1. Major Depressive Disorder (MDD)

• Prevalence: Very common worldwide.

• Impact on Functioning:

  • Social: Withdrawal from friends and family, loss of interest in social activities, strained relationships due to irritability or lack of engagement.

  • Occupational/Educational: Difficulty concentrating, making decisions, and lack of motivation can lead to poor performance at work or school, absenteeism, and even job loss or dropping out.

  • Self-Care: Neglect of personal hygiene, poor appetite leading to weight loss (or overeating leading to weight gain), disrupted sleep patterns.

  • Emotional: Persistent sadness, hopelessness, worthlessness, guilt, and an inability to experience pleasure can make everyday life feel overwhelming and joyless.

  • Physical: Chronic fatigue, aches, and pains are common.

  • Risk: Increased risk of suicidal thoughts and behaviors.

2. Generalized Anxiety Disorder (GAD)

• Prevalence: Common.

• Impact on Functioning:

  • Cognitive: Constant worry and difficulty concentrating can impair focus on tasks at work, school, or home. Decision-making can be difficult.

  • Emotional: Persistent feelings of unease, tension, irritability, and being “on edge.”

  • Physical: Muscle tension, fatigue (from being constantly “keyed up”), headaches, gastrointestinal issues, sleep disturbances.

  • Social: May avoid situations perceived as stressful or triggering, or social interactions might be strained due to irritability or preoccupation with worry.

  • Daily Life: Can make routine tasks feel overwhelming and lead to procrastination due to worry about outcomes.

3. Social Anxiety Disorder (Social Phobia)

• Prevalence: Common.

• Impact on Functioning:

  • Social: Significant avoidance of social situations or enduring them with intense distress. This can severely limit friendships, romantic relationships, and participation in group activities.

  • Occupational/Educational: Difficulty with presentations, speaking in meetings, participating in class, or even interacting with colleagues/classmates. May avoid jobs or educational paths that require significant social interaction.

  • Daily Life: Can make everyday interactions like shopping, asking for directions, or eating in public extremely challenging.

  • Emotional: Intense fear of judgment, embarrassment, or humiliation. Low self-esteem is common.

4. Panic Disorder

• Prevalence: Less common than GAD or Social Anxiety, but still significant.

• Impact on Functioning:

  • Daily Life: Constant fear of having another panic attack can lead to avoidance of places or situations where attacks have occurred or where escape might be difficult (leading to agoraphobia in some).

  • Occupational/Educational: Unpredictable panic attacks can disrupt work or school. Fear of an attack can lead to absenteeism.

  • Social: May avoid social outings or situations due to fear of having a panic attack in public.

  • Physical/Emotional: During an attack, physical symptoms are overwhelming and often misinterpreted as a life-threatening medical event (e.g., heart attack), causing intense fear.

5. Post-Traumatic Stress Disorder (PTSD)

• Prevalence: Depends on exposure to trauma; can be common in certain populations.

• Impact on Functioning:

  • Emotional: Persistent fear, horror, anger, guilt, or shame. Emotional numbness and inability to experience positive emotions.

  • Cognitive: Intrusive memories, flashbacks, nightmares. Difficulty concentrating. Negative beliefs about self, others, or the world.

  • Behavioral: Avoidance of trauma-related reminders. Hypervigilance, exaggerated startle response, irritability, angry outbursts, reckless or self-destructive behavior.

  • Social: Difficulty with relationships, detachment from others, loss of interest in activities.

  • Occupational/Educational: Symptoms can significantly interfere with work or school performance and attendance.

  • Sleep: Significant sleep disturbances are common.

6. Obsessive-Compulsive Disorder (OCD)

• Prevalence: Less common than major anxiety disorders but can be severely disabling.

• Impact on Functioning:

  • Time: Compulsions can be extremely time-consuming, taking up hours each day and interfering with daily routines, work, school, and social life.

  • Emotional: Significant anxiety and distress from obsessions and the urge to perform compulsions. Guilt or shame about the obsessions/compulsions.

  • Social: Avoidance of situations that trigger obsessions. Relationships can be strained by the need for reassurance or involvement in rituals.

  • Occupational/Educational: Difficulty concentrating due to obsessions. Compulsions may make it hard to complete tasks on time or attend work/school.

  • Physical: Some compulsions (e.g., excessive handwashing) can lead to physical problems (e.g., skin damage).

7. Bipolar Disorder

• Prevalence: Less common than MDD.

• Impact on Functioning (varies with mood state):

  • Manic/Hypomanic Episodes:

    • Occupational/Social: Impaired judgment, impulsivity, and grandiosity can lead to reckless decisions, financial problems, damaged relationships, and job loss. Increased productivity initially, but often becomes disorganized and ineffective. Irritability can lead to conflict.

    • Physical: Decreased need for sleep can lead to exhaustion over time.

  • Depressive Episodes: Similar impact to MDD (see above).

  • Overall: The cyclical nature makes it difficult to maintain consistent functioning in work, school, and relationships. High risk of substance use and suicide.

8. Schizophrenia

• Prevalence: Relatively low, but has a profound impact.

• Impact on Functioning:

  • Cognitive: Difficulties with attention, memory, and executive functions (planning, organizing) are core features and significantly impact daily life. Disorganized thinking impairs communication.

  • Social: Social withdrawal, difficulty forming and maintaining relationships due to negative symptoms, positive symptoms (e.g., paranoia), or impaired social cognition.

  • Occupational/Educational: Often severe impairment in ability to work or attend school.

  • Self-Care: Negative symptoms (avolition, alogia) can lead to significant neglect of personal hygiene and daily tasks.

  • Perception of Reality: Delusions and hallucinations fundamentally alter the individual’s experience of the world, making it difficult to navigate reality.

  • Risk: Increased risk of homelessness, substance use, and comorbid medical conditions.

Key Overarching Impacts on Function Across Many Disorders:

• Impaired Social Relationships: Difficulty forming or maintaining connections with family, friends, and partners.

• Reduced Occupational/Educational Performance: Challenges in maintaining employment or succeeding academically.

• Difficulties with Self-Care: Neglect of personal hygiene, nutrition, or adherence to medical care.

• Decreased Quality of Life: Overall reduction in satisfaction and enjoyment of life.

• Increased Risk of Co-occurring Conditions: Substance use disorders and other medical conditions are common.

• Stigma: Societal and self-stigma can create additional barriers to functioning and seeking help.