Defining a disorder
A psychological disorder is a pattern of thinking, feeling or behaving that is unusual, causes distress or impairs functioning, and is not just an expected cultural response. Clinicians use manuals such as the DSM to define and diagnose disorders. Most modern explanations are biopsychosocial: biology, psychology and social context all play a part.
Anxiety-related disorders
- Generalised anxiety disorder: persistent, hard-to-control worry about many things.
- Specific phobia: intense, irrational fear of a particular object or situation, such as spiders or flying.
- Panic disorder: repeated panic attacks, sudden surges of fear with racing heart, sweating and shortness of breath.
- Obsessive-compulsive disorder (OCD): unwanted intrusive thoughts (obsessions) and repetitive rituals (compulsions) performed to reduce anxiety.
- PTSD: lasting re-experiencing, avoidance and arousal after a traumatic event.
Mood disorders
- Major depressive disorder: at least two weeks of persistently low mood or loss of interest, plus symptoms such as sleep changes, fatigue or feelings of worthlessness.
- Bipolar disorder: episodes of mania (unusually elevated, energetic mood) alternating with depression.
Schizophrenia
Schizophrenia involves a loss of contact with reality. Positive symptoms are added experiences, such as hallucinations (perceiving things with no external source, like hearing voices) and delusions (fixed false beliefs). Negative symptoms are reduced functioning, such as flat emotion. It is not "split personality".
Treatment
- Psychotherapy. Cognitive-behavioural therapy (CBT) helps people identify and change unhelpful thoughts and behaviours. Exposure therapy gradually brings a person into controlled contact with a feared stimulus until fear fades. Psychodynamic therapy explores unconscious conflict and past experience.
- Medication. Antidepressants such as SSRIs block serotonin reuptake, leaving more serotonin in the synapse. Antipsychotics reduce positive symptoms; mood stabilisers treat bipolar disorder.
- Brain stimulation. Electroconvulsive therapy (ECT) is used for severe depression when other treatments fail.
Psychiatrists are medical doctors and can prescribe; clinical psychologists hold doctoral degrees in psychology and mainly provide therapy and assessment.
Worked example
Daniel is afraid to fly. He avoids airports, and even viewing pictures of planes makes his heart pound.
- Diagnosis: the fear is intense, specific and impairs his life, consistent with a specific phobia.
- A good treatment choice: exposure therapy, starting with pictures, then a visit to an airport, then a short flight, each step paired with relaxation.
- Why it works: staying with the feared stimulus without harm lets the fear response extinguish.
Stigma and help-seeking
Disorders are common and treatable. If you or someone you know is struggling, contact a doctor or a local crisis line.