Mental Illness - Other types of mental disorders
There are a number of other mental or psychological disorders that afflict millions of people each day. These can range from disorders most often appearing in old age, such as Alzheimer's disease, to gender-identity disorders, in which people wish to be members of the opposite sex. Eating disorders are also a common mental illness. [For more information on eating disorders, see Chapter 13: Eating Disorders.]
What follows is a small sampling of other common psychological disorders.
Somatoform Disorder
Sometimes people will complain of pain or discomfort that lingers but, when these individuals seek medical treatment, doctors can find no physical cause for the symptoms. When this persists, and the pain and discomfort prevent a person from participating in day-to-day life, a mental health professional may diagnose that person with pain disorder, which is just one of several somatoform disorders. Somatoform disorders are psychological disorders that manifest themselves physically without the presence of a true physical ailment.
Somatoform disorders can include conversion disorders, which can result in sudden loss of vision (once called hysterical blindness) or paralysis. People have also been known to lose their senses of hearing and smell as well. Another somatoform disorder is body dysmorphic disorder (BDD). While many people would like to change something about themselves (such as being more muscular, having smaller ears, having straight or curly hair, being taller or shorter, etc.), people with BDD grossly exaggerate what they perceive to be flaws with themselves and spend hours obsessing about these so-called flaws. Some BDD sufferers even take measures to act upon their impulses by picking at their skin (if they think they have too many blemishes) or getting plastic surgery unnecessarily.
As with many other mental disorders, there is no single theory that can account for why certain people develop somatoform disorders while others do not. Oftentimes, a person will recover suddenly from the problem while others require therapy. Behavior therapists will use techniques that center around making it appealing for a person to abandon his or her symptoms. Other therapists have used techniques similar to those used on people with phobias, wherein the patient will be exposed to the cause of the stress in order to diminish its effect.
Dissociative Disorder
When someone dissociates, it means that a certain behavior or part of the personality becomes removed from the rest of his or her consciousness. This can be something as harmless as becoming preoccupied while listening to a song on a portable stereo while walking and then not remembering which route was taken upon arriving at a destination. However, dissociation can also be a very serious problem and several disorders are attached to this phenomenon.
BARON VON MUNCHAUSEN AND MENTAL ILLNESS
Baron Von Munchausen was an eighteenth-century German huntsman and soldier known for telling greatly exaggerated tales about his exploits. Because of his reputation and the publication of tales based on his anecdotes (written by Rudolph Erich Raspe), the name Munchausen is now associated with exaggeration. So it came to be that when people faked symptoms of illnesses or parents faked the illnesses of their children, those disorders were named the Munchausen syndrome and Munchausen-by-proxy syndrome, respectively.
Although Munchausen syndrome and Munchausen-by-proxy syndrome are still recognizable names and in use, the proper clinical terms for these somatoform disorders are malingering (in the case of an individual who fakes illness in order to avoid doing something or to receive attention) and factitious disorder (in which a parent or guardian lies about a child's medical history and current condition in order to make others believe the child is ill). Both syndromes go beyond fibbing; they are serious psychological disorders, and both have consequences that affect others.
In the case of malingering (or Munchausen syndrome), a healthy individual is wasting the time of medical professionals and perhaps even taking up valuable bed space in a hospital. Factitious disorder (or Munchausen-by-proxy syndrome) can threaten the life of an otherwise healthy child because the disturbed caretaker may even go so far as to injure the child or taint blood or urine specimens to sustain the illusion of illness. Most often, sufferers from factitious disorder do what they do based on a warped need for attention from others and the desire for an abnormally intense and dependent relationship with the child.
DISSOCIATIVE AMNESIA. Dissociative amnesia, which occurs when a person cannot remember personal information, such as where a person has been, who a person is, or even entire conversations. Often this is prompted by a stressful event, such as abuse, a traumatic experience similar to those detailed in the section on PTSD, or the death of a loved one. Memory loss is the primary symptom of this disorder, which is more common among young adults.
DISSOCIATIVE FUGUE. Dissociative fugue (pronounced fyoog) is a particularly disturbing mental phenomenon as it involves one or more instances of a person leaving their normal, everyday life for a period of time and taking up a new life, with no recollection of their former life. Like dissociative amnesia, fugues are often triggered by traumatic events and are often fueled by unfulfilled wishes. An individual in the midst of a fugue will often leave home, abandoning all aspects of his or her life, and assume a new identity in another place. A fugue can last hours or days or longer.
DISSOCIATIVE IDENTITY DISORDER. Dissociative identity disorder, or DID (formerly known as multiple personality disorder, or MPD), involves an individual having two or more identities or personalities that are in control of an individual's behaviors and thoughts at different times. A controversial diagnosis (as it violates the basic belief that only one person can inhabit a body), people diagnosed with DID will often have a variety of personalities that are very different from one another and that may be in opposition to one another. For example, one personality may require an individual to wear glasses in order to see clearly, while another personality will not wear glasses. Or one personality may be left-handed whereas the other(s) are right-handed. DID usually begins in childhood and is often the result of severe trauma or an individual's repressing, or keeping back, strong feelings and desires.
Because of the association of the concept of repression (holding back painful memories) with dissociative disorders, psychoanalytic therapists seem to have good success in treating these disorders (for an explanation of the principles of psychoanalysis, see Chapter 15: Mental Health Therapies). Hypnosis may be also be used by psychoanalysts to help uncover forgotten memories in order to get to the root of why individuals disconnect from themselves.
Personality Disorders
People have different personalities (one's behavioral and emotional traits). Many people, however, share a type of personality, which means they have certain tendencies. For example, an individual who is sensitive to criticism might have an avoidant personality type. This is perfectly acceptable unless that person's behavior is extreme, thereby presenting problems in personal relationships and the ability to function in society. If one avoids people in social and work-related situations out of fear of being criticized or rejected; shies away from getting close to other people for fear of being made fun of; has low self-esteem; and is painfully shy and standoffish, that person might have an avoidant personality disorder. In other words, the difference between a personality type and a personality disorder is that the disorder separates people from others and the separation can prevent them from being happy and successful.
There is a wide range of personality disorders. There is the histrionic personality disorder, in which an individual needs to be the center of attention; behaves inappropriately (making sexual comments, for example); wears revealing clothes; is overly dramatic; is easily influenced by other people or events; and exaggerates how emotionally close one actually is to another person.
Dependent personality disorder is marked by an overwhelming need for advice and reassurance from others; being unable to disagree with others for fear he or she will no longer be liked; having a lack of initiative and self-direction; and showing an unusual need for close relationships along with a fear of being alone.
MENTAL ILLNESS IN THE MOVIES
Over the years, a great number of films have presented audiences with characters struggling with a mental illness. Sometimes, filmmakers are able to humanize the face of mental illness and demystify it by showing everyday people triumphing over a disorder. Other times, filmmakers have reached into the darkest depths of the human psyche and created terrifying characters with mental problems so severe that the individuals are a threat to others and themselves. The following films include characters with varying degrees and types of mental illness:
Benny and Joon
Cape Fear
Desperately Seeking Susan
Fatal Attraction
Girl Interrupted
Good Will Hunting
Hamlet
High Anxiety
I Never Promised You a Rose Garden
One Flew over the Cuckoo's Nest
Ordinary People
Primal Fear
Psycho
Rainman
Silence of the Lambs
Spellbound
Splendor in the Grass
Sybil
The Glass Menagerie
The Other Sister
The Prince of Tides
The Three Faces of Eve
Vertigo
What's Eating Gilbert Grape?
Other personality disorders include the paranoid personality disorder (which involves constant distrust and suspicion of other people; thinks others are "out to get them."). There is also the schizoid personality disorder (in which people are removed from social contact with others and have problems experiencing and expressing emotion). Another is the borderline personality disorder (wherein an individual is unstable in relationships with others, has poor self-image and extremist thinking, and is very impulsive). Lastly, there is the narcissistic personality disorder (wherein an individual is overly conceited, having an abnormal need for admiration and lack of empathy for others).
Personality disorders are treated differently, depending upon which type of disorder is present. The difficulty lies in the fact that personality disorders carry risks with them that can affect treatment and a person's personal safety. For instance, people with severe personality disorders often engage in high-risk behavior, such as excessive drinking or taking illegal drugs. Furthermore, they are particularly vulnerable to psychiatric breakdowns, are less likely to take medications prescribed to them in the proper manner, and have a hard time taking responsibility for their behavior or trusting their mental health care provider.
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