Category: Borderline

The Numbers Don’t Lie: Mental Illness in America

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~Mental Illness in America, 2016

Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.1

When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.2 Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness.1

In addition, mental disorders are the leading cause of disability in the U.S. and Canada.3 Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.1

In the U.S., mental disorders are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-V).4

Mood Disorders

Mood disorders include major depressive disorder, dysthymic disorder, and bipolar disorder.

  • Approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder.1,2
  • The median age of onset for mood disorders is 30 years.5
  • Depressive disorders often co-occur with anxiety disorders and substance abuse.5

Major Depressive Disorder

  • Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.3
  • Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.1, 2
  • While major depressive disorder can develop at any age, the median age at onset is 32.5
  • Major depressive disorder is more prevalent in women than in men.6

Dysthymic Disorder

  • Symptoms of dysthymic disorder (chronic, mild depression) must persist for at least two years in adults (one year in children) to meet criteria for the diagnosis. Dysthymic disorder affects approximately 1.5 percent of the U.S. population age 18 and older in a given year.1, This figure translates to about 3.3 million American adults.2
  • The median age of onset of dysthymic disorder is 31.1

Bipolar Disorder

  • Bipolar disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population age 18 and older in a given year.1, 2
  • The median age of onset for bipolar disorders is 25 years.5

Suicide

  • In 2006, 33,300 (approximately 11 per 100,000) people died by suicide in the U.S.7
  • More than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder.8
  • The highest suicide rates in the U.S. are found in white men over age 85.9
  • Four times as many men as women die by suicide9; however, women attempt suicide two to three times as often as men.10

Schizophrenia

  • Approximately 2.4 million American adults, or about 1.1 percent of the population age 18 and older in a given year,11, 2 have schizophrenia.
  • Schizophrenia affects men and women with equal frequency.12
  • Schizophrenia often first appears in men in their late teens or early twenties. In contrast, women are generally affected in their twenties or early thirties.12

Anxiety Disorders

Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias (social phobia, agoraphobia, and specific phobia).

  • Approximately 40 million American adults ages 18 and older, or about 18.1 percent of people in this age group in a given year, have an anxiety disorder.1,2
  • Anxiety disorders frequently co-occur with depressive disorders or substance abuse.1
  • Most people with one anxiety disorder also have another anxiety disorder. Nearly three-quarters of those with an anxiety disorder will have their first episode by age 21.5 5

Panic Disorder

  • Approximately 6 million American adults ages 18 and older, or about 2.7 percent of people in this age group in a given year, have panic disorder.1, 2
  • Panic disorder typically develops in early adulthood (median age of onset is 24), but the age of onset extends throughout adulthood.5
  • About one in three people with panic disorder develops agoraphobia, a condition in which the individual becomes afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack.12

Obsessive-Compulsive Disorder (OCD)

  • Approximately 2.2 million American adults age 18 and older, or about 1.0 percent of people in this age group in a given year, have OCD.1, 2
  • The first symptoms of OCD often begin during childhood or adolescence, however, the median age of onset is 19.5

Post-Traumatic Stress Disorder (PTSD)

  • Approximately 7.7 million American adults age 18 and older, or about 3.5 percent of people in this age group in a given year, have PTSD.1, 2
  • PTSD can develop at any age, including childhood, but research shows that the median age of onset is 23 years.5
  • About 19 percent of Vietnam veterans experienced PTSD at some point after the war.13 The disorder also frequently occurs after violent personal assaults such as rape, mugging, or domestic violence; terrorism; natural or human-caused disasters; and accidents.

Generalized Anxiety Disorder (GAD)

  • Approximately 6.8 million American adults, or about 3.1 percent of people age 18 and over, have GAD in a given year.1, 2
  • GAD can begin across the life cycle, though the median age of onset is 31 years old.5
To finish reading this article, you will need to go to its source at:

http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml  

 

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1 in 4 Church Homes Are Dealing With This!

By Carlene Hill Byron

How many families in your church have a loved one who struggles with mental health problems? That’s kind of a trick question. People don’t talk about mental health problems. You’re more likely to hear them describe their child’s condition as “something like autism,” as the elder of one church we know says.

Or they might cover up entirely, as does an elder’s wife in another congregation. When her bipolar disorder swung into mania after childbirth, her family, already managing the added responsibilities of a newborn, had to manage her condition as well. But because her condition is a secret, they did so without any support beyond the usual “new baby” dinners.

The answer to the question is, if your congregation is representative of the U.S. population, one in four households will struggle with someone’s mental health problems over their lifetime. That’s schizophrenia, bipolar disorder, obsessive compulsive disorder, disabling chronic depression, and various anxiety disorders.  Look at the faces seated around you this Sunday.  Someone is probably hurting. And they’re probably afraid to tell you.

The least acceptable disability

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Out of Control

A study where people ranked disabilities by their “acceptability” returned these results, in order–most acceptable: obvious physical disabilities, blindness, deafness, a jail record, learning disabilities, and alcoholism.

Least acceptable: mental health problems. People with mental health problems frighten us because when people become mental ill, they become someone we don’t know. A bright boy who was his family’s bright hope may find he just can’t cut it anymore as schizophrenia turns him paranoid, disoriented, unmotivated in the extreme, and overwhelmed by delusional voices that tell him, over and over, how worthless he is.

Or, in the case of bipolar disorder, a girl who was a well-liked and active member of her Teen Challenge group may suddenly turn promiscuous, run away from home, and make a new home in the streets of a strange city. Laziness. Promiscuity. Violence. Sin. That’s what many people see when they look at those with mental health problems. It’s hard to believe that people may behave in such unacceptable ways and not be in control of their behavior.

Having a mental health problem is a lot like being on alcohol or drugs, without being able to stop. Medications “work” for about two-thirds of us. That means that a third of us can’t ever get off the chemical ride that our brains produce.

For those of us who can use medications, the side effects can be daunting. I have lost about 20 percent of my small motor functionality as a result of one of the five medications I take for bipolar disorder. I prefer that to losing large motor control and having another auto accident, being so disoriented I can’t find my way home from the store, losing bowel control in a busy bookstore, gaining 45 pounds, or any of dozens of side effects I’ve experienced on other medications.

Many people become so frustrated with side effects that they stop taking medications. Only about half of us accept treatment. Even when we are treated, not everyone regains their status as a fully functioning adult. In our extended family, six people have diagnoses. Those with bipolar disorder and chronic depression are successfully medicated and work full-time. Those with panic disorder and schizophrenia are on permanent disability. Nothing has pulled them through.

 

What the Bible says

The Bible talks about mental illness, as well as physical illness.

  • It describes a king who was made mentally ill until he would recognize the sovereignty of God (Dan. 4:29-34).
  • It describes demonized men who lived among the tombs and terrorized everyone until Jesus set them free (Matt. 8:28-33).
  • It also describes as demonized a young boy that most scholars today say had epilepsy (Matt. 17:15-18). Jesus delivered him, too.
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What was once believed

What does this tell us about illness?

First, that God is able to heal. Second, that some physical and mental illnesses are caused by demons. Third, that some mental illnesses are caused by sin. But are all mental illnesses caused by demons or sin, and is seeking God our sole resource for physical and mental healing?

Since the 1950s, we have usually sent church members with epilepsy to doctors for effective treatment with anti-convulsant drugs. In a similar way, we’ve learned that medicines can effectively treat many cases of mental illness. So if all mental illnesses were caused by demons and sin, medicine would be exorcising demons and turning hearts to repentance. That is certainly untrue, for those are the works of the Holy Spirit.

Instead, we now know that most if not all mental illnesses are biological in origin, with environmental factors possibly triggering an existing genetic predisposition to the illness. Mental illnesses, just like epilepsy, are biological disorders of the brain.

What can the church do?

Compassionate service is one of our core charges as Christians. We observe it almost daily in the experience of one man we know with schizophrenia. His life is confined almost entirely to his home due to the fear, indecision, and lethargy that have become the shape of the illness in his body. But neighbors bring him occasional meals. The secretary of his small church talks to him by telephone every weekday. Several other members take weekly calls at designated times to help break his isolation. If he doesn’t feel up to driving to his Bible study meeting or Sunday services, some member will give him a ride. Nearby relatives help him plan and manage his finances, and come by to clean occasionally and for DVD “movie nights.” Phone cards given as gifts allow him to call his mother nightly. There’s much more that could be done—more frequent house cleaning and more meals and more visits—but he enjoys far more contact with many more loving people than many shut-ins.

The challenging good news is that when people with mental illness turn to someone outside “the system” for help, the church is first to get the call 40 percent of the time. Is your church ready?

…………………..

Carlene Hill Byron is the former Director of Communications for Vision New England. Through NAMI—the Nation’s Voice on Mental Illness, she and her husband, James, train churches to effectively serve people within the congregation with mental health problems and also teach NAMI’s class for families of people with mental health problems. They are members of Asbury United Methodist Church in Raleigh, North Carolina, where James serves on staff. First published by Vision New England’s Ministries with the Disabled, Acton, Massachusetts.

http://www.mentalhealthministries.net/index.html

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BPD Central: An Illness of Extremes

What is Borderline Personality Disorder (BPD)?

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Sometimes, it's just too much

A borderline writes: 

“Being a borderline feels like eternal hell. Nothing less. Pain, anger, confusion, hurt, never knowing how I’m gonna feel from one minute to the next. Hurting because I hurt those who I love. Feeling misunderstood. Analyzing everything. Nothing gives me pleasure. Once in a great while I will get “too happy” and then anxious because of that. Then I self-medicate with alcohol. Then I physically hurt myself. Then I feel guilty because of that. Shame. Wanting to die but not being able to kill myself because I’d feel too much guilt for those I’d hurt, and then feeling angry about that so I cut myself or O.D. to make all the feelings go away. Stress!”

Therapists use a book called “Diagnostic and Statistical Manual” (DSM) to make mental health diagnoses. They’ve outlined nine traits that borderlines seem to have in common; the presence of five or more of them may indicate BPD. However, please note the following: Everyone has all these traits to a certain extent. Especially teenagers. These traits must be long-standing (lasting years) and persistent. And they must be intense.

Be very careful about diagnosing yourself or others. In fact, don’t do it. Top researchers guide patients through several days of testing before they make a diagnosis. Don’t make your own diagnosis on the basis of a WWW site or a book!

Many people who have BPD also have other concerns, such as depression, eating disorders, substance abuse — even multiple personality disorder or attention deficit disorder. It can be difficult to isolate what is BPD and what might be something else. Again, you need to talk to a qualified professional.

DSM-IV Definition of BPD

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5).

A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called “splitting.” Following is a definition of splitting from the book “I Hate You, Don’t Leave Me” by Jerry Kreisman, M.D. From page 10:

 “The world of a BP, like that of a child, is split into heroes and villains. A child emotionally, the BP cannot tolerate human inconsistencies and ambiguities; he cannot reconcile good and bad qualities into a constant coherent understanding of another person. At any particular moment, one is either Good or EVIL. There is no in-between; no gray area….people are idolized one day; totally devalued and dismissed the next.”

“Normal people are ambivalent and can experience two contradictory states at one time; BPs shift back and forth, entirely unaware of one feeling state while in the other. When the idealized person finally disappoints (as we all do, sooner or later) the borderline must drastically restructure his one-dimensional conceptionalization. Either the idol is banished to the dungeon, or the borderline banishes himself in other to preserve the all-good image of the other person.”

“Splitting is intended to shield the BP from a barrage of contradictory feelings and images and from the anxiety of trying to reconcile those images. But splitting often achieves the opposite effect. The frays in the BP’s personality become rips, and the sense of his own identity and the identity of others shifts even more dramatically and frequently.”

Identity disturbance: markedly and persistently unstable self-image or sense of self.

Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior, already covered.

Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

Chronic feelings of emptiness.

Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

Transient, stress-related paranoid ideation or severe dissociative symptoms.

Dissociation is the state in which, on some level or another, one becomes somewhat removed from “reality,” whether this be daydreaming, performing actions without being fully connected to their performance (“running on automatic”), or other, more disconnected actions. It is the opposite of “association” and involves the lack of association, usually of one’s identity, with the rest of the world.

 There is no “pure” BPD; it coexists with other illnesses. These are the most common. BPD may coexist with:

  1. Post traumatic stress disorder
  2. Mood disorders
  3. Panic/anxiety disorders
  4. Substance abuse (54% of BPs also have a problem with substance abuse)
  5. Gender identity disorder
  6. Attention deficit disorder
  7. Eating disorders
  8. Multiple personality disorder
  9. Obsessive-compulsive disorder

Statistics about BPD/ BPs comprise:

  • 2% of the general population
  • 10% of all mental health outpatients
  • 20% of psychiatric inpatients
  • 75% of those diagnosed are women
  • 75% have been physically or sexually abused

Learn about the causes and treatment of BPD.  Contact BPD Central at  tel: 1-888-357-4355 or 1-800-431-1579 or check out this web link: http://www.bpdcentral.com/index.php

Out in mid-November: Randi Kreger’s new book “The Essential Family Guide to Borderline Personality Disorder!” If you care about someone with BPD, you must have this book.   Get an excerpt and/or order from BPD Central web site.

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