A Guide To Mental Health Terminology
A panic disorder that involves intense fear and avoidance of any place or situation where it is perceived that escape might be difficult or help unavailable in the event of developing sudden panic-like symptoms. The fear can especially be directed towards situations in which feelings of panic have occurred before. These situations may include driving, shopping, crowded places, traveling, standing in line, meetings, social gatherings and even being alone.
A progressive disorder that gradually destroys a person’s memory and ability to learn, reason, make judgments, communicate and carry out daily activities. Individuals with more advanced stages of Alzheimer’s disease may also experience changes in personality and behavior such as anxiety, suspiciousness or agitation, as well as delusions or hallucinations. The disease usually starts in middle or old age, beginning with memory loss concerning recent events and spreading to memory loss concerning events that are more distant.
Chronic feelings of overwhelming anxiety and fear, unattached to any obvious source, that can grow progressively worse if not treated. The anxiety is often accompanied by physical symptoms such as sweating, cardiac disturbances, diarrhea or dizziness. Generalized anxiety disorder, panic disorder, agoraphobia, obsessive- compulsive disorder and posttraumatic stress disorder are considered anxiety disorders (all defined individually in Glossary).
A Pervasive Developmental Disorder (PDD) characterized by normal language and intelligence development, but impaired social and communication skills as well as difficulty with transitions or changes. Individuals with Asperger’s Syndrome often have obsessive routines and may be preoccupied with one particular field of interest. Although they may be low functioning in many areas, they often have above-average performance in a narrow field.
Attention Deficit Disorder (ADD)
A biologically-based disorder that includes distractibility and impulsiveness. Recent research suggests that ADD can be inherited and may be due to an imbalance of neurotransmitters (chemicals used by the brain to control behavior) or abnormal glucose metabolism in the central nervous system.
Attention Deficit Hyperactivity Disorder (ADHD)
A form of ADD that includes hyperactivity. Children with ADHD are unable to sit still. They may walk, run or climb around when others are seated, and often talk when others are talking.
A Pervasive Developmental Disorder (PDD) that affects a person’s ability to communicate, form normal social relationships and respond appropriately to the external world. Autism typically appears in the first three years of life, although there may be signs in infancy such as avoiding eye contact and abruptly stopping language development. Children with autism may stare into space for hours, throw uncontrollable tantrums and show no interest in people including their parents. They may pursue strange, repetitive activities with no apparent purpose. Some people with autism can function at a relatively high level, with speech and intelligence intact. Others, however, have serious learning problems and language delays, and some never speak.
Also known as manic-depressive illness. A serious illness that causes shifts in a person’s mood, energy and ability to function. Dramatic mood swings can move from “high” feelings of extreme euphoria or irritability to depression, sometimes with periods of normal moods in between. Manic episodes may include such behaviors as prolonged periods without sleep or uncontrolled shopping. Each episode of mania or depression can last for hours, weeks or several months.
Borderline Personality Disorder
A mental illness marked by a pattern of unstable personal relationships and self image, as well as marked impulsivity. Individuals with Borderline Personality Disorder often have a strong fear of abandonment and may exhibit recurrent suicidal behavior, gestures or threats or self-mutilating behavior. They also may have inappropriate, intense anger or difficulty controlling anger.
Any abnormality in the brain that results in impaired functioning or thinking.
A process in which individuals are partners in the management of their mental illnesses and in their recovery. Case management focuses on accelerating the use of available services to restore or maintain independent functioning to the fullest extent possible. In pursuing this goal, case management helps people connect to needed services and supports within the community.
A marked psychomotor disturbance that may involve stupor or mutism, negativism, rigidity, purposeless excitement and inappropriate or bizarre posturing. Catatonic schizophrenia is a form of the illness characterized by a tendency to remain in a fixed stuporous state for long periods. This catatonia may give way to short periods of extreme excitement.
An initiative resulting from a six-year, $9.5 million cooperative agreement between the City of Fort Worth and the Substance Abuse and Mental Health Services Administration (SAMHSA), a part of the U.S. Department of Health and Human Services. Community Solutions’ goal is to create an accessible, culturally competent and seamless child- and family-driven system of care for Fort Worth families dealing with severe emotional disturbances. The City of Fort Worth Public Health Department serves as the lead agency, partnering with the Fort Worth Independent School District and members of Mental Health Connection of Tarrant County. Approximately 445 children will be served under the grant between 2002 and 2008.
In mental health, an individual who is using one or more mental health services.
Continuum of Care
A complete range of programs for children and adolescents with mental illness. According to the American Academy of Child and Adolescent Psychiatry, a seamless continuum of care includes, from least to most intensive:
- Office or outpatient clinic, with visits usually under one hour.
- Intensive case management, with specially trained individuals coordinating or providing psychiatric, financial, legal and medical services to help the child or adolescent live successfully at home and in the community.
- Home-based treatment services, with a team of specially trained staff members who go into a home and develop a treatment program to help the child and family.
- Family support services, which help families care for their children, possibly including parent training and support groups.
- Day treatment program, an intensive combination of psychiatric treatment with special education, which the child or adolescent usually attends five days a week.
- Partial hospitalization (day hospital), which provides all the treatment services of a psychiatric hospital; however, the patients go home each evening.
- Emergency/crisis services, providing 24-hour support for emergencies. May include hospital emergency departments and mobile crisis teams.
- Respite care services, which provide a brief period in which the patient stays away from home with specially trained individuals.
- Therapeutic group home or community residence, which usually includes six to 10 children or adolescents in each home. This may be linked with a day treatment program or specialized educational program.
- Crisis residence, which provides short-term (usually fewer than 15 days) crisis intervention and treatment. Patients receive 24-hour supervision.
- Residential treatment facility, where seriously disturbed patients receive intensive and comprehensive psychiatric treatment in a campus-like setting on a longer-term basis.
- Hospital treatment, where patients receive comprehensive psychiatric treatment in a hospital. The length of treatment depends on each situation.
In general, the existence of two or more illnesses – whether physical or mental – at the same time in a single individual. With SAMHSA, the term usually means the co- existence of mental illness and substance abuse.
In referring to mental health, communication and coordination among mental health, public and private agencies that may be working with the same individual. The goal is to benefit the individual with seamless care across the system.
CRCG (Community Resource Coordination Group)
A local group composed of public and private providers that come together to develop individual service plans for children, youth and adults whose needs can be met only through interagency coordination and cooperation.
A group of skills, attitudes and knowledge that allows persons, organizations and systems to work effectively with diverse racial, ethnic and social groups.
A belief that is false, fanciful or derived from deception. In psychiatry, a false belief strongly held in spite of evidence that it is not true, especially as a symptom of a mental illness.
A condition of declining mental abilities, especially memory. Individuals with dementia may have trouble doing things they used to do such as keeping the checkbook, driving a car safely or planning a meal. They often have trouble finding the right word and may become confused when given too many things to do at one time. Individuals with dementia may also experience changes in personality, becoming aggressive, paranoid or depressed.
Department of Aging and Disability Services (DADS)
Created in September 2004, this department consolidates the mental retardation services and state school programs of the Department of Mental Health and Mental Retardation; community care, nursing facility, and long-term care regulatory services of the Department of Human Services; and aging services and programs of the Department on Aging.
Department of Health and Human Services (HHS)
The United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.
In psychiatry, a disorder marked especially by sadness, inactivity, difficulty with thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness and sometimes suicidal thoughts or attempts to commit suicide. While standing alone as a mental illness, depression also can be experienced in other disorders such as bipolar disorder. Depression can range from mild to severe, and is very treatable with today’s medications and/or therapy.
Diagnosable Mental Illness
Any mental illness or mental disorder, including those that have not yet received a formal diagnosis from a medical or mental health professional. Sometimes referred to as a “brain disorder.”
A disorder marked by a separation from or interruption of a person’s fundamental aspects of waking consciousness, such as personal identity or personal history. The dissociative aspect in any form is thought to be a coping mechanism stemming from trauma of some kind. The individual literally dissociates or separates from a situation or experience that is too traumatic to integrate with the conscious self. There are many forms of dissociative disorders:
Characterized by blocking out critical information, usually of a traumatic or stressful nature. The amnesia may be localized to a specific window of time; selective, allowing the patient to remember only small parts of events that took place in a defined period of time; generalized to the patient’s entire life; or systematized, in which the loss of memory is related to a specific category of information.Dissociative fugue: A rare disorder in which an individual suddenly and unexpectedly takes physical leave of his or her surroundings and sets off on a journey of some kind. Individuals in a fugue state are unaware of or confused about their identities. Rarely, these individuals will assume a new identity. Dissociative identity disorder: Previously known as multiple personality disorder. Individuals with DID have more than one distinct identity or personality state that surfaces on a recurring basis. The disorder is also marked by differences in memory, which vary with the individual’s “alters” or other personalities.Depersonalization disorder – Marked by recurrent feelings of detachment or distance from one’s own experience, body or self. When severe, individuals with this disorder may believe the external world is unreal or distorted.
DSM-IVThe Diagnostic and Statistical Manual of Mental Disorders.
The standard classification of mental disorders used by mental health professionals in the United States.
In mental health, diagnosing and treating mental illnesses early in their development. Studies have shown early intervention can result in higher recovery rates. However, many individuals do not have the advantage of early intervention because the stigma of mental illness and other factors keep them from pursuing help until later in the illness’ development.
A serious disturbance in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating. Usually accompanied by feelings of distress or extreme concern about body shape or weight. Eating disorders, which are treatable, usually develop in adolescence or early adulthood and frequently co-occur with other psychiatric disorders such as depression, substance abuse and anxiety disorders. Eating disorders can lead to serious physical health complications including heart conditions and kidney failure, which may lead to death. The main types of eating disorders are anorexia nervosa and bulimia nervosa.
Electroconvulsive Therapy (Electroshock Therapy)
A treatment for some severe mental illnesses in which a brief application of electrical stimulus is used to generate a generalized seizure. According to the National Institutes of Health, this therapy has been highly successful in treating certain types of depression, especially when followed with anti-depressant medication. It has not been effective with individuals who have less severe forms of depression.
Refers to treatment guidelines that can be supported by quality clinical research.
In mental health, a model in which families have a primary decision-making role in the care of their own children. Families also have a primary role in the policies and procedures governing care for all children in their community. Family involvement includes choosing supports, services and providers; setting goals; designing and implementing programs; monitoring outcomes; and determining the effectiveness of all efforts to promote the mental health of children and youth.
Generalized Anxiety Disorder
Characterized by excessive uncontrollable worry about everyday things. The chronic worrying can affect daily functioning and cause physical symptoms, filling an individual’s days with tension even though there is little or nothing to provoke it. Unlike a phobia, Generalized Anxiety Disorder is not triggered by a specific object or situation. Individuals with this disorder are always anticipating disaster, often worrying excessively about health, money, family or work. In addition to chronic worry, symptoms may include trembling, muscular aches, insomnia, abdominal upsets, dizziness and irritability.
HIPAA (Health Insurance Portability and Accountability Act of 1996)
HIPAA Title I protects health insurance coverage for workers and their families when they change or lose their jobs. HIPAA Title II addresses the security and privacy of health data. It requires the U.S. Department of Health and Human Services to establish national standards for electronic health care transactions, as well as national identifiers for providers, health plans and employers. To comply with HIPAA, systems of care must establish ways to ensure patient privacy as the patients move seamlessly from one agency to another.
Chronically homeless individuals have a disability and have been homeless for a year or more, or they have had at least four episodes of homelessness within the past three years. Homeless also refers to individuals living in transitional housing or those who spend most nights in a supervised or private facility that provides temporary living quarters.
Juvenile Justice Facility
Encompasses detention centers, shelters, reception or diagnostic centers, training schools, ranches, forestry camps or farms, halfway houses, group homes and residential treatment centers for young offenders.
A system of health care that combines delivery and payment. Managed care influences use of services by employing management techniques designed to promote the delivery of cost-effective health care.
Managed Health Care Plan
An arrangement that integrates financing and management with the delivery of health care services to an enrolled population. A managed health care plan employs or contracts with an organized system of providers that delivers services and frequently shares financial risks.
See Bipolar Disorder
A health condition characterized by alterations in thinking, mood or behavior (or a combination of the three). Mental disorders are mediated by the brain and associated with distress and/or impaired functioning. They can be the result of family history, genetics or other biological, environmental, social or behavioral factors that occur alone or in combination.
The condition of being mentally and emotionally sound and well adjusted, characterized by the absence of mental disorder and by adequate adjustment. Individuals with mental health feel comfortable about themselves, have positive feelings about others and exhibit an ability to meet the demands of life.
Mental Health Services
Diagnostic, treatment and preventive services that help improve the way individuals with mental illness feel, both physically and emotionally, as well as the way they interact with others. These services also intervene on behalf of those who have a strong risk of developing a mental illness.
Refers collectively to all diagnosable mental disorders. Can refer to a disease of the brain with predominant behavioral symptoms as in acute alcoholism or a disease of the mind or personality that results in abnormal behavior as with hysteria or schizophrenia. Can refer to any psychiatric illness listed in Current Medical Information and Terminology of the American Medical Association or in the Diagnostic and Statistical Manual for Mental Disorders of the American Psychiatric Association.
Below normal intellectual ability that originates during the developmental period. Mental retardation is associated with impairment in maturation, learning and/or social adjustment. In general with mental retardation, the IQ is equivalent to or less than 70 and the condition is present from birth or infancy. Individuals with mental retardation have abnormal development, learning difficulties and problems in social adjustment.
Multiple Personality Disorder
See Dissociative Disorder
NAMI (formerly National Association for the Mentally Ill)
A nonprofit, grassroots, self-help support and advocacy organization made up of consumers, families and friends of people with severe mental illnesses.
A branch of the life sciences that deals with the anatomy, physiology and pathology of the nervous system. The term refers especially to the biology of the brain when used in conjunction with learning disorders, some mental illnesses, Alzheimer’s disease and other diseases that may be caused or impacted by the central nervous system.
A branch of medicine concerned with both neurology (the scientific study of the nervous system) and psychiatry (a branch of medicine that deals with the science and practice of treating mental, emotional and behavioral disorders).
Nonverbal Learning Disorder
A neurological disorder originating in the right hemisphere of the brain. Because reception of information is impaired in the right brain, those with nonverbal learning disorder may experience a lack of psychomotor coordination and an inability to recognize nonverbal social cues such as body language, facial expressions, personal space, touch and tone of voice. It can also affect organizational and evaluative skills.
A disorder in which individuals are plagued by persistent, recurring thoughts or obsessions that reflect exaggerated anxiety or fears. Typical obsessions include worry about being contaminated or fears of behaving improperly or acting violently. The obsessions may lead to the performance of ritual or routine compulsions such as washing hands, repeating phrases or hoarding.
Oppositional Defiant Disorder
A disruptive behavior pattern of childhood and adolescence characterized by defiant, disobedient and hostile behavior, especially toward adults in positions of authority.
An anxiety disorder in which individuals have feelings of terror that strike suddenly and repeatedly with no warning. Individuals cannot predict when an attack will occur and may develop intense anxiety between episodes, worrying when the next one will strike. Symptoms can include heart palpitations, chest pain or discomfort, sweating, trembling, tingling sensations, a feeling of choking, fear of dying, fear of losing control and feelings of unreality.
In mental health, equivalent benefits and restrictions in insurance coverage for mental health services with other health services.
Pervasive Developmental Disorder (PDD)
A class of neurological disorders usually evident by age 3. They are characterized by severe and pervasive impairment in social interaction skills, communication skills and possibly by stereotyped behavior, interests and activities. Pervasive Developmental Disorders include autism, Asperger’s syndrome and nonverbal learning disorder.
An enduring pattern of inner experience and behavior that deviates from expectations. A personality disorder is pervasive and inflexible, beginning in adolescence or early adulthood. Individuals with a personality disorder tend to be stable over time, but the disorder leads to distress or impairment. There are currently 10 personality disorders identified in DSM-IV:
- Antisocial Personality Disorder: Lack of regard for the moral or legal standards in the local culture, along with a marked inability to get along with others or abide by societal rules. Sometimes called psychopaths or sociopaths.
- Avoidant Personality Disorder: Marked social inhibition, feelings of inadequacy and extremely sensitive to criticism.
- Borderline Personality Disorder: Lack of one’s own identity, with rapid changes in mood, intense unstable interpersonal relationships, marked impulsivity, instability in affect and in self-image.
- Dependent Personality Disorder: Extreme need of other people, to a point where the person is unable to make any decisions or take an independent stand on his or her own. Submissive behavior and fear of separation. Marked lack of decisiveness and self-confidence.
- Histrionic Personality Disorder: Exaggerated and often inappropriate displays of emotional reactions, approaching theatricality, in everyday behavior. Sudden and rapidly shifting expressions of emotion.
- Narcissistic Personality Disorder: Behavior or a fantasy of grandiosity, a lack of empathy, a need to be admired by others, an inability to see the viewpoints of others and hypersensitivity to the opinions of others.
- Obsessive-Compulsive Personality Disorder: Characterized by perfectionism and inflexibility as well as preoccupation with uncontrollable patterns of thought and action.
- Paranoid Personality Disorder: Marked distrust of others, including the belief, without reason, that others are exploiting, harming or trying to deceive him or her; lack of trust; belief of others’ betrayal; belief in hidden meanings; unforgiving and grudge holding.
- Schizoid Personality Disorder: Primarily characterized by a very limited range of expressing and experiencing emotion. Indifferent to social relationships.
- Schizotypal Personality Disorder: Peculiarities of thinking, odd beliefs and eccentricities of appearance, behavior, interpersonal style and thought (e.g., belief in psychic phenomena and having magical powers).
An intense and sometimes disabling fear reaction to a specific object or situation that poses little or no actual danger. The level of fear is usually recognized by the individual as being irrational.
A potentially serious condition that occurs within six months after childbirth in which a woman feels extreme sensations of sadness, despair, anxiety and/or irritability. Differs from “baby blues” in intensity and duration. Postpartum often keeps a woman from doing the things she needs to do every day. Some symptoms include:
- Loss of interest or pleasure in life
- Loss of appetite
- Less energy and motivation to do things
- A hard time falling asleep or staying asleep
- Sleeping more than usual
- Increased crying or tearfulness
- Feeling worthless, hopeless or overly guilty
- Feeling restless, irritable or anxious
- Unexplained weight loss or gain
- Feeling like life isn’t worth living
- Having thoughts about hurting herself
- Worrying about hurting her baby
A rare but very serious mental illness that can affect new mothers within the first six months after childbirth. Women lose touch with reality, often having hallucinations and delusions focused on the baby. Other symptoms include severe insomnia, paranoia, agitation and restlessness. Homicidal and suicidal thoughts are not uncommon. This condition poses significant danger to the baby’s safety and should be managed as a medical emergency requiring hospitalization of the mother.
Posttraumatic Stress Disorder
A psychological reaction that occurs after experiencing a highly stressing event, such as wartime combat, physical violence or a natural disaster. It is usually characterized by depression, anxiety, flashbacks, recurrent nightmares and avoidance of reminders of the event. Individuals can feel emotionally numb, especially with people who were once close to them. Also called delayed-stress disorder or posttraumatic stress syndrome.
The branch of medicine that deals with the science and practice of treating mental, emotional or behavioral disorders.
A serious mental disorder characterized by defective or lost contact with reality, often with hallucinations or delusions, causing deterioration of normal social functioning.
In mental illness, a medication prescribed to treat the illness or symptoms of that illness.
According to the President’s New Freedom Commission on Mental Illness, a process by which people who have a mental illness are able to work, learn and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability. For others, recovery implies the reduction or complete remission of symptoms.
Intensive and comprehensive psychiatric treatment in a campus-like setting, usually for a minimum of several months.
An ability to recover from or adjust easily to significant challenges such as misfortune or change.
A pervasive pattern of detachment from social relationships, social isolation and a restricted range of expressing emotions in interpersonal settings. Pattern begins in early adulthood. Does not occur exclusively with schizophrenia, but may also appear with another psychotic disorder or a pervasive developmental disorder. Schizoid behavior is indicated by four or more of the following:
- neither desires nor enjoys close relationships, including being part of a family
- almost always chooses solitary activities
- has little, if any, interest in having sexual experiences with another person
- takes pleasure in few, if any, activities
- lacks close friends or confidants other than first-degree relatives
- appears indifferent to the praise or criticism of others
- shows emotional coldness, detachment or flattened affectivity
A psychotic disorder characterized by loss of contact with the environment, noticeable deterioration in the level of functioning in everyday life and disintegration of feeling, thought and conduct. Individuals with schizophrenia often hear internal voices not heard by others (hallucinations) or believe things that other people find absurd (delusions). The symptoms also may include disorganized speech and grossly disorganized or catatonic behavior. Individuals with schizophrenia have marked impairment in social or occupational functioning.
In mental health, a brief formal or informal assessment to identify individuals who have mental health problems or are likely to develop such problems. If a problem is detected, the screening can also determine the most appropriate mental health services for the individual.
Selective Serotonin Reuptake Inhibitors (SSRI)
A class of antidepressants that act within the brain to increase the amount of serotonin, a chemical nerves use to send messages to one another (neurotransmitter). Neurotransmitters are released by one nerve and taken up by other nerves. Those that are not taken up by other nerves are taken up by the same nerve that released them, a process called reuptake. By inhibiting reuptake, SSRIs allow more serotonin to be taken up by other nerves.
Serious Emotional Disturbance (SED)
A diagnosable mental disorder found in individuals from birth to 18 years of age. The disorder is so severe and long lasting it seriously interferes with functioning in family, school, community or other major life activities.
Serious Mental Illness
A diagnosable mental disorder found in individuals aged 18 years and older. The disorder is so severe and long lasting, it seriously interferes with a person’s ability to take part in major life activities.
Social Anxiety Disorder
Characterized by extreme anxiety about being judged by others or behaving in a way that might cause embarrassment or ridicule. Individuals experience excessive self- consciousness in everyday social situations. Physical symptoms may include heart palpitations, faintness, blushing and profuse sweating. Individuals often worry for days or weeks in advance of a dreaded situation. Symptoms may be limited to only one type of situation, such as fear of speaking in formal or informal situations or eating, drinking or writing in front of others. In its most severe form, individuals may experience symptoms anytime they are around other people.
Education that ensures all children with disabilities have receive appropriate public education that emphasizes services designed to meet their unique needs and prepare them for employment and independent living. Services may be available to students with a physical disability, mental retardation, emotional disturbance, learning disability, autism, speech disability or traumatic brain injury.
A mark of shame or discredit. A sign of social unacceptability.
In mental health, a process that builds upon an individual’s strengths to work towards recovery.
Substance AbuseThe inappropriate use of and possibly addiction to illegal and legal substances including alcohol and prescription and non-prescription drugs.
Substance Abuse and Mental Health Services Administration (SAMHSA)
An agency within the United States Department of Health and Human Services (HHS) that is committed to improving the lives of people with or at risk for substance abuse or mental illness. SAMHSA’s vision is A life in the community for everyone, based upon the principle that people of all ages with or at risk for substance abuse disorders and mental illnesses should have the opportunity for a fulfilling life that includes a job, a home, and meaningful relationships with family and friends.
System of Care
A partnership of mental health, education, child welfare and juvenile justice agencies as well as teachers, children with serious emotional disturbances and their families and other caregivers. These agencies and individuals work together to ensure children with mental, emotional and behavioral problems and their families have access to the services and supports they need to succeed. Together, this team creates an individualized service plan that builds on the unique strengths of each child and each family. The plan is then implemented in a way that is consistent with the family’s culture and language.
Treatment of physical, mental or behavioral problems that is meant to cure or rehabilitate. Psychotherapy emphasizes substituting desirable responses and behavior patterns for undesirable ones.
A process in which families with children who have severe emotional disturbance are able to address their needs through a strengths-based, family-driven team approach. A “wraparound facilitator” helps link families of children with severe emotional disturbances with needed services and supports. All members of the family are served through a partnership with the facilitator and other service professionals. The family can choose others they want to have as a part of the team, including friends, church members and relatives. Wraparound helps develop creative strategies to meet the needs of each person that may include both traditional and non-traditional approaches and supports.