STRESS-RELATED DISORDERS F40–F48 (ICD-10)

Understanding stress correctly to protect mental health in the modern world

In today’s fast-paced life with increasing pressures, “stress” has become a familiar term. However, not everyone clearly understands the boundary between stress as a normal biological response and stress that develops into a mental health disorder. According to the International Classification of Diseases (ICD-10), stress-related disorders are coded from F40 to F48, encompassing psychological disorders that have causes directly linked to stressors, trauma, or difficulties in the adaptation process.

Stress – from a biological response to a pathological risk

The concept of “stress” was first mentioned in the 15th century to describe adverse or tense conditions in various fields such as engineering and architecture, and later in medicine. In 1914, Walter Cannon, an American physiologist, was the first to use the term to describe emotional responses in threatening situations, associated with the “fight or flight” mechanism. Later, Hans Selye, a Canadian scientist, developed a deeper definition, viewing stress as a nonspecific biological response of the body to restore internal balance, helping humans adapt to constantly changing living conditions. However, if the adaptive capacity is disrupted, stress is no longer a

Stress is not just “pressure,” but also a pathology

Stress consists of two main components:
• Stressor: can come from the living environment, work, social relationships, or internal conflicts within the body.
• Body’s response: depending on the level of adaptation, this response can be supportive or, in adverse cases, the cause of serious mental health disorders

Stress is not just “pressure,” but also a pathology

One of the common disorders in the F40–F48 group is Generalized Anxiety Disorder (GAD). This is not the ordinary worry people experience in daily life. GAD is characterized by persistent, widespread, and nonspecific anxiety that is not tied to any particular event or situation, yet lasts over time and significantly affects daily activities, learning, work, and relationships.

Individuals with GAD often experience chronic tension accompanied by physical symptoms such as insomnia, palpitations, fatigue, digestive disturbances, or difficulty concentrating. These recurring anxious thoughts spiral in the mind, gradually exhausting the person both physically and mentally.

Stress-related disorders should not be taken lightly

The F40–F48 group includes not only generalized anxiety disorder but also obsessive-compulsive disorder (OCD), adjustment disorders, dissociative disorders, and even post-traumatic stress disorder (PTSD). These disorders cause internal suffering and impair social, educational, and occupational functioning. Without timely intervention, they can become chronic, leading to depression, substance abuse, or personality disorders.

From recognition to treatment – a journey that requires support

Early identification of the signs of stress-related disorders is an important first step. However, effective treatment requires a combination of psychological therapy, medication when necessary, and support from family and society. At Hoang Yen Specialized Psychiatric Clinic, experienced psychiatrists are always ready to accompany you on the journey to overcome stress and regain mental balance.

In the modern world, understanding stress correctly and responding appropriately is the key to protecting your mental health and that of your loved ones.
Start with care – for a peaceful life, from within.

Bipolar Disorder

Bipolar Disorder – When Emotions Become an “Out-of-Control Roller Coaster”
A pathological analysis according to ICD-10 and clinical perspectives

One fine day, you feel full of energy, ideas flowing nonstop, and you don’t need sleep yet feel no fatigue. Then, just a few weeks later, you sink into gloom, lose interest in everything, feel worthless, and utterly exhausted. If you’ve experienced such emotional swings, it may not just be “moodiness,” but a sign of bipolar disorder – a complex mental health condition that challenges both patients and clinicians.

1. What is Bipolar Disorder?

Bipolar disorder (BD – coded F31 in ICD-10) is an endogenous condition characterized by abnormal alternations between manic and depressive episodes. Unlike unipolar depression, individuals with BD experience two opposing “poles”: one marked by elevated mood and impulsivity, the other by collapse and withdrawal from the world.

The prevalence of BD is approximately 1.5%–2.5% of the population, with a common onset age between 20–30 years – a stage when people are building careers and social relationships. Alarmingly, nearly 50% of cases are misdiagnosed as unipolar depression, leading to ineffective treatment and potentially prolonging the illness.

2. Biological Basis: Central Nervous System Dysregulation

Bipolar disorder is not “mental weakness” but the result of biochemical changes in the brain. Neurotransmitters such as serotonin, dopamine, noradrenaline, and GABA become imbalanced, disrupting how the brain regulates emotions, behavior, and energy. This explains why many individuals with normal cognition and intelligence still cannot control their mood or impulses.

3. The Manic Phase – “When the World Moves Too Slowly for Me”

According to ICD-10 criteria, a manic episode is characterized by elevated mood along with at least three of the following symptoms:

• Increased activity or restlessness

• Talking excessively, racing thoughts, jumping from one topic to another

• Reduced need for sleep without feeling tired

• Grandiosity or an inflated sense of extraordinary abilities

• Inappropriate social behavior such as reckless spending, risky driving, or excessive sexual activity

• Rapidly changing plans and poor concentration

This phase typically lasts at least one week and may include psychotic symptoms, causing impaired judgment and loss of contact with reality.

4. The Depressive Phase – “A Bottomless Pit”

In stark contrast to mania, the depressive phase is marked by prolonged sadness, hopelessness, and loss of interest in all activities, even those previously enjoyed.

A depressive episode is diagnosed based on:

• At least 2 out of 3 core symptoms (usually depressed mood, loss of interest, and reduced energy)

• Plus 2 out of 7 common symptoms (such as low self-esteem, poor concentration, anxiety, or negative thinking)

• And 4 out of 8 physical symptoms (including sleep disturbances, appetite changes, and sexual dysfunction)

This phase carries a high risk of suicide, particularly when the individual feels like a burden and sees no way out of their despair.

5. Classification of Bipolar Disorder

• Bipolar I Disorder: At least one distinct manic episode is required, which may or may not be accompanied by depressive episodes.

• Bipolar II Disorder: At least one hypomanic episode and one typical depressive episode. Hypomania is generally less severe but still significantly impacts daily functioning.

• Important: Other causes, such as substance abuse or brain injury, must be ruled out before making a definitive diagnosis.

6. Treatment: Balancing Medication and Psychotherapy

Treatment of bipolar disorder requires a long-term plan, typically including:

• Mood stabilizers (such as lithium or valproate)

• Antidepressants and antipsychotic medications, when necessary

• Cognitive-behavioral therapy (CBT) to help patients recognize and manage mood episodes

• Support from family, friends, and healthcare providers

Bipolar disorder is not a “sentence,” but a journey that requires understanding, support, and persistence. Early recognition, proper treatment, and cultivating a positive living environment are key to helping individuals with bipolar disorder regain balance — transforming emotions from an out-of-control roller coaster into a natural part of life’s journey.

Hoang Yen Specialized Psychiatric Clinic is always ready to support you on the journey to rediscover yourself, using modern medicine, empathy, and the expertise of professionals who truly understand the human mind.

Understanding Instinctive Behaviors

In human life, there are mechanisms that operate naturally without conscious control; these are instinctive behaviors. However, when these behaviors become disordered, they not only affect actions but also indicate serious mental health issues that require proper attention. Additionally, sleep – normally a physiological state – can become a “vulnerability” when disrupted, leading to numerous physical and mental health consequences.

Disorders of instinctive behavior – when instincts dominate actions

Instinctive behaviors are innate reflexes that do not require conscious control. They play a crucial role in sustaining life and can strongly influence human behavior. However, when these behaviors become disordered, dangerous and uncontrollable actions may arise.

Some common types of disorders:

Impulsive behavior: Appears suddenly without a clear cause. This may be a manifestation of conditions such as schizophrenia, epilepsy, or depressive disorders.

Instinctive impulses: Occur in sequences, beginning as a strong urge from instinct. The patient initially struggles to resist, but gradually instinct overrides reason, leading to uncontrollable actions. These impulses are often cyclical, repetitive, and pose significant risks to both the individual and those around them.

Early recognition and intervention are crucial in treatment, helping patients avoid serious consequences for both their health and social life.

Sleep disorders – the “silent enemy” of quality of life

Sleep is the period during which the body restores energy, supporting physical and mental functioning. However, when sleep is disrupted, the body cannot properly recover, leading to serious impacts on overall health.

Common types of sleep disorders:

• Prolonged insomnia: When sleep is reduced in both duration and quality over an extended period, it can cause severe exhaustion, affect the nervous system, and impair the body’s ability to regulate temperature. In severe cases, it may even threaten life.

• Chronic insomnia: Patients experience persistent fatigue, decreased concentration, memory impairment, disordered cognition, and difficulties in daily functioning.

• REM-related sleep disorders: Include phenomena such as sleepwalking, night terrors, and nightmares, often occurring in the early stages of the sleep cycle.

According to ICD-10 (1992), non-organic sleep disorders are classified under group F51 – usually arising from emotional factors such as stress, depression, or bipolar disorder.

Expert advice:

If you or a loved one show abnormal behaviors or sleep patterns, do not hesitate to seek medical support. Early detection and proper treatment help manage the condition effectively, improve quality of life, and prevent serious complications.

Hoang Yen Psychiatric Clinic is always ready to accompany you on the journey of mental health care. Let us listen to and support you, starting from the smallest signs.