Behavioral Health Disorders

What Inquiring Minds Want to Know About Behavioral Health Disorders
By Andrea M. Sopko, CHDS

What are the symptoms of a behavioral disorder?
According to Boston Children’s Hospital, some of the emotional symptoms of behavioral disorders include:

Easily getting annoyed or nervous
Often appearing angry
Putting blame on others
Refusing to follow rules or questioning authority
Arguing and throwing temper tantrums
Having difficulty in handling frustration

Sometimes people suffering from a behavioral disorder will develop a substance abuse problem, and could show physical symptoms such as burnt fingertips, shaking, or bloodshot eyes.

What is the difference between a phycologist and a psychiatrist?
The professions of psychiatry and psychology differ in terms of education. Psychiatrists are trained in general medicine. They earn their MD, and then they
practice four years of residency training in psychiatry. As trained medical doctors, psychiatrists can prescribe medications, and they spend much of their time with patients on medication management as a course of treatment.

Psychologists obtain a PhD or PsyD doctoral degree. Throughout their education, psychologists study personality development, the history of psychological problems and the science of psychological research. Graduate school provides rigorous preparation
for a career in psychology by teaching students how to diagnose mental and emotional disorders. Their focus is extensively on psychotherapy and treating emotional and mental suffering in patients with behavioral intervention. Psychologists can
conduct psychological testing, which is critical in assessing a person’s mental state to help determine the most effective course of treatment.

What tests are used to classify behavioral disorders?
There are so many types of behavioral disorders. These range from children, to adolescents, and to adults. They can be emotional or physical. The updated criteria
used to diagnosing behaviors can be found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

There are a myriad of psychological tests. Familiar test names may include the Wechsler Adult Intelligence Scale – Third Edition (WAIS-III), Stanford Binet Intelligence Scale – Fifth Edition, Rorschach Inkblot Test, Minnesota Multiphasic Personality
Inventory – Form R, and the Beck’s Depression Inventory-II (1996). The following links will help you find the particular test name you may be researching.

http://www.assessmentpsychology.com/testlist.htm
http://www.valueoptions.com/providers/Forms/Clinical/List_of_Psychological_Tests.pdf

What does GAF mean?
The GAF stands for “Global Assessment of Functioning and is a scale from 0 to 100. The higher score indicates a greater level of functioning. This would include optimal mental health and coping
capabilities in the range of 91 – 100. Those with mild psychological problems are included in the 71 – 90 range. Severe problems fall in the 21 – 30 range and the 1 – 10 range is used for persistently suicidal persons or persons incapable of
meeting even minimal personal hygiene standards. The GAF rating is made as a standard part of all psychiatric/psychological diagnoses.

What are the signs that an antidepressant is not working?
Finding the right depression treatment can take time. You can help speed up the process if you know the signs that an antidepressant isn’t working for you.

By Elizabeth Shimer Bowers

Medically Reviewed by Niya Jones, MD, MPH

You feel better right away. Antidepressants work by increasing and balancing feel-good neurochemicals in your brain, including serotonin, dopamine, and norepinephrine,
a process that takes some time. Depression relief from an antidepressant usually takes two to 12 weeks to set in, with a peak at six to eight weeks.
You skipped a dose — or several. Lack of adherence to antidepressant medication can be a reason medications don’t work, as well as a major barrier to
depression treatment.
You experience no relief from depression symptoms after a few months. You should see some improvement within three months of starting an antidepressant. If you have been on an adequate dose of a depression medication for
three months, and you don’t get results, it’s probably time to try something new.
You feel a sudden surge of energy — along with the blues. Having more physical energy after starting an antidepressant, but still feeling depressed can be good and bad news. The medication is starting to work, but not
in the right way. Increased physical energy combined with depression is a bad combination that can make you act out or increase your risk for suicide.
You’re experiencing unpleasant side effects. Studies looking at the effectiveness of antidepressants found that there are no marked differences, and they all pretty much work the same. Gaining weight or having sexual
problems can be side effects of antidepressants. You may want to switch to one without those side effects.
Your antidepressant doesn’t pack the punch it used to. If you have been on an antidepressant for a long time, your body may develop a tolerance. While your medication may have worked well as a depression treatment at first,
you may be feeling that its power has faded. Talk to your doctor about increasing the dosage.
Your depression gets deeper. If your depression symptoms get worse as soon as you start taking an antidepressant, or they get better and then very suddenly get worse, it’s a sign that the depression medication isn’t working
properly. Specific warning signs to look out for include feeling agitated or restless, pacing or constant movement, hand wringing, or feeling generally out of control.
Your depression symptoms have improved, but you’re still not yourself. If you experience some relief on an antidepressant, but it’s not the relief you hoped for, it may be time to try something new. That may include trying
another depression medication or adding counseling, psychotherapy, mood-boosting cardio exercise, or even light therapy to your treatment regimen.
You’re having violent mood swings. Mood swings can be caused by depression medications, especially in people who have a tendency toward bipolar disorder — depression and mania. Experiencing unusual elation or having
uncharacteristic bouts of rage may mean you need to change your antidepressant.
After an extended period on an antidepressant, your depression is gone. Taking antidepressants for at least 6 months could lead to remission. One could actually stop their antidepressants. Do not do so acutely!
It is important to slowly taper off depression medications. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can produce physical symptoms of withdrawal if you stop taking them suddenly. It is best to
titrate this medication down, usually over a few weeks.
Antidepressants can be very helpful, but they’re not like taking aspirin for a headache. If you feel your medication isn’t working up to your expectations, call your doctor to help you get back on track to feeling better.

everyday HEALTH – https://www.everydayhealth.com/
Last Updated:7/23/2015

Is there a drug website just for psychiatry meds?
Try googling. Depending on the phrase you search for, you will find the links below and many others.

Familiarize yourself with the web page when it opens to help with its searchability.

https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml
https://www.nami.org/Learn-More/Treatment/Mental-Health-Medications
https://psychcentral.com/drugs/
https://www.mind.org.uk/information-support/drugs-and-treatments/medication/drug-names-a-z/#.Wl_nfa6nH3g

What is a MMSE?
The Mini Mental State Examination (MMSE) is a tool that can be used to systematically and thoroughly assess mental status. Older adults may experience decline in cognitive functioning often due to illness
or injury. The MMSE assessment, though with different names or different administrators, is done to assess cognitive status. With this testing early changes in physiological status, ability to learn, and evaluating responses to treatment can
be identified.

It is an 11-question measure that tests 5 areas of cognitive function.
Orientation, registration, attention and calculation, recall and language.
Maximum score 30.
A score of 23 or lower is indicative of cognitive impairment.
The MMSE takes only 5-10 minutes to administer.

What do they ask on an MMSE?

What is the (year) (season) (date) (day) (month)?
Where are we (state) (country) (town) (hospital) (floor)?
Name 3 objects: 1 second to say each. Then ask the patient all 3 after you have said them.
Serial 7’s.
Alternatively spell “world” backward.
Ask for the 3 objects repeated above.
Name a pencil and watch.
Repeat the following “No ifs, ands, or buts”
Follow a 3-stage command: “Take a paper in your hand, fold it in half, and put it on the floor.”
Read and obey the following: Close your eyes. Write a sentence. Copy the design shown (there is a design at the bottom of the test).

What is the Social and Occupational Functioning Assessment Scale?
Social and Occupational Functioning Assessment Scale (SOFAS) The SOFAS is a new scale that differs from the Global Assessment of Functioning (GAF) Scale
in that it focuses exclusively on the individual’s level of social and occupational functioning and is not directly influenced by the overall severity of the individual’s psychological symptoms. Any impairment in social and occupational functioning
that is due to general medical conditions is considered in making the SOFAS rating. The SOFAS is usually used to rate functioning for the current period (i.e., the level of functioning at the time of the evaluation).

For more information see – https://www.kenniscentrum-kjp.nl/app/webroot/files/tmpwebsite/Downloadable_PDFs_Instrumenten/sofas.pdf