Mental Health Disorders Overview

Mental Health Disorders Overview

• Mental health disorders (MHD) affect approximately 13% of the global population (971 million people).
• Anxiety is the most prevalent MHD worldwide, affecting 284 million people.
• Depression affects an estimated 264 million people globally; women are more affected.
• Mixed anxiety and depression is the most common MHD in the UK, affecting 7.8% of the population.
• One in four people experience a mental health problem in England annually since the COVID-19 pandemic; depression rates have doubled.
• MHD prevalence often correlates with chronic illnesses; those with physical health problems increased risk of developing MHD; vice versa. Over 15 million people in the UK have chronic conditions, and over 4 million also have MHD.

Types of Mental Health Disorders

• Anxiety: A natural human response (worry, tension, fear). Becomes a disorder when it significantly impacts daily life, exhibiting avoidance, extreme worry, strong and enduring anxieties, difficulty with daily activities, and disproportionate fears.
• Depression: Long-lasting or recurrent, characterized by sadness, loss of interest, disturbed sleep/appetite, feelings of guilt, tiredness, and poor concentration.
• Bipolar Disorder: Globally affects around 45 million; often includes manic and depressive episodes, separated by periods of normal mood; individuals sometimes experience manic attacks without depressive episodes. Manic episodes often involve elevated/irritable moods, overactivity, rapid speech, high self-esteem, and decreased need for sleep.
• PTSD: Develops after a traumatic experience; involves reliving traumatic events, alertness, avoidance of memories, difficult feelings, upset, anxiety symptoms, and panic attacks when reminded of the trauma. Impacts everyday life, impacting abilities to look after oneself, keep jobs, cope with change, and potentially causes issues with other mental health conditions like anxiety, depression and suicidal feelings.

Management

• Anxiety: Self-directed management (self-help workbooks, online cognitive behavioral therapy programs); talking therapies (applied relaxation therapy); medication (antidepressants, SSRIs, pregabalin, beta-blockers, benzodiazepines).
• Depression: Mild/moderate cases- talking therapies (CBT, Psychotherapy); moderate/severe cases- medication (anti-depressants).
• Bipolar Disorder: Depressive episodes- medication, psychological treatments (e.g., CBT); manic episodes- medication, talking therapies (CBT, Interpersonal therapy), long term- enhanced relapse prevention.
• PTSD: Talking therapies (CBT, eye movement desensitization and reprocessing (EMDR)); medication (Paroxetine, Mirtazapine, Amitriptyline, Phenelzine).
• Schizophrenia: Talking therapies (CBT, psychodynamic therapy, family intervention); medication (antipsychotics); arts therapies (art, music, dance, drama).
• OCD: Talking therapies (CBT); medication (selective serotonin reuptake inhibitors (SSRIs), Fluoxetine, Sertraline, Citalopram, dopamine blockers (Risperidone, Aripiprazole, Olanzapine)).

Additional Considerations

• Autism: Challenges in understanding others' thoughts and feelings, anxieties about social situations, difficulty describing feelings, taking things literally, sensory sensitivities, avoidance of eye contact, dislike of being touched. Treatment for associated conditions such as Epilepsy, ADHD, Anxiety, Depression, OCD.
• Feeding and Eating Disorders: Conditions with abnormal eating behaviors that are not culturally acceptable or developmentally appropriate; Examples like anorexia, bulimia, binge eating, avoidant/restrictive food intake disorder.
• Patient Management: Tailor management plans to individuals' needs; consider communication styles (language, delivery of message, empathy, support).

Barriers and Resources

• Barriers: Stigma, discrimination, avoidance, socio-economic disadvantages, isolation.
• Raising Concerns: Report concerns to senior colleagues or safeguarding leads.

Additional Considerations and Management

• Smoking, Alcohol, Substance misuse : Impacts dental health.
• Tooth wear, Oral appearance, Caries, Self-neglect, Reduced motivation, Avoidance, : Associated factors impacting dental care.
• Medication side effects : Requires management (dry mouth, altered taste, vomiting).

Further Reading

• References: Provided in the text.
• Resources: Links to UK based mental health organizations.

Lecture Outline

• Introduction to Mental Health Disorders
• Types of Mental Health Disorders (anxiety, depression, bipolar, PTSD, schizophrenia, OCD, Autism, Eating disorders)
• Dental implications and management