Mental disability

A mental disability occurs when a person cannot process and use new information. In addition to a reduction in intelligence, social skills are also severely impaired. Intellectual disability can be both congenital and acquired. A mental handicap cannot be cured, but depending on its severity it can be treated in order to enable those affected to lead a “normal” life.

What is an intellectual disability?

Intellectual disability is when the ability to understand or use new or already known information is severely impaired. Furthermore, there is a reduction in the ability to learn and use new skills. Due to the reduced or impaired intelligence, it is seldom possible for those affected to lead a self-sufficient (independent) life. The intellectual disability also affects social competence.

The term “intellectual disability” also depends on society and its norms. Intellectual disability can begin before birth in the womb. According to the WHO (World Health Organization), the term “intellectual disability” also includes the disease autism, since people with it usually have cognitive impairments.

Developmental disorders and psychological problems are also included, although it is controversial whether these can be classified as intellectual disabilities. In the case of dementia, previously learned skills are lost, so that one speaks of a mental disability. The demarcation between mental and intellectual disabilities is fluid, so that a clear allocation can often not be made.

Some sufferers can lead an independent life with appropriate therapy. The more severe the intellectual disability, the more likely it is that those affected will be dependent on help and care from third parties for the rest of their lives.

causes

Intellectual disability can have many causes. A distinction is made between endogenous and exogenous factors.

Endogenous factors include the hereditary component. Diseases caused by genetic defects, such as B. Down syndrome, are inherited from generation to generation.

Exogenous factors include causes that already occurred during pregnancy and that caused lasting damage to the embryo. In addition to alcohol and drug abuse, eating disorders can also disrupt cerebral development.

Chemotherapy and radiation therapy can also result in intellectual disabilities. If cancer is diagnosed in a pregnant woman, all treating physicians should consider what measures should be taken to protect the lives of mother and child.

The human brain is very sensitive to a lack of oxygen. Oxygen deficiency can occur during childbirth, especially in high-risk pregnancies, which can often result in a more or less pronounced intellectual disability.

Symptoms, ailments & signs

Because intellectual disability is defined by a low intelligence quotient (IQ), there are typically many different symptoms. Mentally disabled children often think and act as if they are younger than they actually are. Depending on how severe the mental handicap is, there can be several years between actual age and “mental age”. Such a deviation is also possible in adults.

The cause of this apparent age shift lies in cognitive and other psychological abilities. These are less developed in people with intellectual disabilities than in most other people. As a result, difficulties in learning to read, count, or do arithmetic often arise. In toddlerhood, a possible early sign is insufficient or late language development - however, this symptom alone is not enough to speak of an intellectual disability.

Intellectual disability can also affect emotional processing and coping. The mentally handicapped feel like any other person, but sometimes they are unable to control their emotions. As a result, they often appear impulsive and uninhibited. They can be more susceptible to the emotional contagion in which they pick up on emotions from their environment and feel them themselves.

Social skills can also be underdeveloped. In addition to the symptoms of intellectual disability, motor impairments can also be added.

Diagnosis & course

The mental handicap is diagnosed by the neurologist and psychologist. Intelligence is measured using intelligence tests. The mental handicap is classified as follows: slight mental handicap (IQ between 50 and 69), moderate mental handicap (IQ between 35 and 49), severe mental handicap (IQ between 20 and 34), severe mental handicap (IQ under 20).

As there is often a physical disability in addition to intelligence, a traditional intelligence test is sometimes not possible. That is why other specific tests are carried out to determine to what extent the person concerned can take care of himself independently, e.g. B. Dressing, eating or performing light activities.

Assessing intellectual disability using an intelligence test is highly controversial. In the meantime the diagnostic methods z. In some cases, it has already been adjusted so that the individual patient is assessed using a systemic human-environment relationship analysis.

Further examinations are carried out to aid the diagnosis. In addition to a chromosome analysis and a subtelomere analysis, a test for fragile X syndrome is also carried out.

It is difficult to classify the course in the case of an intellectual disability. Adequate therapy can lead to a normal life, especially with a mild intellectual disability. As a rule, however, those affected are dependent on the help of third parties for their entire life. Depending on how pronounced the mental handicap is, facilities should be considered that can guarantee adequate care around the clock.

With regard to life expectancy, there is no difference to healthy people. For some types of intellectual disabilities, which are primarily associated with physical impairments, life expectancy can be shortened.

Complications

Intellectual disability is a severe limitation in a person's emotional or cognitive performance. This can be expressed in thought disorders, intellectual deficits and deficits in social coexistence. The intellectual disabilities include, for example, Down syndrome, autism or meningitis.

In some cases, the patients receive medication and other therapies such as occupational therapy, speech therapy as well as curative educational measures and rehabilitation measures. However, complications can arise if a patient has an unforeseen disease flare-up. Even if medication is not taken, not taken regularly, or discontinued against medical advice, this can lead to incalculable problems.

Complications also include the fact that the patient can endanger himself or others. Therefore, it can be difficult to assign responsible tasks in professional or social life to those affected, as they can react differently than healthy people. In some cases it is often advisable to employ people with intellectual disabilities in protected work areas or to allow them to participate in social life through inclusion projects.

The care key in social institutions or on the second job market can also be a factor in avoiding complications. However, the top priority should be to follow the advice of doctors, psychologists and educators.

When should you go to the doctor?

If relatives or close confidants notice any abnormal behavior on the part of the person concerned, a doctor should be consulted. If there are inappropriate reactions or if the person concerned does not react at all to certain stimuli, this is unusual and should be examined by a doctor. Abnormal eye movements, head or body posture, and motor disorders should be examined and treated. A doctor should be presented with severe mental retardation, reduced intelligence or a learning disability.

Developmental disorders and a lack of social skills indicate mental problems that require a doctor's visit. Disturbances of attention, concentration and orientation problems should be medically controlled. A delay in speech formation or communication disorders are indications that must be investigated by a doctor. If the person concerned is unable to lead an independent lifestyle, daily help is needed. If the sick person cannot take care of himself or fulfill daily duties, a doctor should be consulted.

If there are problems understanding or if the person concerned does not stick to simple agreements, the cause of the irregularities should be determined. In the event of indifference, apathy, disinterest in social activities or an interpersonal exchange, the observations should be discussed with a doctor. If control over body excretions cannot be learned, a doctor's visit is required.

Doctors & therapists in your area

Treatment & Therapy

Treating an intellectual disability is difficult. Since an intellectual disability i. d. Usually already present from birth, the treatment should take place by means of early intervention. Early intervention includes various treatment concepts. With the help of occupational therapy, speech therapy, curative education and individual drug therapy, mental as well as physical skills are trained in a targeted manner.

If the mental handicap only occurs at a later stage in life, e.g. B. as a result of an accident, psychosocial and educational measures during rehabilitation can help to partially restore skills and functions that were previously learned and mastered. Since only the basis for treatment can be laid in the rehabilitation centers, it is necessary to continue the therapy in outpatient rehabilitation centers.

For a treatment to be successful, it is necessary to carry out the various therapies for a lifetime.

Outlook & forecast

The prognosis for an intellectual disability depends heavily on the severity of the disability itself. In no case is a cure from the mental retardation expected. In some cases - for example due to degenerative diseases - the symptoms can worsen.

People with mild intellectual disabilities are usually able to lead a largely independent life. Although they are denied some knowledge and skills, they can - with a little support - build a life worth living. The same applies to people with moderate intellectual disabilities.

You can find your way in life, but depending on the situation, you need more outside help. The quality of life of these mentally handicapped people is heavily dependent on the support they receive. Mentally disabled people who learn practical and social skills have a good chance of a largely fulfilling existence.

However, lifelong support is required in the case of severe and extremely severe intellectual disabilities. Those affected cannot find their way around in life and will never get out of this state. Promotion measures are important, but they will not lead to an increase in intelligence. If mentally handicapped people do not experience any support measures or care, they usually do not even reach the mental maturity of a three-year-old. Without support, they are not viable.

prevention

Since an intellectual disability usually has many causes, various prophylactic measures can be taken.

If mental disabilities have already occurred in the family, genetic counseling is required, especially if there is a desire to have children. Pregnant women should be warned that alcohol, nicotine and drugs increase the risk of intellectual disabilities many times over.

A healthy and balanced diet, the use of preventive medical check-ups for pregnant women and adequate vaccination protection for the mother and later the newborn are good measures to prevent intellectual disability.

Since an intellectual disability can also be the result of an accident, preventive measures to prevent accidents in the home, kindergarten, school and with means of transport such as bicycles, motorcycles and cars are useful.

Aftercare

If you have an intellectual disability, care and aftercare can go a long way. The aftercare measures can include psychosocial and physiotherapeutic measures as well as necessary aftercare for addiction problems or delinquency. The latter two are taboo subjects.

Unfortunately, there are so far only a few outpatient addiction counseling centers that are dedicated to this topic and include an aftercare group for mentally disabled addiction patients. This topic is also of some relevance in the penal system. Psychological follow-up care is particularly important here. Mentally disabled people need special care when they experience trauma and develop post-traumatic stress disorder.

Depending on the age at which the mentally handicapped person is, language and speech promotion or the promotion of motor skills can help them participate more fully in the lives of others. In addition, physical limitations such as short stature or club feet can also be present with genetic causes. These too require medical or orthopedic follow-up treatment and monitoring.

For mentally handicapped people, aftercare includes comprehensive measures, which vary depending on the family situation and the degree of disability. Mentally handicapped people need a special place of work. You need assisted living offers. The fact that support has turned some people with Down syndrome into successful actors and fashion models speaks for itself. It shows that many people with intellectual disabilities can lead an independent life.

You can do that yourself

Most intellectual disabilities are genetic or irreversible due to illness. In the area of ​​self-help in everyday life, it is therefore not about healing the mental impairment, but about ways to deal with it better.

Accepting an intellectual disability as such is difficult, especially when one has been confronted with it suddenly. In order to manage everyday life well, psychological support can therefore be useful. Depending on the exact form of the intellectual disability, a structured everyday life is also very important.

This helps the person affected to find their way around better in everyday life. But a meaningful structure can also be important for the social environment in order to cope with all upcoming tasks and still be able to find periods of rest for yourself.

In order for this to succeed, all possibilities of support should be used in everyday life. This includes, on the one hand, the offers that come from the local area itself, but on the other hand, all possibilities of state or municipal support through financial aid or concrete support in caring for people with intellectual disabilities. Many counseling centers give those affected an overview of all the offers to which they are entitled.