Many mental illnesses can have a significant impact on both the substance and quality of a person’s life. But is it possible to determine what is the hardest mental disorder to live with?
Why Are Mental Disorders Hard to Live With?
If we want to attempt to answer the question, What is the hardest mental disorder to live with? we first have to consider the factors that can make life difficult for anyone who has any type of mental health concerns.
In other words, what specific features of mental health conditions are particularly challenging for the people who develop them?
For the purposes of this post, let’s look at three potential criteria for determining what is the hardest mental disorder to live with: the symptoms a person experiences, the level of stigma they face, and the quality of the support they receive.
Symptoms
This is perhaps the most obvious criteria when considering which mental disorders are the hardest to live with. What types of symptoms does the disorder cause, how severe do they become, and how do they impact a person’s ability to function?
However, there is a limit to how helpful this criteria can be, because the type and severity of symptoms can vary considerably among people who have the same disorder.
For example, some people who have depression only experience minimally disruptive symptoms that are easily treated with medication. But others endure severe, life-altering effects that don’t respond to either medication or therapy.
Stigma
While this criteria doesn’t apply directly to the mental disorders themselves, it can have a significant influence over the degree of difficulty that people are likely to experience.
Decades of education efforts and awareness campaigns have improved public understanding and led to greater acceptance of people with mental health concerns. Unfortunately, though, many people continue to hold outdated, incorrect opinions of what it means to have a mental illness.
The impact of stigma can include diminished self-confidence, lost opportunities, delays in seeking treatment, and lower overall quality of life.
Support
Two people who are caught outside in the same rainstorm can have decidedly different experiences if only one of them has an umbrella. In a similar vein, the way people are impacted by mental health disorders can vary considerably depending on the support they receive.
For example, do they have friends and family members who accept them without judgment and provide meaningful assistance? Do they have access to treatment – and is that treatment effective? Does their workplace provide reasonable accommodations as required by law?
What is The Hardest Mental Disorder to Live With?
Given the variability in symptoms, stigma, and support among people who have the same disorder, it would be impossible to state that one mental disorder is undoubtedly the hardest to live with.
But it is possible to identify disorders that typically have a more profound negative impact on a person’s ability to live a productive and satisfying life.
Here, listed in alphabetical order, are five disorders that can be particularly difficult to live with:
1. Anorexia nervosa
As noted in a January 2020 article in the journal BMC Psychiatry, anorexia has a higher mortality rate than all other psychiatric conditions.
This is due in part to the tremendous physical damage that is associated with this disorder. The medical impact of anorexia can include electrolyte imbalances, irregular heart rate, damage to the heart muscle, loss of bone density (osteoporosis), and kidney problems
In addition to their physical pain, people with anorexia often also endure immense emotional suffering.
According to an August 2018 study in the journal Current Opinions in Psychology, suicide is the second-leading cause of death among people with anorexia. The suicide rate within this population is 18 times higher than among the general public.
2. Bipolar disorder
The symptoms of bipolar disorder can include dramatic, unpredictable swings in mood, motivation, self-confidence, and a host of additional characteristics.
During periods of mania, a person with bipolar disorder may experience racing thoughts, inflated self-esteem, and heightened impulsiveness. These symptoms can lead to harmful behaviors such as unsafe sex, unwise financial decisions, and extravagant spending sprees.
Depressive episodes can involve persistent sadness, low energy, disrupted sleep and eating habits, and recurrent thoughts of death and dying.
A January 2022 analysis in the Journal of Affective Disorders reported that the average life expectancy of people with bipolar disorder may be 8-20 years shorter than among individuals of equal age who do not have this condition.
3. Borderline personality disorder (BPD)
According to a November 2021 study from the University of Turn (Italy), experts estimate that borderline personality disorder affects about 1.6% of people within the general population.
However, the authors of this study reported, “In primary care settings [the rate of BPD] can reach about 6%, increasing to 10% in outpatient mental health clinics and as high as 20% among psychiatric inpatients.”
Additional information about the impact of BPD from that study include:
- Only about 25% of people with BPD have full-time jobs.
- About 40% of those with the condition receive some type of disability payment.
- The estimated suicide rate among people with borderline personality disorder is 8%-10%.
Also, BPD is closely associated with a history of adverse childhood experiences (ACEs) such as abuse, neglect, and assault. One small study that was published in the Industrial Psychiatry Journal reported that 44% of adult participants with BPD had been sexually assaulted during childhood.
4. Obsessive-compulsive disorder (OCD)
In popular media such as TV shows and movies, OCD is often portrayed as little more than a quirky insistence on organization. In reality, this disorder can be a source of immense mental anguish, with some symptoms having the potential to cause substantial disruptions in a person’s life.
As the full name of the disorder indicates, people with OCD may be affected by both obsessions and compulsions:
- Obsessions are intrusive fear-based thoughts, such as believing that they may become contaminated, harm themselves or someone else, or accidentally say something offensive or blasphemous.
- Compulsions are behaviors that a person feels forced to act out, often over and over again.
The National Institute of Mental Health (NIMH) has reported that 50.6% of all people with OCD are severely impaired as measured on the Sheehan Disability Scale, while another 34.8% experience moderate impairment.
5. Schizophrenia & schizoaffective disorder
Someone with schizophrenia may experience hallucinations and delusions, have difficulty organizing their thoughts and communicating effectively, and exhibit abnormal behaviors.
In addition to having these types of symptoms, a person with schizoaffective disorder will also go through manic or depressive episodes (similar to what people with bipolar disorder experience).
As reported in a November 2022 article in the journal Healthcare (Basel), people with schizophrenia and schizoaffective disorder have significantly shorter average lifespans than the general public.
Factors that contribute to this early death rate include increased risk of suicide, greater likelihood of being victims of violence, and poor self-care.
Find Mental Health Treatment in Atlanta
Serious mental illnesses can be highly disruptive, but most are treatable. With the right type of care, people who have these types of conditions can learn to manage their symptoms and experience improved quality of life.
North Atlanta Behavioral Health is a trusted provider of personalized outpatient mental health services for adults who have BPD, OCD, schizophrenia, and other complex disorders. Treatment options at our center in Atlanta, GA, include a partial hospitalization program (PHP), an intensive outpatient program (IOP), and an outpatient program (OP).
To learn more about how we can help you or a loved one, please visit our Contact page or call us today.
