Mental Disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) includes this definition:

A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (i.e., a painful symptom) or disability (i.e., an impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. The syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event. It must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual. No definition adequately specifies precise boundaries for the concept of mental disorder. Also known as mental health, mental impairment, mental illness, brain illness, and serious brain disorder (DSM-IV, 1994; p. xxi).

An estimated 44 million Americans meet the diagnostic criteria for some form of mental disorder, according to the National Institute of Mental Health, and 5.6 million of those live with a serious mental illness, like schizophrenia or manic-depression (Denton County NAMI Newsletter, Oct./Nov. 1999; p.5).

Childhood psychiatric illness is an escalating problem. Twelve percent of the population under the age of 18, that’s about 8 million children, teenagers, in the United States today have a diagnosable psychiatric illness (Denton County NAMI Newsletter, June/July 1999; p.5).

A well-designed physical fitness program has been show to singificantly improve improve measures of depression, increase maximum oxygen uptake and the use of active strategies in solving problems (Van De Vliet, Van Coppenolle, Knapen, Pieters, & Peuskens, 1995; p. 427). Fitness training has an anxiety reducing effect (Van De Vliet, Knapen, Van Coppenolle, Joos, Pieters, & Koninckx, 1995; p. 717).

Prominent Behaviors of Individuals with Mental Disorders: (range from but are not limited to) (Torrey, 1995; Van De Vliet, Van Coppenolle, Knapen, Pieters, & Peuskens, 1995)

Physically sedentary
Low or bad physical fitness levels
Highly reduced maximal oxygen uptake
Negative body image
Negative perception of physical skills
Negative feelings of general competence
Low self-esteem
Feelings of awkwardness or clumsiness
Fine tremors or gross jerky movements
    [caused by drug interactions]
Repetitious movements i.e. tics, tremors, tongue and sucking       movements
Catatonia (remaining motionless for a period of time)
    [most dramatic]

Suggested Activities and Teaching Tips:
Passive/calming/breathing exercises, relaxation training. Stretching and flexibility exercises.
Warm ups and cool downs.

Create an environment that will enable the individual to achieve success.

Conduct a program with a compatible, support, social group i.e. Mental Health Mental Retardation (MHMR) groups.

Create progress charts to submit to multidisciplinary team.

Monitor any type of strenuous physical activity (watch for obsessive tendencies).

Encourage movement and activities that assist or allow the individual to express emotions. Seek counseling advice if individual’s emotional issues become strong.

Adjust frequency, intensity and time (duration) over an extended period of time.

Incorporate a well-rounded program of aerobic/anaerobic exercise, nutrition, and health/fitness education for the individual.

Limit the level of stress the individual experiences.

Special Considerations:

Any exercise program must be individually considered and based on the individual’s needs, exercise tolerance, and medical history.

Before actual programming, check with the individual’s multidisciplinary team, which may include the individual, family/guardian individuals, educational personnel, legal representatives, mental health care advisors/counselors, pharmacist, nurses and physicians.

Symptoms may be masked and cautions must be taken when exercising if the individual is on medication. Monitor the individual’s heart rate and blood pressure throughout the exercise session or activity.

Monitor the individual’s agitation and frustration levels during the exercise session or activity. Allow individual to have short breaks when tension level appears to be building.

Establish a structured, predictable, routine that is in the individual’s patient or personal environment, often, one-on-one attention/instruction is initially most successful and suggested.

Medication/drug therapies may cause i.e. reduced coordination and concentration, poor reaction time, drowsiness, blurred vision, irregular heart rates, muscle cramping, dry mouth, profuse sweating, irritability, weight gain, nausea, muscle stiffness, listlessness, and others. In some cases exercising may need to be stopped due to these medication contraindications. Avoid exposure to extreme temperatures.

Exercise programs may be stopped for various reasons i.e., counseling/therapeutic sessions, sleep/rest periods, medication/drug administrations, family/guardian/legal visitations.

Recommended Web Site

National Alliance for the Mentally Ill, 200 North Glebe Road, Suite 1015, Arlington, VA 22203

NAMI Helpline: (800) 950-6264; http://www.nami.org.

References:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV). (4th ed.). Washington, DC: Author.

NAMI (National Alliance for the Mentally Ill) in Denton County Newsletter. (1998, Sept.). Child and adolescent OCD fact sheet. Where can parents turn for help?, 11(7), p. 6-7.

NAMI (National Alliance for the Mentally Ill) in Denton County Newsletter. (1999, Oct./Nov.). Gentle drive to make voters of those with mental illness. 12(5), p. 2, 5-7.

Torrey, E. F. (1995). Surviving schizophrenia: A manual for families, consumers and providers. (3rd ed.). New York: HarperCollins.

Van De Vliet, P., Knapen, J., Van Coppenolle, H., Joos, S., Pieters, G., & Koninckx, M. (1995). Does fitness training improve the quality of life of an anxious psychiatric patient? Case study with single subject design. In I. Morisbak, P.E. Jorgensen (Eds.). Quality of life through adapted physical activity and sport: A lifespan concept. (pp. 715-717). 10th International Symposium on Adapted Physical Activity.

Van De Vliet, P., Van Coppenolle, H., Knapen, J., Pieters, G., & Peuskens, J. (1995). Physical fitness as a driving force to enhance psychological well-being in the treatment of depressive disorders. In I. Morisbak, P.E. Jorgensen (Eds.). Quality of life through adapted physical activity and sport: A lifespan concept. (pp. 414-429). 10th International Symposium on Adapted Physical Activity.

This disability fact sheet was written by Linda C. Hilgenbrinck, a doctoral candidate in Adapted Physical Education at Texas Woman's University, whose brother is an individual with a mental disorder, schizophrenia, which was diagnosed in the late 1970's.

Links

Internet Mental Health Disorders

Basic Information on Mental Disorders from MentalWellness.com

Newsgroup Support Links from About.com