82°F
weather icon Partly Cloudy

Diagnosing mental issues can be as much art as science

Someone with a mental disorder may be the last person to realize they need help. Often, it’s those around them who notice things aren’t right. Symptoms may include changes in mood, personality, personal habits and/or social withdrawal.

According to the World Health Organization, mental illnesses account for more disability in developed countries than any other group of illnesses, including cancer and heart disease; published studies report that about 25 percent of American adults have a mental illness and that nearly 50 percent of the population will develop at least one mental illness during their lifetime.

“There are clinical criteria that indicate treatment using medications, but that also can be somewhat of a challenge,” said Dr. Jeffery Talbot, director of the Research Center on Substance Abuse and Depression at the Roseman University of Health Sciences. “We often refer to the mental condition not as defined illnesses with defined causes because the symptoms can vary from patient to patient, so it would be fair to say the diagnosis … can be as much art as science.”

When it comes to diagnosing mental illness, the first clues a clinician gets often come from the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, compiled by the American Psychiatric Association. The DSM-5 form is filled out by patients on their initial visit.

Questions include: Have you had little interest in doing things?; Feeling, down, depressed or hopeless?; Avoiding situations that make you anxious?; Hearing things other people couldn’t hear, such as voices when no one else is around?; and Feeling detached or distant from yourself, your body, your physical surroundings, or your memories?

Patients can rate the impact of the symptom on their life on a scale of one to four.

One’s medical history will need to be disclosed as will all medications taken. The psychiatrist will then delve further into the person’s symptoms and note when they began.

Local psychologist Dr. Charles Colosimo takes many factors into consideration during the interview: appearance, mood, and whether cognizant functions are operating in the here and now.

“You can’t rely (just on) the DSM-5,” Colosimo said. “You have to get (symptoms) sorted out first of all to see if there’s any medical ideology or neurological ideology, or if there’s been a traumatic brain injury or some outside (trigger), or is it internal. I definitely will try to find out what the situation is that brought them in and how much the crisis or the clinical problem they’re having is affecting their daily functioning.”

Colosimo said personal situations, such as divorce or custody issues, are factors in mental distress.

He added that discerning between issues, such as bipolar and post-traumatic stress disorder (PTSD), in a patient is key.

“You have to figure out what the primary issue is,” Colosimo said. “That’s the one you focus on. If their bipolar has kicked in and caused them to be very unstable, or if they’re having a terrible time, they could not be taking their medication, or maybe they’re not even prescribed medication. All those things have to be sorted out in terms of where you go with it. … If it’s PTSD, you work with it and figure out what the trigger was and how to (treat it).”

He said some physical issues could manifest psychological ones.

“So, we always have to be on top of that,” Colosimo said.

While prescribing medication is often a first step, therapy is important to address the underlying cause.

How long does it take for people to get back on track and on with life? There’s no one answer.

“If someone comes in, and you determine they need therapy, you don’t want to give them four weeks of therapy,” said Patrick Bozarth, ‎executive director at Community Counseling Center of Southern Nevada, 714 E. Sahara Ave. “That’s not going to do anything.”

He estimated that a person would need at least six months of weekly sessions. Group therapy is seen as important because it provides peer support.

One’s position in life can be an indicator of mental challenges. Data from the National Health and Nutrition Examination Survey, 2009-12, shows that those living below the poverty line were nearly two and a half times more likely to have depression than people at or above the poverty level. Sometimes life’s day-to-day drama can bring on bouts of depression.

“We have a higher percentage of mental illness,” Bozarth said of Las Vegas. “I think that has to do with Las Vegas being a transient community. … For so long, we’ve had economic issues that affect the population. The housing crisis that we went through, and that still exists, unemployment, long-term unemployment and the inability to find a decent-paying job — these are all stress-ers that (lead to) anxiety.”

Those with mental health problems can affect the rest of the population, as well.

Bozarth said there’s a cost to society, seen in the panhandlers on the street or erratic driving as people turn to drugs or self-medicate.

“Theft, rape, violent crime can be attributed in part to mental health,” he said, “and certainly substance abuse issues.”

If you or someone you know is in crisis now, seek help immediately. Call 800-273- 8255 or dial 911.

Editor’s Note: This is part of an ongoing story series in View looking at mental health in Southern Nevada.

To reach Summerlin Area View reporter Jan Hogan, email jhogan@viewnews.com or call 702-387-2949.

Don't miss the big stories. Like us on Facebook.
Entertainment Videos
Heavier traffic expected from EDC festival attendees
Electric Daisy Carnival attendees began to vacate the Las Vegas Motor Speedway starting before 5 a.m., the majority heading south on Interstate 15.
What it's like to skip the lines and fly by helicopter to EDC
What it's like to skip the lines and fly by helicopter to EDC. (Janna Karel Las Vegas Review-Journal)
DJ Steve Aoki visits Las Vegas comic book store
DJ Steve Aoki visits Torpedo Comics in Las Vegas Friday, May 17, 2019, for a signing for his new comic book series "Neon Future." (K.M. Cannon/Las Vegas Review-Journal) @KMCannonPhoto
Las Vegas Smith & Wollensky opens at The Venetian
After 18 years, the Smith & Wollensky location on Las Vegas’ south Strip closed in 2017, to be re-born two years later with a rib-cutting — instead of a ribbon-cutting — in The Grand Canal Shoppes at The Venetian. (Heidi Knapp Rinella/Review-Journal)
Colin Cantwell, Creator Of Iconic Star Wars Ships Visits Vegas
Colin Cantwell, who created and designed such "Star Wars" ships as the X-Wing fighter, and Death Star, met fans at Rogue Toys in Las Vegas today. (Mat Luschek / Review-Journal)
Beauty & Essex in Las Vegas makes an EDC Wonder Wheel
In honor of the Electric Daisy Carnival, Beauty & Essex at The Cosmopolitan of Las Vegas makes its Wonder Wheel party-worthy. (Heidi Knapp Rinella/Las Vegas Review-Journal)
Giada talks Vegas Uncork’d
Giada De Laurentiis talks during Aperitivo Hour, a Vegas Uncork'd event, at her Caesars Palace restaurant, Pronto, May 10, 2019. (Al Mancini/Las Vegas Review-Journal)
Scenes from Vegas Uncork’d 2019 on the Las Vegas Strip
The 13th edition of Vegas Uncork’d by Bon Appetit brought four days of food, wine, celebrity chefs and parties to town, May 9-12. (Heidi Knapp Rinella/Las Vegas Review-Journal)
Three ingredients Gordon Ramsay can’t live without
Bon Appetit's Andy Baraghani interviews the "Hell's Kitchen" chef during a Vegas Uncork'd event at Caesars Palace, May 11, 2019. (Al Mancini/Las Vegas Review-Journal)
Vegas Uncork’d launches wiith bubbles and a blade
Dozens of chefs representing some of the Strip’s top restaurants gathered Thursday at The Cosmopolitan of Las Vegas to launch the 2019 edition of Vegas Uncork’d by Bon Appetit. (Al Mancini/Las Vegas Review-Journal)
Bunky the Clown at the clown convention
Bob "Bunky the Clown" Gretton talks about his life as a clown and the Clown Convention which was in Las Vegas at Texas Station this week. (Mat Luschek / Review-Journal)
Frying soft-shell crab at Lola’s in Las Vegas
At Lola’s: A Louisiana Kitchen in Las Vegas, soft-shell crab is breaded and fried and served either as an appetizer, po’boy or platter. Heidi Knapp Rinella/Review-Journal
The Stove in Henderson makes Pecan Pie Pancakes
At The Stove in Henderson, chef/partner Antonio Nunez stacks buttermilk pancakes with pecans and dulce de leche and tops them pie crust crumbs. (Heidi Knapp Rinella/Las Vegas Review-Journal)
Vinnie Paul remembered at Count's Vamp'd
The late rocker's favorite table at one of his favorite clubs in Las Vegas. (Jason Bracelin/Las Vegas Review-Journal)
4DX movie experience at Red Rock
4DX movie experience during a demo reel at Red Rock. (Christopher Lawrence/Las Vegas Review-Journal)
What To Do On May The 4th
There are plenty of events going on May the 4th this year around Las Vegas. Celebrate Star Wars and Comic Book Day all at once. The Rogue Toys, the 501st, Rebel Legion and Millennium Fandom Bar are all hosting fun events to help celebrate your geek-dom. (Mat Luschek / Review-Journal)
Las Vegas Water Sports Introduces New Attraction At Lake Las Vegas
Las Vegas Water Sports will debut its new aqua park attraction at Lake Las Vegas Days this weekend. (Mat Luschek / Review-Journal)
Making the Space Invader at Greene St. Kitchen in Las Vegas
Lysa Huerta, pastry cook at Greene St. Kitchen at the Palms in Las Vegas, starts with angel food cake, Fruity Pebbles ice cream and strawberry sorbet to create a space creature engulfed in flashing lights and swirling mists. (Heidi Knapp Rinella/Las Vegas Review-Journal)
Las Vegas Pools
The M, Park MGM and NoMad are just a few great pools in Las Vegas. (Mat Luschek/Las Vegas Review-Journal)
Jose Andres explains Iberico pork
(Al Mancini/Las Vega Review-Journal)
Inside Life is Beautiful
Craig Asher Nyman explains how Life is Beautiful festival is booked and talks about this year's line-up. (Jason Bracelin/Las Vegas Review-Journal)
Tattoo'd America Pops Up In Vegas
Tattoo'd America, a new pop-up attraction on the Linq Promenade, had their grand opening Friday. The attraction is dedicate to the culture of tattoos. (Mat Luschek / Review-Journal)
Jose Andres gets key to the Strip
Chef Jose Andres was presented with a Key to the Las Vegas Strip and a proclamation declaring April 26 Jose Andres Day in Clark County by County Commissioner Tick Segerblom on Friday. The ceremony took place at his restaurant Bazaar Meat in the SLS Las Vegas. (Al Mancini/Las Vegas Review-Journal)
Sadelle’s in Las Vegas makes a grilled cheese with an inverted bagel
Michael Vargas, executive sous chef at Sadelle’s at Bellagio in Las Vegas, inverts an everything bagel and grills it with Swiss, cheddar and Muenster cheeses to make the Inverted Bagel Grilled Cheese. (Heidi Knapp Rinella/Las Vegas Review-Journal)
Learn how to make China Poblano's Salt Air Margarita
Learn how to make China Poblano's Salt Air Margarita (Janna Karel Las Vegas Review-Journal)
Tattoo'd America invites you to have fun and take pictures
Kassandra Lopez at Tattoo'd America invites you to have fun and take pictures. (Janna Karel/Las Vegas Review-Journal)
Prime rib is carved tableside at Lawry’s The Prime Rib in Las Vegas
Dave Simmons, executive chef of Lawry’s The Prime in Las Vegas, which plans special cuts for National Prime Rib Day, demonstrates the restaurant’s service from rolling tableside carving carts. (Heidi Knapp Rinella/Las Vegas Review-Journal)
Making gluten-free pizza at Good Pie in Las Vegas
Good Pie owner/pizzaiola Vincent Rotolo makes his gluten-free pizza.
Rockabilly fans enjoy Las Vegas weather poolside
Viva Las Vegas Rockabilly Weekender runs Thursday, April 18th through Sunday, April 21st with a huge car show on Saturday featuring The Reverend Horton Heat, The Delta Bombers and The Coasters. (Michael Quine/Las Vegas Review-Journal)
Brownie sundae at VegeNation in Las Vegas is completely vegan
Donald Lemperle, chef/owner of VegeNation in Las Vegas and nearby Henderson, NV, makes his sundae with ice cream made with coconut and almond milks, a brownie made with coconut flour and oil and organic sugar and cacao, and fresh fruit. (Heidi Knapp Rinella/Las Vegas Review-Journal)
THE LATEST