Video Transcript: What is Mental Illness?

Welcome back to mental health integration. In this section, we are going to be  going through all of these mental illnesses and what they look like and  definitions. It's going to be quite a knowledge dump, which I'm excited about for  because you just need to know these things. You need to know what's around  and so when you hear something like, I have BPD, or I have this other issue,  you know what it is. You at least have a place to put it in your mind. So that said, we are going to jump right in to different mental illnesses. The DSM-V starts with neurodevelopmental disorders. These are a different type of disorder. They  affect about 8.8% of the population, but ironically enough, they affect more  males than females. Among those are autism spectrum disorders which make  up 1.8% as you see, ADHD or Attention Deficit Hyperactivity Disorder, which  makes up 8.8% communication disorders, specific learning disorders, motor  disorders, inner intellectual disabilities, these are all issues of how your  neurology comes to be. And so when we're talking about these, we will start with autism spectrum disorders. Now, autism affects how your brain forms in autism,  specifically, there's a huge range of what autism can look like. It ranges from  very, very, very mild autism, all the way to extreme autism, where people can be  non functional. But what autism does is it creates your neural networks  differently, so your brain naturally wires itself, and it naturally forms all of these  connections between your different neurons. And in autism, some areas of your  brain will form extra connections, while others just won't form the connections  they're supposed to. And because that, it greatly affects how people process. So you see, people have different issues about maybe not understanding the  person in front of them, or not understanding cues, or not understanding how  things naturally work as far as expectations of interactions, it changes how  people work within systems of people, it changes what is most important to  them. Some really famous people with autism spectrum disorders have really  began to say autism is actually a really good thing, because people with autism  tend to be focused on especially with what used to be called Asperger's, and  now is a less severe form of autism spectrum disorder. These are people who  create and generate and build things, and while everyone else is around sitting  around a campfire, someone with autism may invent a diverse spear because  they were focused on building and creating something. So it's not necessarily  that these are bad things, that these are terrible things all the time. Sometimes  there is a really, really bright silver lining to these, these diagnoses that can have really profound implications. So autism spectrum disorder affects a few people.  We also, we also have ADHD on that list, which affects more men than women.  Once again, that could be the way that it's diagnosed, or it could also just be that that's how it happens that more men than women have ADHD, you also saw that we have communication disorders. Which communication disorders include, like language disorders, they include speech sound disorders, child onset fluid  fluency disorders, they're really about, can you communicate with the world 

around you? Because if you can't communicate with the world around you, the  world's a pretty hard place to get around. And beyond that, we also have motor  disorders. Are your neural networks forming so that you can do things with your  

hands and your body like you're supposed to be able to, and intellectual  disabilities. So sometimes your brain just doesn't form exactly the way that it's  supposed to, and you get specific learning disorders, or you get something like  an intellectual disability. The interesting thing about these disorders is, since  they are about. Forming of your neurology they all come early. They all diagnose these between birth and 17 years old. But since they're about your neurology  forming, they all happen right away. There aren't these disorders that show up  when you're 42 or 43 likes happens with some other mental illnesses where they have late onset. That said we are going to jump into schizophrenia spectrum  and other psychotic disorders they affect about 0.4% of the US population in any given year. Schizophrenia is normally considered like the most severe mental  illness in studies where they measure people's reactions to the severity of  mental illness, normally, schizophrenia is at the top of the list. This is what  people perceive as the most severe mental illness. The definition of  schizophrenia is that Schizophrenia is a mental disorder characterized by  disruptions and thought processes, perceptions, emotional responsiveness and  social interactions. Although the course of schizophrenia varies among  individuals, it's typically persistent and can be both severe and disabling.  Symptoms include psychotic symptoms like hallucinations, delusions, thought  disorder and reduced expression of emotions. Now they often start in late  adolescence or early adulthood, but it can start earlier. This reflects sometimes  this happens as you have hard life events or something that will trigger the onset of what biology is dictated is going to happen, and then it manifests. If  schizophrenia is left untreated, though it is incredibly, incredibly damaging.  Interesting to note about schizophrenia is there have been a number of things  that have come out about schizophrenia, like the movie A Beautiful Mind, and  there's been books written about schizophrenia. It's not there's some problems  sometimes when people confuse dissociative identity disorder and  schizophrenia. Schizophrenia has hallucinations. It has all these things that  happen in your head, but it does not have you switching from one personality to  another. That's a different diagnosis altogether. Bipolar disorder and related  disorders affect about 2.8% of the US population in any given year. Now that  may seem a little bit low, because there's a lifetime prevalence of 4.4% and  that's because bipolar disorder and these related disorders are called episodic  disorders. You can have an episode of bipolar disorder where you can have a  bipolar and a manic faze, and then you could not experienced another episode  for years. So there are a number of people who exist in a space where they  have the disorder but are not symptomatic for long periods of time. As you can  see, it sometimes refers to a manic depressive disorder, that was the name, 

especially 80s and before it was often called manic depressive disorder, and it's  characterized by dramatic shifts in mood energy and affects levels, affects  activity levels that affect a person's ability to carry out day to day tasks. In  bipolar disorder, you have massive mood shifts from what we think of as really,  really depressed, these incredibly low depressions, to Manias, which are the flip  side of that, are these periods of hyperactivity and where it feels almost like you  can do anything, like your brain is on fire, because there's so much activity  happening so fast. And then bipolar disorder, you actually move between those  two poles. So bipolar and sometimes spending little or no time in the middle  between those two things. Data about comorbidity, Bipolar disorder is not  diagnosed as mild to moderate very often. You can see this, that in the vast  majority of cases, in 82.9% of cases, it's diagnosed as a severe mental illness,  and only a very small minority of cases, less than a quarter of cases, it's  diagnosed as a moderate that was according to 2019 so these are major,  massive disorders. They have huge, huge implications for people. And often  people with bipolar disorder end up on disability because they are not able to  work because of the severity of their mental illness. Next. We're going to talk  about depressive disorders. And depressive disorders, major depression is  awful. There's levels of depressive disorders, just like there are of autism or of  bipolar disorder. But depressive illnesses can set in for incredibly long periods of time or short periods of time, but the minimum that you can diagnose a person  with is at least two weeks where their depression affects them. And you can see  that from the definition from the National Institute of Mental Health in 2019 I also have this video from Dr Greg Knapp, Greg Knopf, I'm sorry, who's a friend. Let's  cut that section and redo it. I also have a video from Dr Greg Knopf, who is a  doctor in Portland, who's written a number of books about depression. He's a  friend, and he has come up with this video about depression and what  depression does in the brain. Thanks to Dr Greg Knopf for that. That was just a  beautiful piece, and it shows us exactly how our own neurotransmitters affect  depression, and what happens in that now, depression affects a lot of people  overall, it affects a little bit less than 8% of the population. Once again, numbers  are skewed for females to males, 9.6% of females versus 6% of males, and you  can see the same skew that we saw in mental illnesses and severe mental  illnesses, where the skew is toward younger people, age 18 to 25 having by far  the highest rates of depression at 15.2 and then dwindling down to less than 5% after age 50. You can also see that whites continue to have some of the higher  rates. But you can see in the case that there are two or more races, or in the  case of American Indians or Native Americans, these rates are actually much  higher, with two or more races being the highest at 13.7% in the last year. It is  important to note that in depression, since there are so many different types of  depression and severities, that depression could mean that someone goes  through an episode and they're fine, or depression, could be that someone has 

clinical depression where it is absolutely disabling and cannot be overcome  without medications, and that just depends on the person, and it depends on  how their body works. So once again, since it's a spectrum disorder, it can be  anywhere on that spectrum, next. Comes anxiety disorders. Anxiety disorders  are the most prevalent mental illness that there is. Here's your definition.  Occasional anxiety is an expected part of life, but anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety  does not go away and get worse over time. The symptoms can interfere with  daily activities such as job performance, schoolwork and relationships. There  are several different types, including Generalized Anxiety Disorder, Panic  Disorder,and various phobia related disorders. You can see the commonality of  these disorders overall, it's about 19.1% of people will experience anxiety in a  given year, and that is an anxiety disorder, not just any level of anxiety. These  rates, again, are skewed higher female to male, and once again, they're a little  bit higher in younger ages, but you can see in 60 plus that just drops off  significantly. But before then it's it's quite a bit higher. It's also important to note  that during covid, with the increase in anxiety and depressive disorders, there  was an increase of, like, a full five percentage points, and those with unmet  mental health care needs and other increases. And there was were largely those who were 18 to 29 years old and without an education. So anxiety is bad in the  last couple years, it's gotten in some ways worse. So just an important thing to  know, also important to know is panic disorders, phobias, these all fit under  anxiety disorders, so things like fears of open spaces, arachnophobia, you name it, all of those things are also phobia disorders or anxiety disorders, as are panic disorders and panic attacks. Those are brought on and also a type of anxiety  disorder, obsessive, compulsive and related disorders. OCD is a common  chronic, long, lasting disorder in which a person has uncontrollable recurring  thoughts, obsessions and or behaviors which he or she feels the urge to repeat  over and over again. It's not very common. It affects about 1.2% of the  population, and the rates once again, are skewed much higher female to male,  and once again, higher in younger age groups. These are incredibly damaging  disorders. Often though, we think of, you know, the show Monk and about how  he was incredibly detail oriented about his cleaning and about his sanitation of  things, but I have a number of friends with obsessive compulsive disorder, and  the way those manifest can be crippling in how they have to go about their days, and how the intrusive thoughts they don't go away, and they just butt in and in  some ways dominate a person's conscious life. It's it's a very difficult and very  strange sort of situation. Next are trauma and stress related disorders like  PTSD. Now, these are not necessarily considered just like mental illnesses.  These are actually injuries in the way they happen. They actually damage your  brain, not that your brain gets hit by a hammer or something. But the brain, the  way your brain works, is rewired by traumatic events. So these are almost like if 

your brain got injured, it can develop after exposure to potentially traumatic  events, and that are beyond typical stressors, events that may lead to PTSD  include but are not limited to violent, personal assaults, natural or human  caused disasters, accidents, combats or other forms of violence. Exposure to  events like these are common about one half of all US adults will experience a  traumatic event in their life that would be significant enough that it could cause  PTSD, but most do not develop PTSD. People who are experienced PTSD may  have persistent fighting frightening thoughts and memories, experience sleep  problems, feel detached or numb. They can be easily started, and they can  significantly impair a person's ability to function at work, at home or socially. We  see this especially commonly with people who have been through issues of  violence, whether that was sexual violence or whether that was battlefield  violence. It changes how our brain functions, it breaks us, and then that  breaking has to be worked with in very specific and very detailed ways in order  to work past there's even specific modalities of therapy to work through trauma.  And I'm really glad that we've developed some really great ways of working, and we'll talk more about those as they come up later in the course. The mental  health rates of PTSD are around three and a half percent. They get highest  among people in 44 to 45 to 59 age gap, which is interesting, but it could be that there has been more chance to live life. There have been more opportunities for  traumatic events to set in, and more opportunities for people to have bad things  happen, which is unfortunately part of what happens. And according to the  criterion A definition we're talking about the definition of when trauma happens.  How many people are affected by trauma? Most people are trauma exposed.  87.7% of participants were trauma exposed. In this study, of those 12 and a half  percent or 12.7% met diagnostic requirements for PTSD. So when you get  trauma, it doesn't necessarily mean PTSD happens, right? This was a study of  complex trauma, and in that you can say 87% of people were exposed, but only  12 and a half percent made it. That's a significantly lower number. It's about one  in five people actually developed PTSD even when there was trauma.  dissociative disorders are what many people think of as schizophrenia, but it's  actually not this is where you have your brain break into sometimes multiple  personalities used to be called Multiple Personality Disorder. Simple people talk  about it as different parts of you, but it's not very common. It's about one and a  half percent of the global population. It's often misdiagnosed. It's often in people  who have had really traumatic upbringings, and it's often associated with self  injury and suicide attempts. Somatic symptoms, disorder is among those which  is characterized by an extreme focus on physical symptoms such as pain or  fatigue that causes a major emotional distress and problems functioning. So  sometimes you have a problem somatic your body. So you have a symptom in  your body that feels really terrible, and that affects five to 7% of the population  among mental health issues. You also have feeding and eating disorders, which 

these are all about, you know, little babies and when they're having problems  eating and growing. But then you get to eating disorders such as anorexia and  bulimia, women suffer from the many, much more often than men do. But  interesting to note, there are some of the most deadly mental illnesses that exist are actually eating disorders. Elimination disorders are only basically for kids, it's when we have problems going through, going to the restroom and the right way  is the right places. There's also sexual dysfunctions like gender dysphoria,  especially now with questions about transgender and what race you were or  what sex you were meant to be at birth, there's questions about how you walk  through if a person feels like they were made wrong, and you can teach an  entire class just on Gender dysphoria and how people process that in many  cases, many churches are having to wrestle through these issues really hard  right now, to be blunt, most of this course is going to be focused on the mental  illnesses that you see in your church that are things like depression or bipolar or  schizophrenia or anxiety issues about the theology of what it means to be made  male or female, and what it means to be made at birth, are huge issues that are  much, much too big for us to cover in this course. Well, sleep, wake disorders  affect a number of people, about six to 10% of people have insomnia. You also  get restless leg, narcolepsy, all sorts of things. These are just problems sleeping or staying asleep. And then we also get disruptive impulse control, impulse  control and conduct disorders. And there's tons of different ways that these  exhibit themselves. They're all about, you know, destroying property, defiance,  stealing, rule breaking. But there's more than that. There's there's a piece of that that isn't normal. You know, fire is really handy and good and fun, but not every  person who enjoys fire, because it's really a great tool in life, has a is a  pyromaniac. And likewise, you know, it's great to have good things, but not every person is a kleptomaniac and steals things. So that is to say that they are about  impulse control and and they're they're fairly big issues. But once again, when  you're talking about mental illnesses, these are generally considered almost like  moral issues, instead of mental issues, they're somehow taken off of the mental  illness space when we talk about mental illnesses often, and instead, people  generally tend to focus on depression, bipolar, anxiety, schizophrenia and those  sorts of things. So we're not going to touch on these really heavily at all in this in this course, but they're there, and you would. At some point need to work or deal with them. Most likely, what you will have to deal with on a really regular basis,  though, is substance related and addictive disorders, and that's because the  comorbidity between substance related and addictive behaviors and things like  bipolar disorder, depression or anxiety is amazingly high. So many people cope  with things like bipolar disorder, with substances and with addictions. It's It's  terrifying, but it's part of what is going on. The lifetime rate for alcohol use  disorder in teens is 8% illicit drug rates is two to 3% but that how they affect  people is just so much higher than that. The rates of alcoholism and the number 

of people who are affected by alcoholism are going they're just incredibly high,  especially since covid. They've been going up. Since covid, the rates of opioid  use and the opioid crisis going on is just going through the roof, especially since  covid began in 2020, so we're seeing much higher rates of some of these things, in part because they're coping mechanisms. Addictions exist because someone  needs to cope with something, and addictions are really bad solution to an  existing problem. In this case, I can't deal with my life, and I need an outlet or  something like that. And because of that, the addiction becomes the outlet to  that problem and then feed on itself until it becomes its own kind of problem.  Neurocognitive disorders refer to disorders of cognitive decline. So we talk  about neuro neurogenerative disorders. These are forming those neurons.  Neurocognitive disorders are on the latter end of life. Specifically, we're talking  about Alzheimer's and dementia mostly. But those are becoming epidemic. The  number is growing incredibly quickly, 6.2 million Americans age 65 or older  today, but they're expecting the number to grow to 13.8 million by 2060 and I've  heard guesses that it could even grow much more than that, with relations to  different medical conditions that are showing to be more common in people who  are younger. It's also important to know that Alzheimer's dementia putting  incredibly heavy burden on family members. The number of unpaid hours that  family members spend caring for loved ones is astronomical because you you're basically are their primary caregiver, and you have to take care of them all the  time. 15.3 billion hours of care to people with Alzheimer's and dementia in 2020  that's a phenomenal amount of work that was put in caring for people. Finally,  we get to personality disorders, and they fit into one of three clusters, as you  can see, A, B and C and those fit as far as different characteristics of these  disorders. Cluster A, paranoid personality disorder, schizoid personality disorder  and schizotypal personality disorder. Section B, anti social personality,  borderline histrionic personality disorder and narcissistic personality disorder  and Section C, anti social or dependent personality disorder, obsessive consult  compulsive personality disorder. What you need to know about these. These  used to be considered access two disorders, and the DSM-IV, there was access  one and two anyway, but now these are just lumped in personality disorders  their own thing. In the DSM-V, there's no considered access as far as these are  trauma caused or these are biologically caused. But personality disorders are a  massive issue, and churches, especially borderline personality disorder. We  used to talk about borderline as the pastor killer, when I was working with my  quiet cave full time, which was it would just suck people dry, especially pastors,  because there was this, this almost leash like ability for people to feed off of you, because they were so desperately looking for love and care and attention. So  understanding what borderline is and how it works is incredibly important for  you. As a pastor, the number of pastors who I've known who have worked with  Borderline and just been absolutely destroyed because of it is really high. And 

for that, specifically for pastors, there's books like walking on eggshells about  borderline personality disorder and what you can do if you know somebody with  borderline personality disorder that just are incredibly important. I cannot  overemphasize how important it is to get some knowledge about that. The  reason the way borderline specifically works is I need to get my worth and value  from you, because there's such a distrust or hatred of myself and that feeds on  itself, and so I am naturally going to latch on to somebody who can help me get  some belief that I belong or that I matter, but that that core belief that I still do  not matter is still underneath. It's still building. It still has legs, for lack of a better  word, and so as I suck all of that meaning and purpose out of you that you give  to my life. I still hate myself inside. So at some point, this relationship needs to  go sideways, if there's any doubt about me being able to continue to feed and  that reinforces the idea that I am worthless, that I am nothing. And so we see a  lot of the time that there's this pull, I will pull everything out of you until a  boundary comes, and then there is just an absolute destruction of the  relationship, because the only way the relationship could exist was with this flow. And the reason I'm pushing on this extra is because we have seen so many  pastors adversely affected by it. These are the rates of personality disorders and borderline. As you can see, personality disorders are about 9.1% of the  population. Borderline makes up about 1.4% of the population. But if you're  going to find borderline, we used to joke that people with borderline find each  other, and it's just something that happens. So a final note about personality  disorders is most of us have some of the characteristics of personality disorders  in us, right? We naturally are a little bit narcissistic, especially when we're three  years old. That does not mean you have narcissistic personality disorder. We're  naturally have self doubts and problems with believing in ourselves. We  naturally have issues with relating to other people at times, and wanting to pull  back or pull away. But those do not mean you have a disorder. These disorders  are when these things affect daily life in profound ways. So it's not something  that's really, really common. It's about 9% of the population, but in many cases,  it's very severe. It's there's also paraphilic disorders. We're not going to touch on those very much. Those are about sexual desire, and I have never come across  paraphilic desires as something that I was working with on a regular basis  working with mental health issues, so we're just not going to jump into those too  much. Other than that, there are also many other mental disorders and  additional codes that are smaller. There's different types of depression, different  types of Bipolars, where there's different things that affect people, there's  different types of anxiety disorders. We couldn't possibly touch on every single  thing that could possibly exist, because they're coming up with new ones all the  time, because we're still seeing new things that we don't have names for.  There's also medication induced movement disorders. There's other effects of  medication. There are now even treating people. We're getting more problems 

because these medications that we're using are very strong, and sometimes  they have side effects. And so we're finding that there's even different disorders  or different problems just because of medications. So because of that, there's  other conditions that may be a focus of clinical attention, even if there's other  mental illnesses going on. So that is mental illness, and well, as fast as we could possibly run through it. These are the definitions, but in the next week, we're  going to be touching on more what they feel like, what it feels like to go through  them, how it affects the people around you, how it changes your self image, how it changes you as a person inside. I think that gives you a deeper perspective.  These very, very clinical look. That things can feel pretty heartless and pretty  shallow, and in some ways, that's because it is when you read things like bipolar disorder can cause high or low moods that doesn't capture what someone with  bipolar disorder is going through. Or when you read that schizophrenia may  cause hallucinations, you might think, Oh, well, they just see something, and  that doesn't convey the depth and the changes that happen inside your concept  of who you are and your concept of how the world works because of what  happens. Likewise, when we talk about anxiety, it doesn't capture the panic that  panic disorders are. It doesn't capture how incredibly terrifying it is to be so out  of control. And we're going to touch on that a little bit more next time, with a few  stories and a few pieces. In the next section of this week, we're going to be  talking about suicide, and then next week, we will start hitting on all of those  other topics. Thank you so much for spending this time with me, and I look  forward to seeing you in the next section.