Learn about the different kinds of treatments and services that are effective in helping people with mental disorders.
Mental disorders are generally characterized by changes in mood, thought, and/or behavior. They can make daily activities difficult and impair a person’s ability to work, interact with family, and fulfill other major life functions. The National Survey on Drug Use and Health data — 2014 (PFD | 3.4 MB) shows that 43.6 million adults ages 18 and older experienced some form of mental illness in the past year, or about 18.1% of the adult population.
SAMHSA’s Community Mental Health Services Block Grant (MHBG) provides funds and technical assistance for community-based mental health services to adults with serious mental illnesses and to children with serious emotional disturbances. SAMHSA also funds a number of other grant programs to help individuals with or at risk of developing mental disorders. For more information about these programs, read about SAMHSA’s grant opportunities and the grant application, review, and management process.
Anxiety disorders range from specific phobias, such as the fear of flying, to more generalized feelings of worry and tension. This group of disorders includes panic disorder, separation anxiety disorder, social phobia, and generalized anxiety disorder.
The use of medication to treat anxiety disorders may be recommended, and while medication alone does not address the underlying reasons that a person develops an anxiety disorder, the use of medication can help keep symptoms under control while other forms of treatment are implemented. Examples of medication that may be used as part of a treatment approach to anxiety disorders includes anti-anxiety drugs (benzodiazepines) such as clonazepam, lorazepam, and alprazolam. Anti-depressants such as fluoxetine, sertraline, and venlafaxine may be used. In some circumstances beta-blockers can also be prescribed to reduce physical symptoms such as sweating. Importantly, medications work differently in different people and need to be prescribed and monitored by appropriate medical personnel.
Effective treatments for anxiety disorders also include various forms of counseling, including:
- Cognitive-behavioral therapies that help people address their fears by modifying the way they think and respond to stressful events
- Mindfulness therapy that helps patients stay focused in the present and to stop struggling to control distressing thoughts and feelings resulting in greater self-acceptance
- Exposure therapies that use a method of gradual exposure to fearful situations that leads to decreased anxiety
Exercise and relaxation techniques such as meditation can be useful for people with this disorder because they help to lower stress and to manage severe worry. Positive support from family, friends, and other peers also helps to reinforce anxiety disorder treatment.
Attention deficit hyperactivity disorder (ADHD) is a mental disorder characterized by excessive hyperactivity, impulsivity, or inattention. While ADHD is typically diagnosed in childhood, symptoms may persist into adulthood. ADHD is most effectively treated with a combination of medication and counseling. Prescription stimulants are the most widely used medications to treat ADHD. Seventy to 80% of children with ADHD show improved attention span, reduced impulsivity, and improved on-task behavior while taking stimulant medications.
Different types of counseling and behavioral therapies are used to treat ADHD. Providing practical assistance, such as helping a child organize tasks or complete schoolwork teaches a child how to monitor his or her own behavior. Helping a child control anger or think before acting is another goal of counseling for ADHD. Laying out clear rules, chore lists, and other structured routines helps a child control his or her behavior. Counseling can also be used to help adults by educating them about ADHD, helping develop skills such as organization and planning, and applying these skills in daily life. ADHD coaching is an emerging treatment option that may help adults with the disorder. ADHD coaches work with individuals on improving their skills on scheduling, goal setting, confidence building, organization, and persisting at life tasks.
Depressive disorders are characterized by a pervading sense of sadness and/or loss of interest or pleasure in most activities, and include major depressive disorder and persistent depressive disorder (dysthymia). Like most mental illness, depressive disorders are best treated with a combination of medication and counseling.
Many medications exist for the treatment of depressive disorders. These medications, known as antidepressants, work by affecting neurotransmitters, especially serotonin and norepinephrine. These medications fall into a number of classes including selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs). There are numerous forms of medication across these classes and each has different side effects. People sometimes need to try different medications to find a medication that relieves their depression and has tolerable side effects.
People with a depressive disorder often benefit from seeing a psychiatrist, psychologist, or other mental health counselor. If medication is needed, the person must see a psychiatrist or other healthcare professional with prescribing privileges. Interpersonal therapy, a form of behavioral therapy, is a short-term treatment option that aims to help people work through troubled relationships that may be affecting their condition.
It is important that those with major depression who experience suicidal thinking, a common symptom of major depression, and who are treated with antidepressants, have ongoing close psychiatric follow-up because energy levels may improve before mood symptoms and suicidal thinking resolve thereby potentially increasing the risk of suicide early in the course of treatment. Cognitive-behavioral therapies tailored to address the thoughts and behaviors that can accompany depressive disorders are another treatment option.
Bipolar disorder causes highs (mania) and lows (depression) in mood. Symptoms of bipolar disorder are severe and can result in damaged relationships, poor job or school performance, and even suicide. A combination of medication and counseling is recommended to treat bipolar disorder.
Bipolar disorder can be treated with a range of medications depending on the specific symptoms an individual with bipolar disorder experiences. These medications include mood stabilizers, antipsychotics, and antidepressants. Because some of these medications have serious side effects, especially mood stabilizers and antipsychotics, it is important for people with bipolar disorder to closely monitor side effects and have close support from their psychiatrist to properly manage their medication.
A number of psychotherapies can help with the treatment of bipolar disorder including cognitive-behavioral therapy to identify negative patterns and behaviors, interpersonal and family therapies that help people with bipolar disorder improve relationships and communications, and psychoeducation, which can educate people with bipolar disorder and their family members about the illness and help them to identify the signs of mood swings before they happen.
Schizophrenia is a serious mental illness that affects about 1% of the U.S. population. It usually appears between the ages of 16 and 30. Symptoms of schizophrenia include hallucinations and delusions, disorganized thinking, social withdrawal, flat affect, lack of pleasure, difficulty starting and sustaining activities, problems with decision making, problems with working memory (recalling what has been learned previously), and problems with attention.
Treatments for schizophrenia focus on eliminating the symptoms of the disease. They include a combination of antipsychotic medication and behavioral therapy. Hallucinations and other symptoms of agitation usually subside within days after starting medications. It typically takes about six weeks on these medications for people to experience a marked improvement. Individual response to treatment can vary widely among individuals, so people living with schizophrenia will need to work collaboratively with their psychiatrist and other treatment providers to determine the course of medication, behavioral therapy, and other recovery supports that will most effectively help them to achieve the highest possible level of function.
Those who are diagnosed with schizophrenia can benefit from behavioral therapies, including:
- Illness management—Once patients learn basic facts about schizophrenia and its treatment, they can make informed decisions about their care and watch for the early warning signs of relapse.
- Rehabilitation—This involves social and vocational training to help people with schizophrenia function better in their communities.
- Family education—People with schizophrenia are often discharged from the hospital into the care of their families, so it is important that family members learn about the illness. With the help of a therapist, family members can learn coping strategies and problem-solving skills.
- Cognitive-behavioral therapy—Therapy helps patients to understand and cope with symptoms that do not go away even when they take medication.
- Mutual support groups—These groups provide support and help people feel less isolated.
SAMHSA works with the National Institute of Mental Health (NIMH) to advance the Recovery After an Initial Schizophrenia Episode (RAISE) project, which aims to reduce long-term disability from schizophrenia by promoting coordinated and aggressive treatment in the early stages of the illness.
Trauma is a widespread, harmful and costly public health concern. It may occur as a result of violence, abuse, neglect, loss, disaster, war, and other emotionally harmful experiences. Post-traumatic stress disorder (PTSD) is a reaction to traumatic stress, and people with PTSD may feel stressed or frightened even when they are no longer in danger following a traumatic event. PTSD can affect different people, from survivors of sexual or physical assault or natural disasters to military service men and women. Not everyone who experiences trauma develops PTSD. However, about 10% of women and 5% of men are diagnosed with PTSD in their lifetime. Learn more about trauma and violence.
Treatment strategies work best when they are customized to meet a person with PTSD’s individual needs. The selection of treatment and services should also reflect an individual’s stage of recovery. Some of the most common forms of treatment for PTSD include:
- Exposure therapy helps people face and control their fear by exposing them to the trauma they experienced in a safe way. It uses mental imagery, writing, or visits to the place where the event happened to encourage the development of coping strategies.
- Cognitive restructuring helps people make sense of bad memories and address negative thinking.
- Psychological therapies teach people helpful ways to react to frightening events that trigger their PTSD symptoms.
Medications are often prescribed with behavioral therapy to treat the common co-occurrence of depression, related anxiety disorders, aggression, or impulsivity. Emerging complementary and alternative treatments such as meditation, acupuncture, and relaxation therapy may help people with PTSD. Research on therapy dogs for PTSD has been called for because anecdotal reports are promising, but controlled studies have not yet been completed.