Specific Mental Health Conditions and Suicide

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Attention Deficit Hyperactivity Disorder:

Attention deficit hyperactivity disorder (ADHD) is a condition characterized by inattention, hyperactivity and impulsivity. ADHD is most commonly diagnosed in young people. An estimated 8.8% of children aged 4-17 have ADHD. While ADHD is usually diagnosed in childhood, it does not only affect children.

Symptoms: Someone with ADHD will have trouble controlling the following behaviors and will show them frequently and for longer than a 6-month period.

Signs of inattention include:

• Becoming easily distracted, and jumping from activity to activity.
• Becoming bored with a task quickly.
• Difficulty focusing attention or completing a single task or activity.
• Trouble completing or turning in homework assignments.
• Losing things such as school supplies or toys.
• Not listening or paying attention when spoken to.
• Daydreaming or wandering with lack of motivation.
• Difficulty processing information quickly.
• Struggling to follow directions.

Signs of hyperactivity include:

• Fidgeting and squirming, having trouble sitting still.
• Non-stop talking.
• Touching or playing with everything.
• Difficulty doing quiet tasks or activities.

Signs of impulsivity include:

• Impatience.
• Acting without regard for consequences, blurting things out.
• Difficulty taking turns, waiting or sharing.
• Interrupting others.

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Obsessive Compulsive Disorder:

Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don’t make sense, they are often unable to stop them.

Symptoms typically begin during childhood, teenage years, or young adulthood, with males often developing them at a younger age than females. 1.2% of U.S. adults experience OCD each year.

Symptoms: Most people have occasional obsessive thoughts or compulsive behaviors. In an obsessive-compulsive disorder, however, these symptoms generally last more than an hour each day and interfere with daily life.

Obsessions are intrusive, irrational thoughts or impulses that repeatedly occur. People with these disorders know these thoughts are irrational but are afraid that somehow they might be true. These thoughts and impulses are upsetting, and people may try to ignore or suppress them.

Examples of obsessions include:

• Thoughts about harming or having harmed someone
• Doubts about having done something right, like turning off the stove or locking a door
• Unpleasant sexual images
• Fears of saying or shouting inappropriate things in public

Compulsions are repetitive acts that temporarily relieve the stress brought on by an obsession. People with these disorders know that these rituals don’t make sense but feel they must perform them to relieve the anxiety and, in some cases, to prevent something bad from happening. Like obsessions, people may try not to perform compulsive acts but feel forced to do so to relieve anxiety.

Examples of compulsions include:

• Hand washing due to a fear of germs
• Counting and recounting money because a person is can’t be sure they added correctly
• Checking to see if a door is locked or the stove is off
• ‘Mental checking’ that goes with intrusive thoughts is also a form of compulsion

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Anxiety Disorders:

We all experience anxiety from time to time. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.

Anxiety disorders are the most common mental health concern in the United States. Over 40 million adults in the U.S. (19.1%) have an anxiety disorder. Approximately 7% of children aged 3-17 experience issues with anxiety each year. Most people develop symptoms before age 21.

Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening. People typically experience one or more of the following symptoms:

• Emotional symptoms:
• Feelings of apprehension or dread
• Feeling tense or jumpy
• Restlessness or irritability
• Anticipating the worst and being watchful for signs of danger
• Physical symptoms:
• Pounding or racing heart and shortness of breath
•  Sweating, tremors and twitches.
• Headaches, fatigue and insomnia
• Upset stomach, frequent urination or diarrhea    

Types of Anxiety Disorders:

• Social Anxiety Disorder:

More than shyness, this disorder causes intense fear about social interaction,
often driven by irrational worries about humiliation (e.g. saying something stupid
or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

• Generalized Anxiety Disorder:

GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.

• Panic Disorder:

This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset. Many people will go to desperate measures to avoid an attack, including social isolation.

• Separation anxiety disorder:

Separation anxiety disorder is characterized by persistent and excessive anxiety during impending separation from the primary caretaker. Other symptoms include repeated nightmares involving the theme of separation, complaints of physical symptoms when separated from major attachment figures and reluctance to go to school or engage in social activities. To meet the criteria for diagnosis, SAD must cause severe impairment in social, occupational or academic settings. Early and traumatic separation from the mother, father or other caretaker is known to be a risk factor for the development of separation anxiety in children.

• Phobia:

For someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

Bipolar Disorder:

Bipolar disorder is a mental illness that causes dramatic shifts in a person’s mood, energy and ability to think clearly. People with bipolar experience high and low moods—known as mania and depression—which differ from the ‘typical’ ups-and-downs most people experience.
The average age-of-onset is about 25, but it can occur in the teens, or more uncommonly, in childhood. The condition affects men and women equally, with about 2.8% of the U.S. population diagnosed with bipolar disorder and nearly 83% of cases classified as severe.

Symptoms: Symptoms and their severity can vary. A person with bipolar disorder may have distinct manic or depressed states but may also have extended periods—sometimes years— without symptoms. A person can also experience both extremes simultaneously or in rapid sequence.

Severe bipolar episodes of mania or depression may include psychotic symptoms such as hallucinations or delusions. Usually, these psychotic symptoms mirror a person’s extreme mood. People with bipolar disorder who have psychotic symptoms can be wrongly diagnosed as having schizophrenia.

• Mania                                                                                                                                                                          

To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania. Hypomania is a milder form of mania that doesn’t include psychotic episodes. People with hypomania can often function well in social situations or at work. Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life; others may experience them only rarely.

Although someone with bipolar may find an elevated mood of mania appealing— especially if it occurs after depression—the “high” does not stop at a comfortable or controllable level. Moods can rapidly become more irritable, behavior more unpredictable and judgment more impaired. During periods of mania, people frequently behave impulsively, make reckless decisions and take unusual risks.

Most of the time, people in manic states are unaware of the negative consequences of their actions. With bipolar disorder, suicide is an ever-present danger because some people become suicidal even in manic states. Learning from prior episodes what kinds of behavior signals “red flags” of manic behavior can help manage the symptoms of the illness.

• Depression                                                                                                                                                                        

The lows of bipolar depression are often so debilitating that people may be unable to get out of bed. Typically, people experiencing a depressive episode have difficulty falling and staying asleep, while others sleep far more than usual. When people are depressed, even minor decisions such as what to eat for dinner can be overwhelming. They may become obsessed with feelings of loss, personal failure, guilt or helplessness; this negative thinking can lead to thoughts of suicide. Depression associated with bipolar disorder may be more difficult to treat and require a customized treatment plan.

Major Depressive Disorder: …

Major Depressive Disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and healthy lifestyle choices, many people can and do get better.

Some will only experience one depressive episode in a lifetime, but for most, depressive disorder recurs. Without treatment, episodes may last a few months to several years.

About 21 million U.S. adults—8.4% of the population—had at least one major depressive episode in 2020. People of all ages and all racial, ethnic and socioeconomic backgrounds experience depression, but it does affect some groups more than others.

Symptoms:

Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:

• Changes in sleep
• Changes in appetite
• Lack of concentration
• Loss of energy
• Lack of interest in activities
• Hopelessness or guilty thoughts
• Changes in movement (less activity or agitation)
• Physical aches and pains
• Suicidal thoughts

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Schizophrenia:

Schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness. The exact prevalence of schizophrenia is difficult to measure, but estimates range from 0.25% to 0.64% of U.S. adults.

Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It is possible to live well with schizophrenia.

Symptoms: It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include:

• a change of friends
• a drop in grades
• sleep problems
•  irritability
• common and nonspecific adolescent behavior                                      

Other factors include:

• isolating oneself and withdrawing from others
• an increase in unusual thoughts and suspicions
• a family history of psychosis.   In young people who develop schizophrenia, this stage of the disorder is called the “prodromal” period. With any condition, it’s essential to get a comprehensive medical evaluation in order to obtain the best diagnosis.

For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning for a least 6 months:

• Hallucinations. These include a person hearing voices, seeing things, or smelling things others can’t perceive. The hallucination is very real to the person experiencing it, and it may be very confusing for a loved one to witness. The voices in the hallucination can be critical or threatening. Voices may involve people that are known or unknown to the person hearing them.
• Delusions. These are false beliefs that don’t change even when the person who holds them is presented with new ideas or facts. People who have delusions often also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.
• Negative symptoms are ones that diminish a person’s abilities. Negative symptoms often include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression.
• Cognitive issues/disorganized thinking. People with the cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts or complete tasks. Commonly, people with schizophrenia have anosognosia or “lack of insight.” This means the person is unaware that he has the illness, which can make treating or working with him much more challenging.

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Substance Use Disorder:

Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequences. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day-to-day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.

Symptoms of substance use disorder are grouped into four categories:

• Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use.
• Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use.
• Risky use: substance is used in risky settings; continued use despite known problems.
• Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance).

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Conduct Disorder:

Conduct Disorder refers to a group of behavioral and emotional problems in children and adolescents. Individuals with a conduct disorder have excessive difficulty following rules and behaving in a socially acceptable way. They tend to be impulsive, hard to control, and not concerned about the feelings of other people.

• Individuals with a conduct disorder have a repetitive and persistent pattern of behaviors that fall into four major groupings, including: aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules.
• It is common for children with a conduct disorder to have coexisting conditions such as mood disorders, anxiety, PTSD, substance abuse,
• ADHD, or learning problems                                      

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Autism Spectrum Disorder:

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave.

People with ASD often have:

• Difficulty with communication and interaction with other people
• Restricted interests and repetitive behaviors
• Symptoms affecting their ability to function in school, work, and other areas of life.

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Suicide:

Suicide is defined as the act of killing oneself.

Although commonly defined as death caused by injuring oneself with the intent to die, the majority of people who feel suicidal do not actually want to die; they just want the situation they’re in or the way they’re feeling to stop.

Frequently suicide occurs in the context of a major depressive episode, but it may also occur as a result of a substance use or other disorder. It sometimes occurs in the absence of any psychiatric disorder, especially in untenable situations, such as extreme or prolonged bereavement or declining health.

In 90% of suicide deaths, the person also had a mental health condition.

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Other Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046577/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181951/

https://www.news-medical.net/health/The-Genetics-of-Mental-Disorder.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573560/

https://med.stanford.edu/depressiongenetics/mddandgenes.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820161/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477224/

https://www.apa.org/topics/suicide

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