Mental Disorders

What is Mental Disorders?

Most people do not have access to effective care. A mental disorder is characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour. It is usually associated with distress or impairment in important areas of functioning. There are many different types of mental disorders.  Mental disorders may also be referred to as mental health conditions. The latter is a broader term covering mental disorders, psychosocial disabilities and (other) mental states associated with significant distress, impairment in functioning, or risk of self-harm.  This fact sheet focuses on mental disorders as described by the International Classification of Diseases 11th Revision (ICD-11).

In 2019, 1 in every 8 people, or 970 million people around the world were living with a mental disorder, with anxiety and depressive disorders the most common (1). In 2020, the number of people living with anxiety and depressive disorders rose significantly because of the COVID-19 pandemic.  Initial estimates show a 26% and 28% increase respectively for anxiety and major depressive disorders in just one year (2). While effective prevention and treatment options exist, most people with mental disorders do not have access to effective care. Many people also experience stigma, discrimination and violations of human rights. 

What is Depression?

Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life.  During a depressive episode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day, for at least two weeks. Several other symptoms are also present, which may include poor concentration, feelings of excessive guilt or low self-worth, hopelessness about the future, thoughts about dying or suicide, disrupted sleep, changes in appetite or weight, and feeling especially tired or low in energy. People with depression are at an increased risk of suicide. Yet, effective psychological treatment exists, and depending on the age and severity, medication may also be considered. 

Researchers have noted differences in the brains of people who have clinical depression compared with those who do not. For instance, the hippocampus, a small part of the brain that is vital to the storage of memories, appears to be smaller in some people with a history of depression than in those who've never been depressed. A smaller hippocampus has fewer serotonin receptors. Serotonin is one of many brain chemicals known as neurotransmitters that allow communication across circuits that connect the brain regions involved in processing emotions.

Scientists do not know why the hippocampus may be smaller in some people with depression. Some researchers have found that the stress hormone cortisol is produced in excess in depressed people. These investigators believe that cortisol has a toxic or "shrinking" effect on the development of the hippocampus. Some experts think depressed people may be simply born with a smaller hippocampus and are thus inclined to have depression. There are many other brain regions, and pathways between specific regions, thought to be involved with depression, and likely, no single brain structure or pathway fully accounts for clinical depression.

One thing is certain: Depression is a complex illness with many contributing factors. The latest scans and studies of brain structure and function suggest that antidepressants can exert "neurotrophic effects," meaning that they can help sustain nerve cells, prevent them from dying, and allow them to form stronger connections that withstand biological stresses. As scientists gain a better understanding of the causes of depression, health professionals will be able to make better "tailored" diagnoses and, in turn, prescribe more effective treatment plans.

What is Anxiety Disorders?

Many people suffer from anxiety. Anxiety disorders are characterised by excessive fear and worry and related behavioural disturbances. Symptoms are severe enough to result in significant distress or significant impairment in functioning. There are several different kinds of anxiety disorders, such as: generalised anxiety disorder (characterised by excessive worry), panic disorder (characterised by panic attacks), social anxiety disorder (characterised by excessive fear and worry in social situations), separation anxiety disorder (characterised by excessive fear or anxiety about separation from those individuals to whom the person has a deep emotional bond), and others. Effective psychological treatment exists, and depending on the age and severity, medication may also be considered.In the case of an anxiety disorder, the feeling of fear may be with you all the time. It’s intense and sometimes debilitating.

This type of anxiety may cause you to stop doing things you enjoy. For example, it may prevent you from entering an elevator, crossing the street, or even leaving your home in extreme cases. If left untreated, the anxiety will keep getting worse.

Anxiety disorders are the most common form of emotional disorder and can affect anyone. But, according to the American Psychiatric Association, women are more likely than men to receive a diagnosis of an anxiety disorder.

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Causes

The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited

Complications

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

• Depression (which often occurs with an anxiety disorder) or other mental health disorders
• Substance misuse
• Trouble sleeping (insomnia)
• Digestive or bowel problems
• Headaches and chronic pain
• Social isolation
• Problems functioning at school or work
• Poor quality of life
• Suicide

 traits also can be a factor

Examples of medical problems that can be linked to anxiety include:

• Heart disease
• Diabetes
• Thyroid problems, such as hyperthyroidism
• Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
• Drug misuse or withdrawal
• Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
• Chronic pain or irritable bowel syndrome
• Rare tumors that produce certain fight-or-flight hormones