the duration of depressive symptoms are out of proportion to the person’s life situation.For example, some people might respond to a minor setback aggressively and end up developing an intense major depression that leaves them vulnerable and totally out of control of their lives.Some people experience develop/exhibit a less intense form of depression known as Dysthymia. Even though the Dysthymia might create an impression of less severity,due to its impact on personal and occupational functioning but outrageously,it is masked inflammatory type of depression.It is more chronic and long lasting form of misery, occurring for months and can even be elevated to years.
How would you define depression?…depression is a first and foremost to mood.This might vary from slight disconsolate expression to utter misery and dejection.Depression can also be used as an indicating element of an illness which prevent the sufferer from functioning and requires active treatment to restore the body and mind to a state of health.What is usually shared between the victim and the relatives/acquaintances is the inner state.What is shared is the symptoms and manifestations;which is an exact description or the nature of the condition itself and is usually outside the understanding of the sufferer and those close to him.Personal awareness and communication of the depressive state go through successive phases.

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psychodiagnosis;The classification of Disorders

Psychopathology is a wide field of mental disorders ranging from anxiety disorders to mood disorders.For us to  be able to distinguish the various existing disorders ,we need to understand the ailments at their individual level from their  diagnosis to prognosis to their treatments.Mental disorders differ in their manifestations,their severity and the duration in which they occur.These disorders vary at different degrees and thus clinicians and other renown scientists (e.g Williams,1999) sought to discover a much simpler way of classifying and grouping the mental disorders so as to make their understanding easier.The principles and rules of taxonomy still applies here,and its main purpose is to bring some order which at first seems as host of diverse phenomena.If the taxonomy turns out to be valid,then disorders which have similar conditions,prognosis and treatment will be classified as one.

Mental disorders need not to be treated differently from the physical illnesses this is because both of them undergo a process of disposition from normality.In psychopathology,the diagnostic process begins with a clinical interview where the doctor asks the patient to describe his/her problems and observes the patient throughout.As a result,the patient will respond on how they feel  (complaints) which builds up the symptoms.Patients who say“i feel tired all the time” or “I feel isolated” are actually providing symptoms.The practitioner then looks for signs which  might accompany those symptoms i.e shaking of hands,anxiety,or even having teary eyes will eventually give a hint on what the patient might probably be suffering from.Sometimes the symptoms do  not correspond to the signs and therefore such discrepancies should not be taken lightly.An example of such is that a patient might state“my head aches a lot,its like I’m being hammered on”,such a statement seems so intense and what is expected of that particular patient is to behave in a certain manner that depicts pain.But what if this patient says that statement  with full of confidence and in a more calm way?,would you still reconsider that statement?

The full pattern of the patient’s signs and symptoms provide an embodiment at which the practitioner uses to render his opinion about a particular disorder and this opinion is termed as Diagnosis.The diagnosis serves as the practitioner’s best  judgment about the patient’s condition.From this information,outlook for the patient,suggestions of the most effective treatments and even the disorder’s etiology can be implied.

There are many disorders and as at 1952, the American Psychiatric Association unveiled the DSM-I and as a result almost 100 disorders were described.Revisions intended to improve the systems were incorporated into the second edition published in 1968,but the diagnostic guidelines were pretty sketchy.However the third edition(DSM-III) was published in 1980,represented a major advance,as the diagnostic criteria were made much more explicit,concrete,and detailed to facilitate more consistent diagnosis amongst clinicians.(please infer on DSM-V which has been recently updated,this version describes about 5 times as many types of psychological disorders as DSM-I )

These are some of the classifications of mental disorders according to DSM-5;

1.Depressive Disorders

2.Bipolar and Related Disorders

3.Anxiety Disorders

4.Schizophrenia Spectrum and other Psychotic Disorders

5.Obsessive Compulsive and Related Disorders

6.Trauma and Stressor Related Disorders

7.Neurodevelopmental Disorders

8.Dissociative Disorders

9.Somatic Symptom and Related Disorders

10.Feeding and Eating Disorders

11.Elimination Disorders

12.Breathing- Related and Sleep Disorders

13.Sexual Dysfunctions

14.Disruptive Impulse-control and Conduct Disorders

15.Gender Dysphoria

16.Substance Related and Addictive Disorders

17.Neurocognitive Disorders

18.Non-Substance Related Disorders

19.Personality Disorders

20.Paraphilic Disorders

21.Other Mental Disorders

DIFFERENT CONCEPTIONS OF PSYCHOPATHOLOGY

There are quite a number of views in which psychopathology can be understood and it has been clearly depicted to have improved over the years.This is because of emergence of skilled personnel who have engaged themselves in trying to explain what mental illness really entails.There are five approaches on how mental illness was perceived and i will briefly discuss them in a clearly transformed texts with respective to the events as deployed by the time they occurred.

  1. Psychopathology as a Demonic Possession:

What leads to mental disorder? one of the earliest theories stated that the afflicted person was possessed by evil spirits.It followed  that the cure for such a malady was to drive the devils out and so one of the earliest approaches was merely to provide them with a physical escape route.According to some anthropologists,this may explain why Stone Age people sometimes cut large holes into their fellows’ skulls; many such trephined  skulls have been found,often with a sign that tried to survive the operation.

 

verano_trepanned_inca_skull_72  An example of a trephined skull

Later treatment regimens attempted to calm the unruly demons by music,to chase them with prayers/excorcisms, or even to purge them with ematics(potions that induce vomiting) or laxatives.

Accordingly, patients were variously chained,starved,flogged, immersed in ice or boiling water.It came to surprise a lot of people that none of the treatments was particularly effective and patients were often driven into worse and worse derangement.

    2.Psychopathology as a disease:

This demonological theory of mental abnormality is largely a thing of the past.Even in the old era,during the plague-ridden middle Ages,there was an alternative view that such condition were actually kinds of diseases (Allderidge,1979;Neugebauer ,1979). Regrettably ,this belief usually did not lead to more humane treatment of the afflicted.The diseased “mad men” were treated with little sympathy.There was no common bond with humanity hence considered nuisances at best and menaces at worst.After that,a number of hospitals were established throughout Europe.These hospitals,most were for purpose of public figure only (Name Sake).Their real function basically was to confine all kinds of social undesirable and isolate them from the rest of human kind.

Criminal beggers and the epileptics,incurables of all sorts were institutionalized and treated the same way as mentally disturbed(Rosen,1966).The treatments were barbaric and in-human and very few patients could survive.

One author described conditions in the major mental hospital for Parisian women at the end  of 18th century. 

            Mad women seized by fits of violence are chained like dogs at their cell doors,and separated from keepers and visitors alike by a long corridor protected by an Iron grille,through this grille is passed their food and the straw on which they sleep;by means of rakes,part of the filth that surrounds them is cleaned out”.(Foucalt,1965 pg.72)

*The life of philippe pinel (1745-1826) favoured people from a higher social class more preferentially than those who were then referred to as “peasants”.

    3.Mental Disorder As an Organic Illness:

Pinel and other reformers had a similar mind autonomy or theme of “madness” to be a disease.This strongly implied that inmates were patients needing treatment rather than animals deserving confinement.But if these patients had a disease or rather diseases,since people were already aware of the varieties of mental illness,the question being debated is “what is the cause?”.At first,the notion of mental disorder as an illness suggested an organic or bodily cause,most likely from within the brain.Proponents of this somatogenic hypothesis could point the obvious effects of stroke in impairing speech,clear evidence that a disorder in the brain can affect the psychological functioning of the whole body.But the somatogenic position gamed it’s greatest impetus at the end of the 19th century ,thanks to the discovery of a debilitating disorder known as General Parensis.This disorder is characterised by a general decline in physical and psychological functions culminating in an abnormal behaviour marked by personality aberrations that may include childish delusions i.e “I am the President of the United States” or profound hypochondriacal depressions such as “My heart has stopped beating” or “My head is falling”.Without a proper medication,this disorder/illness can build up and paralysis ensues as a result,death may occur within a few years.

  4.Mental disorder as a Psychological illness.

The achievements of the somatogenic approach were impressive,but at the end of 19th century,it became clear that this approach could not explain the full spectrum of mental disorders.An example of such illness is hysteria which refers to a group of presumably psychogenic disorders including conversion disorders and dissociative disorders.Since ‘DSM-III’ ,it is no longer used as a diagnostic category in part because of an erroneous implication that the condition is more prevalent in women.

DSM-III:The diagnostic manual of the American Psychiatric Association adopted in 1980.A major distinction between it and it’s predecessor is that it categorizes mental disorders by their descriptive characteristics rather than by theories about their underlying cause.

The study of hysteria currently known as conversion disorder,was crucial in leading Freud to develop his theories on psychopathology.Patients with hysteria had odd complaints that seemed organic but did not conform to the clinical picture of organic disorders.For example,hysterics would appear with limbs that were “Paralyzed”.Under hypnosis,however,the patients would move their limbs perfectly well at the hypnotist’s suggestion ,indicating that the nerves and muscles were fully functional.From this clear statement,it seemed so logical that hysteria was a psychological disorder,that  is a disorder whose origin were psychological rather than organic.A number of cases studied by French hypnotists of the 19th century appeared to originate in traumatic incidents.For example ,one patient trapped underneath a derailed railroad car developed hysterical paralysis of his legs.His legs were in a perfect physical condition,but his belief that his leg has been completely crushed ultimately produced his symptoms.We will turn to the modern conception of conversion disorder later.For now,the important point is that by 1900,most theorists had become convinced that hysteria was psychogenic.In other words,these were illnesses that did not conform to a strictly somatogenic account.

  5.Modern conception of Psychopathology:

The perception of mental illness has changed over the years and people look at it now from a broader perspective that it is a reality and it is also accompanied by a logical explanation as to why it is in existence.We also have to accept these people who suffer from these mental ailments as normal beings just like us who  need to be treated in a more compassionate and affectionate manner.Currently,over 50,000 institutions across the globe has been established to offer medical assistance to these afflicted persons.Non-governmental organisations too has been formed to insight positively and to create awareness regarding these Psychopathological disorders.It is with no doubt that when we converge in harmony and understand one another and accept that being different is something we should appreciate then the world would be a better place to live.

MALADJUSTMENT

Are we aware of mental illness? And if so,have we learnt to accept their existence?
In this topic,we will discuss how we,the advocates of scrutiny view mental illness and we’ll also look at the various conceptions of psychopathology as a whole.

In our own sophistication,we have quite a little difficulty in accepting the concepts of mental illness intellectually.We tend to develop a mechanism of self denial and to some extent,we fail to understand ourselves hence we look for validation from others and how they think/view about the matter in subject.Emotionally, many of us do not accept mental illness as being relative to our own lives.

Mentally deranged persons are not a class apart from other people.The average visitor to a mental hospital is usually surprised on how those patients seem to be normal and in perfect condition.Some of course, have been given drugs and others are just pitiful of themselves because they feel that no one should see them in that particular condition,so they tend to hide it away and act normal.

These are possible relationships of living conditions to mental health:
-A study of mental illness in urban poverty communities provides a self-explanatory data which supports the relationship between striving and mental health.
This study involved interviews from 3000 culturally deprieved people about their; Plans,ambitions,opportunities,failures and fears involved in their lives.The data were consistent from information obtained from other studies in that disturbed people set themselves unreasonably high/low goals compared to those of normal subjects.The mentally ill seek higher goals than they can achieve and experience periodically higher levels of self-imposed stress.

-Living under crowded conditions,and trying to work things out or to pave oneself in terms of opportunities promptly exaggerates mental problems that under a better psychological climate could be adjusted.Striving to achieve under unfavourable opportunities creates stress which forces an individual to give up in what he/she intends to do and instead seek refuge in other places.

Different people have different conceptions of mental illness and as result it leads to social misfit which prevents us to know the real story behind madness.

Mental disorders existed long before there were mental health professions.One of the earliest known medical documents , The Eber Papyrus (written about 1900 B.C) refers to mental disorders being relative to depression. (Andersen and Black,1996)

-The Greek hero, Ajax , slew a flock of sheep that he mistook for his enemies.
-King Soul of Judea alternated between bouts of homicidal frenzy and suicidal depression; Such phenomena were evidently not isolated instances.
-According to the Bible, young David feigned madness while seeking refuge from his enemies at a court of Philistine King. This king suprisingly had obviously encountered Psychopathology before and uphraided his servants:

 

Do i lack madmen?, that you have brought this fellow to play the madmen in my presence?

Those are quite a number of relating stories about the existence of mental disorders centuries back.Mental disorders is not something that has come to existence in the modern world,it is aged phenomena and we have to understand and accept the fact that it exists.

Psychopathology

INTRODUCTION

Ella is an islander,coming from Guam to America, Chicago to be exact.She left her father, stepmother and two brothers behind.This is where the madness started conquering Ella’s soul.In Chicago,she leaves with her two sisters,her mother and her stepfather.But since Ella is the oldest sister, the two younger ones dominate the house.This makes Ella feel unloved and not special at home. Four years later,the voices in her head start to get louder and more violent.Kylie,her only cousin ,is the only person she could talk about this to.She felt she could trust her.But unfortunately,Kylie was very innocent then and she thought that Ella was actually jocking.Days went by and it reached a point when the voices started ordering Ella to kill herself. Can Kylie or the doctors help her? Or will she give in to the little people inside her head?

“Black Rose” by Iced Burito

From the above short story, we could see that Ella was an advocate of a certain type of mental illness known as Schizophrenia.She was torn in between thoughts and emotions and she didn’t have anyone who could understand her situation.We will discuss more about this disorder as we progress later on in this directive.

But before proceeding to talk about other aspects of this topic,we have to understand what the term “psychopathology” or to those  who would like to refer it as “Abnormal Psychology” means.

-Psychopathology refers to the study of mental disorders.

-It can also be defined to some extent as a question of statistical deviance.For example,most of us have occasionally heard someone talk to us or call our names, only to discover, when we turned around,that no one was actually there.In the statistical deviance view, hearing voices once a year might be normal,but hearing them thrice or even on continous progessive sequences in a day ,then that might be diagnosable.