Mental Health Disorders Defined
Mental disorders are difficult to define largely because there is no single definition that covers all situations and because the term mental disorder implies a distinction between one’s mental health and one’s physical health.
Mental health disorders are complex and often do not occur in isolation from physical disorders. Significant amounts of literature demonstrate that physical and mental health are interwoven (U.S. Department of Health and Human Services [U.S. DHHS], 2001). Perhaps because of these complexities, our body of literature lacks a “consistent operational definition” for mental disorder (American Psychiatric Association [APA], 2000, p. xxx). Although the worthiness/credibility of the Diagnostic and Statistical Manual (DSM) is debated, it is the guiding publication for mental health practitioners. The DSM offers a thoughtful definition of mental disorder and was first published in the DSM-III (cf. APA, 1987). Mental disorder is aclinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom), or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk for suffering death, pain, disability, or an important loss of freedom. (APA, 2000, p. xxxi)
The DSM offers an expansion of the definition by clarifying that situationally and/or culturally relevant responses must not be contributing to the disorder. “In addition, this syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one” (APA, 2000, p. xxxi). It is inappropriate, therefore, to diagnose a person who is grieving the (somewhat recent) death of a loved one with depression. Sadness and depression are natural responses to the process of grief, and according to the DSM’s definition of mental disorder, a diagnosis must be made independently of an “expectable” response to a given event.
Mental disorders are broad, complex, and encompass many aspects of one’s level of functioning. For the purposes of this chapter, therefore, the focus of mental disorders is limited to four areas: (1) depression, (2) anxiety, (3) substance abuse and dependence, and (4) schizophrenia.