MENTAL HEALTH

1. MENTAL HEALTH

2. WHEN IS IT A DISORDER? • World Health Organization (WHO) reports (2008) that some 450 million people suffer from mental or behavioral disorders. • Psychological disorders are patterns of thoughts, feelings or behaviors that are deviant, distressful, and dysfunctional. (Standards for “deviant” will vary by culture and time; for example, in the case of homosexuality.) • To classify disorders, we use the DSM-IV (Fifth edition to be released in 2013.) Diagnostic and Statistical Manual of Mental Illness

3. ANXIETY DISORDERS • DISORDERS MARKED BY FEELINGS OF EXCESSIVE APPREHENSION AND ANXIETY • SYMPTOMS MAY INCLUDE: • WORRY, TREMBLING, MUSCLE TENSION, DIARRHEA, DIZZINESS, FAINTNESS, HEART PALPATATIONS, DIFFICULTY BREATHING, CHEST PAIN, FEAR WITH NO KNOW CAUSE OR WITH A KNOWN CAUSE (PHOBIAS)

4. ANXIETY DISORDERS • INCLUDE: GENERALIZED ANXIETY DISORDER, PHOBIC DISORDERS, PANIC DISORDER, OBSESSIVE-COMPULSIVE DISORDER & POST TRAUMATIC STRESS DISORDER(PTSD) • TERMS TO KNOW: • OBSESSIONS ARE REACURRING THOUGHTS • COMPULSIONS ARE BEHAVIORS • PTSD OCCURS AFTER A TRAUMATIC EVENT

5. ANXIETY DISORDERS • Anxiety disorders may arise due tobiological reasons such as varying levels of neurotransmitters possibly influence by hormonal changes. • They can also be sustained from conditioning (learning) and compulsive behaviors (which reduce the uncomfortable feelings of the anxiety) reinforce themselves.

6. ANXIETY DISORDERS • Treatments options • Anti-depressants or sometimes anti-anxiety meds such as prozac, zoloft, xanax, valium, etc. • Biofeedback…learn your body’s signs; EEG and brain stimulation can be utilized, too. • Counterconditioning: pair stimulus with NEW response • Exposure therapy: expose them to what they fear Systematic desensitization (Wolpe) is gradual; flooding is dramatic • Virtual reality exposure therapy (PTSD)

7. SOMATOFORM DISORDERS • PHYSICAL AILMENTS THAT CANNOT BE FULLY EXPLAINED BY ORGANIC CONDITIONS AND ARE LARGELY DUE TO PSYCHOLOGICAL FACTORS • Do not assume that they are faking their illnesses, though! malingering is a term for disorders that are faked and fit into a different category.

8. SOMATOFORM DISORDERS • INCLUDE: • SOMATIZATION DISORDER: history of multiple physical symptoms but are not due to a physical disorder or injury • CONVERSION DISORDER: one or more symptoms or deficits affecting voluntary movement and sensory functioning • HYPOCHONDRIASIS: preoccupation with the fear or belief that one has a serious physical disease based on incorrect/exaggerated interpretation of symptoms • BODY DISMORPHIC DISORDER: excessive preoccupation with an imagined defect in physical appearance (shares features with OCD)

9. SOMATOFORM DISORDERS • In some cultures it is more acceptable to seek treatment for physical ailments than psychological ones. • To treat somatoform disorders, Freud utilized free association in hopes the underlying problem would be revealed. (hysteria was a name used for what is now known as conversion disorder) • Cognitive behavioral therapy is common to help people manage their out of control thoughts, especially in the case of hypochondria. • Counterconditioning is helpful if being sick has been routinely reinforced. Start reinforcing being healthy.

10. DISSOCIATIVE DISORDERS • CLASS OF DISORDERS IN WHICH PEOPLE LOSE CONTACT WITH PORTIONS OF THEIR CONSCIOUSNESS OR MEMORY, RESULTING IN DISRUPTIONS IN THEIR SENSE OF IDENTITY. • SYMPTOMS MAY INCLUDE: “LOSING TIME,” MEMORY DEFICITS, DEVELOPMENT OF DIFFERENT PERSONALITIES, UNEXPLAINED ABSENCE OR TRAVEL

11. DISSOCIATIVE DISORDERS • INCLUDE: AMNESIA, FUGUE, AND DISSOCIATIVE IDENTITY DISORDER. • D.I.D. IS OFTEN CONFUSED WITH SCHIZOPHRENIA BUT THEY ARE CLINICALLY NOT ALIKE AT ALL. • Often dissociative disorders occur in conjunction with anxiety, personality, and mood disorders. • FUGUE (unexplained travel) & AMNESIA are often triggered by stress • D.I.D. is often linked to severe childhood trauma

12. DISSOCIATIVE DISORDERS: REAL? • Some theorists argue the validity of the diagnosis, and some believe that therapists may actually attribute to its development • Prior to the 1970’s only ~79 reported cases, but by the late 1990’s ~40,000 cases…under diagnosed or over diagnosed? • Is it intentional role playing? • Is there an incentive to manufacture the disorder?

13. DISSOCIATIVE DISORDERS • In dealing with dissociative disorders traditional talk therapy is used as well as family therapy. • Hypnosis has been utilized, but this therapy is as controversial as the diagnosis. • Medications are typically not effective. • If trauma is the culprit, then treatments used for PTSD might be appropriate.

14. MOOD DISORDERS • DISORDERS MARKED BY EMOTIONAL DISTRUBANCES OF VARIED KINDS THAT MAY SPILL OVER TO DISRUPT PHYSICAL, PERCEPTUAL, SOCIAL, AND THOUGHT PROCESSES • ARE OFTEN EPISODIC • 2 TYPES: UNIPOLAR AND BIPOLAR • OFTEN DIAGNOSED IN TERMS OF FREQUENCY OF EPISODE AND DEGREE

15. MOOD DISORDERS • INCLUDE: MAJOR DEPRESSIVE DISORDER, DYSTHYMIC DISORDER, BIPOLAR DISORDER (FORMERLY KNOWN AS MANIC-DEPRESSIVE), AND CYCLOTHYMIC DISORDER • Symptoms of depression and vary in extremes as can symptoms of mania…often mania appears to be a positive reprieve from the depression but it may lead a person to behave extremely and dangerously

16. MOOD DISORDERS • Because mood disorders involve extreme emotions and our emotions are influenced by our thoughts, cognitive therapies are often helpful. • Cognitive-behavioral therapy attempts to alter the way people think and the way they behave. It attempts to replace irrational thoughts with more adaptive thoughts and to develop a more positive approach to everyday settings. • Anti-depressant medications are also helpful. SSRI’s such as Prozac are some of the most widely prescribed medications to help treat psychological symptoms.

17. SCHIZOPHRENIC DISORDERS • CLASS OF DISORDERS MARKED BY DELUSIONS, HALLUCINATIONS, DISORGANIZED SPEECH, AND DETERIORATION OF ADAPTIVE BEHAVIOR • SIGNS AND SYMPTOMS MAY INCLUDE: HEARING OF VOICES, EMOTIONALLY VOLATILE, IRRATIONAL THOUGHTS, DISREGARD FOR PERSONAL HYGIENE, DELUSIONAL THOUGHTS • DELUSIONS are false beliefs that are maintained even though they clearly are out of touch with reality.

18. SCHIZOPHRENIC DISORDERS • TYPES INCLUDE: PARANOID, CATATONIC, DISORGANIZED, AND UNDIFFERENTIATED • Paranoid type is dominated by delusions of persecution and gradeur • Catatonic is marked by striking motor disturbances • Disorganized type is evident by severe deterioration of adaptive behavior • POSITIVE SYMPTOMS ARE THE PRESENCE OF SYMPTOMS & NEGATIVE SYMPTOMS ARE THE ABSENCE OF NORMAL BEHAVIORS.

19. SCHIZOPHRENIC DISORDERS • Schizophrenia has been linked to excessive amounts of dopamine receptors, and it is assumed that it is the high levels of dopamine contribute to positive symptoms such as hallucinations. Dopamine blocking medications prove to be helpful with these symptoms. • Abnormal brain activity a various places may also be a factor in schizophrenia. Sometimes electro-convulsive shock therapy has been attempted to help treat. • Pre natal development is also significant especially exposure to famine and viral infections.

20. PERSONALITY DISORDERS • EXTREME, INFLEXIBLE PERSONALITY TRAITS THAT CAUSE SUBJECTIVE DISTRESS OR IMPAIRED SOCIAL AND OCCUPATIONAL FUNCTIONING • Often mild in comparison to axis i disorders • Debate on whether they should be measured on a separate axis • Difficult to distinguish because many of the symptoms overlap

21. PERSONALITY DISORDERS • ANXIOUS/FEARFUL CLUSTER INCLUDES: AVOIDANT, DEPENDENT, & OBSESSIVE-COMPULSIVE • ODD/ECCENTRIC CLUSTER INCLUDE: SCHIZOID, SCHIZOTYPAL, PARANOID • DRAMATIC/IMPULSIVE CLUSTER INCLUDES: HISTRIONIC, NARCISSISTIC, BORDERLINE, AND ANTISOCIAL

22. PERSONALITY DISORDERS • Often people with personality disorders don’t recognize that there is a problem until it involves others. Treatment is difficult. • Group or family therapy: This approach is helpful in drawing attention to behaviors by one that are causing distress in others. • Genetics has shown to be linked in people with personality disorders (most studied is antisocial). • Drug an alcohol abuse is often an issue, so treatments for this behavior could be helpful as well.

23. DISORDERS DIAGNOSED IN CHILDHOOD • There are a wide range of disorders and symptoms illustrated in this category. What ties them all together is that symptoms are seen early on and therefore diagnosis will occur in childhood. • Examples include: autism, Asperger’s syndrome, Tourette’s syndrome, ADD/ADHD, oppositional defiant disorder

24. DISORDERS DIAGNOSED IN CHILDHOOD • Autism: a disorder that appears in childhood and is marked by deficient communication, social interaction, and understanding of others’ states of mind. • Asperger’s: is a disorder that falls on the “autism spectrum.” It is considered a “high functioning” form of autism, marked by normal intelligence but deficits in social interactions and communication are apparent. • Genetic and prenatal factors seem to contribute to the development of autism. • Treatment options range based on the severity of the disorder.

25. DISORDERS DIAGNOSED IN CHILDHOOD • Tourette’s syndrome has also been consider a part of the autism spectrum, but I don’t believe all experts agree on this. • Symptoms include repetitive behaviors, AKA “tics” that can take the form of verbal words or physical actions (hand flapping, head, shoulder, or facial twitching) • Biofeedback…knowing one’s triggers is effective treatment

26. DISORDERS DIAGNOSED IN CHILDHOOD • Attention deficit disorder (with or w/o hyperactivity) is diagnosed when a range of symptoms are illustrated which can include impulsivity, hyperactivity, and extreme inattention. • Health care professionals have been guilty of over diagnosing this disorder, so improvements have been made in helping them make more proper diagnosis. • Common treatment includes the use of stimulants such as Ritalin. Behavioral therapy including impulse control is important, too.

27. DISORDERS DIAGNOSED IN CHILDHOOD • Oppositional defiant disorder is marked by outward behaviors of anger, aggression, and hostility and typically directed at authority figures. These children have extreme difficulty complying with rules and often challenge adults. • Treatments typically include family therapy to teach children and parents how to work with one another. Also, behavioral modification and rewarding the child when they are compliant can be effective.

28. DEMENTIA • Is a symptom, not a disorder in itself. • Dementia is the erosion of mental function and can be a result of stroke, tumors, Alzheimer’s disease, Parkinson’s disease, and drug/alcohol abuse.

29. IMPULSE-CONTROL DISORDERS • These include pyromania (fire setting), kleptomania (stealing), and trichotillomania (hair pulling. • It is compulsive behavior that is done not to hurt or hard but to alleviate a sensation of anxiety. Doing these things feels good to the sufferer. • These are difficult to treat, but sometimes therapies used in treating anxiety disorders can be helpful.