Chapter 17 - § 17.1 • COMMON DIAGNOSES

• Jurisdiction: Colorado

§ 17.1 • COMMON DIAGNOSES

It really is not fair to say that certain diagnoses create more concern than others, or to focus attention on one over another person's legitimate mental health. Nevertheless, it is easy to misunderstand what it means for a person to have a mental health disorder or rely on popular conceptions of mental health disorders, which is not helpful to anyone. Thus, it is fair to bring some attention to different diagnoses with the caveat that this is not exhaustive nor representative of the only disorders deserving of careful attention. Some diagnoses the practitioner should be aware of include:

• Major depressive disorder can cause a person to have significant issues with basic functionality and Activities of Daily Living (ADLs) when severe. A person must feel either depressed mood or loss of interest or pleasure. Other diagnostic markers include sudden weight loss or weight gain, insomnia or hypersomnia, feelings of worthlessness or excessive guilt, diminished concentration, and recurrent thoughts of death, as well as others. Feelings of grief should be distinguished from a Major Depressive Episode (MDE); where in grief a person feels loss and emptiness, an MDE is marked by persistent depressed mood and inability to anticipate happiness or pleasure. Grief is experienced "in waves," self-esteem is usually preserved or at least feelings of guilt relate to the relationship with the decedent, and positive emotions and humor often remain present in grief. In the most severe cases, a person with severe depression can present with psychotic features, including hallucinations and delusional thinking.
• Schizophrenia in elderly adults commonly appears differently than in younger adults. Positive symptoms — symptoms like audio and visual hallucinations, response to internal stimuli, are not as commonly seen in older populations, while negative symptoms are — symptoms like irritability, depression, aggressive behavior, and mental disorganization. Because irritability and aggressive behavior are also commonly found in elderly patients with dementia disorders, it can be very challenging to properly diagnose. Nevertheless, schizophrenia can show up in older adults for the first time and the focus should be on maintaining functional skills if at all possible. David P. Folsom, et al., "Schizophrenia in Late Life: Emerging Issues, 8 Dialogues in Clinical Neuroscience 1, 45 (2006); available at www.ncbi.nlm.nih.gov/pubmed/16640113. Chemical restraints

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