Disorder and Dysfunction

The twentieth century saw the exploration of many avenues in the treatment of mental disorders. Treatments ranging from classical psychoanalysis to cognitive and humanistic therapies to the use of therapeutic drugs were applied. Psychologists examined the effects of mental disorders on many aspects of life, including cognition and personality. These disorders affect the most essential of human functions, including cognition, which has to do with the way in which the mind thinks and makes decisions. Cognition does not work in "ordinary" ways in the person with a serious mental illness, making his or her behavior very difficult for family, friends, and others to understand. Another aspect of cognition is perception. Perception has to do with the way that the mind, or brain, interprets and understands the information which comes to a person through the senses. There is a general consensus among most human beings about what they see and hear, and perhaps to a lesser extent about what they touch, taste, and smell. The victim of mental illness, however, often perceives the world in a much different way. This person may see objects or events that no one else sees, phenomena called hallucinations. The hallucinations may be visual—for example, the person may see a frightening wild animal that no one else sees—or aural—for example, the person may hear a voice that no one else hears, accusing him or her of terrible crimes or behaviors.

A different kind of cognitive disorder is delusions. Delusions are untrue and often strange ideas, usually growing out of psychological needs or problems of a person who may have only tenuous contact with reality. A person, for example, may believe that other employees are plotting to harm her in some way when, in fact, they are merely telling innocuous stories around the water cooler. Sometimes people with mental illness will be disoriented, which means that they do not know where they are in time (what year, what season, or what time of day) or in space (where they live, where they are at the present moment, or where they are going).

In addition to experiencing cognitive dysfunction that creates havoc, mentally ill persons may have emotional problems that go beyond the ordinary. For example, they may live on such an emotional "high" for weeks or months at a time that their behavior is exhausting both to themselves and to those around them. They may exhibit bizarre behavior; for example, they may talk about giving away vast amounts of money (which they do not have), or they may go without sleep for days until they drop from exhaustion. This emotional "excitement" seems to dominate their lives and is called mania. The word "maniac" comes from this terrible emotional extreme.

At the other end of the emotional spectrum is clinical depression. This does not refer to the "blues" of ordinary daily life, with all its ups and downs, but to an emotional emptiness in which the individual seems to have lost all emotional energy. The individual often seems completely apathetic. The person may feel life is not life worth living and may have anhedonia, which refers to an inability to experience pleasure of almost any kind.

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