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Mental Health and Mental Illness

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The concepts of mental health and mental illness are culturally defined. ... Undoing. 9/16/09. 27. Psychological Responses (cont. ... – PowerPoint PPT presentation

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Title: Mental Health and Mental Illness


1
Chapter 1
  • Mental Health and Mental Illness

2
Mental Health and Mental Illness
  • What is Mental Health?

3
Introduction
  • The concepts of mental health and mental illness
    are culturally defined.
  • What is acceptable behavior depends upon cultural
    norms.
  • Give some examples from your own culture.
  • People respond to stress with physical and
    psychological symptoms.

4
Classification of Mental Illnesses
  • The Diagnostic and Statistical Manual of Mental
    Disorders, 4th Edition, Text Revision
    (DSM-IV-TR).
  • Diagnostic criteria are listed for each of the
    psychiatric disorders.
  • A multiaxial system- people are evaluated from
    multiple aspects points of function.

5
Mental Health
  • Maslow identified
  • A hierarchy of needs
  • Self-actualization as fulfillment of
  • ones highest potential

6
Maslows Hierarchy
7
Mental Health (cont.)
  • Defined 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.

8
Mental Health/Mental Illness
  • Continuum-not static

Mental health
Mental illness
9
Aspects of mental health
  • Emotional Intelligence-
  • Emotions are skills for living.
  • Important to recognize our emotions-know
  • ourselves.
  • Have emotional self control.
  • Recognize emotions in others.
  • Handle relationships.

10
Aspects of Mental Health
  • Resiliency- emerge and grow from negative life
    events.

11
Aspects of Mental Health
  • Spirituality
  • that part of us that deals with relationships,
    values, and addresses questions of purpose and
    meaning in life.

12
Mental Illness
13
Mental Illness
  • Defined 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.

14
Mental Illness (cont.)
  • 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

15
PHYSICAL AND PSYCHOLOGIAL RESPONSES TO STRESS
16
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

17
Physical Responses (cont.)
  • Selyes General Adaptation Syndrome
  • Alarm reaction stage- the physiological
    responses of fight or flight.
  • Stage of resistance-attempting to adapt to the
    stressor.
  • Stage of exhaustion-adaptive energy is gone, can
    no longer draw from resources, may become
    physically or psychologically ill.

18
Physical Responses to Stress
19
Physical Responses (cont.)
  • The Fight-or-Flight Syndrome
  • Initial stress response
  • Sustained stress response

20
Physical Responses
  • Sustained physical responses to stress promote
    susceptibility to diseases of adaptation

21
Physical and Psychological Responses to Stress
22
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.

23
Psychological Responses (cont.)
  • 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

24
Psychological Responses (cont.)
  • Peplaus four levels of anxiety
  • Mild - seldom a problem
  • Moderate - perceptual field diminishes
  • Severe - perceptual field is so diminished that
    concentration centers on one detail only or on
    many extraneous details
  • Panic - the most intense state

25
Psychological Responses (cont.)
  • 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, laughing, and
    talking to
  • persons with whom theyfeel comfortable.

26
Psychological Responses (cont.)
  • 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

27
Psychological Responses (cont.)
  • 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,
    phobias, panic disorders, somatoform disorders
    and dissociative disorders. (DSM-IV-TR)

28
Psychological Responses (cont.)
  • Extended periods of functioning at the panic
    level of anxiety may result in psychotic
    behavior for example, schizophrenic,
    schizoaffective, and delusional disorders.
  • Person is not able to process what is happening.
  • May lose touch with reality.
  • A flight from reality into a less stressful world.

29
Anxiety
A feeling of tension, distress, and discomfort
produced by a perceived or threatened loss of
inner control rather than from external
danger. DEFENSE MECHANISMS Alleviate anxiety by
denying, misinterpreting or distorting reality.
Mostly unconscious
30
Psychological Responses (cont.)
  • Grief
  • The subjective state of emotional, physical, and
    social responses to the loss of a valued entity
    the loss may be real or perceived. CHANGE
  • Elisabeth Kübler-Ross
  • (5 Stages of Grief)
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

31
Psychological Responses (cont.)
  • Anticipatory grief - The experiencing of the
    grief process before the actual loss occurs.
  • How does change relate to grief?
  • 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.

32
Psychological Responses (cont.)
  • The experience of guilt for having had a
    love-hate 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. May
    result in disengaging from the loved one.
    Rejection/abandonment issues
  • 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.

33
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.

34
Psychological Responses (cont.)
  • Maladaptive grief responses
  • Prolonged response-intense preoccupation with
    the memory of the loved one. Can be many years
    later. Anger, Denial. Difficulty functioning,
    intense pain.
  • Delayed/inhibited response- fixed in denial
    stage/ the emotional pain is not experienced.
  • Distorted response- fixed at anger stage.
    Interferes with normal functioning. Depression

35
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

36
Global Assessment of Function Scale- GAF
  • http//depts.washington.edu/wimirt/GAF20Index.htm
  • http//dpa.state.ky.us/library/manuals/mental/Ch22
    .html
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