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Psychological Health Chapter 3
Psychological Health • Psychological health versus psychological normality • What is Mentally normal?
Psychological Health • Normality: The psychological characteristics attributed to the majority of people in a population at a given time.
Psychological Health • Psychological Health: • Negative: Absence of sickness/disease • Positive: Presence of wellness • The capacity to think rationally and logically and to cope with life’s transitions, stresses, traumas, and losses in a way that allows for emotional stability and growth.
Psychological Health • Psychological Disorder: A diagnosable mental, behavioral, or emotional disorder that interferes with one or more major activities in life—like dressing, eating, or working
Mental HealthAbraham Maslow • Hierarchy of Needs • Self-Actualized • Realism • Acceptance • Autonomy • Intimacy • Creativity
Achieving Healthy Self-esteem • Positive Self Concept • Meeting the Challenges—Recognize things about yourself (Realistic self-talk, page 71) • Less Defensive (Defense Mechanisms, Table 3-2) • Optimism
Honest Communications • When you are the speaker: • State your concern as clearly as possible. • Take responsibility for your feelings; use “I” statements. • Avoid generalizations. • Avoid blaming, accusing, and belittling. • Ask for action ahead of time, not after the fact. • As a Listener: • Don’t give unsolicited advice. • Listen reflectively, Don’t interrupt, judge, blame,or evaluate. • Really listen, Try to tune in to the other person’s feelings. • Let the other person know that you value what he or she is saying and want to understand.
Dealing With Anger • Distinguish between assertiveness and hostile anger • Manage your anger. • Reframe • Distract • Dealing with anger in other people • Try to focus on solving the problem • Assertive/calm
Psychological Disorders • Anxiety: Unfocused worry/excessive concern • Simple, specific phobias- • Social phobias • Panic disorders • Generalized Anxiety disorder (GAD) • Obsessive-Compulsive disorders (OCD) • Compulsions • Post-Traumatic stress disorders (PTSD)
Generalized Anxiety Disorder • Characteristics: • Anxiety expressed more consistently and intensely than most people • Difficulty expressing excessive concern • Restless • Inability to Concentrate • Fatigue • Tense
Generalized Anxiety Disorders • Treatment • Counseling/psychotherapy/behavioral therapy • Drugs • Combination
Obsessive Compulsive Disorder • Neurotransmitter—serotonin • As many as 1 in 40 • Genetic Predisposition • Obsession: Recurrent, unwanted thoughts or impulses • Compulsions: Repetitive, difficult-to-resist actions • Exp. Handwashing/germs, HIV from handshake, counting or repeating tasks, checking things, hoarding—realize bizarre but can’t control
Obsessive Compulsive Disorder • Treatment • Behavioral therapy, such as desensitation • Drugs • Combination • 70-80% improve with medication
Panic Attacks • Genetic predisposition to excessive cortical activity combined with a triggering event (may be without reason or warning)
Panic Attacks • Symptoms: • Rapid heart rate, chest pain • Sweating, chills, hot flashes, dizziness, feeling light-headed • Choking, smothering, SOB • Nausea/vomiting • Feelings of numbness • Feelings of loss of control, “going crazy”, impending death, live with dread of another • Females more than twice as likely
Panic Attacks • Treatment • Drugs (block excessive flow of excitatory signals reaching cortex of brain) • Teaching coping strategies, such as breathing techniques
Simple Phobias • Phobias are the most prevalent type of anxiety disorder • A persistent, excessive, specific fear—animals, certain locations, high places • Sometimes no explanation • Sometimes results from a bad experience
Social Phobias • Specific fears relating to social aspects • Exp: Fear humiliation/embarrassment in public, fear of public speaking • Treatment: • Systematic desensitation—a type of behavioral therapy • Meds often not effective by themselves • Medical hypnosis
Schizophrenia • A psychological disorder that involves a disturbance in thinking and in perceiving reality • Can diagnose your own depression, but not this • Profoundly affects sense of reality • 1 in 100-150, runs in families, clinical onset late adolescence 17-24, may be triggered by environmental factors
Schizophrenia • Neurotransmitter disorder—faulty functioning of receptor sites (dopamine and others) • Partial recovery more likely than return to high-level functioning • Some do recover with treatment, others do not
Schizophrenia • Symptoms: • Delusions (false beliefs of importance) • Hallucinations (false sensory perceptions) • Hear, see, feel things that don’t exist • Some quite logical except on the subject of their disillusions • Some show disorganized thoughts/speech • Catatonic behavior (immobility) • Odd or purposeless movement • Negativism (motiveless response to all instruction)
Schizophrenia--Symptoms • Inappropriate emotions (absent or strong but inappropriate • Observable dysfunction in work, social, and self-care activities (compared to how they were before onset)
Schizophrenia • Treatment: • Therapy • Drugs • Thorazine, Haldol, Risperidone (Risperal), Olanzapine (Zyprexa), Clozapine (Clozaril) • Some of the new drugs, less side effects • Combination Regular medication is a key element!
Mood Disorders • Bipolar disorder: (Manic depression) Emotional disorder in which the mood swings between highly excited and depressed periods
Mood Disorders • Bipolar (Manic) • Highly excited: • Easily distracted • Devote themselves to fantastic projects • Spend more money than they have • Very confident • Need little sleep • Talk nonstop
Mood Disorders • Bipolar (Manic) • Depressed period: • Withdraw from personal involvement • Abandon projects • Negative feelings of self-worth • Low periods of depression • May consider suicide
Mood Disorders • Bipolar: Treatment • Tranquilizers to treat individual episodes • Traditional longterm therapy to prevent further episodes (Lithium)
Mood Disorders One of the most frequently occurring conditions physicians fail to recognize Many don’t seek help (35%)—don’t want to tell anyone Symptoms masked or confused with symptoms associated with other conditions Most treatable—80% marked improvement
Mood Disorders • Depression: many forms and degrees • A feeling of sadness, hopelessness, worthlessness • Loss of pleasure in usual activities • Poor appetite and weight loss • Or eating too much • Insomnia or disturbed sleep • Restlessness or, alternatively, fatigue • Thought of worthlessness and guilt • Trouble concentrating or making decisions • Thoughts of death or suicide • Persistent physical symptoms or pains that do not respond to treatment
Mood Disorders • Depression: • Thought to be caused by a chemical imbalance • May be due to a triggering event: marital problems, death of someone close, repressed problems from childhood (exogenous vs. endogenous)
Getting Help • Professional • Psychiatrists/psychologists (difference?) • Social workers • Licensed Counselors • Clergy • Treatment Team • Drugs (i.e. Zoloft, Prozac) • ECT (severe cases) • SAD—light therapy • Often combination of drugs/therapy best
Getting Help • Self-Help Strategies for Mild Depression • Identify stressors—change surroundings • Don’t cut yourself off from others—talk it out • Exercise • Do something you are good at • Don’t vary normal routine • Pamper yourself • Give yourself some quiet time each day • Write in a journal • Be informed • Minimize contact with others who are depressed • Be realistic—are you exaggerating the significance of the event • Avoid temptation to ease depression by using alcohol or other drugs
Gender Differences • Bipolar—Men/women approximately same • Major depressive episode--Women almost twice as likely as men • Panic disorder—More than twice as likely in women as in men • OCD—1.7% men vs. 2.8% women • See Table 3-3 Why? Gender matters—page 80
Suicide: Figure 3-2 • Warning signs: • Expressing the wish to be dead or revealing contemplated methods • Increasing social withdrawal and isolation • Decreased interest in activities that used to bring pleasure • Inappropriate or excessive guilt • Feelings of worthlessness, hopelessness and self-reproach • Giving away prized possessions • Making things “right” • A sudden, inexplicable lightening of mood • Change in appetite, sleep patterns, concentration levels
Myth/Fact • Myth: People who really intend to kill themselves do not let anyone know about it. • Fact: Most people who eventually commit suicide have talked about doing it.
Myth/Fact • Myth: People who succeed in suicide really wanted to die. • Fact: Some people are only trying to make a dramatic gesture or plea for help. We cannot be sure.
Myth/Fact • Myth: Suicide is proof of mental illness. • Fact: Many suicides are committed by people who do not meet ordinary criteria for mental illness, although people with depression, schizophrenia, and other psychological disorders have a MUCH higher than average suicide rate.
Myth/Fact • Myth: People inherit suicidal tendencies. • Fact: Certain kinds of depression that lead to suicide do have a genetic component. But many examples of suicide running in a family can be explained by factors such as psychologically identifying with a family member who committed suicide, often a parent.
Myth/Fact • Myth: If you ask an adolescent about suicidal intentions, you will encourage the young person to commit suicide. • Fact: Frequently asking a person about suicide will not only allow that person to unload built up anxiety and stress, but also reduce the likelihood of suicide.
Myth/Fact • Myth: When a depression lifts, there is no longer any danger of suicide. • Fact: Research suggests that the time of greatest risk of suicide is in the first 3 months after an adolescent begins recovery.