How are Mental Illness Disorders Diagnosed?

What is Mental Illness

Mental illnesses are health conditions involving changes in thinking, emotion or behavior (or a combination of these).  Mental illnesses are associated with distress and/or problems functioning in social, work or family activities (Parekh, PhD. 2015).  Most importantly, mental illness is treatable and the majority of people diagnosed with a mental disorder can effectively function in their daily activities when appropriate treatment is applied.  Examples of serious mental illness include major depressive disorder, schizophrenia and bipolar disorder.

Signs & Symptoms of Detecting a Mental Illness

Signs and symptoms of mental illness can vary, depending on the disorder, circumstances and other factors.  Mental illness symptoms can affect emotions, thoughts and behaviors (www.mayoclinic.org).  Examples of signs and symptoms include:

• Feeling sad or down
• Confused thinking or reduced ability to concentrate
• Excessive fears or worries, or extreme feelings of guilt
• Extreme mood changes of highs and lows
• Withdrawal from friends and activities
• Significant tiredness, low energy or problems sleeping
• Detachment from reality (delusions), paranoia or hallucinations
• Inability to cope with daily problems or stress
• Trouble understanding and relating to situations and to people
• Alcohol or drug abuse
• Major changes in eating habits
• Sex drive changes
• Excessive anger, hostility or violence
• Suicidal thinking

Getting a Diagnosis
Unlike other diseases like diabetes or cancer, there is no medical test that can provide a diagnosis of mental illness.  Determining which disorder is causing a person's symptoms may be quite involved, however, it is extremely important to take the time to properly diagnose a mental disorder so appropriate treatment can be applied.  To determine a mental illness diagnosis, several events are likely to occur:

Step 1-Physical Exam

TALK TO YOUR DOCTOR

A physical exam given by your health care professional.  A physical evaluation can rule out any underlying medical conditions that may be causing the reported symptoms.  Lab tests may also be performed to check proper thyroid function, hormone imbalances, or presence of drugs and/or alcohol.  Once the other medical conditions are ruled out, the next step is to see a mental health professional.

Step 2-Psychological Exam
A psychological exam given by your doctor or mental health provider, where a series of questions will be asked to help describe your symptoms, thoughts, feelings, and behavior patterns.  Your mental health professional will use what is called the Diagnostic and Statistical Manual of Mental Disorders, fifth edition to make a diagnosis of which disorder you may have.

       How to Determine Which Mental Disorder

Mental illness refers collectively to more than 200 diagnosable disorders.  The DSM-5, published by the American Psychiatric Association, lists criteria including feelings, symptoms and behaviors over a period of time that a person must meet in order to be officially diagnosed with an illness (www.nami.org)  "The Diagnostic and Statistical Manual of Mental Disorders-often referred to as the DSM-is the diagnostic bible for mental health professionals" (Lane, PhD. C.).

Navigating the DSM-5 Manual
The primary purpose of the DSM-5 is to assist trained clinicans in the diagnosis of their patients' mental disorders that leads to a comprehensive treatment plan for each individual.  The symptoms contained in the diagnostic criteria sets are intended to summarize characteristics of signs and symptoms that provide a guide to determine an underlying disorder.  There are three sections that comprise the DSM-5.  The primary goals for the manual's new framework are to help clinicians make more accurate and consistent diagnoses, and to help researchers better study how disorders relate to one another.  In turn, this leads to better treatment for patients (www.psychiatry.org).  The DSM- is divided into three sections.

1. Introduction and instructions on how to use the new version
2. Diagnostic categories
3. Conditions that need additional research, a glossary of terms, and other important information.

Complete Listing of DSM-5 chapters:

• Neurodevelopmental Disorders
• Schizophrenia Spectrum and Other Psychotic Disorders
• Bipolar and Related Disorders
• Depressive Disorders
• Anxiety Disorders
• Obsessive-Compulsive and Related Disorders
• Trauma-and Stressor-Related
• Dissociative Disorders
• Somatic Symptom Disorders                 
• Feeding and Eating Disorders
• Elimination Disorders
• Sleep-Wake Disorders
• Sexual Dysfunctions
• Gender Dysphoria
• Disruptive, Impulse control and conduct Disorders
• Substance Use and Addictive Disorders
• Neurocognitive Disorders
•  Personality disorders
•  Paraphilic Disorders
• Other Disorders

Treatment & Support

Once a mental disorder is appropriately diagnosed, an effective treatment plan will be put into place by your medical professional treatment team that may consist of your primary care doctor, nurses, pharmacist and therapist.  The treatment you receive will depend on the type of disorder diagnosed, the severity of the disorder, and the what works best for you.  In many cases, a combination of several treatments produce the best outcomes for improving mental health.

Parekh, PhD. R. 2015. https://www.psychiatry.org/patients-families/what-is-mental-illness

http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/symptoms/con-20033813

https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition/Understanding-Your-Diagnosis

https://www.psychiatry.org

Lane, PhD. C. http://www.psyweb.com/content/main-pages/dsm-5-fifth-edition-of-the-diagnostic-and-statistical-manual-of-mental-disorders

Confidentiality & Telepsychology

CONFIDENTIALITY:

“Psychologists and consumers of psychological services are frequently concerned about the issue of who is allowed to see and use information about individuals generated during research, consultation, or therapy” (csbsju.edu). Generally, the public puts their trust in psychologists' promises of confidentiality, and it's imperative for psychologists to be clear about what and why information is being released. In most cases, private information must remain confident. The American Psychological Association provides Ethical Principles of Psychologists Code of Conduct (APA, 2017) http://www.apa.org/ethics/code/ that is intended to provide specific standards to cover most situations that psychologists may encounter. Mental health providers must comply with all practices presented in the ethics code and requires a personal commitment and lifelong effort to act ethically.

As technology continues to progress, an increased number of psychologists’ are incorporating technology as a part of their treatment practice. Psychologists are expanding their practice of counseling through the use of phone, text, email, and video media. Telepsychology is one such method psychologists are implementing into their practices to help their patients, however, its use raises a number of ethical privacy issues as the trend continues to become more popular.

Telepsychlology

TECHNOLOGY: 

Telepsychology, also known as “telehealth” defined by the APA Guidelines for the Practice of Telepsychology “as the provision of psychological services using telecommunication technologies. Telecommunications is the preparation, transmission, communication, or related processing of information by electrical, electromagnetic, electromechanical, electro-optical, or electronic means” (APA, 2017).

Psychologists in the United States must be aware of the security and privacy risks of providing online therapy. Psychologists and other healthcare providers are governed very stringently by the Health Insurance Portability and Accountability Act (HIPAA), and issues arise when engaging in this type of treatment with technological platforms that aren’t completely HIPAA compliant. Psychologists are encouraged to take specific care when deciding to use such technologies when delivering psychological services to the patient, and also decide which service can be delivered and by what platform it can be delivered compliantly, without breech of patient confidentiality.

The use of telepsychology for mental health treatment, seems to provide a valid option for many individuals as long as the provider takes necessary precaution to protect patient privacy, researches compliant technological formats to provide the treatment, and assesses the patient appropriately in order to provide beneficial technological treatments that are specific to individual needs. Whether you choose a career in psychology, or any other vocation, we all must make great effort to examine what we are doing in terms of applying ethical implications and understand the requirements and limits of confidentiality, while also having the courage to confront and correct unethical behavior when it arises. Regardless of the technology used, the motivations for utilizing it, and how it is applied, each psychologist must consider the ethical issues prior to integrating technologies into their treatment practice.

http://www.apa.org/helpcenter/online-therapy.aspx

http://www.apapracticecentral.org/ce/guidelines/telepsychology-guidelines.pdf

https://www.csbsju.edu/psychology/student-resources/issues

Technology Gaining in the Therapy World

New technologies may have a place in the mental health field, a field that seemed to be lacking traction in innovative development. However, technological advances are giving mental health professionals new tools to help their patients. In the following, I will discuss the Fisher Wallace Stimulator and how it works, helping to change the lives of many.

The Fischer Wallace Simulator is a cranial electrotherapy stimulator (CES) that mental health professionals can equip patients with to help be successful when treating symptoms of depression, anxiety, insomnia, “…an innovative device changing the mental health game is the Fisher Wallace Simulator, an FDA-approved neurostimulation device …” (Forbes, 2016). The Fisher Wallace Stimulator uses “patented waveforms to gently stimulate the brain to produce serotonin and other neurochemicals responsible for healthy mood and sleep” (fisherwallace.com, 2017).

The stimulator is a portable medical device that is easily used at home with a doctor’s prescription. The stimulator generates gentle electrical pulses through a wearable headband. The treatment sessions last 20 minutes each, in which you can engage in quiet activities like reading a book or watching TV. The cranial electrotherapy stimulation helps the brain to produce neurochemicals that provide the patient relief. Two sponges are connected to electrical wires controlled by the battery operated base unit, and are secured under the headband against the skin at each temple area. The base unit controls the level of stimulation with a dial that illuminates lights next to the preferred levels 1 through 4. The higher level number corresponds to a higher level of electrical frequency and/or treatment indication.

Treating Depression/Anxiety:

The stimulator works very differently from conventional anti-depressant/anxiety medications that prevent the absorption of serotonin, by actually helping the brain to produce serotonin and reduce cortisol. Serotonin is a natural neurochemical that stabilizes our moods. Experts have linked low levels of the hormone with depression and anxiety. “Cortisol is a life sustaining adrenal hormone essential to the maintenance of homeostasis. Called ‘the stress hormone,’ cortisol influences, regulates or modulates many of the changes that occur in the body in response to stress…” (adrenalfatigue.org, 2017). And as a result, effective CES treatment may reduce dependencies on medications that were initially used to alleviate depression and anxiety symptoms.

Treating Insomnia:

The Fisher Wallace Stimulator is shown to provide effective treatment for insomnia by stimulating the brain to create melatonin. “Melatonin is a natural hormone made by your body's pineal (pih-knee-uhl) gland. During the day the pineal is inactive. When the sun goes down and darkness occurs, the pineal is "turned on" by the SCN (suprachiasmatic nucleus) and begins to actively produce melatonin, which is released into the blood” (sleepfoundation.org, 2017). Elevated melatonin levels in the blood are responsible for feeling less alert and signaling your body to want sleep. The device’s recommended use is 20 minutes prior to bedtime to stimulate melatonin production.

Patients report no pain or discomfort when using the Fisher Wallace Stimulator and contribute their mood and sleep health improvement to the drug free device. Unlike addictive medications, users report no groggy or drowsy feeling when waking in the morning and were also able to fall asleep much faster and stay asleep during the night. Many patients using the device for depression and anxiety report a return feeling of normality and relief with decreased levels of anxiety and depression. The device has been cleared by the FDA and is proven in multiple published studies that can be found on the Fisher Wallace website, www.fisherwallace.com.

Continued development of innovating mental health technologies is important to patients and their providers, especially those who prefer drug-free and natural alternatives to treating symptoms. And some, may even depend on such developments, especially those patients who have proven to be pharmacotherapy resistant. Overall, new and continued technological advances, like the Fisher Wallace Stimulator, have shown to be an effective treatment option for depression, anxiety, and insomnia; and are providing patients alternative therapies to improve their quality of life.





http://adrenalfatigue.org/cortisol-adrenal-function

https://www.fisherwallace.com/pages/how-it-works

https://www.forbes.com/sites/toriutley/2016/01/25/4-technologies-innovating-mental-health-in-2016/#4b1563746bb3

https://sleepfoundation.org/sleep-topics/melatonin-and-sleep

https://youtu.be/uEbYVtloYR0

So You Want to Become a Counselor

What Is Mental Health

Lets start with the basics.  Mental health effects how we think, feel, and behave on an everyday basis. It is maintaining some state of well being emotionally, psychologically, and socially while also having an absence of mental illness such as depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.

How Do You Become A Mental Health Counselor

Professional counseling can offer a rewarding career path for those who have one thing in common-a desire to help people work through life’s challenges. Good education is imperative to begin a career in mental health counseling and a graduate's degree from an accredited mental health counseling program is required in most states. According to the American Mental Health Counselors Association (AMHCA), you will need to complete counseling experiences under the supervision of a licensed mental health practitioner after completing a master's degree program (www. policies.org). A minimum of at least two years or 3,000 hours of post-master's practice is generally necessary for licensure eligibility, though exact requirements depend on the state. Once you have completed all requirements per your state you are credentialed. You have a professional title and the initials to follow. All states require that you work under supervision for a period of time to gain full licensure. It is important to understand your particular state's requirements and policies for licensure. This part is a little tricky as some states provide an associate license and others require you to register your supervison. In Wyoming there are two levels of licensure to complete. You will become a Licensed Professional Counselor (LPC) at the completion of all requirements including education, supervised work experience, and licensing exam. Prior to fulfilling your supervised work you will be credentialed as a Provisional Professional Counselor (PPC). Your best bet is to contact your state board if you have any questions about the process that your state requires.  The Bureau of Labor Statistics says the availibility of future job opportunities looks good.

"Employment of mental health counselors and marriage and family therapists is projected to grow 19 percent from 2014 to 2024, much faster than the average for all occupations. Growth is expected in both occupations as more people have mental health counseling services covered by their insurance policies" (www. credentialing.gov). 

What Does A Mental Health Counselor Do

Mental Health Counselors can work in a variety of different settings including but not limited to:

• Hospitals
• Substance Abuse Centers
• Private Practice
• Managed Behavioral Health Care Organizations

A Graduate education and extensive clinical experiences prepare mental health counselors to provide services that help clients with a variety of mental and emotional issues.  They will work with individuals (couples, families, adults, children, or the elderly) to deal with personal issues like depression, anger, suicidal thoughts, addiction, and serious mental illness like bipolar disorder.  Some counselors also work with people trying to cope with the everyday difficult circumstances of life.  For example, coping with a death of a loved one handling grief, relationship dysfunction or divorce, stressors within a job, parenting and physical illness. It is important for counselors to know when to refer clients to seek additional resources beyond their scope of ability.  A referal to a psychologist is apropriate in cases where medications may need to be prescribed. The types of work counselors provide include psychotherapy (collaborative or talk therapy), completing assessments and diagnoses, substance abuse treatment and crisis management; all focused towards helping the patient heal and learn constructive ways to deal with problems or issues affecting their life.  While being a "good listener" (humourously explained in the video clip) is a great quality to have and will benefit you greatly in a mental health counseling career, however, it is definetley not the only reason you should become one as I have outlined.