What are non-psychotic affective disorders

Affective disorders entail mood disorders from extreme emotional lows (depression) to highs (mania). In some individuals the mood is dominantly low, and some people experience phases of extreme emotional lows and extreme emotional highs (which is also not pleasant, especially for their surroundings). Rarely do people have only episodes of emotional highs. Mood swings are accompanied by changes of the person’s activities. The terms that you may encounter as used by psychiatrists to designate such disorders are depressive episodes, manic episodes, bipolar disorder, etc. Some mood disorders may occur as reactions to certain events and stress, and others may be the consequences of the overall personal history and the structure of the given person.

There is also such a thing as hypomania (the slightly elevated mood, which may be a personality trait of someone individuals). Such people are often full of energy and ideas, communicative, and can also be very inventive and creative. When hypomania is mild and an inherent part of a functional personality, such people are not treated, but rather we call them “the lucky ones”.

Depression, Mania, Cyclothymia, Dysthymia

Depression can be mild, moderate or severe. It features low mood, lack of energy, decreased activity. In a depressive phase or state, the capacity for enjoyment and happiness is diminished, interests are decreased, it is difficult to concentrate and pay attention. The person is chronically fatigued and activities that otherwise are not demanding cannot be completed. Appetite and sleep are disrupted (sometimes increased, sometimes decreased). Self-confidence and self-worth are reduced, accompanied by ideas of guilt and worthlessness. There is a sense that life is tasteless, senseless, unbearable and that it is such in essence. If the person recalls ever feeling good, they have a sense that it was fake, that actual life is as they experience it presently.

Depression can also manifest itself both through physical symptoms and through concern for one’s own health. Generally, depression features a loss of interest, enjoyment, lack of sexual desire and anxiety to physical agitation. It often also includes insomnia.

In some cases depression is manifest in the morning, with waking up early, and some people feel relatively good in the morning, but their mood decreases after dark. Severe depression can sometimes lead to suicidal thoughts, plans, attempted suicide and actual suicide.

Manic episodesfeature euphoria, which may reach the intensity of uncontrolled excitement. The increased energy leads to hyperactivity, the need for constant talking, the inability to maintain attention, jumping from one topic to another. Such a state may include a feeling of grandiosity, excessive self-confidence, as well as a lack of social inhibitions, which may lead to impulsive and uncontrolled inappropriate behaviour. There is a reduced need for sleep. Manic persons may also have a characteristic appearance, which corresponds to the internal mood. Manic episodes are usually brief and are followed by depression. When depression and mania alternate, then it is a case of bipolar disorder.

Cyclothymia entails an unstable mood, consisting of longer periods of depression, which is occasionally interrupted by episodes of elation. Such episodes never achieve the intensity of bipolar disorder.

Dysthymia is a chronic depressive mood, of mild intensity and lasting several years. Dysthymia implies that the mood is not so low that it could be labelled as depression and can sometimes be considered as the person’s disposition given its duration. The person may think that life is simply like that and be surprised when psychotherapy leads to them feeling joy and full satisfaction with life.

What Are Anxiety Disorders And Phobias?

Anxiety disorders are disorders where anxiety symptoms are most prominent, but are not the direct reaction to life events. Anxiety is most often an accompanying symptom of other mental disorders, such as depression, obsessive behaviour, etc. Anxiety and depression can be combined into a mixed anxiety and depressive disorder.

Anxiety Disorder, Panic Disorders (Panic Attacks), Phobias

Anxiety disorder

The symptoms of anxiety disorder include a feeling of tension, nervousness, muscular tension, excessive perspiration, light-headedness, heart racing and other unpleasant physical sensations that occur in certain situations. The physical symptoms are accompanied by a sense of indistinct dread, concern which may be specifically or vaguely defined.

Panic disorder (panic attack)

This disorder entails a strong feeling of anxiety in certain circumstances, which may not always be the same. A panic attack is accompanied by chest pain, heart racing, a feeling of suffocation, light-headedness, a sensation of derealization (an altered perception of one’s self (depersonalization), one’s body and others). Also common are fear of death, loss of control, and fear of insanity.

Phobias

When anxiety is manifested in only a given situation that does not represent an actual threat, then it is called a phobia. A person avoids the object of phobia at all costs, and just thinking of the object or situation causes anxiety and fear.

The most common phobias are agoraphobia (fear of leaving the house, going into the street, public places, crowds, entering shops, travelling, etc.), social phobia (fear of social situations linked to low self-confidence and fear of criticism, accompanied by blushing, tremor, nausea, etc.) claustrophobia (fear of closed spaces), acrophobia (fear of heights), etc. Common phobias include fear of certain animals, such as arachnophobia (fear of spiders), katsaridaphobia (fear of cockroaches), musophobia (fear of mice), alektorophobia (fear of chickens), cynophobia (fear of dogs), ophidiophobia (fear of snakes), etc. There are also lesser known phobias such as fear of clowns (coulrophobia), laughter (geliophobia), mirrors (eisoptrophobia), snow (chionophobia), and marriage (gamophobia), which most people finds more comprehensible than for example hexakosioihexekontahexaphobia (fear of the number 666) or xanthophobia (fear of the colour yellow).

Obsessive-Compulsive Disorders

Obsessive-compulsive disorder entails two separate elements: obsessive thoughts and compulsive behaviour. Occasionally, only one of the two elements may be present. Obsessive thoughts can be ideas, images or impulses that keep reoccurring in a stereotypical form. They are unpleasant for the individual, who tries to rid themselves of and resist them. Compulsive behaviours are actions, conducts or rituals that the person keeps repeating. The given actions are not necessarily pleasant, but they have a supposed function (e.g. the person believes that they will avoid an unpleasant outcome). The compulsive behaviours are associated with anxiety, and if the person resists such actions, the anxiety increases. The compulsive behaviours are often linked to hygiene (washing hands, tidying things) or the prevention of dangerous situations (locking doors, cars, checking whether the stove is off, etc.). Behind the obsessions and compulsive behaviours is actually the great anxiety that stems from the person’s unconsciousness.

CMHR also treats the following mental disorders and difficulties

• Dissociative disorders
• Somatoform disorders
• Posttraumatic stress syndrome
• Attention deficiency and hyperactivity disorders
• Chronic fatigue syndrome
• Impulse disorders (pathological gambling, pyromania, kleptomania, trichotillomania, etc.)
• Eating disorders,(in collaboration with a psychiatrist, after hospitalization, or when it is not a life-threatening stage of anorexia)

The mental difficulties that can be successfully resolved through psychotherapy include anger, rage, prolonged grief, problems related to concentration, learning difficulties, increased jealousy, low self-confidence, performance anxiety, psychosexual problems, psychosomatic symptoms, self-harm, partnership problems, insomnia, lack of self-discipline, overcoming various painful and traumatic experiences, increased stress, lack of understanding of a social surroundings, difficulties in accepting sexual identity, etc.

What are dissociative disorders?

Dissociative or conversion disorders entail a certain split between different parts of the personality. Instead of integration of one’s own identity, memories and sense of self, in certain parts there is disintegration. These disorders include amnesia, fugue, stupor, convulsions and motor disorders, loss of sensation in certain parts of the body, etc. If linked to a traumatic event, dissociation in memory (amnesia) usually passes after several weeks or months. In the case of chronic dissociation, they can be grouped into a disorder called hysteria and whose cause and function are psychological. Symptoms are usually a symbolic expression of unconscious conflicts and mental difficulties.

What are somatoform disorders?

Somatoform disorders entail the existence of lasting and reoccurring physical symptoms that have no physical cause, i.e. medical basis. These disorders include different somatisations, hypochondria, chronic pain, chronic fatigue, etc. The symptoms have their psychological causes and functions and only when those specific issues are developed through psychotherapy do the physical symptoms disappear.

Posttraumatic stress syndrome

Posttraumatic stress syndrome is a psychological disorder that occurs as the consequence of a stressful event or situation (brief or long-lasting). Typical symptoms include sleep disorder, uncontrolled recollection of certain images from the experience (flashback), night terrors, emotional numbness, withdrawal from others, avoiding social and other activities, depression and anxiety symptoms. This symptom can also be accompanied by suicidality. Even though the symptoms of disorder are dramatic, in most case a significant or complete recovery is expected.