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Mental Health Terminology

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Affect	Affect represents an immediately expressed and observed emotion (e.g. the patient’s facial expression or overall demeanor). It is an observable expression of a patient’s inner feelings. The normal expression of affect involves variability in facial expression, pitch of voice, and the use of hand and body movements. Affect is described by such terms as constricted, normal range, appropriate to context, flat, and shallow. • Restricted affect is characterized by a clear reduction in the expressive range and intensity of affects. • Constricted affect refers to a mild restriction in the range or intensity of display of feelings. As the display of emotion becomes more severely limited, the term blunted affect may be applied. • Blunted affect is market by a severe reduction in the intensity of affective expression. • Flat affect is a lack of signs of affective expression/ exhibition of emotions – the voice may be monotonous, the face is expressionless, and the body is immobile.
Anhedonia	Anhedonia refers to the loss of the capacity to experience pleasure. The inability to gain pleasure from normally pleasurable experiences. Anhedonia is a core clinical feature of depression, schizophrenia, and some other mental illnesses.
Compulsion	Repetitive behaviors that help to prevent or relieve anxiety. Obsessions are persistent unwanted thoughts that produce distress. Compulsions are repetitive rule-bound behaviors that the individual feels must be performed in order to ward off distressing situations.
Defense Mechanisms	Defense mechanisms are thought to safeguard the mind against feelings and thoughts that are too difficult for the conscious mind to cope with. Examples of commonly used defense mechanisms: • Denial is probably one of the best-known defense mechanisms, used often to describe situations in which people seem unable to face reality or admit an obvious truth. Denial is an outright refusal to admit or recognize that something has occurred or is currently occurring. • Repression is another well-known defense mechanism. Repression acts to keep information out of conscious awareness. However, these memories don’t just disappear; they continue to influence our behavior. • Sublimation is a defense mechanism that allows us to act out unacceptable impulses by converting these behaviors into a more acceptable form. For example, a person experiencing extreme anger might take up kick-boxing as a means of venting frustration. • Projection is a defense mechanism that involves taking our own unacceptable qualities or feelings and ascribing them to other people. • Intellectualization works to reduce anxiety by thinking about events in a cold, clinical way. This defense mechanism allows us to avoid thinking about the stressful, emotional aspect of the situation and instead focus only on the intellectual component. • Rationalization is a defense mechanism that involves explaining an unacceptable behavior or feeling in a rational or logical manner, avoiding the true reasons for the behavior. • Regression is when confronted by stressful events, people sometimes abandon coping strategies and revert to patterns of behavior used earlier in development. • Reaction formation reduces anxiety by taking up the opposite feeling, impulse, or behavior. An example of reaction formation would be treating someone you strongly dislike in an excessively friendly manner in order to hide your true feelings.
Dissociative Disorders	Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life. Dissociative disorders usually develop as a reaction to trauma and help keep difficult memories at bay. Symptoms depend in part on the type of dissociative disorder you have. Times of stress can temporarily worsen symptoms, making them more obvious. There are three major dissociative disorders defined DSM-5: 1. Dissociative amnesia. The main symptom is memory loss that’s more severe than normal forgetfulness and that can’t be explained by a medical condition. You can’t recall information about yourself or events and people in your life, especially from a traumatic time. 2. Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by “switching” to alternate identities. 3. Depersonalization-derealization disorder. This involves an ongoing or episodic sense of detachment or being outside yourself — observing your actions, feelings, thoughts and self from a distance as though watching a movie (depersonalization). Other people and things around you may feel detached and foggy or dreamlike, time may be slowed down or sped up, and the world may seem unreal (derealization).
Euthymia	Euthymia is the state of living without mood disturbances. It’s commonly associated with bipolar disorder but people with dysthymia (persistent depressive disorder), or other types of mood disorders, may also experience periods of euthymia. While in a euthymic state, one typically experiences feelings of cheerfulness and tranquility. A person in this state may also display an increased level of resilience to stress. One way of understanding a euthymic mood is to think of it in terms of the severity of the symptoms. If depression is on one end of the bipolar disorder continuum and mania is at the other end, euthymia lies somewhere in the middle. That’s why you can think of euthymia as living in a state of “normal” or “stable” moods. While a euthymic mood is considered a relatively normal or steady state, there are a few ways that you can experience euthymia. • Euthymia with reactive affect. A reactive affect in a euthymic state means that you respond appropriately to the subject of a conversation. • Euthymia with congruent affect. Congruent euthymia is evident when your emotions match the situation. In other words, the emotional reaction you have is congruent or in agreement with the situation you’re experiencing
Euphoria	Euphoria is a desirable and natural occurrence when it results from happy or exciting events. An excessive degree of euphoria that is not linked to events, is characteristic of hypomania or mania, abnormal mood states associated with bipolar disorders. Euphoria may also be a side effect of certain drugs.
Mood	Mood represents a sustained emotion present over a prolonged period of time that can alter an individual’s perception of the world. To explore these, you need to ask the patient questions about their mood: “How are you feeling?” “Have you been feeling low/depressed/anxious lately?” Examples of various mood states: • Low/depressed • Angry/irritable • Apathetic • Elated To understand the relationship between affect and mood, it can be useful to think of mood as the climate and affect as the weather. In the mental state exam affect is what you observe, whereas mood is what you enquire about.
Obsession	An unpleasant or nonsensical thought which intrudes into a person’s mind, despite a degree of resistance by the person who recognizes the thought as pointless or senseless, but nevertheless a product of their own mind. Obsessions may be accompanied by compulsive behaviors which serve to reduce the associated anxiety.
Phobias	The definition of a phobia is the persistent fear of a situation, activity, or thing that causes one to want to avoid it. The three types of phobias are social phobia (fear of public speaking, meeting new people or other social situations), agoraphobia (fear of being outside), and specific phobias (fear of other items or situations).
Psychosis <span data-mce-type="bookmark" style="display: inline-block; width: 0px; overflow: hidden; line-height: 0;" class="mce_SELRES_start"></span>	Psychosis is an umbrella term; it means that an individual has sensory experiences of things that do not exist and/or beliefs with no basis in reality. During a psychotic episode, an individual may experience hallucinations and/or delusions.
Psychotherapy <span data-mce-type="bookmark" style="display: inline-block; width: 0px; overflow: hidden; line-height: 0;" class="mce_SELRES_start"></span>	Psychotherapy is a general term for treating mental health problems by talking with a psychiatrist, psychologist or other mental health provider. During psychotherapy, you learn about your condition and your moods, feelings, thoughts and behaviors. Psychotherapy helps you learn how to take control of your life and respond to challenging situations with healthy coping skills.
Somatoform Disorders <span data-mce-type="bookmark" style="display: inline-block; width: 0px; overflow: hidden; line-height: 0;" class="mce_SELRES_start"></span>	Somatization is the tendency of individuals to experience and communicate psychological distress in the form of somatic symptoms and to seek medical help for them. This psychological process gives rise to somatoform disorders, which are typically first seen in non-psychiatric settings. Their core features comprise somatic symptoms and signs that cannot be explained by known disease and that result in social and occupational impairment. To meet the DSM-IV criteria for somatoform disorders, symptoms must be significant enough to cause substantial distress or interfere with work, relationships, and other areas of functioning. Somatoform disorders:• Somatization disorder. Develops before age 30 and lasts for years; involves multiple symptoms, typically a combination of pain, gastrointestinal distress, neurological problems (such as numbness), and sexual dysfunction.• Undifferentiated somatoform disorder. Involves unexplained physical symptoms that last for at least six months, but do not meet the diagnostic threshold for somatization disorder.• Conversion disorder. Involves unexplained neurological deficits in movement or sensory perception that are likely caused by psychological factors.• Pain disorder. Pain is the main symptom; psychological factors contribute to its onset, severity, and continuation.• Hypochondriasis. Preoccupation with or fear of having a particular disease, rather than a focus on individual symptoms.• Body dysmorphic disorder. Excessive focus on a perceived defect in physical appearance or a particular part of the body.• Somatoform disorder not otherwise specified. Unexplained physical symptoms that do not meet the criteria for the other somatoform disorders.

Affect

Affect represents an immediately expressed and observed emotion (e.g. the patient’s facial expression or overall demeanor). It is an observable expression of a patient’s inner feelings.

The normal expression of affect involves variability in facial expression, pitch of voice, and the use of hand and body movements. Affect is described by such terms as constricted, normal range, appropriate to context, flat, and shallow.

• Restricted affect is characterized by a clear reduction in the expressive range and intensity of affects.

• Constricted affect refers to a mild restriction in the range or intensity of display of feelings. As the display of emotion becomes more severely limited, the term blunted affect may be applied.

• Blunted affect is market by a severe reduction in the intensity of affective expression.

• Flat affect is a lack of signs of affective expression/ exhibition of emotions – the voice may be monotonous, the face is expressionless, and the body is immobile.

Anhedonia

Anhedonia refers to the loss of the capacity to experience pleasure. The inability to gain pleasure from normally pleasurable experiences. Anhedonia is a core clinical feature of depression, schizophrenia, and some other mental illnesses.

Compulsion

Repetitive behaviors that help to prevent or relieve anxiety. Obsessions are persistent unwanted thoughts that produce distress. Compulsions are repetitive rule-bound behaviors that the individual feels must be performed in order to ward off distressing situations.

Defense Mechanisms

Defense mechanisms are thought to safeguard the mind against feelings and thoughts that are too difficult for the conscious mind to cope with.

Examples of commonly used defense mechanisms:

• Denial is probably one of the best-known defense mechanisms, used often to describe situations in which people seem unable to face reality or admit an obvious truth. Denial is an outright refusal to admit or recognize that something has occurred or is currently occurring.

• Repression is another well-known defense mechanism. Repression acts to keep information out of conscious awareness. However, these memories don’t just disappear; they continue to influence our behavior.

• Sublimation is a defense mechanism that allows us to act out unacceptable impulses by converting these behaviors into a more acceptable form. For example, a person experiencing extreme anger might take up kick-boxing as a means of venting frustration.

• Projection is a defense mechanism that involves taking our own unacceptable qualities or feelings and ascribing them to other people.

• Intellectualization works to reduce anxiety by thinking about events in a cold, clinical way. This defense mechanism allows us to avoid thinking about the stressful, emotional aspect of the situation and instead focus only on the intellectual component.

• Rationalization is a defense mechanism that involves explaining an unacceptable behavior or feeling in a rational or logical manner, avoiding the true reasons for the behavior.

• Regression is when confronted by stressful events, people sometimes abandon coping strategies and revert to patterns of behavior used earlier in development.

• Reaction formation reduces anxiety by taking up the opposite feeling, impulse, or behavior. An example of reaction formation would be treating someone you strongly dislike in an excessively friendly manner in order to hide your true feelings.

Dissociative Disorders

Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life.

Dissociative disorders usually develop as a reaction to trauma and help keep difficult memories at bay.
Symptoms depend in part on the type of dissociative disorder you have. Times of stress can temporarily worsen symptoms, making them more obvious.

There are three major dissociative disorders defined DSM-5:
1. Dissociative amnesia. The main symptom is memory loss that’s more severe than normal forgetfulness and that can’t be explained by a medical condition. You can’t recall information about yourself or events and people in your life, especially from a traumatic time.

2. Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by “switching” to alternate identities.

3. Depersonalization-derealization disorder. This involves an ongoing or episodic sense of detachment or being outside yourself — observing your actions, feelings, thoughts and self from a distance as though watching a movie (depersonalization). Other people and things around you may feel detached and foggy or dreamlike, time may be slowed down or sped up, and the world may seem unreal (derealization).

Euthymia

Euthymia is the state of living without mood disturbances. It’s commonly associated with bipolar disorder but people with dysthymia (persistent depressive disorder), or other types of mood disorders, may also experience periods of euthymia. While in a euthymic state, one typically experiences feelings of cheerfulness and tranquility. A person in this state may also display an increased level of resilience to stress.
One way of understanding a euthymic mood is to think of it in terms of the severity of the symptoms. If depression is on one end of the bipolar disorder continuum and mania is at the other end, euthymia lies somewhere in the middle. That’s why you can think of euthymia as living in a state of “normal” or “stable” moods. While a euthymic mood is considered a relatively normal or steady state, there are a few ways that you can experience euthymia.
• Euthymia with reactive affect. A reactive affect in a euthymic state means that you respond appropriately to the subject of a conversation.
• Euthymia with congruent affect. Congruent euthymia is evident when your emotions match the situation. In other words, the emotional reaction you have is congruent or in agreement with the situation you’re experiencing

Euphoria

Euphoria is a desirable and natural occurrence when it results from happy or exciting events. An excessive degree of euphoria that is not linked to events, is characteristic of hypomania or mania, abnormal mood states associated with bipolar disorders. Euphoria may also be a side effect of certain drugs.

Mood

Mood represents a sustained emotion present over a prolonged period of time that can alter an individual’s perception of the world. To explore these, you need to ask the patient questions about their mood:

“How are you feeling?”

“Have you been feeling low/depressed/anxious lately?”

Examples of various mood states:

• Low/depressed

• Angry/irritable

• Apathetic

• Elated

To understand the relationship between affect and mood, it can be useful to think of mood as the climate and affect as the weather. In the mental state exam affect is what you observe, whereas mood is what you enquire about.

Obsession

An unpleasant or nonsensical thought which intrudes into a person’s mind, despite a degree of resistance by the person who recognizes the thought as pointless or senseless, but nevertheless a product of their own mind. Obsessions may be accompanied by compulsive behaviors which serve to reduce the associated anxiety.

Phobias

The definition of a phobia is the persistent fear of a situation, activity, or thing that causes one to want to avoid it.
The three types of phobias are social phobia (fear of public speaking, meeting new people or other social situations), agoraphobia (fear of being outside), and specific phobias (fear of other items or situations).

Psychosis

Psychosis is an umbrella term; it means that an individual has sensory experiences of things that do not exist and/or beliefs with no basis in reality. During a psychotic episode, an individual may experience hallucinations and/or delusions.

Psychotherapy

Psychotherapy is a general term for treating mental health problems by talking with a psychiatrist, psychologist or other mental health provider.

During psychotherapy, you learn about your condition and your moods, feelings, thoughts and behaviors. Psychotherapy helps you learn how to take control of your life and respond to challenging situations with healthy coping skills.

Somatoform Disorders

Somatization is the tendency of individuals to experience and communicate psychological distress in the form of somatic symptoms and to seek medical help for them. This psychological process gives rise to somatoform disorders, which are typically first seen in non-psychiatric settings. Their core features comprise somatic symptoms and signs that cannot be explained by known disease and that result in social and occupational impairment.
To meet the DSM-IV criteria for somatoform disorders, symptoms must be significant enough to cause substantial distress or interfere with work, relationships, and other areas of functioning. Somatoform disorders:• Somatization disorder. Develops before age 30 and lasts for years; involves multiple symptoms, typically a combination of pain, gastrointestinal distress, neurological problems (such as numbness), and sexual dysfunction.• Undifferentiated somatoform disorder. Involves unexplained physical symptoms that last for at least six months, but do not meet the diagnostic threshold for somatization disorder.• Conversion disorder. Involves unexplained neurological deficits in movement or sensory perception that are likely caused by psychological factors.• Pain disorder. Pain is the main symptom; psychological factors contribute to its onset, severity, and continuation.• Hypochondriasis. Preoccupation with or fear of having a particular disease, rather than a focus on individual symptoms.• Body dysmorphic disorder. Excessive focus on a perceived defect in physical appearance or a particular part of the body.• Somatoform disorder not otherwise specified. Unexplained physical symptoms that do not meet the criteria for the other somatoform disorders.

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