WEEK 8

1. WEEK 8 Basic Psychopathologies

2. Mental Health in Australia • In Australia, around one in five people will experience a mental illness at some stage of their life, including alcohol or other substance abuse disorders, many experiencing more than one mental illness at one time. • In extreme cases, mental illness can be debilitating, affecting all areas of a person’s life from employment, to relationships, to everyday functioning

3. What is Psychopathology • Psychopathology is the study of mental illness, mental distress, and abnormal/maladaptive behaviour. • The term is most commonly used within psychiatry where pathology refers to disease processes. • Psychopathology should not be confused with psychopathy, a theoretical subtype of antisocial personality disorder.

4. Types of Mental Illness • Anxiety disorders • Mood disorders • Psychotic disorders • Eating disorders • Impulse control and addiction disorders • Personality disorders

5. Anxiety Disorders • People with anxiety disorders respond to certain objects or situations with fear and dread, as well as with physical signs of anxiety or nervousness, such as a rapid heartbeat and sweating. • Is diagnosed if the person's response is not appropriate for the situation, if the person cannot control the response, or if the anxiety interferes with normal functioning. • Include generalized anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and specific phobias.

6. Mood Disorders • These disorders, also called affective disorders, involve persistent feelings of sadness or periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness. • The most common mood disorders are depression, mania, and bipolar disorder.

7. Types of Depression • Major depressive disorder • Dysthymia • Bipolar disorder • Psychotic depression • Melancholia • Seasonal affective disorder • Post-partum or postnatal depression

8. Depression commonly occurs together with other mental and physical health problems. • For example, a person with a depressive disorder might also have an anxiety disorder or a problem with alcohol or other drugs. Depression also commonly occurs in people with physical health problems, like heart disease, cancer or thyroid conditions.

9. Student Activity Quiz – Answer True or False

10. Quiz • 1. People with depression can snap out of it if they put their minds to it. • 2. Depression can be a disabling disease • 3. Although most people feel down in the dumps occasionally, clinical depression is rare. • 4. All people with depression appear sad, unhappy or teary • 5. Depression does not have physical symptoms

11. Quiz Continued • 6. Depression can be triggered by a stressful life event like divorce. • 7. Recreational drugs that give you a high are unlikely to affect depression • 8. Some people with depression hear voices that are not real telling them bad things • 9. Most people with depression do not need treatment, they just need to do something relaxing like go on holiday. • 10. Some chronic (long-lasting) illnesses can cause depression.

12. Quiz Responses

13. 1. People with depression can snap out of it if they put their minds to it. • False • There used to be a misconception that depression is all in the mind and that people should be able to pull themselves out of it. Researchers have since found that people with depression have an altered balance of chemicals in the brain, and this has led to the recognition that depression is a serious illness that needs treatment.

14. 2. Depression can be a disabling disease • True • Depression can have a large impact on a person's life, making it difficult for them to work, maintain their interests and look after their family. Depression can be more disabling than many physical illnesses.

15. 3. Although most people feel down in the dumps occasionally, clinical depression is rare. • False • Clinical depression is a common condition in Australia one in 7 adults will experience it at some point in life and one in 15 will develop it in any given year.

16. 4. All people with depression appear sad, unhappy or teary • False • Although some people with depression do appear depressed, others do not. For a diagnosis of depression to be made, people do not necessarily have to feel down or sad; some people instead experience loss of interest or enjoyment in activities that used to bring them pleasure.

17. 5. Depression does not have physical symptoms • False • Physical symptoms like weight gain or loss, fatigue, headaches and muscle aches, and gastrointestinal disturbances such as indigestion, constipation and diarrhoea are quite common in depression.

18. 6. Depression can be triggered by a stressful life event like divorce. • True • Depression can be triggered by a stressful or upsetting episode in your life. However, this is not always the case some people experience depression out of the blue.

19. 7. Recreational drugs that give you a high are unlikely to affect depression • False • Recreational drugs such as amphetamines and MDMA (ecstasy) disturb chemicals in the brain and can trigger depression or make it worse. This is also the case for alcohol. Although people with depression are sometimes tempted to take these substances to improve their mood, it is not a good idea and is only likely to make things worse

20. 8. Some people with depression hear voices that are not real telling them bad things • True • A very severe form of depression known as psychotic depression can cause people to hear voices. They may also develop the unshakeable but false belief that they are the cause of certain bad things, such as natural disasters, happening in the world. However, this form of depression is uncommon (15 per cent of all episodes of clinical depression). If you are experiencing such symptoms or are worried about someone who is, it is important that you seek urgent medical help.

21. 9. Most people with depression do not need treatment, they just need to do something relaxing like go on holiday • False • While reducing stress can alleviate depression, it will not normally go away by itself. Remember that asking for help is not a sign of weakness. If you are feeling depressed, your doctor will be able to assess you, and together you will be able to decide on a treatment approach that's right for you.

22. 10. Some chronic (long-lasting) illnesses can cause depression. • True • Having a chronic illness such as heart disease, cancer, Alzheimer's disease or an underactive thyroid puts you at greater risk of depression than people without a chronic illness. In some cases this is due to the stress of living with the illness, while in other cases it's a direct result of the effects of the illness on the brain.

23. Psychotic Disorders • Psychotic disorders involve distorted awareness and thinking. • Two of the most common symptoms of psychotic disorders are hallucinations and delusions. • Schizophrenia is an example of a psychotic disorder.

24. Eating Disorders • Eating disorders involve extreme emotions, attitudes, and behaviours involving weight and food. • Anorexia nervosa, bulimia nervosa and binge eating disorder are the most common eating disorders.

25. Impulse Control and Addiction Disorders • People with impulse control disorders are unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others. • Pyromania, kleptomania, and compulsive gambling are examples of impulse control disorders. • Alcohol and drugs are common objects of addictions. • Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships.

26. Personality Disorders • People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school, or social relationships. • In addition, the person's patterns of thinking and behaviour significantly differ from the expectations of society and are so rigid that they interfere with the person's normal functioning. • Examples include antisocial personality disorder, obsessive-compulsive personality disorder, and paranoid personality disorder.

27. Student Activity Mental Health First Aid

28. Other, less common psychopathologies • Adjustment Disorders • Dissociative Disorders • Factitious Disorders • Sexual & Gender Disorders • Somatoform Disorders • Tic Disorders

29. Adjustment disorder • Adjustment disorder occurs when a person develops emotional or behavioural symptoms in response to a stressful event or situation. • The stressors may include natural disasters, such as an earthquake or tornado; events or crises, such as a car accident or the diagnosis of a major illness; or interpersonal problems. • Adjustment disorder usually begins within three months of the event or situation and ends within six months after the stressor is eliminated.

30. Dissociative Disorders • People with these disorders suffer severe disturbances or changes in memory, consciousness, identity, and general awareness of themselves and their surroundings. • These disorders usually are associated with overwhelming stress, which may be the result of traumatic events, accidents, or disasters that may be experienced or witnessed by the individual. • Dissociative identity disorder, formerly called multiple personality disorder, or "split personality", and depersonalization disorder are examples of dissociative disorders.

31. Factitous disorders • Conditions in which physical and/or emotional symptoms are created in order to place the individual in the role of a patient or a person in need of help. • A person acts as if he or she has an illness by deliberately producing, feigning, or exaggerating symptoms. Factitious disorder by proxy is a condition in which a person deliberately produces, feigns, or exaggerates symptoms in a person who is in their care. • Münchausen syndrome is a more common term for Factitious disorder. • Sufferers be motivated either as a patient or by proxy to gain any variety of benefits; attention, nurturance, sympathy, leniency.

32. Somatoform Disorder • A person with a somatoform disorder, formerly known as psychosomatic disorder, experiences physical symptoms of an illness even though a doctor can find no medical cause for the symptoms. • Closely rated to Factitious Disorder • Their appearance in the literature extends back to the time of the Roman physician Galen who wrote about them in the second century

33. Sexual and Gender disorders • These include disorders that affect sexual desire, performance, and behaviour. • Sexual dysfunction and gender identity disorder are examples of sexual and gender disorders.

34. Tic Disorders • People with tic disorders make sounds or display body movements that are repeated, quick, sudden, and/or uncontrollable. • Tourette's syndrome is an example of a tic disorder.

35. Other conditions • Other diseases or conditions, including various sleep-related problems and many forms of dementia, including Alzheimer's disease, are sometimes classified as mental illnesses because they involve the brain • Some have treatments available and others can only treat the symptoms.

36. How Mental Health Is Experienced

37. Gender Differences • Women more likely than men to report anxiety and affective disorders. • Men are more than twice as likely as women to have substance use disorders, with alcohol disorders being three times more common than drug use disorders. • Men are affected by schizophrenia in slightly greater numbers; women tend to experience later onset, fewer periods of illness, and better recovery. • Obsessive-compulsive disorder is equally common in males and females. • Up to 90% of eating disorders occur in women. • Gender differences in different types of mental illness are influenced by cultural backgrounds.

38. Young People • The greatest numbers of people with a mental illness are in the 18-24 year age group. • 25% of Australian children and adolescents aged 4-17 years have mental health problems. This rate of mental health problems is found in all age and gender groups, although boys are slightly more likely to experience mental health problems than girls. • Onset of bipolar disorder and schizophrenia usually occurs in the mid to late teen years. • Depression is one of the most common mental health problems in young people. • Adolescents with mental health problems report a high rate of suicidal thoughts and other health-risk behaviour, including smoking and drug use.

39. Indigenous Peoples • At present, there is no definitive national data about the incidence or prevalence of mental disorders in ATSI Australians. • Limited available research: serious mental disorders occur in these populations, and are at least as common as in the mainstream population. • ATSI people receive proportionately reduced access to specialised care for mental disorders and behavioural disorders, yet their involuntary hospitalisation rate is significantly increased compared to the wider community. • The death rate associated with mental disorders among ATSI males is over 3x the rate for other Australian males. However, the rate is the same for ATSI females as those in the general Australian population. • An ATSI person may also see particular feelings, beliefs or hallucinations, including hearing voices, as a spiritual or personal issue rather than mental illness.

40. Culterally Diverse • The prevalence of mental or behavioural problems among people born overseas is similar to those born in Australia. Similarly, the rates among people who speak a LOTE at home are about the same as for those who speak English at home. • People from CALD backgrounds do not access mental health services as often as the mainstream populations. • The conceptualisation of mental illness differs from culture to culture, as the level of stigma attached to mental disorder and mental health problems. some evidence that people with mental illness may be > stigmatised and marginalised in some cultural groups. • Loss, physical illness or disability, or the onset of disorders such as dementia, which often result in a loss of competency in English, can increase the risk of depressive disorders and suicide in older people from culturally and linguistically diverse backgrounds.

41. Rural and Remote • There is little data about the prevalence and incidence of mental illness among people who live in rural and remote Australia. • The 1997 National Survey of Mental Health and Wellbeing found no differences in the overall rates for affective disorders, anxiety disorders and substance use disorders between urban and rural areas but did note some gender differences. • For males, the rate of disorder was slightly higher for those living in a capital city, while for females it was higher for those living in rural or remote areas.

42. Student Activity Mental Health Myth Busters Answer True or False to the Following Myths

43. MYTHS • People who are mentally ill are violent • Mental illness is a life sentence • Mental illnesses are all the same • Some cultural groups are more likely than others to experience mental illness

44. Myth buster Responses

45. Myth: people who are mentally ill are violent • Most violent people have no history of mental disorder. • Most with a mental illness have no history of violent behaviour. • The use of drugs or alcohol has a stronger association with violence than does mental illness. • People living with a mental illness are more likely to be victims of violence, especially self-harm. • When it does occur, violent behaviour usually happens in the context of distressing hallucinations or treatment that has not been effective.

46. Myth: mental illness is a life sentence • Most people will recover fully from mental illness, especially if they receive help early.  • Some people will only experience one episode of mental illness and recover fully, others may be well for long periods with occasional episodes, and a minority of people will experience ongoing disability. • Most people with mental illness will be treated in the community.

47. Myth: mental illnesses are all the same • There are many types of mental illnesses and many types of symptoms. Not everyone with the same diagnosis will experience the same symptoms. • A mental illness may also have physical as well psychological features, such as insomnia, weight gain or loss, increase or loss of energy, chest pain and nausea.

48. Myth: some cultural groups are more likely than others to experience mental illness • People from any background can develop mental illness. • Cultural background affects how people experience mental illness and how they understand and interpret the symptoms of mental illness. • Many ATSI people carry a significant burden of grief and loss from an early age, due in part to the high rates of mortality, illness, incarceration, and deaths in custody. • Pre-migration experiences and the process of resettlement in a foreign land can impact on the mental health of people from culturally and linguistically diverse backgrounds and their children.

49. http://www.webmd.com/mental-health/mental-health-types-illnesshttp://www.webmd.com/mental-health/mental-health-types-illness • http://emedicine.medscape.com/article/291304-overview • http://www.mindframe-media.info/site/index.cfm?display=86529 • http://www.mhfa.com.au/documents/whatworks_depression.pdf References