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Mental Health

Mental Health. Anxiety Disorders. Most commonly diagnosed of all disorders Characterized by excessive or inappropriate anxiety reactions Several subtypes Generalized anxiety disorder Persistent anxiety, “free floating” Always worried about everything Interrupts normal functioning Phobias

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Mental Health

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  1. Mental Health

  2. Anxiety Disorders • Most commonly diagnosed of all disorders • Characterized by excessive or inappropriate anxiety reactions • Several subtypes • Generalized anxiety disorder • Persistent anxiety, “free floating” • Always worried about everything • Interrupts normal functioning • Phobias • Irrational or excessive fear of particular object, person, place, etc. • Include • Social phobias • Specific phobias

  3. Anxiety Disorders • Panic Disorder • Sudden episode of terror/incredible fear • May mimic symptoms of asthma, heart attack • Must occur across several months • While people report they come “out of the blue” they often occur in particular situations/settings • Finding what you are afraid of is critical • May develop into agoraphobia • Fear of “open places” • Often, a fear of having a panic attack!

  4. Anxiety Disorders • Obsessive-Compulsive disorder • Obsession: • nagging, intrusive thoughts • you are compelled to repeatedly think about • can’t “get it out of your head” • Compulsion: • behavior in which you repeatedly engage • can’t stop, even if is intrusive or harmful. Feel compelled to engage in the ritual • Appear to develop as a means of dealing with anxiety

  5. Post-traumatic Stress disorder • Always has been around • Refers to anxiety and potentially depression that results from repeatedly re-experiencing a traumatic event • Must occur at least 3 mos after traumatic event • Symptoms of anxiety with • Flashbacks • Edginess and hyper-vigilance • Emotional flatness

  6. Causes of Anxiety • Biological factors: genetics and predispositions • Psychological factors • Stress • Many phobias/fears and anxiety LEARNED via operant and classical conditioning • Modeling • Cognitive style

  7. Treatment: • Cognitive-Behavioral therapy or CBT • Changes how person thinks • You cannot control how you feel, but you an control what you think about, and this can influence what you feel • Teaches individual to focus thinking on positive events/behavior changes • Antidepressants or antianxiety/anxiolytic drugs • SSRI’s such as prozac, luvox,paxil, zoloft, celexa • Mixed NE+5HT reuptake blockers: Effexor, cymbalta • DA reuptake blockers: welbutrin • Presynaptic effects on NE and Serotonin: Remeron • Best treatment: often a combo of both

  8. Dissociative and Somatoform Disorders • Dissociative disorders: involve • changes in consciousness • Memory • self-identity • Somatoform disorders: involve • physical ailments or complaints • cannot be explained by organic causes • Dissociative Identity Disorder (DID) • Old multiple personality or split personality • NOT schizophrenia • Appearance of multiple personalities within the same individual

  9. Dissociative Disorders • Multiple personality • Dissociative Amnesia • Psychogenic Fugue state • Why? • Attempt to disconnect or dissociate from traumatic events • Make a separate “personality” for the bad stuff, or forget the “bad” stuff • Some question whether DID actually exists

  10. Personality Disorders • Class of psychological disorders that are characterized by • Rigid personality traits • These traits impair one’s ability to adjust to demands of everyday life • Interfere with relationships with others • Some are more treatable than others • Treatment involves ongoing effort (lifetime) • Jails/prisons often dumping ground for people who do not follow societal rules

  11. Major features of personality disorders • Paranoid personality disorder • High levels of suspicion of motives/intentions of others • No outright paranoid delusions • Schizoid • Aloof and distant from others • Shallow or blunted emotions • Histrionic • Dramatic, emotional behavior • Excessive demands to be center of attention, • Needs reassurance, praise or approval • Narcissistic • Grandiose self image • Excessive need for admiration • Avoidant personality • Avoids social interactions • Out of fear/rejection • Dependent • Excessive pattern of dependence on others • Difficulties being independent • Obsessive-compulsive • Excessive need for orderliness and attention to detail • Perfectionism, rigid ways of relating to people

  12. Two debilitating personality disorders • Borderline • Failure to develop stable self-image • Pattern of widely varying strong mood changes • Holding beliefs or showing behaviors that are odd or peculiar, but not psychotic • Antisocial • Antisocial and irresponsible behavior • Callous treatment of others • Lack of remorse for wrong doing • No guilt/conscience

  13. Causes and treatment? • Genetics • Environment • Antisocial and Borderline types appear to have truly different brains • Treatment: • No real medication treatment • Talk therapy • VERY difficult to change

  14. Mood Disorders • Class of disorders involving disturbances of mood • Include • Dysthymic disorder • General depression • Mania • Cyclothymic disorder • Bipolar disorder • Most common of all disorders • Depression: 10-25% of women; 5-12% of men (underreported) • Bipolar disorder: about 1% of population

  15. Depression Sleep disturbances Sad mood Low energy Suicidal Guilt Hopelessness anhedonia Mania Decreased need for sleep Elation Hyperactivity Grandiosity Distractibility Irritability psychosis Affective disorders

  16. Depression • Several subtypes • Dysthymia • Major depression • Bipolar disorder • Adjustment disorder • Grief • Seasonal affective disorder • Can be secondary to • Another medical condition • Another mental illness

  17. Scoring • 0-8: presence of a depressive disorder is unlikely • 9-16: • Presence of depressive disorder is likely • Recommend a consultation/evaluation with a mental health professional • 17-30 • Presence of depressive disorder is highly likely • STRONG recommendation for consultation/evaluation with a mental health professional

  18. Mania Little to no sleep Pressured speech and thinking Markedly increased energy Grandiosity Irritability Impulsivity, spending money, driving too fast, hypersexual Psychosis: break with reality Extremely poor judgment Hypomania Similar to mania, but not as severe Can have irritability, decreased sleep, increased energy, talking and thinking faster than usual Can be pleasurable or productive, but can get out of control Problems often identified by family/friends, minimized by patient Mania and hypomania

  19. Bipolar disorder • Experience periods of BOTH mania and depression • Show symptoms of both • Often tend toward one “pole” • Several types • Type I is more manic • Type II is more depressed (and more common) • Type III: not otherwise specified or NOS • Type IV: cyclothymic disorder

  20. Causes of mood disorders • Genetic/biologic • Exogenous depression vs. endogenous depression • Psychological • Stress • Learning • Cognition: attribution style • In particular: LEARNED HELPLESSNESS • Diathesis stress model- it takes both genetics and environment!

  21. How control? • Can learn to predict/control mood swings • Mood stabilizers • More effective for up than down • Lithium • Depakote • Tegretol • Antipsychotic medication: usually atypicals • Talk therapy, particularly cognitive-behaivoral therapies

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