Most people who experience difficulties and who can benefit from therapy or counseling do not suffer from a "severe mental illness." However, some 15 to 20% of the population may experience a diagnosable severe mental disorder at some point in their lives. Very few seek professional help. The problem: myths and confusion about what mental illnesses really are, how to recognize them and what kinds of treatments are available.

As with many other diseases, mental disorders can be brought about by heredity or other biological factors or by environmental influences. Scientists now believe that severe mental disorders are linked to functional abnormalities of the brain. Yet people continue to stigmatize those with mental illnesses and do not acknowledge the biological causes. Serious mental illnesses have a profound effect not only on individuals experiencing these disorders, but on their families, friends and co-workers.

Following are brief descriptions or the most commonly mentioned severe mental disorders. A range of treatments, including medication, hospitalization, psychotherapy and social services may be used to treat these disorders. Family members and friends may benefit from therapy and/or support groups as well. Local branches of the Mental Health Association and the Alliance for the Mentally Ill can provide listings of support group available in the community.

Schizophrenia
It is believed that approximately one in every one hundred people in the United States today has schizophrenia, which may be caused by a biochemical disorder of the brain. Schizophrenia may be characterized by an inability to differentiate between reality and non-reality. The illness often manifests itself in early adulthood between the ages of 16 - 25. Some of the more obvious symptoms include delusions (false beliefs, despite obvious proof to the contrary), hallucinations (seeing or hearing things that are not present), thought disorders (revealed by disconnected speech or, in severe cases, incoherence), loss of self-identity, withdrawal from the outside world and abnormal psychomotor activity (rocking, pacing or immobility).

Choice of treatment and medications varies, but accurate diagnosis by a qualified psychiatrist or clinical psychologist is essential. "Split personality" is not a symptom of schizophrenia but rather is manifested in a mental illness known as dissociative identity disorder.

Mood Disorders
Periods of sadness may be normal reactions to life. When mood symptoms become disabling, a mood disorder may be present. Mood disorders are characterized by periods of severe depression and/or periods of abnormally high energy and poor judgment.

Depression is a word commonly used to describe temporary "down" moods or sad feelings, but for 10 million people in the U.S., it means something much more serious.

For these individuals, clinical depression is a severe illness, preventing them from maintaining normal life activities. The depression lingers on, often resulting in feelings of complete despair, worthlessness and suicidal behavior.

Depression takes many different forms, each of which varies from person to person. In general, though, clinical depression is referred to as either major depression (the sad kind), or manic-depression/bipolar behavior (periods or intense sadness often alternating with inappropriate mania elation).

Symptoms of the manic phase of bipolar disorder may include excessive sleeplessness, increased desire to talk, distractibility, irritability, hyperactivity, hyper-sexuality, inflated self-esteem or poor judgment.

Symptoms of a depressive phase may include changes in sleep patterns, changes in appetite, feelings of sadness or worthlessness, difficulties with concentration, giving away money and possessions and thoughts of or attempts at suicide.

Fortunately, effective treatment through medication psychotherapy or both, is available for more than 80% of those with depressive illnesses.

Anxiety Disorders
Although anxiety is a normal, necessary part of life, when it becomes too severe for a person to control, it is considered an anxiety disorder. It is the most common of the severe mental disorders, affecting some 10 to 15% of the adult population. The following are some of the chief anxiety disorders.

General anxiety disorders are marked by excessive worry, jumpiness, irritability, tension, sweating, heart pounding or racing. The person is apprehensive, on edge and has problems sleeping. If such symptoms persist for a month or more he or she should seek help.

People with panic disorder are subject to attacks of panic with no obvious cause. They become extremely frightened and may think they are going to die. They may suffer heart palpitations, dizziness, chest pains and a sense of unreality. The disorder may be limited to a few weeks or months, recur several times or persist over a long period of time. Although the attack itself generally lasts only a few minutes, anticipating the feeling of helplessness or loss of control that accompanies the panic can make the person reluctant to be alone or to leave home.

When these situations recur frequently and normal activities become increasingly restricted, the individual is usually diagnosed as having agoraphobia. The person with agoraphobia usually avoids situations in which he/she believes escape would be difficult or impossible - crowds, tunnels, stores, bridges, elevators and public transportation, for example.

Other types of phobias include specific phobias, the persistent and irrational fear of a specific object, activity or situation and social phobias, the irrational fear of humiliating or embarrassing oneself in public.

Obsessive/compulsive disorder (OCD) is a condition in which a person feels compelled to perform pointless rituals, or is troubled by recurrent peculiar worries.

Another anxiety disorder is post-traumatic stress disorder, which is a reaction to a psychologically traumatic event that is outside the range of usual human experience, such as wartime combat, automobile accidents, physical and sexual abuse, rape, earthquakes and other disasters. Symptoms include re-experiencing the event, non-responsiveness to others, little interest in outside activities, sleeplessness, memory problems and loss of concentration.

Other Severe Disorders

Personality Disorders
The individual with a personality disorder demonstrates a general failure to adjust to socially acceptable behavior and is incapable of establishing adequate social relationships and is often troubled by a poor self image. Characteristics of these disorders are rigid and deeply rooted patterns in relating, perceiving and thinking. Personality disorders may become apparent in adolescence, or earlier, and may be less obvious in middle and old age. This is especially true of the individual with an anti-social personality, who is in continuous social or legal trouble and who does not seem to profit from parental or societal punishment.

Individuals with paranoid personality behave toward others with unwarranted suspicion. They may believe that others have taken advantage of them, even when evidence to the contrary is presented.