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MODULE TWO -- Defining the Illnesses
A Suggested Learning Objective: Learners will begin to understand how inaccurate portrayals and stereotypes of mental illnesses create barriers to medical treatment.
1. Lesson Plan: Mental Illnesses Myths and Stereotypes- Through class discussion, make a list of recent movies, books, or television characters that portray -- accurately or inaccurately -- persons with mental illnesses. Use the handout, Destroying the Myths and Stereotypes, to discuss and determine the accuracy of each portrayal. (20 minutes)
2. Mental Illnesses Terms and Definitions Discussion--Through classroom or small group discussion, compile a list of words and expressions used to describe mental illnesses. Use the Mental Illnesses Terms and Definitions Discussion Guide to start the discussion. Ask for individual or group definitions and then check the definition provided in the glossary. Score the class, the groups or the individuals according to the number of correct definitions. (30 minutes)
Assignment: Copy and distribute for review the Fact Sheets provided in Module Three. Advise students that the next class will begin with a brief quiz on the disorders.
Background: Discussion Guide
Visuals/Handouts: Destroying the Myths and Stereotypes
Spread The Words: A Mental Illnesses Glossary
DISCUSSION GUIDE: Mental illnesses - Terms and Definition
Sample Question: What are some of the slang terms that were used to describe someone with mental illness? Examples: maniac, psycho, schizo, crazy, paranoid, wacko.
Sample Answer: Many of these terms are still used today. Unfortunately, such careless use creates negative impressions about the people suffering from mental illnesses and misunderstanding of the illnesses themselves. The term paranoid is a good example. Paranoia is in fact a rare condition characterized by the gradual development of intricate, complex and elaborate systems of thinking based on (and often proceeding logically from) misinterpretation of actual events. But we too frequently use the term to describe any unexplained fear or normal anxiety. Another example is schizophrenia. Many of us confuse schizophrenia, a severe disorder characterized by disturbances of language, communication and thoughts, with multiple personality disorder, an emotional state in which a person adopts two or more personalities. Because of the "misuse" of psychiatric terms by many in society, including the advertising and entertainment industry, many illnesses continue to be misunderstood and many people hesitate to seek treatment.
Sample Question: Why do people use "slang" to describe people with mental illnesses?
Sample Answer: Some of the slang terms have been generated by misunderstanding and confusion about what mental illnesses are. Mental illnesses are, in many cases, illnesses of the brain. Because the brain is the center for behavior as well, people confuse the illnesses with the behavior. It is no more appropriate to describe a person with mental illness in derogatory terms than it is to use similar terms for a person who suffers from diabetes, high blood pressure or cancer.
DESTROYING THE MYTHS AND STEREOTYPES
Spread The Words
Schizophrenia is not "split personality." It is a severe mental illness that affects a person's ability to think and distorts his/her sensory perceptions. It tends to be inherited, and current research links it to abnormalities in brain structure. Multiple personality disorder is the illness that causes a person to adopt two or more distinct personalities. People with MPD usually have a sudden, temporary change in their consciousness, identity and behavior when they switch from one personality to another.
Mental illnesses do not make people into evil geniuses. People with mental illnesses -- like other people with disabilities -- are far more likely to be victims of crime than they are to be criminals. While they concentrate on coping with the stresses of their illness, these people often fail to act prudently. As a result, they are prey for personal attacks or con artists.
Psychosis is not a permanent state. Most often it is a transient condition. People suffering from mental illnesses involving psychosis -- such as schizophrenia -- do have periods when they are lucid and free of delusions and hallucinations. With proper management, including medications, the majority of these patients can permanently end the occurrence of psychosis.
The symptoms of most mental illnesses can be controlled with appropriate use of psychiatric medications. Like all medications, psychiatric prescriptions must be tailored to each patient. Age, size, weight and other factors determine the most effective dosage and adjustments take time. As with any other medication, psychiatric prescriptions can have side effects, most of them minor. When treatment is successful, most patients consider the side effects negligible compared to the anguish of suffering an untreated mental illness.
Psychiatrists and psychologists are not the same. Psychiatrists are physicians who have completed medi- cal school and specialized in the diagnosis and treatment of mental illnesses by successfully completing a four-year residency in psychiatry. Psychiatrists have the medical knowledge to determine what other physical conditions may be affecting the patient and what course of treatment will be most effective, including whether medications are necessary. A psychologist holds a degree in psychology, which is an academic discipline, a profession and a science dealing with the study of mental processes and behavior. Clinical Psychologists are licensed under state law. They generally hold a doctoral degree in psychology and have two years of supervised work experience. Psychiatrists and psychologists often work closely together in hospitals and other treatment settings.
No one -- not even a psychiatrist -- can predict behavior. A psychiatric diagnosis is no more likely to indicate or predict certain behaviors or outcomes than any other medical diagnosis. A diagnosis of a specific mental illness can affect each patient differently.
SPREAD THE WORDS
A Mental Illnesses Glossary
The following glossary has been excerpted from The American Psychiatric Glossary.
addiction - Dependence on a chemical substance to the extent that a physiological or strong psychological need is established. The need appears as withdrawal symptoms when the substance is removed. Narcotics, alcohol, nicotine and most sedative drugs may produce addiction.
AIDS-related dementia - One of the syndromes commonly associated with infection by the AIDS virus. AIDS-related dementia, which is caused by the disease's effect on the central nervous system, usually begins with impaired concentration and mild memory loss and is often misdiagnosed as depression or as a psychological response to the threat of impending death. Over a period of several weeks or months, the syndrome causes severe deterioration in mental functioning and motor control.
alcoholism - A chronic illness evidenced by compulsive, repeated drinking that injures one's health and social and economic functioning.
Alzheimer's disease - A progressive, irreversible disease, most prevalent in late life, characterized by deterioration of the brain cells and leading to impaired mental functioning.
anorexia nervosa - An eating disorder characterized by severe and prolonged refusal to eat, extreme weight loss, distorted body image, termination of the menstrual cycle or impotence, and intense fear of becoming obese; (often occurring but not limited to) girls and young women.
anxiety - Anxiety and fear are often used to describe the same thing. When the word anxiety is used to discuss a group of mental illnesses (anxiety disorders), it refers to an unpleasant and overriding inner emotional tension that has no apparent identifiable cause. Fear, on the other hand, causes emotional tension due to a specific, external reason. Anxiety disorders include phobias, panic disorder, obsessive- compulsive disorder and post-traumatic stress disorder. These disorders are severe enough to interfere with social or occupational functioning.
attention deficit disorder - A childhood disorder characterized by short attention span and poor concentration. Symptoms can persist into adulthood. Stimulants or antidepressant drugs are often effectively used to treat ADD.
autism - A condition caused by a physical disorder of the brain that appears during the first three years of life. Symptoms include disturbances in physical, social and language skills; abnormal responses to sensations; and abnormal ways of relating to people, objects and events.
bipolar (manic-depressive) disorder - A major affective or mood disorder in which there are episodes of both mania and severe, disabling depression. Psychiatric researchers believe it is caused by a chemical imbalance in the brain.
bulimia - A disorder characterized by compulsive eating binges followed by some effort to counteract the weight gain that would result from these binges usually vomiting, but often excessive exercising, fasting or use of diet pills, laxatives or diuretics. Overconcern with weight and body shape are also symptoms of bulimia. It is often accompanied by depression. Symptoms of bulimia and anorexia can appear in the same person.
compulsion - An insistent, repetitive and unwanted urge to perform an act as a means of relieving anxiety. However, the ritualistic behavior, such as repeated hand washing, is not related realistically to what the person is trying to avoid.
delusion - A false belief persistently held despite indisputable and obvious proof to the contrary. The belief is not one ordinarily accepted by other members of the persons culture. Examples are delusions of grandeur or of persecution.
dementia - A disorder in which there is loss or impairment of mental powers due to organic causes (physical disease) and severe enough to interfere with work or social functioning. Memory disturbance is the most prominent symptom. Other symptoms include personality change and impairment of abstract thinking, judgment and control of impulses. Dementia may be progressive, static or reversible, depending on the particular conditions of the disease and its treatment.
depression - When used to describe a mood, depression refers to what may be normal feelings of sadness, despair and discouragement. More serious depression may be a symptom of a variety of physical and mental disorders, a syndrome of associated symptoms secondary to an underlying disorder or it may itself be a specific mental disorder. The disorder known as major depression is characterized by slowed thinking, decreased purposeful physical activity, sleep and appetite disturbances, low self-esteem, loss of sex drive and feelings of guilt and hopelessness.
eating disorders - Marked disturbance in eating behavior, including, among others, overeating, anorexia nervosa, bulimia nervosa and pica.
euphoria - An exaggerated feeling of emotional and physical well being, usually of psychological origin. This condition is seen in organic mental disorders, toxic and drug-induced states and mania.
hallucination - The false perception of a sight, sound, taste, smell or touch when no actual stimulus is present. Hallucination also refers to the imaginary object apparently seen and heard.
insane - An obsolete term used colloquially to describe a person with a mental disorder. Now a legal term applied by the courts to a person who, because of mental disease or mental retardation, was unable I to appreciate the wrongfulness or criminality of his conduct at the time of an offense, or in some jurisdictions, unable to control his/her actions.
insomnia - The unusually prolonged inability to fall asleep, difficulty staying asleep, and/or early morning awakening.
kleptomania - A disorder in which the sufferer has the compulsion to steal.
mania - A mood disorder characterized by excessive elation or irritability, hyperactivity, hypersexuality, poor concentration and accelerated thinking and speaking, and resulting in impairment. Mania is seen in major disorders involving disturbance of mood and in organic mental disorders.
manic-depressive disorder - See bipolar disorder.
megalomania - An abnormal preoccupation with delusions of grandeur, wealth and power.
melancholia - An outmoded term used formerly to describe the extreme depression of spirits that psychiatrists now see as part of depression and manic-depressive (bipolar) illness.
mental illnesses - A broad range of disorders with psychological or behavioral symptoms and/or impairment in functioning due to a social, psychological, genetic, physical chemical or biological disturbance.
multiple personality - A rare type of dissociative state in which a person adopts two or more personalities. Dissociative disorders involve a sudden, temporary change in normally integrated functions of consciousness, identity or motor behavior, so that some part of one or more of these functions is lost.
neurosis - An emotional disorder that arises due to unresolved conflicts, anxiety being the chief characteristic. In contrast to the psychoses, neuroses do not involve gross distortions of reality.
obsessive-compulsive disorder - A type of anxiety disorder marked by the persistent intrusion of unwanted and uncontrollable thoughts. Commonly, patients who suffer from obsessions also suffer from compulsions -- repeated, senseless rituals victims go through in an attempt to reduce their anxiety. While compulsive behavior is almost always preceded by obsessive thoughts, some people have obsessive thoughts but do not ritualize.
panic disorder - A type of anxiety disorder in which a person suffers intense, overwhelming terror suddenly and for no apparent reason. The fear is accompanied by such physical symptoms as shortness of breath, heart palpitations, chest discomfort, choking or smothering sensations, unsteadiness, feelings of unreality, tingling, hot or cold flashes, sweating, faintness, trembling, and fear of losing control, dying or going crazy.
paraphilia - Mental disorders in which persistent and repetitive sexually arousing fantasies of an unusual nature are associated with either preference for or use of a nonhuman object for sexual arousal (fetishism, transvestism), repetitive sexual suffering or humiliation (sadism, masochism), or repetitive sexual activity with nonconsenting partners (exhibitionism, pedophilia, voyeurism).
paranoia - A rare condition characterized by the gradual development of an intricate, complex and elaborate system of thinking based on (and often proceeding logically from) misinterpretation of an actual event. A person with paranoia often considers him/herself endowed with unique and superior abilities, and may also have the delusion that others are conspiring to do him! her harm.
Parkinson's disease - A disorder of the nervous sys- tem characterized by rapid tremors, pill-rolling movements, masklike expression, rigidity, drooling, reduced movement, slowness of physical and mental responses; and disturbance of gait. Parkinsonism is associated with a depletion of dopamine, a chemical in the brain.
pedophilia - A mental disorder (and a criminal offense) in which an adult engages in sexual activity with a child.
personality disorder - A deeply ingrained, inflexible, maladaptive pattern of relating, perceiving and thinking, serious enough to cause distress or im- paired functioning. Personality disorders are usually recognizable by adolescence or earlier, continue throughout adulthood and become less obvious in middle or old age. Examples of formally identified personality disorders are antisocial, borderline, compulsive, histrionic, dependent, narcissistic, paranoid, passive-aggressive, schizoid and schizotypal.
phobia - An obsessive, persistent, unrealistic fear of an object or situation. Some common phobias are: acrophobia (fear of heights), agoraphobia (fear of leaving the familiar setting of the home), claustrophobia (fear of closed places) and xenophobia (fear of strangers).
pica - An eating disorder consisting of the craving for and eating of non-nutritive foods or other substances, such as dirt or paint. Seen in a variety of medical conditions, pregnancy and emotional disturbances.
post-traumatic stress disorder (PTSD) - A disorder that develops after a person experiences a psycho- logically distressing event outside the range of usual human experience for example, disasters such as an earthquake, a plane crash, war or rape. PTSD is characterized by reexperiencing the traumatic event, often through nightmares or flashbacks, or a numbing of general responsiveness that was not present before the trauma, and avoidance of stimuli associated with it.
psychosis - A symptom of a major mental disorder of organic or emotional origin, in which the personality is seriously disorganized and contact with reality is usually impaired. The psychotic condition is often characterized by regressive behavior, inappropriate mood, diminished impulse control, delusions or hallucinations.
retarded - A term used to describe a person who has mental retardation, the lack since birth of intellectual functioning present in the normal individual. The condition is apparent during the developmental period and also involves a deficiency in adaptive behavior.
schizophrenia - A group of severe disorders of un- known cause (but considered brain disorders), typically characterized by disturbances of language and communication; thought disturbances that may involve distortion of reality, misperceptions and some times delusions and hallucinations; mood changes and withdrawn, regressive or bizarre behavior. These symptoms must last longer than six months to fall into the category of schizophrenia.
senility - A term used to refer to senile dementia, a chronic progressive mental disorder associated with general deterioration of the brain resulting from the death of neurons. Although the cause is unknown, several promising theories are under study. Senility is not due to aging per se, but may be a late form of Alzheimer's disease. Deterioration may range from minimum to severe.
split personality - A slang term often associated (inaccurately) with schizophrenia and multiple personality disorder. See multiple personality disorder.
Tourette's syndrome - A genetically determined disorder usually beginning in early childhood and characterized by repetitive tics, other movement, uncontrolled grunts, unintelligible sounds, echoing and, occasionally, verbal obscenities.
trichotillomania - The recurrent failure to resist impulses to pullout one's own hair.