Classes and Resources

Glossary of Mental Health Terminology

Diagnostic and Statistical Manual of Mental Disorders (DSM)

Mental health professionals in the United States use the Diagnostic and Statistical Manual of Mental Disorders (DSM) as the standard classification of mental disorders. It contains a listing of diagnostic criteria for every psychiatric disorder recognized by the U.S. healthcare system.

It is used in settings, such as, inpatient, outpatient, partial hospital, consultation-liaison, clinic, private practice, and primary care, and with community populations and by psychiatrists, psychologists, social workers, nurses, occupational and rehabilitation therapists, counselors, and other health and mental health professionals. It is also a necessary tool for collecting and communicating accurate public health statistics about the diagnosis of psychiatric disorders.

Click here for more information about mental disorder classifications as set forth in the DSM. Source for the terminology: SAMHSA terminology definitions

Click a title below to review information.

Antisocial Personality

A personality style beginning in childhood that involves a behavior pattern that seriously violates the rights of others. Individuals with this disorder are irresponsible in their work, school, finances, and personal relationships. [more…]

Antisocial Personality Disorder

A condition characterized by antisocial behavior (such as lying, stealing, and sometimes violence), lack of social emotions (guilt and shame), and impulsivity. [more…]

Anxiety Disorders

Anxiety disorders have multiple physical and psychological symptoms, but all have in common feelings of apprehension, tension, or uneasiness. Among the anxiety disorders are panic disorder, agoraphobia, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder.

The different types of anxiety disorders are:

Panic Disorder

Those suffering from panic disorder experience reoccurring and unexpected panic attacks-instances of extreme fear or discomfort that start abruptly and build to a rapid peak, usually within ten minutes. Panic attacks are characterized by such physical symptoms as heart palpitations, sweating, trembling, shortness of breath, the sensation of choking, chest pain, nausea, dizziness, disorientation, fear of losing control or dying, numbness, chills, and hot flushes. Additionally, panic attacks are usually accompanied by a sense of looming danger and the strong desire to escape. Attacks can be brought on by specific triggers or can occur “out of the blue.” The frequency of attacks tends to vary according to the individual.

To be diagnosed with panic disorder, one’s panic attacks must have been followed by at least one month of steady worry about having more attacks, concern about why the attacks have happened and what they mean (fears of having a serious physical illness or “losing one’s mind” are common), or a significant change in behavior brought about by the attacks (many feel the need to avoid certain situations or remove themselves from particular environments).

Panic disorder is diagnosed more often in women than in men. Although the age of onset varies considerably, it is most commonly experienced for the first time between late adolescence and the mid-30’s. Up to one-half of those diagnosed with panic disorder also have agoraphobia.

Phobias

Defined as exaggerated, involuntary, and irrational fears of particular situations or things, phobias are generally divided into three separate types.

Specific (or simple) phobia-this type of phobia is brought about by a specific object or situation such as flying, heights, needles, or snakes. Specific phobias are generally more common in women than in men and usually first appear during childhood.

Social phobia (social anxiety disorder)-limited specifically to social situations, this particular phobia is typified by extreme fear of meeting new people and of being embarrassed, humiliated, or judged by others. Social phobia appears to be diagnosed equally among the sexes. Usually first appearing in mid-teens, social phobia sometimes arises from a history of childhood shyness.

A diagnosis of specific or social phobia requires that exposure to the feared object or situation induces anxiety (often in the form of panic attacks), that the individual experiencing the phobia recognizes the irrational nature of their fear, and that the anxiety caused by the phobia become disruptive to the individual’s lifestyle.

Agoraphobia-those with agoraphobia have an intense fear of being trapped in particular places or situations or of not being able to find help if they experience anxiety or a panic attack. Fears of those with this type of phobia often center around being alone in an open area or being in a large crowd. Often, those with agoraphobia avoid such situations altogether; being subjected to such situations causes notable anxiety or panic.

It is important to remember that diagnosed phobias cause severe impairment-everyone has certain fears and experiences times of shyness and anxiety.

Obsessive-Compulsive Disorder (OCD)

OCD is an anxiety disorder characterized by persistently intrusive and inappropriate thoughts, impulses, or images that run through one’s mind (obsessions) and repetitive

behaviors that one feels they must do (compulsions). Common obsessions include fear of contamination, fixation or lucky or unlucky numbers, fear of danger to oneself or others, need for order or exactness, and excessive doubt. The most common compulsions performed in response to these obsessions include ritualistic handwashing, counting, checking, hoarding, and arranging.

Although most people experience such thoughts and behaviors at some times, OCD is considered to occur when these obsessions and compulsions are experienced for more than an hour each day in a way that interferes with one’s life or causes great anxiety.

Equally common in males and females, OCD often appears earlier in males. Generally, the disorder first begins in adolescence or early adulthood, although it may start in childhood.

Posttraumatic stress disorder (PTSD)

Personally experiencing or witnessing a violent or tragic event that resulted in feelings of intense fear, helplessness, or horror can sometimes cause PTSD. Events that often lead to the development of this anxiety disorder include rape, war, natural disasters, abuse, and serious accidents. While it is common to experience a brief state of anxiety or depression after such occurrences, those with PTSD continually re-experience the traumatic event through ways such as nightmares, hallucinations, or flashbacks; avoid all things associated with the event (often displaying an accompanying sense of detachment); and exhibit increased arousal (e.g. difficulty sleeping, irritability, difficulty concentrating, extreme alertness, jumpiness).

Those diagnosed with PTSD experience symptoms for longer than one month and are unable to function as they did before the event. PTSD usually appears within three months of the traumatic experience, but in some circumstances can surface months or even years later. PTSD can occur at any age.

Similar to PTSD is an anxiety disorder known as acute stress disorder. Also in response to a traumatic event, acute stress disorder involves symptoms of re-experience, avoidance, and increased arousal as well. The main difference between the two disorders is twofold. First of all, acute stress disorder features a greater element of dissociation-those with the disorder experience detachment, a sense of withdrawal from reality, or even sometimes amnesia. The other major distinction between PTSD and acute stress disorder is in the length of time the symptoms are experienced. Acute stress disorder is only diagnosed if the disturbance occurs within four weeks of the traumatic event and lasts for a minimum of two days and a maximum of four weeks. What is first sometimes thought to be acute stress disorder is often eventually diagnosed as PTSD.

Generalized anxiety disorder (GAD)

Individuals with GAD experience excessive anxiety and worry about several everyday events or activities. Furthermore, the anxiety in those with GAD is difficult to control and causes notable complications in daily work and social settings. Physical symptoms of the disorder include edginess, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. To be diagnosed with GAD, one must experience this excessive anxiety for the majority of days during a period of six months or longer.

Most of those with GAD claim to have felt anxious for their entire lives and the disorder is first seen in childhood or adolescence. However, adult onset of the disorder is not uncommon.

Other anxiety disorders

Certain persons can experience anxiety in response to a general medical condition or from substance abuse. Others exhibit certain signs of particular anxiety disorders without meeting all the criteria for an official diagnosis.

How common are anxiety disorders?
Anxiety disorders are the most common mental illnesses in the United States. These serious brain disorders are estimated to affect more than 20 million Americans (approximately one in nine) every year

Are anxiety disorders associated with other disorders?

Most definitely, it is quite common for one anxiety disorder to coexist with another or several others. Furthermore, those with anxiety disorders frequently also suffer from depression, substance-related disorders, and/or eating disorders. In fact, it is estimated that over half of those diagnosed with panic disorder or OCD have depression too.

What causes anxiety disorders?

Several factors seem to contribute to the development of an anxiety disorder. Much new research suggests that these disorders both run in families and are the result of one’s brain chemistry. Certain life experiences and one’s general personality are also thought to influence the likelihood of having an anxiety disorder.

How can anxiety disorders be treated?

Effective treatments are available for anxiety disorders. While the symptoms of the various anxiety disorders do differ, both medication and talk therapy have proven helpful in alleviating many of the problems of those faced with each of these illnesses.

The most common medications used to treat anxiety disorders are antidepressants and benzodiazepines. There are a variety of drugs of both types that have proven quite helpful. So, if a particular medication does not seem to work, others are available. And, many new drugs are on the horizon.

The forms of talk therapy most often effective in treating anxiety disorders are behavioral therapy and cognitive-behavioral therapy. Behavioral therapy involves relaxation techniques and gradual exposure to the thing or situation that causes the anxiety in an attempt to reduce symptoms.

Behavior Disorders

Many terms are used interchangeably to classify children who exhibit extreme or unacceptable chronic behavior problems. These children lag behind their age mates in social development and are often isolated from others either because they withdraw from social contact or because they behave in an aggressive, hostile manner. Behavior disorders result from persistent negative social interactions between the child and the environment. Behavior disorders generally consist of four clusters of traits, including conduct disorders, anxiety-withdrawal, immaturity, and socialized aggression.

Borderline Personality Disorder (BPD)

Symptoms of BPD

  • Mood swings
  • Periods of intense depression, irritability, and/or anxiety lasting from a few hours to a few days
  • Inappropriate, intense or uncontrolled anger
  • Impulsiveness in spending, sex, substance use, shoplifting, reckless driving, or binge eating
  • Recurring suicidal threats or self-injurious behavior
  • Unstable, intense personal relationships
  • Extreme black-and-white views of people and experiences, sometimes alternating between “all good” idealization and “all bad” devaluation
  • Persistent uncertainly about self-image, long-term goals, friendships and values
  • Chronic boredom or feelings of emptiness
  • Frantic efforts to avoid real or imagined abandonment

Treatment for BPD

  • Medication
  • Reduces anxiety, depression and impulsivity
  • Helps one deal with harmful patterns of thinking and interacting
  • Fails to correct ingrained character difficulties
  • Antidepressants
  • Anticonvulsants
  • Neuroleptics
  • Psychotherapy
  • Short-term hospitalization when necessary during times of extreme stress, impulsivity or substance abuse
  • Generally difficult and long term
  • BPD symptoms often interfere with therapy
  • Usually effective

What is BPD?

Fairly common biologically based disorder
Characterized by impulsivity and instability in mood, self-image and personal relationships
Diagnosed more often in females than in males

Causes of BPD

  • Unclear, but psychological and biological factors may be involved
  • Originally thought to border on schizophrenia
  • Related to serious depressive illness
  • Associated with neurological and attention deficit disorders abuse or neglect may create identity and personality problems
  • More research is needed

Simultaneously present disorders

  • Serious depressive illness, including bipolar disorder
  • Eating disorders
  • Alcohol/drug abuse
  • Sleep disorder

Bipolar Disorder

Bipolar disorder, also known as manic-depression is a type of mental illness that involves a disorder of affect or mood. The person’s mood usually swings between overly “high” or irritable to sad and hopeless, and then back again, with periods of normal mood in between.

The high (manic) mood associated with manic-depression is sometimes a pleasurable, euphoric and productive state but can involve potentially dangerous lapses of judgment, impulsive and potentially ruinous behavior, and, in the most severe forms, can involve extreme agitation and loss of reason (psychosis). The depressed phase is similar to, and can be confused with, major depression, and involves feelings of sadness, hopelessness and helplessness.

Mental health specialists refer to bipolar disorder by type: Type I bipolar disorder involves extreme upswings in mood (mania) coupled with downward spirals. In Type II, the upward swings are more mild (hypomania), but the frequency and intensity of the depressive phase is often severe. Since the elevated mood states of Type II are relatively mild, they are often missed and the bipolar nature of the illness goes undiagnosed.

Consumers affected by Bipolar Disorder

Manic-depression affects more than 2% of the general population over a lifetime. Unfortunately, due to the stigma surrounding the illness, misdiagnosis, and the propensity of those with manic-depression to deny that anything is wrong, only a fraction of these people ever receive treatment. Although the illness can occur at any age, fully half of cases begin before age 20. The disorder occurs about equally in men and women, and, because it tends to run in families, there appears to be a strong genetic link. In addition, this illness can have profound effects on friends and family members.

Symptoms of Depression

  • Persistent sad, anxious or empty mood
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in ordinary activities
  • Decreased energy, a feeling of fatigue
  • Difficulty concentrating or making decisions
  • Restlessness or irritability
  • Inability to sleep or oversleeping
  • Changes in appetite or weight
  • Unexplained aches and pains
  • Thoughts of death or suicide

Symptoms of Mania

  • Extreme irritability and distractibility
  • Excessive “high” or euphoric feelings
  • Increased energy, activity, restlessness
  • Racing thoughts, rapid speech
  • Decreased need for sleep
  • Unrealistic beliefs in one’s abilities and powers
  • Increased sexual drive
  • Abuse of drugs or alcohol
  • Reckless behavior such as spending sprees
  • Rash business decisions, or erratic driving
  • In severe cases, hallucinations and loss of reason

Treatment options

Medication: Varying medicines are effective in the treatment of bipolar disorder. Several types of antidepressants can help relieve the depressive phase of the illness, including the newer selective serotonin reuptake inhibitors (SSRIs), which are often combined with a mood-stabilizer such as lithium. SSRIs have proven to be effective, safe, and have relatively minor adverse effects. Lithium salts have been used for many years to stabilize mood swings and remain an important part of manic-depressive treatment. In addition, anticonvulsants, medicines initially used for treating epileptic consumers, have recently proven very effective in treating mania. In acute mania, doctors may also prescribe antipsychotics to help control hallucinations and restore rational thinking. Long-term stability can be enhanced with lithium, and other alternatives are under investigation.

Psychotherapy: Talking therapy can be an important part of treatment for consumers, as well as for their friends and family members. Talking therapy can help eliminate behaviors, thought patterns, problems with current relationships or difficulties in managing the illness that may be caused by or contribute to the disorder.

Case management

Practice in which the service recipient is a partner in his or her recovery and self-management of mental illness and life.

Clinical

In the mental health field, clinical refers to professionals who interact with patients in order to arrive at a diagnosis and treatment. Several states offer variations on licensing to differentiate between those who are educated in a field, and those who are trained to interact and counsel with clients. The addition of the term, “clinical,” to a professional title sometimes indicates extensive professional experience as well. The presence or absence of term “clinical” in a mental health professional’s title is not a reliable indicator, however. A Licensed Professional Counselor in one state may have the same meaning as Licensed Clinical Professional Counselor in another state.

Co-occurring/comorbidity

In general, the existence of two or more illnesses-whether physical or mental-at the same time in a single individual. In this chapter, comorbidity specifically means the existence of a mental illness and a substance abuse disorder or a mental and a physical illness in the same person at the same time.

Conduct Disorder

A persistent pattern of behavior that involves violation of the rights of others (disobedience, destructiveness, jealousy, boisterousness, and inadequate feelings of guilt). The pattern is seen at home, school, and in the community. Verbal and physical aggression are key features of conduct disorder. See also behavior disorders/emotional disturbance and oppositional-defiant disorder.

Consumer

Any person using mental health services.

Cultural competence

A group of skills, attitudes, and knowledge that allows persons, organizations, and systems to work effectively with diverse racial, ethnic, and social groups.

Decompensation

A process that was formally stable has become unstable, leading to failure

Depression

A state of low mood that is described differently by people who experience it. Commonly described are feelings of sadness, despair, emptiness, or loss of interest or pleasure in nearly all things. Depression also can be experienced in other disorders such as bipolar disorder (manic-depressive disorder).

Diagnosable mental illness

Includes all people with a mental illness in a specified population group, whether or not they have received a formal diagnosis from a medical or mental health professional.

Forensic Psychiatry

Forensic psychiatry is the area of psychiatry related to the law and the legal system. Forensic psychiatrists are trained on both civil and criminal court cases and perform services such as giving expert testimony about issues related to mental health and psychopharmacology, evaluating competency, determining whether a defendant is able to plea not guilty by reason of insanity and suggesting appropriate psychiatric treatment in place of or in addition to a prison sentence. They also provide psychiatric services to patients in legal custody. [more…]

Homeless person

A person who lacks housing. The definition also includes a person living in transitional housing or a person who spends most nights in a supervised public or private facility providing temporary living quarters.

Juvenile justice facility

Includes detention centers, shelters, reception or diagnostic centers, training schools, ranches, forestry camps or farms, halfway houses and group homes, and residential treatment centers for young offenders.

Mental health services

Diagnostic, treatment, and preventive care that helps improve how persons with mental illness feel both physically and emotionally as well as how they interact with other persons. These services also help persons who have a strong risk of developing a mental illness.

Mental illness:

The term that refers collectively to all diagnosable mental disorders. Mental disorders are health conditions characterized by alterations in thinking, mood, or behavior (or some combination thereof) that are all mediated by the brain and associated with distress or impaired functioning or both. Mental disorders spawn a host of human problems that may include personal distress, impaired functioning and disability, pain, or death. These disorders can occur in men and women of any age and in all racial and ethnic groups. They can be the result of family history, genetics, or other biological, environmental, social, or behavioral factors that occur alone or in combination.

Oppositional-Defiant Disorder

A disorder of early to middle childhood that may evolve into a conduct disorder, usually diagnosed before the age of twelve; children with oppositional defiant disorder defy adult rules, are angry, and often lose their tempers. [more…]

Parity, mental health parity

Equivalent benefits and restrictions in insurance coverage for mental health services and for other health services.

Psychiatric Social Worker

Core mental health professionals that have earned the MSW and are trained to appreciate and emphasize the impact of environmental factors on mental disorders. LCSW designates Licensed Clinical Social Worker.

Psychiatrists

These core mental health professionals have had extensive residency experience and have earned the MD degree. Training focuses on psychopharmacology (or medication management of mental health issues) and the other medical therapies, diagnosis, and psychotherapy or psychoanalysis. Specialties include Forensic Psychiatry, Child and Adolescent Psychiatry, and Geriatric Psychiatry.

Psychoanalysis

An approach to psychology that emphasizes unconscious motives and conflicts. It encompasses both a theory of personality and a method of psychotherapy. [more about psychoanalysis]

Psychoanalytic Method

In psychoanalytic therapy, the effort to bring unconscious material into consciousness often through dream recall and free association.

Psychopharmacology

The management of psychiatric illness using medication such as antidepressants, antipsychotics, anti-anxiety medications and more.

Psychotherapy

The treatment of mental disorders, emotional problems, and personality difficulties through talking with a therapist. There are dozens of different styles of psychotherapy, including psychoanalysis.

Recovery

There are several different definitions and uses of this term. In the addiction self-help recovery community, for example, this term refers to the achievement and maintenance of abstinence from alcohol, illicit drugs, and other substances (e.g., tobacco) or activities (e.g., gambling) to which the person has become addicted, vigilance and resolve in the face of an ongoing vulnerability to relapse, and pursuit of a clean and sober lifestyle.

In mental health there are several other forms of recovery. For those fortunate people, for example, who have only one episode of mental illness and then return to their previous functioning with little, if any, residual impairment, the usual sense of recovery used in primary care is probably the most relevant. That is, such people recover from an episode of psychosis or depression in ways that are more similar to, rather than different from, recovery from other acute conditions.

Persons who recover from an episode of major affective disorder or psychosis, but who continue to view themselves as vulnerable to future episodes, may instead consider themselves to be “in recovery” in ways that are more similar to, rather than different from, being in recovery from a heart attack or chronic medical condition. In this case, recovery may take place in the presence of an enduring illness or condition, rather than following on its absence. Many others will recover from serious mental illness over a longer period, after perhaps 15 or more years of disability, constituting an additional sense of recovery found in some other medical conditions such as asthma. More extended periods of disability are often associated with concerns about the effects and side effects of having been labeled with a mental illness as well as with the illness itself, leading some people to consider themselves to be in recovery also from the trauma of having been treated as mental patients.

Finally, those people who view taking control of their illness and minimizing its disruptive impact on their lives as the major concentration of their efforts might find the sense of recovery used in the addiction self-help community to be most compatible with their own experiences. Such a sense of recovery has been embraced, for instance, among some people who suffer from co-occurring psychiatric and addictive disorders who consider themselves to be in “dual recovery.”

For purposes of simplicity and clarity, the Connecticut Department of Mental Health and Addiction Services has adopted the following single definition to capture the common elements of these various forms of recovery:

“Recovery involves a process of restoring or developing a meaningful sense of belonging and positive sense of identity apart from one’s condition while rebuilding a life despite or within the limitations imposed by that condition.” [more…]

Resilience

Manifested competence in the context of significant challenges to adaptation or development

Schizophrenia

A mental disorder lasting for at least six months, including at least one month with two or more active-phase symptoms. Active-phase symptoms include delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior. Schizophrenia is accompanied by marked impairment in social or occupational functioning. . [more…]

Screening for mental health problems

A brief formal or informal assessment to identify persons who have mental health problems or are likely to develop such problems. The screening process helps determine whether a person has a problem and, if so, the most appropriate mental health services for that person.

Serious emotional disturbance (SED)

A diagnosable mental disorder found in persons from birth to age 18 years that is so severe and long lasting that it seriously interferes with functioning in family, school, community, or other major life activities.

Serious mental illness (SMI)

A diagnosable mental disorder found in persons aged 18 years and older that is so long lasting and severe that it seriously interferes with a person’s ability to take part in major life activities.

Substance Abuse and Addiction

Addiction is a serious illness. Health, finances, relationships, careers—all can be ruined. The abuse of drugs and alcohol is by far the leading cause of preventable illnesses and premature death in our society. The importance of substance abuse treatment cannot be overstated, and fortunately many effective treatments are available. The road to recovery, however, begins with recognition. [more…]