Title: Mental Health and Mental Illness

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Chapter 1

 Mental Health and Mental Illness

 What is Mental Health?
 What is Mental Illness?
 Who defines Mental Illness?

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Introduction

 The concepts of mental health and mental illness

are culturally defined.
 For example Homosexuality
 Family members are usually first to identify
deviation from normal
 Families often try to deny and/or normalize
deviations

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Mental Illness and Culture

 Horwitz describes cultural influences that affect

how individuals view mental illness. These
include
 Incomprehensibility - the inability of the
general population to understand the motivation
behind the behavior
 Cultural relativity - the normality
 of behavior determined by
 the culture

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Cultural Aspects of Mental Illness

 Lower socioeconomic classes have the highest

amount of symptoms of mental illness but tolerate
symptoms more
 More educated people recognize mental illness and
seek treatment sooner
 Women are more likely to seek treatment than men

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Mental Health

 Defined by the textbook author as The successful

adaptation to stressors from the internal or
external environment, evidenced by thoughts,
feelings, and behaviors that are age-appropriate
and congruent with local and cultural norms.
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People with Good Mental Health

 Can take lifes disappointments in stride

 Are not overcome by their emotions, their fears,
anger, jealousy, guilt or worries
 Accept their shortcomings
 Have self-respect
 Feel able to deal with most situations that come
their way
 Are able to give love and consider the interests
of others
 Welcome new experiences and new ideas
 Have personal relationships that are satisfying
and lasting

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Maslow

 Maslow identified a hierarchy of needs

 Physiological needs have to be met before higher
level needs
 Mental Health is defined by Maslow as
self-actualization. This person has
 An appropriate perception of reality
 The ability to be spontaneous
 The capacity for problem solving
 The ability to achieve satisfactory relationships
 Creativity
 The ability to accept oneself, others, and human
nature

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APA

 The American Psychiatric Association defines

mental health as Simultaneous success at
working, loving, and creating with the capacity
for mature and flexible resolution of conflicts
between instincts, conscience, important other
people and reality.

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Mental Illness

 Defined by the author as Maladaptive responses

to stressors from the internal or external
environment, evidenced by thoughts, feelings, and
behaviors that are incongruent with the local and
cultural norms and interfere with the
individuals social, occupational, or physical
functioning.
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PHYSICAL AND PSYCHOLOGIAL RESPONSES TO STRESS
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Physical Responses

 Hans Selye defined stress as the state

manifested by a specific syndrome which consists
of all the nonspecifically induced changes within
a biologic system.
 Fight-or-flight syndrome

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Physical Responses

 The Fight-or-Flight Syndrome

 Initial stress response-biological effects occur
when the sympathetic nervous system is
stimulated
 Norepinephrine and epinephrine are released
 Pupils dilate
 Bronchioles dilate and resp
 Heart rate, BP and cardiac output

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Physical Responses

 Selye developed the General Adaptation Syndrome

to describe the general reaction of the body to
stress
 3 Stages
 1. Alarm reaction stage physiological responses
of fight-or-flight begin-pupils dilate, BP , CO
 2. Stage of resistance person uses responses of
stage 1 to cope with stress
 3. Stage of exhaustion when prolonged exposure
to the stressor occur. The person is depleted
and prone to diseases of adaptation. Without
intervention, exhaustion and death can occur

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Physical Responses

 Sustained physical responses to stress promote

susceptibility to diseases of adaptation
 Headaches
 CAD
 Colitis
 Mental disorders
 Ulcers

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The Sustained Response
  Prolonged stress stimulates the pituitary to
release hormones
 ACTH causes decreased immune and inflammatory
responses
 Vasopressin increases fluid retention, and
constricts blood vessels, thus BP
 Growth hormone causes serum glucose
 Thyroid hormones the basal metabolic rate
 Gonadotropins cause _ sex hormones and libido
and impotence

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Psychological Responses

 Anxiety and grief have been described as two

major, primary psychological response patterns to
stress.
 A variety of thoughts, feelings, and behaviors
are associated with each of these response
patterns.
 Adaptation is determined by the extent to which
the thoughts, feelings, and behaviors interfere
with an individuals functioning.

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Psychological Responses

 Anxiety
 A diffuse apprehension that is vague in nature
and is associated with feelings of uncertainty
and helplessness
 Extremely common in our society
 Mild anxiety is adaptive and can provide
motivation for survival

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Psychological Responses

 Hildegard Peplau-nursing educator and theorist

 Peplaus four levels of anxiety
 1. MILD - seldom a problem
 Associated with the tensions of daily living
 Sharpens the senses
 Increases motivation
 Enhances learning
 Perceptual field is increased

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PEPLAU

 2. MODERATE ANXIETY
 Perceptual field decreases
 Attention span decreases
  Concentration decreases
 Muscular tension increases
 Restlessness is present
 Problem solving ability decreases

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Peplau

 3. SEVERE ANXIETY
 Perceptual field severely diminished
 Difficulty completing simple tasks
 Concentration centers on one detail only or many
extraneous details
 Physical symptoms may occur headaches,
palpitations or insomnia
 Emotional symptoms may occur confusion, dread or
horror
 All behavior directed at relieving the anxiety

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Peplau

 4. PANIC
 The most intense state of anxiety
 Inability to focus at all
 Loss of contact with reality may occur
 Delusions or hallucinations may be present
 Desperate behavior or extreme withdrawal may
occur
 Communication usually ineffective
 Person fears they are going crazy or losing
control

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Psychological Responses

 Behavioral adaptation responses to anxiety

 At the mild level, individuals employ various
coping mechanisms to deal with stress. A few of
these include eating, drinking, sleeping,
physical exercise, smoking, crying, daydreaming,
nailbiting, laughing, and talking to
 persons with whom theyfeel comfortable.

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Psychological Responses

 At the mild to moderate level, the ego calls on

defense mechanisms for protection, such as
 Compensation
 Denial
 Displacement
 Identification
  Intellectualization
 Introjection
 Isolation
 Projection

 Rationalization
 Reaction formation
 Regression
 Repression
 Sublimation
 Suppression
 Undoing

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Denial

 Is not a river in Egypt

 Is refusal to acknowledge the existence of a real
situation or the feelings associated with it

 A man drinks alcohol every day after work to the

point he is intoxicated, but fails to acknowledge
that he has a problem.

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Projection

 Attributing feelings or impulses unacceptable to

the self onto another person

 Example A student feels very attracted to her

chemistry professor. She says,
 Hes coming on to me.

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Displacement

 Transferring feelings from one target to another

that is considered less threatening

 A woman who is harassed by her boss at work

starts an argument with her husband and kids

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Rationalization

 Attempting to make excuses to justify

unacceptable feelings or behavior

 A client smokes 2 packs of cigarettes per day and

says that many people smoke to cope with stress
and live long and healthy lives
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Repression

 Involuntarily blocking unpleasant experiences

from awareness.

 An incest victim cannot remember details of the

sexual abuse

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Suppression

 Voluntarily blocking unpleasant thoughts and

feelings from awareness

 A student says I dont want to think about that

test tomorrow. I want to go to the movies
tonight.

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Psychological Responses

 Anxiety at the moderate to severe level that

remains unresolved over an extended period can
contribute to a number of physiological
disorders--for example, migraine headaches,
irritable bowel syndrome, and cardiac
arrhythmias.
 Extended periods of repressed severe anxiety can
result in psychoneurotic patterns of
behaving--for example, anxiety disorders and
somatoform disorders.

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Psychological Responses

 Extended periods of functioning at the panic

level of anxiety may result in psychotic
behavior for example, schizophrenic,
schizoaffective, and delusional disorders.

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Psychological Responses

 Grief a major response to stress of loss

 The subjective state of emotional, physical, and
social responses to the loss of a valued entity
the loss may be real, as in death, hurricane
damage or perceived, as in loss of femininity
post mastectomy
 Elisabeth Kübler-Ross
 (5 Stages of Grief)
 Denial-No-it cant be true
  Anger-Why me?
 Bargaining-If God will help me,
 I promise
 Depression-intense sadness
 Acceptance-feeling of peace

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Psychological Responses

 Anticipatory grief - The experiencing of the

grief process before the actual loss occurs.
 Resolution - Length of the grief process is
entirely individual. It can last from a few weeks
to years. It is influenced by a number of factors.

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Psychological Responses

 The experience of guilt for having had a

love-hate or conflictual relationship with the
lost entity. Guilt often lengthens the grieving
process.
 Anticipatory grieving is thought to shorten the
grief response when the loss actually occurs.
 The length of the grief response is often
extended when an individual has experienced a
number of recent losses and when he or she is
unable to complete one grieving process before
another one begins.

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Psychological Responses (cont.)

 Resolution of the grief response is thought to

occur when an individual can look back on the
relationship with the lost entity and accept both
the pleasures and the disappointments of the
association.

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Psychological Responses (cont.)

 Maladaptive grief responses

 Prolonged response-when intense preoccupation
with grief continues for years
 Delayed/inhibited response-person is fixated in
denial and does not face pain of loss but
develops anxiety disorders instead
 Distorted response-person is fixated in the
anger stage of grief, turns anger inward and is
in despair and unable to function normally

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DSM-IV-TR Multiaxial Evaluation System
  Axis I - Clinical disorders and other conditions
 that may be a focus of clinical
attention
 Axis II - Personality disorders and mental
 retardation
 Axis III - General medical conditions
 Axis IV - Psychosocial and environmental
 problems
 Axis V - The measurement of an individuals
 psychological, social, and
 occupational functioning on
the GAF
 Scale

Title: Types of Mental Illness - Main Groups of Mental Disorders

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Types of Mental Illness - Main Groups of Mental
Disorders
Types of Mental Illness- Main Groups of Mental
Disorders
Types of Mental Illness- Main Groups of Mental
Disorders
Types of Mental Illness- Main Groups of Mental
Disorders
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About Mental Disorder

 With about 56 million Indians suffering from

depression and 38 million from anxiety disorders,
India is undergoing a severe mental health
crisis, says a WHO report. These are mental
disorders and are characterised by problems
associated with ones mind and mood. They can
affect your social, professional, and personal
activities and behaviour.
 Though mental disorders are quite common, most of
us are either unaware of them or dont realise
how dangerous they can be if left untreated. It
has been observed that people with some degree of
mental illness do not bother to get treatment or
are not given the treatment they require due to
social constraints. An estimated 26 are actually
afraid of being mentally ill. This makes it
essential to recognise any unusual behaviour in
your loved ones and give them the right treatment
so that they can lead a healthy life.

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Anxiety Disorder

 Mental disorders are classified into more than

200 types, but here are some of the most commonly
found mental disorders you must know about
 One of the most widespread mental disorders that
is often considered just a symptom is anxiety
disorder. It is a disorder in which you may
respond with fear or horror in certain
situations. Symptoms include panic, rapid
 heartbeat, excessive sweating, and restlessness.
Additionally, being unable to control your
response could disturb your normal activities.
Panic disorder, phobia etc. are some of the types
of panic disorders.
 The inability to focus on one task and being
hyperactive or impulsive corresponds to Attention
Deficit Hyperactivity Disorder (ADHD). It may
occur in children as well as adults.

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Mood Disorder

 Mood disorder is characterized by extreme

fluctuations in mood, ranging from extreme
happiness to sudden intense sadness. You may be
very happy at one moment but can suddenly become
sad the next. Commonly seen mood disorders
include depression, bipolar disorder, etc.

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Eating Disorder

 Eating disorder is a type of mental disorder

where you resort to eating or not eating as a
coping mechanism. This means you either eat a lot
or eat nothing at all during emotional periods of
your life. Anorexia or low appetite and
binge-eating disorders are the most common.

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Psychotic disorders

 Psychotic disorders correspond to disturbed

awareness as well as thinking by a person that
can cause hallucinations or delusions. An apt
example of the psychotic disorder is
schizophrenia.

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Impulse Control Disorder

 Impulse control disorder results in a person not

being able to control the urge or impulse to
perform activities that can either harm them or
others, such as compulsive gambling, kleptomania
(stealing), etc.

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Obsessive-Compulsive Disorder (OCD)

 Obsessive-compulsive disorder (OCD) can

continuously keep you surrounded by some thoughts
or fears (obsessions) that force you to perform
certain activities or rituals again and again
 (compulsions). One of the most common examples is
frequent hand-washing due to fear of germs.

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Post-Traumatic Stress Disorder (PTSD)

 Post-traumatic stress disorder (PTSD) usually

occurs after a traumatic event that can be
physical or emotional, e.g. physical or sexual
assault, natural disaster, sudden loss of a loved
one, etc. These events leave a long-lasting
effect on the mind and make the sufferer
emotionally numb afterwards.


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Postpartum Depression

 Childbirth is exhausting and can sometimes bring

about an unexpected depression. Though this phase
of life brings joy, if there are more episodes of
sadness, then it can be due to postpartum
depression. It mainly affects mothers, but
fathers arent immune to it either, during or
after childbirth.
 Untreated depression kills over 7 lakh people
across the world every year. So, take care of
yourself and your loved ones, and keep a lookout
for signs of mental illnesses. Remember, these
can be managed if diagnosed in time. Make health
check-ups a part of your life so that you can
live healthy and carefree.

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