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Mental Disorders

Awareness and recognition of individuals displaying signs of mental disorders/illnesses

WHAT IS MENTAL ILLNESS?

It is difficult to determine what mental health is, but specialists have been able to determine that "...mentally healthy people have the following characteristics: a positive attitude toward self, an accurate perception of reality, a mastery of the environment, autonomy, personality balance, and growth and self-actualization" (Cavanaugh & Blanchard-Fields, 2015). In determining the mental health status of individuals, these characteristics are evaluated (Cavanaugh & Blanchard-Fields, 2015). Questionable behaviors that could indicate mental disorder or psychopathology include: "...behaviors that are harmful to individuals or others, lowers well-being, and perceived as distressing, disrupting, abnormal, or manipulative" (Cavanaugh & Blanchard-Fields, 2015). Mental disorders are easier to identify in younger to middle aged individuals. Identification and recognition of mental disorders become more difficult in older adults; this is because what is "abnormal" behavior in a younger individual may just be an adaptive behavior for geriatric individuals (Cavanaugh & Blanchard-Fields, 2015). Some of these abnormal behaviors that could be identified involve loneliness, passiveness, and aggressiveness toward others (Cavanaugh & Blanchard-Fields, 2015). Most mental health disorders have been born in adolescence-speaking in terms of brain development (Jones, 2013).


TYPES OF MENTAL HEALTH DISORDERS

  • Depressive & Mood Disorders: Major depressive disorders is a common and serious mental illness that negatively affects how you feel, the way you think, and how you act. Depression causes lack of interest in activities, feelings of severe sadness, no desire to engage with others, and can start to affect relationships, work, hygiene, and overall well-being (American Psychiatric Association, 2022).


  • Generalized Anxiety Disorder: Although nervousness and anxiousness are normal to some extent, generalized anxiety disorders are excess feelings of fear and/or anxiety. This “fight or flight” sensation of worry and dread regularly presents itself in individuals suffering with anxiety so severe that it could potentially affect job performance , relationships, sleep, eating and general self-care (APA, 2022).


  • Schizophrenia: a chronic brain disorder with symptoms that include delusions, hallucinations, disorganized speech, trouble with thinking, and lack of motivation. These symptoms can be so severe that performing daily tasks could be impossible (APA, 2022).


  • Panic Disorders: Individuals suffering with panic disorders have frequent and unexpected panic attacks that can be characterized by a sudden wave of fear, discomfort, or loss of control even without a trigger (National Institute of Mental Health, 2022).


  • Post Traumatic Stress Disorder: PTSD is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event. Some of these events could include surviving a natural disaster, a serious car accident, sexual assault, abusive childhoods, or war (APA, 2022).



WHY IS ASSESSMENT IMPORTANT?

Assessment provides opportunity to describe the behavior or characteristics of people in ways that are meaningful; "assessment is a formal process of measuring, understanding, and predicting behavior" (Cavanaugh & Blanchard-Fields, 2015). Thorough examination is vital to determine the mental health status of an individual; comprehension of medical, psychological, and sociocultural information in a variety of ways. Some ways this can be performed are through observation and documentation, intelligence tests, neuropsychological examinations, clinical interviews and mental status exams (Cavanaugh & Blanchard-Fields, 2015). Bias is something to be aware of; all too often sensory problems, mobility problems, language barriers and/environmental conditions could lead to a misdiagnosis (Cavanaugh & Blanchard-Fields, 2015).


ASSESSMENT METHODS: 

Clinical Interviews: Clinical interviews are the most common method used in data collection because it provides a direct and emotional response from the patient. This method is used to obtain historical information, to determine appropriate follow-up procedures, to build rapport with the patient, to obtain client’s informed consent to participate, and to evaluate the effects of the treatment to continue to make adjustments if necessary (ATI, 2022).


Psycho-physiological Assessment: Psycho-physiological assessments examine relations between physical and psychological functioning. Heart rate, brain wave activity (measured with EEG), muscle activity, and skin temperature all help determine answers for mental health screenings.

Self-reporting: Self-reporting involves the patient telling from first person what they feel and what they think it could be. The problem with this method is that the reliability and validity may be compromised due to inability to properly measure.


Family/Friend Interviews: Interviews with loved ones is an excellent source of information that involves the individual and it truly provides a unique perspective and insight


Observation: Naturalistic observation


​Performance-Based Assessment​: Performance-based assessments involves individuals performing a task and monitored on performance

MENTAL HEALTH TREATMENT

Medical Treatment

There are various types of medications used to help combat the symptoms and effects of mental health disorders. Depending on the desired result, Serotonin Re-uptake Inhibitors, mood stabilizers, or benzodiazepines could be administered for medical treatment.


Psychotherapy

Therapy is always a solution when discussing mental health, mental well-being and mental disorders. Psychotherapy is a type of therapy that involves the patient speaking with a professional with a desire to find the root of the problem.

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DEPRESSION & MOOD DISORDERS

WHAT IS DEPRESSION?

Depression is a mood disorder that puts the individual at a higher potential risk for suicide, substance use disorders, or anxiety disorders (ATI, 2020). 

SIGNS OF DEPRESSION

  • Regularly has Depressed Mood

  • Difficulty/Excessive Sleeping

  • Indecisiveness

  • Decreased Ability to concentrate

  • Suicidal idealization

  • Increase/decrease in motor activity

  • Inability to feel pleasure

  • Significant weight loss/gain

Unlike schizophrenia, depression and anxiety are well-known prior to puberty (Jones, 2013). It is an unfortunate statistic that, "...mood disorders underlie 50-70% of all suicides..." while "23% of depressed patients report health difficulties severe enough to keep them bedridden" (Reddy, 2010). Also according to Reddy, depression is more commonly associated in occupational and interpersonal functioning in comparison to other medical illnesses (Reddy, 2010).

PROMINENT FEATURES OF CLINICAL DEPRESSION:

  • dysphoria: feeling down or blue

  • physical symptoms

  • duration of symptoms

  • identify other causes of observed symptoms and rule them out as the source

  • symptoms affect daily life

TREATMENT:

  • Behavior therapy: attempts to alter current behavior without necessarily addressing underlying causes

  • cognitive behavior therapy: attempt to alter the ways people think

Depression can be alleviated and the earlier signs of depression are noticed, the more likely the outcome could be positive (Reddy, 2010). 

CAUSES OF DEPRESSION:

  • genetic predisposition

  • stressful life events

  • presence of medical illness

  • substance use disorders

  • postpartum period

  • brain changes

  • changes/imbalance in neurotransmitters

    • low levels of serotonin

      • high levels of stress experienced over a long period of time​

      • difficulty concentrating

      • feeling tired

      • racing of the mind with strong feelings of guilt

      • reliving past bad experiences

      • creating negative thought

    • low levels of norepinephrine: regulation of arousal and alertness

      • feelings of fatigue

WHY YOUR HELP MATTERS

  • "Less than 25% of those affected (in some estimates less than 10%) by depression receive treatment. Barriers to effective care include the lack of resources, lack of trained providers, and the stigma" (Reddy, 2010).

  • "Despite the fact that many patients with depressive disorders seek help in primary care, general practitioners have difficulties in diagnosing and treating depression" (Reddy, 2010).

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Mental Health Awareness

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GENERALIZED ANXIETY DISORDER

WHAT IS GENERALIZED ANXIETY DISORDER?

"Generalized anxiety disorder (GAD) usually involves a persistent feeling of anxiety or dread, which can interfere with daily life" (National Institute of Mental Health, 2021). Symptoms can interfere with relationships, employment, and schoolwork (National Institute of Mental Health, 2021). Generalized Anxiety Disorder is excessive and uncontrollable worry that can cause impairment in functioning (Williams, 2020).

SIGNS & SYMPTOMS OF GENERALIZED ANXIETY DISORDER (GAD):

  • Feelings of restlessness or being on-edge

  • Fatigue

  • Difficulty concentrating

  • irritable

  • headaches, muscle aches, stomachaches, or other pains

  • Difficulty controlling feelings of worry

  • insomnia, problems falling and/or staying asleep

  • Restlessness

  • Muscle tension

  • Avoidance of stressful activities or evens

  • Increased time and effort require to prepare for stressful activities

  • Procrastination in decision making

  • Sleep disturbance

RISK FACTORS FOR  DEVELOPING ANXIETY DISORDERS:

  • childhood shyness in regards to being put into new situations

  • exposure to negative or traumatic life events/situations

  • genetic history of anxiety disorders

STRESSORS FOR ANXIETY:

  • health conditions

  • caffeine consumption

  • new/uncomfortable situations

TREATMENT:

Medications

Antidepressants​

  • may help improve the way your brain uses certain chemicals that control mood 

  • because the medication takes weeks to start working, it is common for consumers to get discouraged if there is no noticeable change, but full effectiveness takes time

  • withdrawal symptoms can occur, so if the medication is no longer wanted a gradual decrease in consumption is necessary for withdrawal prevention

  • all medications should be monitored, observed and changed if necessary

Anti-anxiety medication (Benzodiazepines: short term use; Buspirone: taken for long-term treatment of anxiety)

  • reduce the symptoms of anxiety, panic attacks, or extreme fear and worry

  • take effect more quickly than antidepressant medications

  • medications can be addictive & a tolerance can be created

  • if the benzodiazepine is stopped abruptly, withdrawal symptoms can occur- it is best to taper of the medication by gradually decreasing intake

Beta-blockers

  • help relieve the physical symptoms of anxiety, such as rapid heartbeat, shaking, trembling, and blushing

Antihistamines

  • decrease the sensation of anxiety

Anticonvulsants

  • these medications are typically used as mood stabilizers for individuals experiencing anxiety

  • Psychotherapy: Talk Therapy

    • cognitive behavioral therapy​

    • behavioral therapy

    • acceptance and commitment therapy

  • Support Groups

    • self-help literature​

    • online support groups

    • sharing of achievements, goals, and experiences 

  • Natural Techniques

    • check vitamin levels​

    • natural sunlight

    • regular exercise

    • meditation

    • elimination of caffeine consumption

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SCHIZOPHRENIA

WHAT IS SCHIZOPHRENIA?

Schizophrenia is a psychotic developmental disorder that effects an individuals thinking, behavior, emotions, and ability to perceive reality (ATI, 2020). Although, signs usually show from teenage years to mid 20's, schizophrenia has also been seen in younger children and well as developed later in some adults (ATI, 2020). Areas of the individuals function will begin to show signs of decline; some of these include school or work, self-care and interpersonal relationships (ATI, 2020).

SYMPTOMS

“Schizophrenia is characterized by positive and negative symptoms that can influence a patient’s thoughts, perceptions, speech, affect, and behaviors” (Schultz, et al., 2007). 

Positive Symptoms

Positive symptoms of a schizophrenic include all manifestations of symptoms that were not previously present (ATI, 2020).

  • Hallucinations

  • Delusions: alterations in thought

  • Alterations in speech

  • Bizarre behavior

  • Hearing voices that converse about the individual

  • Feelings of severe paranoia

Negative Symptoms:

​Negative symptoms of a schizophrenic involve the absence of things that were already present; negative symptoms are more difficult to treat (ATI, 2020). 

  • Affect: flattened affect: narrow range of expression

  • Alogia: lacking in thought and speech even among loved ones; social withdrawal

  • Anergia: little to no stamina

  • Anhedonia: loss of sense of pleasure and joy; indifferent attitude toward things that once made that individual happy

  • Avolition: loss of will; personal hygiene and activities begin to suffer with no motivation or drive to do so

SIGNS

  • disordered thinking

  • impaired abstract thinking

  • short-term memory loss

  • diffiulty concentrating/sense of distraction

  • inability to make decisions

  • poor problem-solving skill

  • sense of hopelessness

  • suicidal ideation

  • unsable mood

WHAT CAUSES SCHIZOPHRENIA?

According to The Finnish Adoptive Family Study of Schizophrenia, Genetic history of schizophrenia is the most significant risk factor for possessing the illness (Schultz, et al., 2007).


TREATMENT:

“Family physicians can play an important role in the effective treatment of schizophrenia; they are in a position to recognize the early signs of illness, make referrals to appropriate mental health professionals, help patients and their families cope with the devastating effects of schizophrenia and encourage a multidisciplinary approach to address all dimensions of the illness” (Schultz, et al., 2007).

Medications

“Medications can control symptoms, but virtually all antipsychotics have neurological or physical side effects…” (Schultz, et al., 2007).

Conventional anti-psychotics: used to treat positive schizophrenic symptoms

Atypical anti-psychotics: generally treat both positive and negative symptoms

Third-generation anti-psychotics: treatment of both positive and negative symptoms while improving cognitive function of the individual

Anti-depressants: treatment of depression involved with schizophrenia

POSSIBLE OUTCOMES:

  • Implementation of psycho-social rehabilitative interventions that could improve the individuals overall quality of life (Schultz, et al., 2007).

  • "Suicide also is a common cause of death in patients with schizophrenia...suicide is strongly associated with depression, previous suicide attempts, drug abuse, agitation or motor restlessness, fear of mental disintegration, poor adherence to treatment, and recent loss" (Schultz, et al., 2007).

  • A common outcome for those suffering with schizophrenia is anti-psychotic drug overdose either accidental or with intent (Schultz, et al., 2007).

  • patient care, education and treatment should be considered priority importance

  • information regarding ceased use of medications should be taught to the individuals consuming the medication

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POST-TRAUMATIC STRESS DISORDERS

WHAT IS POST-TRAUMATIC STRESS DISORDER?

Also abbreviated to P.T.S.D., Post-traumatic stress disorder is the manifestations of anxiety, detachment, panic and more as a result from being exposed to a traumatic event (ATI, 2020).

PREVENTION

Post traumatic event, health promotion is vital in P.T.S.D. prevention (ATI, 2020).

  • be aware of needs for water, rest and nutrition

  • provide emotional support

  • encourage staff to support each other

  • debrief on the situation to better improve possible future situations

  • encourage expression of feelings, emotions, and thoughts

  • suggest use of counseling sources available

RISK FACTORS

  • exposure to a traumatic event or experience

  • exposure to trauma experienced during a natural disaster

  • exposure or repeated exposure to trauma in an occupational setting

  • living through a traumatic event experienced by a loved one


Medications:

  • antidepressants

  • SSRI's

  • beta adrenergic blocker

Therapeutic Procedures:

  • cognitive-behavioral therapy

  • prolonged exposure therapy

  • psycho-dynamic psychotherapy

  • eye movement desenitization and reprocessing (EMDR)

  • group therapy

  • crisis intervention

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