Mental Disorder

Many people experience mental health challenges from time to time, but mental health challenges do not necessarily indicate mental illness. A mental disorder may be diagnosed if symptoms persist over time, cause significant distress, or interfere with daily functioning. 

Note that not everyone with a mental disorder experiences active challenges with mental health, and not everyone with active mental health challenges is experiencing a mental disorder. Many people with serious mental disorders can manage their symptoms effectively. A combination of approaches, including psychotherapy, medication, and self-care, can help most people manage their disorder(s) and improve their mental health.

When do symptoms become diagnosable? 

In the United States, medical practitioners and mental health professionals use criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), to make mental disorder diagnoses. 

The diagnostic criteria for different mental disorders varies, although many specify the minimum number of symptoms present and how long symptoms must last to receive a diagnosis. Mental disorders may include different specifiers and be classified by severity (mild, moderate, or severe). 

One relevant example of a mental disorder is major depressive disorder (MDD), a common medical condition in the United States. The DSM-V criteria for MDD include the presence of five or more of the following symptoms (of which one must be depressed mood or loss of interest in activities). These symptoms must be present most of the time for every day within at least the past two weeks, and result in a change in functioning (compared to pre-MDD mental health): 

• Depressed mood
• Loss of interest in activities that used to be enjoyable
• Significant unintentional weight and appetite changes
• Sleeping too much or not enough 
• Low energy, fatigue, or difficulty completing routine tasks in a timely manner 
• Difficulty focusing, making decisions, or concentrating 
• Feelings of worthlessness, guilt, hopelessness, or helplessness 
• Suicidal ideation
• Distress or significant disruption to functioning

There are hundreds of other mental disorders listed in the DSM-V, all with unique criteria. 

Some people may have subclinical symptoms of a mental disorder, meaning they experience mental health challenges that are significant enough to impact function or cause distress but do not meet the diagnostic criteria for a mental disorder. In subclinical cases, psychotherapy can help prevent the development of a mental disorder in the future. 

How to get a diagnosis 

Many people see a healthcare professional, such as their primary care provider, when they have a mental health concern. Before making a diagnosis, a medical practitioner may: 

• Conduct a physical evaluation to rule out underlying physical conditions that may cause your symptoms. 
• Order laboratory tests to screen for thyroid and/or order neurological issues. 

A general practitioner may conduct a psychological evaluation or refer patients to an in-person psychologist or psychiatrist. During the assessment, they may ask about your symptoms, thoughts, feelings, and behaviors. They may ask you to fill out a questionnaire to help assess your symptoms. 

If you’ve kept a symptom journal or have any specific questions, writing them down and bringing them to your appointment may be a good idea. By providing detailed information about your symptoms, you can help ensure that your provider has the necessary information to make an accurate diagnosis.

Though there are hundreds of mental disorders recognized in the DSM-V, many fall within the following categories: 

• Anxiety disorders: Anxiety disorders are common disorders characterized by excessive fear or worry in anticipation of a future event or concern. This class of disorders includes social anxiety disorder, specific phobia, panic disorder, generalized anxiety disorder, agoraphobia, separation anxiety disorder, and selective mutism. 
• Mood and related disorders: These disorders primarily impact emotions. Some of the most common mood disorders include major depressive disorder, dysthymia, bipolar disorder, and substance-induced mood disorder. 
• Trauma- and stressor-related disorders: Trauma can occur when someone experiences an event they perceive as threatening or dangerous. Trauma- and stressor-related disorders include post-traumatic stress disorder (PTSD), acute stress disorder (ASD), adjustment disorder, reactive attachment disorder (RAD), disinhibited social engagement disorder (DSED), and other specified or unspecified trauma- and stressor-related disorders. 
• Somatic symptom and related disorders: When someone experiences physical symptoms that are significantly distressing, excessive, and have no clear medical cause, they may meet the criteria for one or more somatic disorders, including pain disorder, hypochondriasis, or somatization disorder. 
• Feeding and eating disorders: Feeding and eating disorders may be diagnosed if eating behaviors cause significant physical, emotional, social, or psychological challenges. Common disorders in this category include anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID).
• Neurodevelopmental disorders: These disorders include a wide range of conditions with onset that occurs during development, including intellectual disability (ID), autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), neurodevelopmental motor disorders, communication disorders, and specific learning disorders. 
• Neurocognitive disorders: This category includes disorders of cognitive decline, such as delirium, minor cognitive impairment, and major cognitive impairment. 
• Schizophrenia spectrum and other psychotic disorders: Psychotic disorders include schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief psychotic disorder, psychotic disorder due to another medical condition, and substance/medication-induced psychotic disorder. 
• Personality disorders: Personality disorders characterize thoughts, feelings, and behaviors that are not in line with cultural expectations and cause distress or difficulty functioning. There are 10 personality disorders in the DSM-V, including paranoid, schizoid, antisocial, borderline, narcissistic, avoidant, dependent, obsessive-compulsive, and histrionic.
• Obsessive-compulsive and related disorders: These disorders include obsessive-compulsive disorder, trichotillomania (hair pulling), hoarding disorder, skin picking disorder, and body dysmorphic disorder. 
• Substance use and related disorders: These disorders include substance use disorder, substance-induced psychotic disorder, substance-induced anxiety disorders, and others. Substance use is sometimes incorrectly referred to using the outdated term “substance abuse.”
• Dissociative disorders: These disorders are characterized by memory, identity, perception, or emotional difficulties. The major types of dissociative disorders are dissociative amnesia, dissociative identity disorder, and depersonalization-derealization disorder. 
• Sleep-wake disorders: Common sleep-wake disorders include insomnia disorder, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep disorders, restless leg syndrome, nightmare disorder, and medication-inducted sleep disorder. 
• Sexual dysfunctions: Sexual dysfunctions may be diagnosed when someone experiences changes in desire, arousal, orgasm, or physical pain during sexual activity that causes distress. Examples of sexual dysfunctions include premature ejaculation, delayed ejaculation, genito-pelvic pain/penetration disorder (GPPPD), male hypoactive sexual desire disorder, female orgasmic disorder, primary anorgasmia, and substance- or medication-induced sexual dysfunction.
• Disruptive, impulse-control, and conduct disorders: Disorders in this category include oppositional defiant disorder, intermittent explosive disorder, conduct disorder, kleptomania, and pyromania. 
• Paraphilic disorders: Paraphilic disorders describe sexual interests that cause personal distress about the interest or desires, or behaviors that involve causing distress or harm to others, including the desire to act out sexual interests with a non-consenting person. This category includes disorders such as voyeuristic disorder, exhibitionistic disorder, frotteuristic disorder, sexual masochistic disorder, pedophilic disorder, and fetishistic disorder. 
• Elimination disorders: These disorders involve the elimination of feces and/or urine at inappropriate times, typically starting in childhood. Elimination disorders include enuresis and encopresis. 

For those experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Here are some common statistics on mental disorders: 

• Every year, approximately 26% of U.S. adults ages 18 and over will experience a diagnosable mental disorder. 
• Mental disorders often co-occur. For example, in 2020, 32.1% of U.S. adults experienced a co-occurring substance use disorder (SUD) and another mental disorder. 
• 46% of people in the United States meet the criteria for a mental disorder at some point in their life, with around 50% of those diagnosed developing a mental disorder by age 14.
• According to the National Institute of Mental Health, 47.2% of people with a mental disorder in 2021 received mental health services.
• Evidence-based treatments for serious mental disorders can be highly effective, with between 70-90% of individuals experiencing significant symptom improvement with a combination of therapy, medications, and other forms of support. 

If you’re experiencing symptoms of a mental disorder, you are not alone. There are resources and effective treatment options available that can help you manage your symptoms.

The prevalence of mental disorders in youth has been rising, particularly since the beginning of the COVID-19 pandemic. 

Some recent studies have been evaluating the development of mental disorders in young people. For example, a group of researchers published a global meta-analysis of 192 studies in 2022 to evaluate the average age of mental disorder onset. The study investigated 708,561 individuals with a mental disorder(s), finding that 33% of individuals were diagnosed with their first mental disorder before age 14, 48.4% before the age of 18, and 62.5% before age 25. 

The authors concluded that greater efforts towards prevention, early intervention, and psychoeducation in these age demographics could reduce the prevalence and severity of mental disorders while improving coping mechanisms and overall mental health.   

Considering the high prevalence of mental health conditions and the demand for mental health services, many studies have evaluated the effectiveness and efficacy of internet-based talk therapy. 

According to the American Psychological Association, several studies have demonstrated the effectiveness of online therapy for a variety of mental disorders and shown positive experiences for both providers and clients. 

For example, a 2017 review of 373 articles found that online cognitive behavioral therapy (CBT) can effectively address a variety of mental disorders, such as anxiety and depressive disorders. The authors also found that online therapy can be a more cost-effective, convenient, and less stigmatizing option compared to in-person therapy.