Mental Health

Behavioral and Emotional Disorders

• A mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as part of normal development or culture.

Mental Health

Behavioral and Emotional Disorders:• Your health care provider can refer you to

one of the following people:– Psychiatrist- diagnose and treat mental disorders. Can prescribe

and admit– Psychologist- Diagnoses and treats emotional and behavioral

disorders by means of counseling. Not an MD, may not prescribe– Psychiatric Social Worker- Provides guidance and treatment for

clients with emotional problems, usually in the setting of a hospital, mental health clinic, or family service agency. No MD, no prescribe or perform physical exams

Mood and Anxiety Disorders• Depression• Bipolar Disorder• Generalized Anxiety Disorder• Performance Disorder• Obsessive-Compulsive Disorder• Panic Disorder• Phobias• Posttraumatic Stress Disorder• Seasonal Affective Disorder• Self Injury - cutters

Causes of Mental Health Issues

• Heredity• Childhood/Recent Events• Physical Health Problems- infection/disease• Injury• Environmental Conditions• Stress• Drugs• Finances and employment

Behavioral and Emotional Disorders• Types of Treatment Available:

– Psychotherapy:• Designed to find the root cause of a problem and

devise a solution.

– Cognitive Therapy:• Identify and correct distorted thinking patterns that

may lead to feelings and behavior of troublesome.

– Behavioral Therapy:• Changing unwanted behaviors through rewards

and reinforcement.

– Group/Family Therapy:• Provides a supportive environment during the

therapeutic process.

Behavioral and Emotional Disorders:• Types of Treatment Available (continued):

– Drug Therapy:• Mood regulating drugs

– Relaxation Treatment:• A form of stress management.

– Talk Therapy:• Individual, Group, Family

– Electroconvulsive Therapy:• Used to treat severe depression.• The individual is anesthetized and receives and electrical

shock in specific parts of the brain.• Does not consciously experience the shock

Mood and Anxiety Disorders

• Depression:– Many people experience depressed moods

or a period of normal sadness.– Affects 14.8 million (6.7%) 18+ Americans

• Depression is caused by:– After a death of a loved one.– For no apparent reason.– Major transitions in life (divorce, advancing

from adolescence to adulthood).

Types of Depression

• Situational Depression– short-term condition that occurs when a person is

unable to cope with, or adjust to, a particular source of stress, such as a major life change, loss or event.

• Clinical Depression– Overwhelms and engulfs your day to day life– Interferes with ability to work, study, sleep, have

fun, etc.

Depression• People who suffer from depression include:

– under severe stress.– depressed family members (genetic link).– psychological disorders.– severe physical disorders.– People taking medicines.

• Gender gap:

– women are twice as likely as men to suffer from both mild and major depression.

• Postpartum Depression• Menstrual period sometimes causes depression.• Men are less likely to seek treatment.

Depression (continued)• Symptoms:

– Feelings of despair, guilt, self worthlessness, no hope for the future, contemplate suicide

– Withdraw from people and society– Unable to concentrate– Can’t sleep– Loss of appetite or can’t stop eating

• Physical symptoms include:– loss of appetite – insomnia/fatigue– backache/headache/upset stomach/constipation

• Treatments:– Psychotherapy– Drugs - Antidepressants

• SSRI – Selective Serotonin Reuptake Inhibitor Prozac, Paxil, Luvox, Zoloft, Celexa

• MAOI -Monoamine Oxidase Inhibitors Phenelzine, which is helpful for people with panic disorder and social phobia. Tranylcypromine and isoprocarboxazid are also used to treat anxiety disorders.

Bipolar Disorder (Manic Depression)• Periods of depression alternate w/ periods of hyperactivity

and uncontrolled elation (mania).

• Affects 5.7 million (2.6%) 18+ Americans

• One in four people attempt suicide; one in ten are successful w/ their attempt.

• Heredity/environment play a role in bipolar disorder.

• Symptoms:– Manic phase includes:

• cheerful, full of energy.• person gets out of control--spending money wildly; takes on huge

projects that are never completed; believes they’re powerful people.

Bipolar Disorder• Symptoms:

– Mania turns to irritability, rage, and paranoia.– Alcohol/drug abuse, loss of job, possible divorce may result.– About 10-20% of sufferers develop “rapid cycling” (four or

more episodes per year).

• Treatment Options:– Seek treatment immediately.– Psychotherapy– An array of medications are used. It is not uncommon for an

individual to take several different types of drugs and to make frequent changes to achieve an acceptable balance between stability and side effects

• prevents the mania and lessens the depression.• Seroquel, Abilify, Depakote, Lithium

Bipolar Disorder• Treatment (continued)

– Lithium has side effects.• weight gain, drowsiness, frequent urination, thirsty.• can injure the kidneys, thyroid gland

– None of the drugs are a cure.– In the early stages of mania the victim may be

prescribed antipsychotic drugs.– Clozopine for antipsychotic– Anticonvulsant (divalproex) may be prescribed if

the mood cycle is very rapid.– In rare cases, electroconvulsive therapy may be

used

Generalized Anxiety Disorder (GAD)• Feelings of apprehension that occur for no

specific reason (last at least one month).Affects 40 million (18.1%) 18+ Americans• Symptoms:

– heart beats faster, breathing becomes faster (hyperventilation), hands tremble, perspire more.

• Physical symptoms include: – upset stomach, headache, and general aches and pain.

• Treatments:– Benzodiazepine drugs (short term).– Antidepressants/Antianxiety drugs (buspirone).– Psychotherapy.

Performance Anxiety• Occurs when a person has to make speech,

take an examination, or make a public appearance.

• Symptoms:– rapid heartbeat, excessive perspiration, trembling

(hands or voice), difficulty in concentrating.

• Treatment:– Cognitive/Behavioral therapy (learn to relax and to

cope w/ the situation.– Beta-blocking medicines are used to control the

physical symptoms.

Obsessive-Compulsive Disorder• Compulsive rituals or actions that are repeated over

and over (take over a person’s life).

Affects 2.2 million (1.0%) 18+ Americans

Obsessions

-persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress

(EX.- thoughts about contamination, repeated doubts, need to have things in a particular order, aggressive or horrific impulses, and sexual imagery)

Compulsions-repeated behaviors or mental acts, the goal of which is to prevent or reduce anxiety or distress, not to provide pleasure or gratification

• Symptoms:– Counting every step while walking.– Constantly cleaning one’s hands or one’s living

space.

• Treatment:– Psychotherapy.– Heterocyclic Antidepressants.– SSRIs.

Panic Disorder• Sudden attacks of intense fear or anxiety for no

apparent reason.• Affects 6 million (2.7%) 18+ Americans

– Attacks can occur several times a day.– Runs in the family.– Usually involves personal loss, major change, or illness.– 1 in 3 develop agoraphobia, fear of being in a place where

escape might be difficult

• Symptoms:– At least four of the following symptoms occur in a person:

• Pounding heartbeat, sweating, trembling, difficulty breathing, choking sensations, chest pain, nausea, dizziness, fear of dying or going crazy, chills, hot flashes, feelings of unreality, numbness or tingling in the extremities.

Panic Disorder (continued)• Symptoms (continued):

– Constant anxiety about having another panic attack.

– Significant behavior change (avoiding certain situations or relying on alcohol or other drugs).

• Treatments:– Psychotherapy/Medications

• Antianxiety Drugs.• Antidepressant Drugs.

Specific Phobias• Irrational sense of fear when a person is confronted

by a common object, activity, or situation, leading the person to avoid the thing that is feared.– Affects 19.2 million (8.7%) 18+ Americans

• Most common form of anxiety

• Symptoms:– sudden, persistent, and irrational panic; dread, horror, or

terror when confronted w/ the object or situation.– Agoraphobia, Acrophobia, Claustrophobia.

• Treatment= Desensitization/Exposure Therapy

Posttraumatic Stress Disorder (PTSD)

• Involves people who have survived traumatic events such as natural disaster, war, physical or sexual assault, and severe illness.

• Affects 7.7 million (3.5%) 18+ Americans

• Prisoners of War and concentration camp survivors are most affected (47-50%).

• Symptoms:– People may relive the distressing event repeatedly in thoughts,

dreams, or flashbacks.

• Treatment:– Psychotherapy– Antidepressants

Seasonal Affective Disorder (SAD)• People experience sadness, depression, and fatigue

that comes on in late fall and subsides in the spring.

• Caused by lack of sunlight.

• Over 10 million Americans are affected (women outnumber men by a 4 to 1 ratio.

• Symptoms include:– headaches, increased appetite, loss of interest in activities,

excessive sleep, irritability, unable to concentrate.

• Treatment= Antidepressant Drugs (SSRI)

Psychosis Diseases

• Known as thought disorders; characterized by gross distortions of reality.

• A psychotic person will often have:– Delusions:

• Fixed beliefs that are false; he or she believes they’re the President or some important figure.

– Hallucinations:• Hearing or seeing things that are not real.

• Schizophrenia is a psychosis disease.

Schizophrenia--Psychosis Disease• Severe mental illness characterized by

delusions and hallucinations.

• Affects 2.4 million (1.1%) 18 + Americans

• Men- late teens, early twenties• Women- late twenties, early thirties

• Three Classifications of Schizophrenia:1. Paranoid Schizophrenia:

• person is being persecuted; delusions of grandiose.

2. Catatonic Schizophrenia:• stops moving and talking and then becomes excitable.

Schizophrenia (continued)3. Disorganized Schizophrenia:

• Person is incoherent; person shows inappropriate emotions or expressionless.

• Cause of schizophrenia is not known.– A child born of two schizophrenia parents has a

40% chance of becoming schizophrenic (avg... risk is 1%).

– Brain produces too much of the neurotransmitter dopamine.

• Symptoms:– Social w/drawal; deterioration of performance at

work or school; delusions of grandeur; hear voices commanding them to do something.

Schizophrenia (continued)

• Treatment Options:– Antipsychotic Drugs

• Haloperidol • Chlorpromazine

– Remains an illness that cannot always be treated successfully.

– Sometimes a person w/ schizophrenia has to be stabilized in a hospital against his or her own will.

– Side Effects of the Antipsychotic Drugs:• Short Term= Dry mouth, blurred vision, difficulty in

urinating.• Long Term= Tardive Dyskinesia (movement disorder).

Addictions• Addiction

– A compelling desire to use a drug or engage in a specific behavior, continued use despite negative consequences

• How Addictions Affect Health Status– Physical health– Safety– Relationships– Problems with the law– Jeopardize financial health

Types of Addiction

• Drug

• Exercise

• Gambling

• Nicotine

• Perfectionism

• Relationship

• Shopping

• Television/computer

• Thrill-Seeking

• Workaholism

• Substance Addiction and Abuse:– People who engage in substance abuse initially

have control of their lifestyle.– Once they have become addicted, they are unable

to control their use of addicting substances (nicotine, alcohol, heroin, etc,).

– Addiction is a physical dependence on a chemical substance.

– This dependence leads to unpleasant symptoms, called withdrawal (when a person stops using the substance).

– Alcohol/Tobacco are the most abused drugs.

Behavioral and Emotional Disorders (continued)

• Compulsive Gambling:– Brain releases a neurotransmitter (much like working out)

when gambling on a person or event.– The number of compulsive gamblers has risen

dramatically in the United States in the past 20 years.– Compulsive gambler shirks daily responsibilities and loved

ones; sells personal property to finance their bets; lie to hide their losses; and engage in illegal activity to support their habit.

– Compulsive gamblers often have other psychiatric problems (must convince person to seek treatment).

– Treatment= Psychotherapy/Gamblers Anonymous

Self-Injury• An unhealthy way to cope with emotions, stress, or

traumatic events• Self-injury can be a symptom of a mood disorder,

anxiety disorder, or eating disorder• Most people aren’t attempting suicide, but it is done

to feel better in a situation– Some people may attempt suicide, but this is due to

emotional problems and not the cutting itself

• Occurs most often in young women, but can occur in young men

• Methods– Cutting or making scratches on the body using sharp objects

to bleed (razor, scissor, pin, glass)– Burning body with a lighter, matches, or cigarettes

ADD/ADHD

• Attention-Deficit Disorder

• Doesn’t pay attention to detail

• Careless mistakes• Disorganized• Doesn’t seem to listen• Forgets to do daily activities• Easily distracted• Difficulty following directions

• Attention-Deficit Hyperactivity Disorder

• Fidgets or squirms while seated

• Trouble staying seated

• Frequently runs or climbs

• Trouble working quietly

• Talks excessively

• Trouble waiting or taking turns

• Interrupts others

Personality Disorder• Group A- Odd or Eccentric Behaviors

• Paranoid Personality Disorder- overly distrustful and suspicious of others

come across as cold

• Schizoid Personality Disorder- detached from personal relationships

may be perceived by others as “loners”

• Schizotypal Personality Disorder-characterized both by a need for isolation and paranoid beliefs

may show inappropriate reaction, none at all, or talk to themselves

• Group B- Dramatic, Emotional, Erratic• Overly emotional or unstable

• Selfish and demanding

• High value on self and not on others

• Anti-social Personality Disorder- (psychopathy or sociopathy)

may commit violent acts without any sense of guilt

lack of empathy or conscience

difficulty controlling impulses and manipulative behaviors

• Borderline Personality Disorder-dramatic and abrupt mood shifts

impulsivity, poor self-image

highly sensitive to rejection and fear abandonment

• Narcissistic Personality Disorder-need for admiration and lack of empathy

tend to be extremely self-absorbed, intolerant of others’ perspectives

insensitive to others’ needs

• Group C- Anxious, Fearful Behavior• Can’t make decisions• Strong need for approval• Avoid people for fear of rejection

• Avoidant Personality Disorderoften hypersensitive to rejection and unwilling to take social risksdisplay high level of social discomfort, timidity, fear of criticism, avoidance of activities that involve interpersonal communication

• Dependent Personality Disorderexhibit a pattern of needy and submissive behaviorrely on others to make decisions for themrequire excessive reassurance and advice

• Obsessive-Compulsive Personality Disorder focused on order and perfection that lack of flexibility interferes with

productivity and efficiencyworkaholics and prefer to work alone for fear that work completed by others will not be done correctly

Eating Disorders

• Anorexia– Constant dieting: to little eating: to no

eating– Affects CNS-Depression-Death

• Bulimia– Binges on food, then purging– Teeth, Heart Muscle, Glands

• Somatoform Disorder– A person has symptoms of disease but no

physical cause can be found

• Hypochondria– A person is constantly worried about illness

• Psychosomatic Disease– A physical illness or disorder that is caused

or aggravated by emotional responses