Disorder of wellbeing

from Wikipedia, the free encyclopedia

A mood disorder is a negative sensation that is perceived purely subjectively. As a psychological disorder, it affects the area of well-being , where stressful or life-coping issues are experienced over time or intensely.

It is distinguished from the everyday -being occurring negative fluctuations ( "malaise"), which in its own observation occur. The absence of disturbances is described as subjective well-being . The term impairment is also used, but is less clearly defined.

The disturbance of well-being (or well-being according to the definition of the World Health Organization ) can be divided into three areas as follows: physical, emotional and social well-being (Bullinger, 1992). In a positive sense, there is usually talk of a good general condition even without this differentiation into different areas. In the negative sense, it is spoken of poor general well-being, if z. B. cease general defense reactions of the body as a result of an illness or disability and / or the functional readiness of the entire organism is reduced. This can e.g. B. occur in weight loss , fever or immune defense and physical or mental exhaustion. This restricts the functions of the entire organism or the general physical adaptation and the functional reserves. Bad general well-being also means an individual disharmony of physical, emotional and social integration, see also web links.

Examples of the variety of symptoms of a disorder

In the literature, disorders of well-being are often referred to in the following contexts: Sensitivity to weather, environmental toxins, for example mold or ozone, nausea after anesthesia in the postoperative phase, gynecological problems.

In order to get a better idea of ​​how diverse the appearance of mental disorders can be, some examples of symptoms that are mentioned in the literature in connection with mental disorders should be listed without claiming to be exhaustive:

Upset mood, anxiety, depressive moods, easy fatigue or tiredness, poor concentration, tears, loss of drive, memory disorders, weight loss, nervousness, exhaustion, sleep disorders, easy excitability, irritability, restlessness, tiredness, weakness, indifference, listlessness or displeasure, sadness, dejection

Organ-related disorders are also called functional disorders: breathing difficulties, irritation of the respiratory tract, cough, hoarseness, heart problems, stenocardia , loss of or lack of appetite (inappetence), nausea (nausea), stomach problems , swallowing disorders , indigestion (such as constipation), dizziness, fainting, " Circulatory weakness ”, dysmenorrhea , dysuria , headache, migraine attacks, pain (rheumatic pain, scar pain), cardiovascular disorders, increased susceptibility to infections, weakness, poor performance, sweating

So it is not just about impairments of mood, but also about impairments of physical well-being. Mood disorders are therefore often referred to in connection with somatoform disorders. Historically, mood disorders associated with the following terms: Crohn hypochondriacus, hypochondria , Febricula , railway illness , Telephonkrankheit , neurasthenia , self-description of hypersensitivity to odors, shinkeishitshu , Epidemic neuromyasthenia , fibromyalgia (fibrositis), multiple chemical sensitivity , chronic fatigue syndrome .

According to the long version of the AWMF guideline Non-specific, functional and somatoform physical complaints, dealing with patients , physical complaints that are medically insufficiently explained and that disappear again by themselves or through the use of simple home remedies or behavioral changes, can best be described as mental disorders.

Connection with the concept of illness

In the literature, a smooth transition between mental disorders and illness is sometimes assumed. If one follows this conviction, it is difficult to distinguish clearly from a disease. If one wants to hold on to the conviction that the transition between the disorder and illness is fluid and that both can therefore never be present at the same time, one must arbitrarily set a threshold (cut-off value) in studies in order to distinguish the two from one another. The assumption of a smooth transition is particularly difficult with regard to a socio-medical assessment. It is easy to understand that a policyholder who applies for occupational disability due to mental disorders has a special obligation to "explain in more detail which health barriers affect him in what specific way to meet the requirements of his profession."

It is sometimes claimed that in order to be able to speak of a disorder, there should be no vegetative disorder or morphological damage to organs. This is intended to distinguish functional disorders, psychosomatic and somatopsychic disorders. One can indeed suffer from a mental disorder without a physical finding, but also have an organic disorder without the mental health being impaired, which is why the physical illness is only recognized late. Mood disorders can, however, also indicate an organic disease. From this point of view, it must be established that there is no fixed connection between the subjective condition and the medical finding. The table on the right shows that in addition to the normal healthy and normal sick there are also sick people who feel healthy and healthy people who feel sick.

Loose connection between well-being and findings
no findings Medical result
Wellbeing "Normal healthy" "Healthy sick"
Malaise "Sick healthy" "Normal sick"

Physical disorder

The physical disorder can be due to an illness , handicap or health impairment (e.g. concentration disorders , hangover , hunger and thirst ). Many illnesses can announce themselves with disorders of wellbeing. Furthermore, conditions such as climate change and weather changes as a result of a sensitivity to the weather are reasons for a disorder. The absorption of toxin active substances by the body can also lead to disturbances of well-being. A common P-phrase is: "If you feel unwell, seek medical advice / call for medical assistance." These can also be triggered by environmental influences, e. B. smells or disgust . Also, menstrual cramps or discomfort of puberty and menopause (menopause problems) are manifested in disturbance of mood.

Symptoms that manifest a discomfort are, for example, tiredness , dizziness or vomiting , a "dull feeling in the epigastric region", dry mucous membranes, or other symptoms that are summarized under malaise and fatigue (symptom complex R53 according to ICD-10).

Mental health disorder

This disorder is due to a negative sensation in the psychological area.

Causes include a. adverse living conditions such as prolonged stress or overdue recovery.

It may be that the person concerned is resentful or that in the long run suffers a mental illness such as insomnia or alcoholism as a result .

The psychological malaise can ultimately lead to despair .

Social disorder

In social interaction , individual members of a community can suffer from a disorder if their social role is disturbed from the outside or from the inside (cf., for example, undesirable physical contact (jostling); bullying or isolation ).

Recording of disorders in the practice

According to the EVAS study from 1989, general practitioners are consulted in 70% of cases for mental disorders. Conversely, Schepank found general psychosomatic complaints in 1987 in 18% of the non-sick population in Mannheim, 8% of which were classified as disease-related. A disorder is usually only detected when the patient reports about it. In order to avoid confusion of language, the patient is advised to refrain from using technical terms such as “coronary artery narrowing” and instead to report subjectively. Otherwise the doctor might feel tempted to reconcile the technical terms with his objective findings.

Because infants and toddlers often do not yet have the consciousness or the language to perceive or express disorders of well-being, outsiders are dependent on objectively observable indicators that can be used to infer a disorder. For example, children under 3-4 years of age cannot reliably verbally express mood disorders such as pain or nausea. The same is likely to apply to patients with brain damage who are unable to express mental disorders.

Theoretical concepts

Empirical results regarding the complaint areas

In practice, impairments of well-being are recorded using so-called complaint questionnaires. These are experienced impairments of physical and / or psychological functions. The subdivision of the complaint areas was mainly carried out using the method of factor analysis ; the individual analyzes show well-matched results. Many complaint recording procedures follow a hierarchical structure; different levels of differentiation are used for recording.

  • General level of complaints (also used psychodiagnostically in complaint questionnaires as a screen for the presence of mental disorders).
    • Physical versus psychological complaints
    • Specific physical complaints - unspecific impairments of well-being - specific psychological complaints
      • Individual complaints areas
        • Digestion, cardiovascular system, sensory disorders, sleep problems (specifically physical)
        • Exhaustion, agitation, poor performance, self-esteem (unspecific)
        • Fears, compulsions, complaints in social communication (specifically psychological)

Psychoanalytic Theory

According to psychoanalytic theories, temporary disorders in the earliest phase of development are responsible for the formation of the child's self . This development usually takes place during the narcissistic or oral development phase through a symbolic occupation of the inner mother image ( imago ). The so-called ›good and bad mother image‹ serve as a starting point for the beginning of self-awareness . The symbolically occupied mother image experiences a differentiation of meanings ( situation circle ). A merging of the child's self with that of the mother ( primary narcissism ) is assumed to be the most original phase of early childhood development . Feelings of the child's ›feeling bad‹ are therefore initially connected or associated with the idea of ​​the ›bad mother‹ . However, negative childish feelings of well-being also contribute to the splitting of the early childhood self-confidence that has merged with the mother ( subject-object split ). Such feelings challenge the child's own incipient abilities, which are set in motion due to the progressive physiological maturation processes of the brain ( scheme of action ). As a result of this increasing separation, parts of the self arise in the child's imagination.

literature

Individual evidence

  1. ↑ subjectivity . "Existing or valid only for the subject, an important characteristic of psychological processes and not to be observed directly by anyone else". cod
  2. ↑ Brigitte Lueger-Schuster: impairment in well-being . ( Memento from March 4, 2016 in the Internet Archive ) In: Clinical Psychology and Health Psychologist .
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  40. ↑ D. v. Zerssen: The Complaints List - Manual . Beltz Test GmbH, Weinheim 1976.
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  44. ↑ Joseph Wiel: Treatise on the diseases of the stomach . Verlag Ludwig Magg, 1868, p. 17