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		Understanding Mental Disorders & Medications By Scott M. Helfrich, M.S. Area Coordinator, Bloomsburg University More and more young adults are entering into college today diagnosed with many different psychological disorders. These students may or may not be taking prescribed psychotropic medications, which subsequently can cause unique challenges for residence life staff members. This article will give a brief introduction to the nature of some of the typical psychological disorders encountered within the residence halls as well as the medications primarily used to treat them. Some basic tips will be included for helping students who have psychological disorders. Mental Disorders Defined Mental disorders are defined and classified by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, typically known as the DSM-IV (the “IV” indicates the version of the manual.) The DSM-IV defines a mental disorder as a “clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress…or disability…or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom” (p. xxi). The Surgeon General’s Report of Mental Health defines mental disorders as “health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.” These disorders are placed into 17 different classifications in the DSM-IV depending upon the types of symptoms experienced. These classifications include mood, anxiety, eating, adjustment, and personality disorders to name just a few. Within these classifications, there are many different types of disorders. For example, there are three different types of eating disorders, which include anorexia nervosa and bulimia nervosa. To be diagnosed with a specific disorder, you must fulfill certain symptomatic criteria, which is listed in the DSM-IV. If someone isn’t experiencing any and/or all of the symptoms listed, they probably don’t have that particular disorder. Please note that there are many subtleties with different criteria so only trained mental health professionals should make diagnoses. Disorders Encountered Students today come to colleges and universities diagnosed (and even undiagnosed) with the full range of mental disorders, including everything from schizophrenia and anorexia to major depression and posttraumatic stress disorder. In a recent study by Dr. Ronald Kessler from Harvard University, it was found that 37% of people aged 15-24 years old have a diagnosable mental illness. Most of college students today fit within this age bracket. It is also very prevalent for someone to have more than one type of disorder at any one time. This is what is referred to as “comorbidity.” A student could be diagnosed with major depressive disorder as well as anorexia nervosa. Another example would include a student diagnosed with alcohol dependence as well as borderline personality disorder. Also, some of the presenting symptoms in some students may be more severe than others. Furthermore, some students may be seeking treatment for these symptoms while others may not. Understand that each school’s student population is completely different so staff members at one school may encounter more and different types of disorders than their counterparts at other schools. According to the National Institute of Mental Health, here are the most prevalent mental disorders and the number of adult Americans, aged 18 and over, diagnosed with them in a given year: Major Depressive Disorder: 9.9 million Dysthymic Disorder: 10.9 million Posttraumatic Stress Disorder: 5.5 million Social Phobia: 5.3 million Generalized Anxiety Disorder: 4.0 million Obsessive-Compulsive Disorder: 3.3 million Panic Disorder: 2.4 million Bipolar Disorder: 2.3 million Schizophrenia: 2.2 million Given the previous statistics, it is understandable that a residence life staff member may encounter a student presenting symptoms of a mood or anxiety disorder. The symptoms for each of these types of disorders are very unique and can be readily treated with proper medication and psychotherapy. Mood Disorders Mood disorders, for the most part, are characterized by symptoms that are exclusively of elevated mood episodes, depressed mood episodes, or the going back-and-forth between elevated and depressed. The length of time and severity of the symptoms will indicate what kind of disorder a person has. Symptoms to be on the lookout for a major depressive episode include: Depressed mood most of the day, nearly every day Loss of pleasure or interest in activities Weight loss or gain or decrease or increase in appetite Insomnia or hypersomnia everyday Feelings of worthlessness or excessive or inappropriate guilt Inability to think or concentrate or indecisiveness Recurrent thoughts of death or suicide ideation Symptoms to be on the lookout for a manic episode include: Inflated self-esteem or grandiosity Decreased need for sleep More talkative than usual Flight of ideas or racing thoughts Distractibility Increased goal-directed activity Excessive involvement in pleasurable activities that can have negative consequences Anxiety Disorders Anxiety disorders are characterized by the symptoms related to panic attacks or panic-like symptoms. The DSM-IV defines a panic attack as: “a discrete period in which there is the sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. During these attacks, symptoms such as shortness of breath, palpitations, chest pain, or discomfort, choking or smothering sensations, and fear of “going crazy” or losing control are present (p. 393). Other anxiety disorders manifest symptoms as the result of the presence of a certain stimuli. For example, people with Posttraumatic Stress Disorder can exhibit symptoms if presented with stimuli that remind them of a traumatic event that occurred within their life such as being raped or being in a car accident. The same holds true for a Specific Phobia such as the fear of heights or snakes. Medications People seeking treatment for psychological disorders may be prescribed various medications to help alleviate the symptoms of their disorder. Psychotropic medications work primarily because they act and/or react with neurotransmitters within the brain. There is a myriad of medications out there today, but you will typically encounter about ten of them, which are listed for the following disorders: Disorder Generic Name Brand Name   Depression Citalopram Celexa   Fluoxetine Prozac   Paroxetine Paxol   Sertraline Zoloft   Bipolar Disorder Lithium Carbonate Eskalith, Lithotabs   Bupropion Wellbutrin, Zyban   Fluvoxamine Luvox   Valproic Acid Depakote   Anxiety Alpraozolam Xanax   Diazepam Valium   It is important to know that taking these medications won’t instantly make someone better or alleviate all symptoms. Most of these medications take anywhere from 4-6 weeks to build up in the body for an effect to take place. You may encounter students who are not “med-complaint” because there is a stigma attached to mental illness and with taking medications. Once the person feels better, they may incorrectly choose not to take the medication anymore because they feel that they don’t need it. Unfortunately, they soon find out that their symptoms quickly return. As a rule of common sense, it is generally wise not to use alcohol when taking these types of medication, as there is a chance that you can inhibit respiratory functioning. This especially holds true for the depressants such as Xanax and Valium. Tips for Helping Students with Disorders Educate against the stigma of mental disorders and use language carefully. Words such as “crazy,” “nuts”, and “weird” have no place for inviting students with disorders into the residence hall community. Staff members should be trained to detect “tell-tale” symptoms of typical psychological disorders seen, such as depression and anxiety, without actually trying to diagnose students themselves. Be careful not able to label someone with “eccentric” behaviors as someone who has a psychological disorder. Just because a student acts differently than the group doesn’t necessarily mean that they have a mental illness. Maybe that’s just the way they are and that’s all right! Utilize the college or university’s student code of conduct and student disciplinary procedures for students who may be creating an unsafe environment and violating policy. Section 504 of the Rehabilitation Act of 1973 does not grant a college or university grounds to dismiss a student just because they have a mental disorder. Know the campus and community resources; know your limits; and know when to refer students! Conclusion Many students in colleges and universities today have many different kinds of psychological disorders for which they may, or may not, be seeking treatment. With the proper education and training of staff members about psychological disorders and the medications used to treat them, staff members will have more confidence when trying to help someone with a disorder and subsequently, the stigma surrounding mental illness may begin to be alleviated within the residence halls. About the Author Scott is currently the area coordinator of Montour and Schuylkill Halls at Bloomsburg University of Pennsylvania. He also serves as the university's advisor to the Residence Hall Advisory Board. Scott completed his undergraduate work at Lock Haven University of Pennsylvania. He earned a clinical master's degree in Mental Health Counseling at Nova Southeastern University in Ft. Lauderdale, FL where he was a Graduate Assistant in Student Life. He then went on to work as the Assistant Coordinator of Student Activities at Broward Community College's South Campus and then served as a resident director at the University of Pittsburgh. Scott has presented at regional and national conferences including NACURH at the University of Oklahoma, CAACURH at Carnegie Mellon, and FJCSGA (Florida Junior College Student Government Association) in Tampa, FL. He has also been published in "Student Leader" and "Campus Activities" magazines.