Prescription for Wellness

Common Adult Brain Disorders

Table 7-3 lists three major categories of mental disorders: anxiety disorders, mood disorders, and psychotic disorders (USDHHS, 1999). Mental disorders affect people of all ages, sex, racial, educational, socioeconomic, and ethnic groups. It is reported that approximately 40 million Americans aged 18-64 years, or 21 percent of the population have a diagnosis of a mental disorder. This translates to 151,842 persons per year in the Travis County area who have a brain disorder. Table 7-3 reflects the prevalence of mental disorders in the Travis County area.

There are many different kinds of brain disorders and mental illnesses experienced by adults. Left untreated, disorders of the brain profoundly disrupt a person's ability to think, feel, and relate to others or their environment. Research over the last few decades has confirmed the biological basis for brain disorders and, most importantly, treatments that work. A summary review of common brain disorders and mental illnesses is provided as follows.

Anxiety Disorders

Anxiety disorders are the most prevalent mental disorders in adults and affect twice as many women as men. Anxiety disorders are common in all human cultures. Anxiety disorders are manifested in the disturbance of a person's mood, thinking, behavior, and physiological behavior. Anxiety may be understood as the pathological complication or extension of normal fear (USDHHS, 1999, p. 225). Early ages of onset, chronicity, relapsing or recurrent episodes of illness, and periods of disability characterize anxiety disorders (USDHHS, 2000). Table 7-4 provides some basic information, risk factors, and intervention/treatment strategies on anxiety disorders in the Travis County area

Table 7-4: Anxiety Disorders Data in Travis County In adults ages 18-54, it is currently estimated that 118,582 of the Travis County population have an anxiety disorder. There is significant comorbity with mood and substance abuse disorders. Panic disorder and agoraphobia are associated with increased risk of suicide. Panic disorder is about twice as common among women as men. Age of onset is most common between late adolescence and mid-adult life. Highest rate of post-traumatic stress disorder is found in women who are victims of crime.

List of Common Anxiety Disorders Panic Disorders Phobias Obsessive-compulsive Disorder Generalized Anxiety Disorder Post-traumatic Stress Disorder

Risk Factors Biological and genetic factors Stressful life events Trauma Acute Stress Response Anatomical and Biochemical Factors Neurotransmitter Alterations Psychological Factors   Intervention/Treatment Pharmacotherapy Psychotherapy and Counseling     Education Source: USDHHS, 1999

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Mood Disorders/Depression

Tragedy, an unexpected loss of a loved one or even employment that leads to periods of sadness may be a realistic experience from time to time. However, a depressive illness is not just a case of the blues but a severe and persistent biological disease. The National Institute of Mental Health (NIMH) reports that scientists believe major depression has a genetic component, meaning that those families with a history of depressive illness may have a biological susceptibility to depression. Healthy People 2010 notes that "major depressive disorder differs both quantitatively and qualitatively from normal sadness or grief, which is typically less pervasive and generally more time-limited" (USDHHS, 2000).

There is current treatment that can alleviate each of these challenges. Medications, counseling, and support services can be used alone or in combination of each other that significantly reduce the impact of depression. Table 7-5 provides some basic information, risk factors, and intervention/ treatment strategies on mood disorders in the Austin/Travis County area.

Table 7-5: Mood Disorders Data in Travis County In adults ages 18-54, it is estimated that 51,337 people in Travis County have a mood disorder. Mood disorders rank among the top 10 causes of worldwide disability. Women between the ages of 18 and 45 comprise the majority of those with major depression (unipolar depression). Depression related visits to the doctor represent a large portion of health care costs (usually under the guise of another complaint due to stigma). Depression is the leading cause of absenteeism and diminished productivity in the workplace. About 24% of Travis County residents report that they accomplish less than they would like as a result of emotional problems such as feeling depressed or anxious. 10 to 15% of the persons formerly hospitalized with depression commit suicide. Mood disorders often coexist with other mental and somatic disorders. 24 to 40% of individuals with mood disorders use alcohol or drugs.

Risk Factors Biological and Genetic Factors Stressful Life Events Cognitive Factors Temperament and Personality Intervention/Treatment Pharmacotherapy Psychotherapy and Counseling

Studies reveal that primary care practice has low rates of both recognizing and providing appropriate treatment of depression. 1/3 to 1/2 of persons with major depression go unrecognized in primary care settings.

Some of the symptoms of severe depression are:

• Hopelessness;
• inability to experience pleasure;
• inability to feel a positive mood shift in response to something agreeable;
• suicidal thoughts; and/or
• psychotic symptoms (such as delusions or hallucinations).

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Schizophrenia

Schizophrenia is a brain disorder, impacting about 1.3 percent of the U.S. population. The rate of schizophrenia is low when compared to other mental disorders, yet its severity and debilitating effects are noticed from the personal level of the individual diagnosed, to family, friends, and the community. Schizophrenia is characterized by profound alterations in cognition and emotion (USDHHS, 1999). Common symptoms associated with schizophrenia are hearing internal voices, hallucinations, and delusions. Diagnosis of schizophrenia is determined by a pattern of signs and symptoms, in conjunction with impaired occupational or social functioning (USDHHS, 2000).

The course of the illness is variable with most people experiencing periods of exacerbation and remission. This can be one of the debilitating effects of the illness with perceived recovery being reversed by another episode (USDHHS, 1999). Table 7-6 provides some basic information, risk factors, and intervention/treatment strategies on schizophrenia in the Travis County area.

Table 7-6 Data on Schizophrenia for the Travis County Area In adults ages 18-54, it is currently estimated that 9,400 people in Travis County have developed schizophrenia. Onset generally occurs during young adulthood (mid-20s for men and late-20s for women). It is estimated that half of the persons diagnosed with schizophrenia develop alcohol or drug abuse problems. It is estimated that about half of the persons who have developed schizophrenia do not seek treatment. Schizophrenia is neither "split personality" nor "multiple personality."

Risk Factors Genetic Vulnerability Anatomical Brain Abnormalities Biological Stressors Environmental Stressors Psychological Stressors Social Stressors Prenatal Stressors   Intervention/Treatment Pharmacotherapy with antipsychotic medication Psychotherapy Psychosocial Rehabilitation and Skills Development Coping and Self-Monitoring Skills Family Interventions Vocational Rehabilitation Source: USDHHS, 1999

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