Mental Health

1. Mental Health CHAPTER 23

2. Mental Health Overview • Mental health • Relative state of mind in which the person who is healthy is able to cope with and adjust to the recurrent stresses of everyday living in an acceptable way

3. Mental Health Overview • Mental disorders • Disturbances of emotional stability, as manifested in maladaptive behavior and impaired functioning • Defense mechanisms • Body’s unconscious reaction to protect itself from conflicts or anxieties

4. Mental Health Overview • Psychology • Study of behavior and processes of the mind as it relates to the individual’s social and physical environment • Psychologist • Professional who specializes in the study of the structure and function of the brain and related mental processes • Not a medical doctor • MA or PhD degree

5. Mental Health Overview • Psychiatry • Branch of medicine that deals with the causes, treatment, and prevention of mental, emotional, and behavioral disorders • Psychiatrist • Medical doctor who specializes in diagnosing, preventing, and treating mental disorders • Many subspecialties

6. Defense Mechanisms • Compensation • Effort to overcome, or make up for, real or imagined inadequacies • Denial • Refusal to admit or acknowledge the reality of something, thus avoiding emotional conflict or anxiety

7. Defense Mechanisms • Displacement • Process of transferring a feeling or emotion from the original idea or object to a substitute idea or object • Introjection • Individual unconsciously identifies with another person or with some object • Individual assumes the supposed feelings and/or characteristics of the other personality or object

8. Defense Mechanisms • Projection • Act of transferring one’s own unacceptable thoughts or feelings on to someone else • Rationalization • Attempting to make excuses or invent logical reasons to justify unacceptable feelings or behaviors, most commonly used defense mechanism

9. Defense Mechanisms • Regression • Response to stress in which the individual reverts to an earlier level of development and comfort measures associated with that level of functioning • Repression • Involuntary blocking of unpleasant feelings and experiences from one’s conscious mind

10. Defense Mechanisms • Sublimation • Rechanneling or redirecting one’s unacceptable impulses and drives into constructive activities • Suppression • Voluntary blocking of unpleasant feelings and experiences from one’s mind

11. Classification of Mental Disorders • DSM-IV-TR Multiaxial Classification System • Sixteen major diagnostic classifications • Each classification includes several disorders • Disorders are grouped based on shared features • Includes five axes for classification

12. Classification of Mental Disorders • Axis I • Clinical Disorders • Other conditions that may be a focus of clinical attention • Axis II • Personality Disorders • Mental retardation

13. Classification of Mental Disorders • Axis III • General Medical Conditions • Axis IV • Psychosocial and Environmental Problems • Axis V • Global Assessment of Functioning

14. SPECIFIC MENTAL DISORDERS Mental Health

15. Cognitive Disorders • Cognitive disorders • Those that affect the individual’s ability to perceive, think, reason, and remember • Organic mental disorders • Includes: • Amnesia disorders • Delirium • Dementia

16. Amnesia Disorders • Pronounced • (am-NEE-zee-ah) • Defined • Characterized by short-term and long-term memory deficits • Have normal attention but are unable to learn new information • Unable to recall previously learned information

17. Delirium • Pronounced • (dee-LEER-ee-um) • Defined • Frenzied excitement that occurs rapidly and is characterized by difficulty maintaining and shifting attention • Individual is easily distracted and must be constantly reminded to focus attention

18. Dementia • Pronounced • (dee-MEN-she-ah) • Defined • Progressive, organic mental disorder characterized by chronic personality disintegration, confusion, disorientation, stupor, deterioration of intellectual capacity and function, and impairment of control of memory, judgment, and impulses

19. Substance-Related Disorders • Associated with the use of drugs • Characteristics: • Psychological dependence on the substance • Daily use • Frequent intoxication by ingestion of the substance • Inability to control use of substance • Physical dependence involves serious withdrawal symptoms

20. Substance-Related Disorders • Drugs of substance-related disorders • Central nervous system depressants • Slow activity of the CNS, causing impaired motor activity, judgment, and concentration • Central nervous system stimulants • Increased activity of CNS, causing elevated blood pressure, heightened behavioral activity and alertness • Hallucinogens • Create perceptual distortions of the mind

21. Schizophrenia • Pronounced • (skiz-oh-FREN-ee-ah) • Defined • Any of a large group of psychotic disorders characterized by gross distortion of reality, disturbances of language and communication, withdrawal from social interaction, and disorganization and fragmentation of thought, perception, and emotional reaction

22. Schizophrenia • Characteristic symptoms • Hallucinations • Person perceives something that does not exist in the external environment • Delusions • Person firmly holds to a persistent abnormal belief or perception despite evidence to the contrary

23. Schizophrenia • Characteristic symptoms • Disorganized speech • Person may move rapidly from one topic to another, making little sense • Disorganized or catatonic behavior • Person may alternate between agitation and non-purposeful or random body movements to little or no behavioral response to the environment • Flattened affect • Individual shows little or no emotional response to the environment

24. Paranoid Schizophrenia • Pronounced • (PAIR-ah-noyd skiz-oh-FREN-ee-ah) • Defined • Condition characterized by the individual being overly suspicious of others and having hallucinations and delusions

25. Mood Disorders • Group of psychiatric disorders characterized by disturbances in physical, emotional, and behavioral response patterns • Extreme elation and agitation to extreme depression with suicidal potential • Includes: • Bipolar disorders • Cyclothymic disorder • Major depressive disorder

26. Bipolar Disorders (Manic-Depressive) • Pronounced • (by-POHL-ar dis-OR-der) • Defined • Psychological disorder characterized by episodes of mania, depression, alternating between the two, or a mixture of the two moods simultaneously

27. Bipolar Disorders (Manic-Depressive) • Characteristics of mania • Extreme excitement, hyperactivity • Agitation, overly talkative • Flight of ideas, fleeting attention • Sometimes violent, destructive, and self-destructive behavior • May have decreased need for sleep and seemingly limitless energy

28. Bipolar Disorders (Manic-Depressive) • Characteristics of depression • Symptoms are inappropriate and out of proportion with reality • Exaggerated feelings of sadness • Discouragement • Hopelessness

29. Anxiety Disorders • Individual feels increased tension, apprehension, a painfully increased sense of helplessness, a feeling of uncertainty, fear, jitteriness, and worry • Includes: • Generalized anxiety disorder • Panic disorder • Phobic disorder • Obsessive-compulsive disorder • Posttraumatic stress disorder

30. Anxiety Disorders • Observable signs of anxiety • Includes but not limited to: • Restlessness • Poor eye contact • Glancing about • Facial tension • Dilated pupils • Increase perspiration • Constant focus on self

31. Generalized Anxiety Disorder • Pronounced • (generalized ang-ZY-eh-tee dis-OR-der) • Defined • Disorder characterized by chronic, unrealistic, and excessive anxiety and worry • Symptoms have usually existed for at least six months or more • Symptoms have no relation to any specific cause

32. Panic Disorder • Pronounced • (PAN-ik dis-OR-der) • Defined • Characterized by recurrent panic attacks that come on unexpectedly, followed by at least one month of persistent concern about having another panic attack

33. Panic Disorder • Characteristics • Intense apprehension, fear, or terror, often associated with feelings of impending doom • Person may experience: • Dyspnea • Dizziness • Sweating • Trembling • Chest pain or palpitations of the heart

34. Phobic Disorder • Pronounced • (FOH-bik dis-OR-der) • Defined • Anxiety disorder characterized by an obsession, irrational, and intense fear of a specific object, of an activity, or of a physical situation • Phobia disorder

35. Phobic Disorder • Classifications of phobias • Acrophobia • Fear of high places that results in extreme anxiety • Aerophobia • Morbid fear of fresh air or drafts • Agoraphobia • Fear of being in an open, crowded, or public place, such as a field, congested street, or busy department store, where escape may be difficult

36. Phobic Disorder • Classifications of phobias • Arachnophobia • Fear of spiders • Claustrophobia • Fear of closed spaces • Nyctophobia • Obsessive, irrational fear of darkness • Zoophobia • Persistent, irrational fear of animals, particularly dogs, snakes, insects, and mice

37. Obsessive-Compulsive Disorder • Pronounced • (ob-SESS-iv kom-PUHL-siv dis-OR-der) • Defined • Disorder characterized by recurrent obsessions or compulsions that are severe enough to be time consuming, (they take more than one hour a day), or to cause obvious distress or a notable handicap

38. Obsessive-Compulsive Disorder • Obsessions • Repeated, persistent thoughts or impulses that are irrational and with which the mind is continually and involuntarily preoccupied • Compulsions • Irresistible, repetitive, irrational impulses to perform an act • Behavior patterns that are intended to reduce anxiety, not to provide pleasure or gratification

39. Posttraumatic Stress Disorder • Pronounced • (post-trah-MAT-ik Stress dis-OR-der) • Defined • Individual experiences characteristic symptoms following exposure to an extremely traumatic event • Individual reacts with horror, extreme fright, or helplessness to the event

40. Somatoform, Sleep, and Factitious Disorders • Somatoform disorders • Any group of neurotic disorders characterized by symptoms suggesting physical illness or disease • No demonstrable organic causes of physiologic dysfunctions

41. Somatoform, Sleep, and Factitious Disorders • Sleep disorders • May be related to stress, anxiety, or physiological problems • Factitious disorders • Characterized by physical or psychological symptoms that are intentionally produced or feigned to assume the sick role

42. Somatoform, Sleep, and Factitious Disorders • Malingering • Willful and deliberate faking of symptoms of a disease or injury to gain some consciously- desired end • Malingering • Of the conscious mind • Results in secondary gain • Somatoform disorder • Unconscious • Results in reduction of anxiety

43. Somatoform, Sleep, and Factitious Disorders • Examples: • Conversion disorder • Hypochondriasis • Munchausen syndrome (by proxy) • Narcolepsy • Pain disorder

44. Conversion Disorder • Pronounced • (kon-VER-zhun dis-OR-der) • Defined • Disorder in which the individual represses anxiety experienced by emotional conflicts by converting the anxious feelings into physical symptoms that have no organic basis, but are perceived to be real by the individual

45. Hypochondriasis • Pronounced • (high-poh-kon-DRY-ah-sis) • Defined • Chronic, abnormal concern about the health of the body characterized by: • Extreme anxiety, depression • Unrealistic interpretation of real or imagined physical symptoms as indications of a serious illness or disease despite rational medical evidence that no disorder is present

46. Munchausen Syndrome (By Proxy) • Pronounced • (mun-CHOW-zen SIN-drom by PROCKS-see) • Defined • Somewhat rare form of child abuse in which a parent of a child falsifies an illness in a child by fabricating or creating the symptoms, and then seeks frequent medical attention for the child

47. Narcolepsy • Pronounced • (NAR-coh-lep-see) • Defined • Sleep disorder that is characterized by repeated, uncontrollable desire to sleep, often several times a day • Attacks must occur daily over a period of at least three months to establish the diagnosis

48. Pain Disorder • Pronounced • (pain dis-OR-der) • Defined • Psychological disorder in which the patient experiences pain in the absence of physiologic findings

49. Dissociative Identity Disorders • Emotional conflicts that are so repressed into the subconscious mind that a separation or split in personality occurs • Results in an altered state of consciousness or a confusion identity • Includes: • Dissociative amnesia • Dissociative fugue • Dissociative identity disorder

50. Dissociative Amnesia(Formerly: Psychogenic Amnesia) • Pronounced • (diss-SOH-see-ah-tiv am-NEE-zee-ah) • Defined • The individual is unable to recall important personal information, usually of a traumatic or stressful nature • Loss of memory is more than simple forgetting