Eating Disorder and Mental Illness - Assignment Example

Eating disorder and mental illness affiliation Eating disorders Introduction Researchers and clinicians use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose and classify mental disorders. Currently, the use of the fifth publication (DSM-5) is the one used to after over two decades of using DSM-4. The following is the classifications of the eating disorders that are found in the DSM-5. Anorexia nervosa, bulimia nervosa, binge-eating disorder, avoidant food intake disorder, pica, rumination disorder and other specified feeding or eating disorder (OSPED). However, the vast majority of the individuals that are diagnosed with these eating disorders do not fully meet the criteria for diagnosis. Because of this, in DSM-5 classification, the clinician is required to specify remission state if applicable (American Psychiatric Association., & American Psychiatric Association, 2013). Diagnostic criteria for anorexia nervosa (AN) In this classification, Body Mass Index (BNI) is used to specify the severity of the disorder (American Psychiatric Association., & American Psychiatric Association, 2013). Criterion A: there is the refusal to maintain body weight at a normal or above normal weight for height and age, or failure to demonstrate expected weight gain during growth period. The individuals show a lower weight as compared to their height and are hence unhealthy. In this new classification, the criterion no longer needs the weight of the patient to be less than 85% of expected weight. Criterion B: the individual experiences intense fear to gain weight or becoming fat even when underweight. They end up not eating and may even be malnutritioned since they do not eat the required amount of food. This does not need to be reported by the patient. Criterion C: There is a disturbance in the way that the body weight or shape of a person is experienced, on self-evaluation, or denial of the seriousness of the current state of low body weight. In this criterion, the patient does not accept themselves as they are. Criterion D: In is common in women at postmenarch, amenorrhea, which is the absence of menstrual flow in at least three consecutive months. This group of patients has a tendency to be selective on what they eat and hence may end up having eating disorders. Diagnosis criteria for bulimia nervosa (BN) In DSM-5, the frequency of inappropriate behavior per week has been used to specify the severity of the disorder (American Psychiatric Association., & American Psychiatric Association, 2013). Criterion A: there are recurrent episodes of binge eating marked by eating in a discrete period, the larger amount of food than what most people would eat under similar circumstance. There is a lack of governance over eating habits. Criterion B: there is recurrent inappropriate compensatory behavior aimed at preventing weight gain such as misuse of laxatives, self-induced vomiting, fasting or excessive exercising. Criterion C: the binge-eating behavior and inappropriate compensatory behaviors occur on average weekly. Criterion D: body shape and weight is unduly influenced by self-evaluation. Criterion E: The disturbance does not occur during episodes of AN. Criteria for diagnosis of Binge-eating disorder The number of times of binge-eating disorder episodes per week is used to state the severity of the disorder. It is defined as recurring episodes of eating much more food in a short period than most people in similar circumstances would eat. Such people have a tendency of taking more food that required so that they can achieve certain body features or shapes. They do not care about nutrition, and their ignorance is accompanied with feeling of lack of self-control. The patient becomes distressed and may have feelings of embarrassment, guilt or disgust. They do not appreciate themselves and always want to be like others. It is reported in average at least once in a week (American Psychiatric Association, & American Psychiatric Association, 2013). The implication for diagnosis and treatment of eating disorder The diagnosis of the mental disorders is based in the DSM-5 criteria. Unfortunately, most people who are diagnosed with an eating disorder do not meet the criteria. This means they will undergo the treatment process just like the patients that fully meet the criteria of eating disorder. The treatment for anorexia nervosa has three major components that target restoring the person weight, treating psychological issues that relate eating disorder and reducing behavior that leads to insufficient eating (Brownell & Fairburn, 2008). So far, no treatment has been found in restoring weight although there is a lot of research underway. However, antidepressants, mood stabilizers and antipsychotics are used to treat some symptoms of anorexia nervosa. The treatment has been proved to have positive results since most of the patients regain normal habits after the diagnosis. A major challenge of these is the economic impact of these medications and the unwillingness of the patient to take the medication because they believe they are in good health. Most patients do not accept that their conditions are like any other diseases and hence fail to follow the physician’s instruction, and they end up not showing positive results. Psychotherapy in different forms is crucial in the treatment of AN. It is done through individual therapy, group and family-based therapy. The persons diagnosed with the eating disorders have psychological issues therefore; it requires supportive psychotherapy and medical attention to resolve the issues. Most eating disorders are based on the mental perception of the patient and hence more treatment is directed to the brain. This has shown great results in weight gain (Brownell & Fairburn, 2008). In patients with BN, psychotherapy by cognitive behavioral therapy has shown to be effective. This therapy helps to change the attitude toward eating and helps the patient to focus on the problem. This enhances change in thoughts, beliefs and attitude. Fluoxetine is used in treating NB as it helps to alleviate depression and anxiety that may be accompanying the disorder. Fluoxetine also appears to be effective in reducing binge-eating disorder, improves eating attitudes and lowers chances of relapse (Lemberg & Cohn, 2009). Nutritional counseling is required in order to ensure the patient can gain weight. Cognitive behavioral therapy has been found effective in managing binge eating disorder (Sandoz et al, 2011). Diagnosis of eating disorder can be very much disturbing psychologically to individuals who do not fully fit in DSM classification criteria. Being a mental disorder, the individuals may feel withdrawn, and their self-esteem is lowered (Feigenbaum, 2012). This can lead to them to develop other mental illnesses such as depression. Psychological implications that accompany the diagnosis are huge and can make the patient not cooperate with treatment. Therefore, before any diagnosis of eating disorder is achieved, the presentations of the patient need to fully fit in the criteria. The diagnosis also has economical and socio-cultural impacts in the life of the patient. The implications for diagnosis and treatment of mental illness Mental illness involves severe and persistent illness that affects the brain. They include disorders such as schizophrenia, panic and anxiety disorders, autism disorder, schizoaffective disorder, obsessive-compulsive disorder, personality disorders, and major depressive disorder among others (Barry & Farmer, 2008). They profoundly impact an individual`s thinking, moods, feeling, ability to relate with others and capacity to cope with life. Diagnosis of mental disorders is based on the symptoms that are presented by the patient mainly as reported by the closest persons with them who notice unusual behaviors (Barry & Farmer, 2008). However, some individuals have been diagnosed and treated with mental illness even though they do not fit in the DSM that was developed by the American Psychological Association. When diagnosed with mental illness, there is the tendency of a denial. This is because of the way vast majority of people perceive mental illness. The social prejudice, stigma and the feeling of social isolation are too much to bear (Fink & Tasman, 2012). Therefore, thorough history taking and clinical observation of individuals should be done before diagnosing individuals with a mental disorder. Anybody can be diagnosed with mental illness irrespective of sex, age or race. Treatment of a mental illness is mainly done in psychiatric hospitals, clinics and a wide range of community mental health centers. The treatment modality depends on the disorder and the patient. The surrounding that the patient is exposed to determines the rate at which they recover. If accepted and supported, their rate of recovery will be high. The mental health medication does not cure the disorder but helps to improve the symptoms in a patient. The major treatment modality is psychotherapy (Horwitz, 2012). There are several forms of psychotherapy that can be utilized depending on the mental disorder of the patient. A number of forms of psychotherapy are used. Cognitive behavioral therapy is helpful in modification of the thought patterns and behavior that are associated to a disorder. Psychoanalysis is employed to uncover the psychic conflicts in a person (Gamble & Brennan, 2006). Systemic or family therapy is utilized in addressing the significant networks of the patient. Several psychiatric medications are utilized to alleviate the symptoms. The major classes of the drugs used include the anxiolytics for managing anxiety disorders, antidepressants to treat clinical depression, mood stabilizers for managing mood disorders and antipsychotics for psychotic disorders. One major implication of the medication that they are used in the management of mental illness is the side effects. Some drugs can exacerbate conditions such as depression, anxiety and Parkinson disease (Horwitz, 2012). The undesired effects can worsen the health condition of the patient. The treatment is also long-term treatment, and mostly challenging the cause of mental illness is related to substance abuse. Episodes of relapse are very high in such individuals. They also experience withdrawal symptoms that are difficult to separate from the side effect of medication. This makes treatment and clinical research harder to achieve. Some of the patients who feel that they were wrongly diagnosed may fail to take the prescribed medications and view the persons who brought them in the hospital as ill minded. Economical implication to the individual, family and society is grave. This is because the mental illness may cause on drop his or her employment, and the cost of the lifelong medication is huge. All this makes treatment very difficult to maintain. Social stigma that accompanies the diagnosis of a mental illness may make the individuals find it difficult to cope in their family or the society (Fink & Tasman, 2012). This makes the patients so isolated and lowers their self-esteem (Scheid & Brown, 2010). In conclusion, clinicians commonly diagnose eating the disorder just like other mental illnesses. The diagnosis of most of them does not fit in the DSM criteria. Diagnosis and treatment of eating disorder has psychosocial and economic impact on the individual. The same case is experienced in mental illness diagnosis and treatment. Anybody can suffer from mental illness. The implication of diagnosis and treatment of mental illness ranges from stigma, depression, loss of productivity, difficulty in adherence in treatment economic impact among others. References American Psychiatric Association., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Washington, D.C: American Psychiatric Association. Barry, P. D., & Farmer, S. (2008). Mental health & mental illness. Philadelphia: Lippincott, Williams & Wilkins. Brownell, K. D., & Fairburn, C. G. (2008). Eating disorders and obesity: A comprehensive handbook. New York, NY : Guilford Press. Feigenbaum, N. (2012). Maintaining recovery from eating disorders: Avoiding relapse and recovering life. London: Jessica Kingsley Publishers Fink, P. J., & Tasman, A. (2012). Stigma and mental illness. Washington, DC: American Psychiatric Press. Gamble, C., & Brennan, G. (2006). Working with serious mental illness: A manual for clinical practice. Edinburgh ; Toronto: Elsevier. Horwitz, A. V. (2012). Creating mental illness. Chicago [u.a.: Univ. of Chicago Press. Lemberg, R., & Cohn, L. (2009). Eating disorders: A reference sourcebook. Phoenix, Ariz: Oryx Press. Sandoz, E., Wilson, K., & DuFrene, T. (2011). Acceptance and Commitment Therapy for Eating Disorders: A Process-Focused Guide to Treating Anorexia and Bulimia. Oakland: New Harbinger Publications. Scheid, T. L., & Brown, T. N. (2010). A handbook for the study of mental health: Social contexts, theories, and systems. 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