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Week 4- Psychological Disorders
Individual Determinants Of Health (PHE1IDH)
La Trobe University
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Psychological Disorders Learning objectives – by the end of this topic, you should be able to: • Describe the epidemiology of mental health conditions in Australia; • Identify signs that clients may be experiencing problems with mental health; and • Apply knowledge of mental health to better understand how people present and interact in health and human service settings Health→ State of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity Mental health→ A state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to contribute to her or his community (WHO- Work Health Organisation, 2014) - Therefore, good mental health means overall state of wellbeing Mental illness→ Refers to clinically diagnosable disorder(s) which interferes with an individual’s cognitive, emotion, or social abilities - Includes wide range of conditions that affects how we feel and think - Usually first experienced in late teens or early twenties - Can arise from interaction of genetic vulnerability and stresses in life - More than 300 mental disorders. Main groups: mood disorders (depression, bipolar disorder), anxiety disorder (social anxiety disorder), personality disorder (borderline/narcissistic personality disorder), psychotic disorder (schizophrenia), eating disorder (anorexia nervosa) and substance abuse disorder. Anxiety - When anxious feelings don’t subside. Feeling of worry are ongoing and exist without any reason or cause. - Significantly impacts on a person’s ability to cope with daily life - Normal to feel anxious from time to time (e. meeting work deadlines, sitting exams, speaking in front of a group of people) BUT if a person experiences anxiety, these feelings cannot be easily controlled. Main types of anxiety conditions: - Generalised anxiety disorder (GAD), Specific phobias, Obsessive compulsive disorder (OCD), Post-traumatic stress disorder (PTSD), Panic disorder, social phobia Common Symptoms of Anxiety Thoughts -‘I’m going crazy’’ -‘’I can’t control myself’’ -‘’I’m about to die’’ -People are judging me’’ -Upsetting dreams of flashbacks of a traumatic event -Find it hard to stop worrying -Unwanted or intrusive thoughts Behavioural -Withdraw from or avoiding fear objects or situations that cause anxiety -Urges to perform certain rituals to try and relieve anxiety -Avoidance (of eye contact for eg) -Difficulty making decisions Being easily startled Psychological -Increase heart rate -Shortness of breath -Vomit, nausea -Stomach pain -Muscle tension, pain -Detached from physical self -Sweat, shake -Dizzy, lightheaded, faint -Numb, tingling -Hot or cold -Difficult [ ]ing Depression→ serious condition that impacts on both physical and mental health - Affects how people feel about themselves - May lose interest in things they enjoy - May lack energy, have difficulty sleeping or sleep more than usual - Feel irritable and hard to concentrate - More difficult to manage form day to day - If for more than two weeks, they feel sad, down or miserable most of the time or has lost interest or pleasure in most of his usual activities and show several signs and symptoms across at least three of the categories below then can be depressed. Common Symptoms of Depression Thoughts -‘’I’m a failure’’ -‘’It’s my fault’’ -‘’Nothing good every happens to me’’ -‘’I’m worthless’’ -‘’Life’s not worth living’’ -‘’People would be better off without me’’ Feelings Overwhelmed Guilty Irritable Frustrated Unconfident Unhappy Indecisive Disappointed Miserable Behavioural -Not going out anymore -Not getting things done at work/home -Withdraw from close family and friends -Alcohol -Unable to concentrate Psychological -Tired all the time -Sick and run down -Headaches, muscle pain, fatigue -Churning, upset stomach -Sleep difficulties -Loss or change of appetite -Significant weight loss or gain How are behaviour and mental health related? - Behaviour→ includes our reactions, the things we say, body language and gestures. - Can be affected by mental illness of other mental disorders→ may impact memory because feel overwhelmed (eg forget to check bus timetables, etc). - Behaviour of someone with a mental illness can often be misunderstood. Once such misconception is that ‘people with a mental illness are lazy and weak, if they tried hard enough, they could ‘snap’ out of it”→ can affect their response to treatment How can mental illness affect a person? - Individual with a mental illness may feel there is often an inherit fear about onset of next episode, confusion and irrational beliefs→ keep reassuring patient, or spend time asking them how they have been since last appointment so they can focus on current appointment - If mental illness is affected all aspect of their life, they may experience anger and bitterness. - Angry outbursts can also come due to delusions or hallucinations, inner frustration and conflict or inability to manage anger - Can be hypersensitive to criticism because they may feel others do not understand them or what they are going through. They may feel rejected from friends and relatives and isolate themselves. - May experience an overwhelming sense of despair, loss of interest, lack of energy or motivation NOTE: About 8 million people will experience a common mental disorder in their lifetime (16-85). (2016) Anxiety affects 2 million people in Australia Depression impacts 1/6 people at some stage of their life. Around 4 million people in Australia. Given that mental illness can directly impact on an individual’s identity, and ability to maintain social roles and relationships, an individual's environment and perceived social support can play a significant role in promoting well-being. Mental illness can directly impact on an individual's sense of identity, and social stigma associated with mental illness can significantly worsen symptoms. Symptoms associated with mental health conditions may also impact upon relationships with family, friends and significant others. Appropriate therapeutic responses, social support and feeling valued play significant roles in emotional and social wellbeing. General practitioners, mental health professionals and community workers offer a range of supports encompassing a biopsychosocial perspective. For example, Jason has a clinical diagnosis of depression, and he is living in a share house with several other people who regularly have friends over and noise can occur at all hours of the night. Jason finds that this can disrupt his sleep patterns which in turn can directly impact Jason’s energy levels, motivation and how he feels. This can further affect his ability to complete activities of daily living, such as working. Social support can take many forms, from service provision to direct assistance with daily living (such support services are provided by Mind in Victoria). Emotional support is also important. Having a friend who can listen empathically is a great support to mental, emotional and social wellbeing and if Jason had such a friend, this could greatly reduce the frequency and intensity of his symptoms. Working in areas of Health and Human Services, it is important to recognise that a lack of social support and feelings of loneliness can make people more vulnerable to mental health, e., depression. However, individuals may also avoid social situations when they’re experiencing mental health difficulties, which at times can make matters worse. As illustrated, supportive structures in the environment (access to services), feeling engaged in the community, healthy living conditions, satisfying work, and perceived social support all combine to promote good mental health and wellbeing. Please see below the Australian Institute of Health and Wellbeing Mental Health Services in brief 2018 Report, you are not required to read it from cover to cover however it has some very important information in it. Please see below for a question to trigger some discussion AIHW Mental Health Services in brief 2018 The mental health care needs of Australian are growing. According to the Mental Health Services Report (2018), what percentage of the total disease burden is mental and substance-use disorders responsible for in Australia? What activities of daily living may be directly impacted as a result of mental health disorder? Mental illness refers to a clinically diagnosable disorder(s) that significantly interferes with an individual’s cognitive, emotional, or social abilities (Slade et al 2009). The most recent statistics illustrate that, mental and substance use disorders are responsible for an estimated 12% of the total disease burden in Australia, making it the third highest group of diseases behind cancer and cardiovascular diseases. Mental illness can result in less effective functioning with activities associated with daily living. This can include (but is not limited to): • Decreased productive activities (work, school, caregiving) • Impact relationships and social engagements, e., withdrawing from close family and friends How can mental health impact a patient’s thoughts, feelings and behaviours in health and human services settings? You are an experienced prosthetist working in a multi-disciplinary rehabilitation centre. The centre specialises in customised prosthetic management of limb amputation from immediate post-operative care through to ongoing, long-term prosthetic management. You are presently working with Graeme, a 67-year-old man who had his right leg amputated due to complications with Type-2 diabetes. Two weeks ago you met Graeme for the initial examination of his residual limb (stump) and you formulated a prescription for the fabrication of a prosthesis. Today you are seeing him for a fitting where the prosthesis is constructed without a cosmetic covering. You notice that Graeme’s presentation has shifted since you saw him last. In the most recent appointment, he appeared frustrated, sad and irritable. Graeme lashed out at you when you asked him to take his first step in his prosthetic leg. His wife also mentioned that lately Graeme is lacking in energy, having difficulty sleeping and is expressing feelings of hopelessness with his current situation making comments such as “it’s all too hard” and “why has this happened to me”. Whilst it is not an prosthetist’s role to treat and manage a client’s mental health, what could you do to support Graeme during this consultation? How might Graeme’s current circumstances be contributing to his thoughts, feelings and behaviours? Having a conversation with Graeme about a referral to a mental health professional such as a GP would be appropriate in this instance. The experience of amputation could most certainly lead to feelings of shock, anger, frustration, sadness and grief/loss, particularly in the initial stages. Stress and worry levels are likely to have increased for Graeme, particularly in the context of him trialling his prosthesis for the first time, as well as the ongoing rehabilitation to walk unassisted. This is likely to be confronting and overwhelming for him, affecting his mood and presentation. CASE STUDIES: How can mental health impact a patient’s lifestyle choices and on the other hand, how might lifestyle choices effect a patient’s mental health? You are a nutritionist working in a holistic, multidisciplinary wellness centre. Your role is to provide one-on-one coaching sessions to assist patients through the process of creating a vision for their health and wellbeing, developing a healthy mindset, healthy habits and encouraging them to accomplish health goals. You are working with 39-year-old Sally who has clinical diagnoses of Generalised Anxiety Disorder (GAD) and Major Depressive Disorder (MDD). Sally’s worry and low mood makes it extremely difficult for her to engage in everyday activities such as work, caring for her children and socialising with friends. She often feels restless and on edge, she has difficulty concentrating and feels irritable all the time. She persistently has morbid thoughts, has lost interest and motivation in things she used to thoroughly enjoy and has started verbally lashing out at her husband and children. In addition to her mental health difficulties, Sally is overweight, has atherosclerosis and polycystic ovarian syndrome. In your first session, Sally discloses to you that she lives a sedentary lifestyle and consumes a high kilojoule diet consisting of mostly highly processed foods. Sally’s psychologist has recommend that she sees you to work on establishing health and wellbeing goals and develop more healthy eating habits and an exercise regime. How might Sally’s mental health conditions contribute to her current dietary choices? Likewise, how might her dietary choices and lifestyle be impacting her mental health? • An individual’s mental health can affect their food choices. And, on the flip side, their food choices can affect their mental health. • Some of the symptoms of depression and anxiety (low mood, irritability, lack of motivation and low energy levels) can have an impact on one’s capacity to make good nutritional choices. For Sally, her low motivation, a symptom of major depressive disorder, may limit her ability to attend the grocery store, purchase healthy produce and then prepare and cook it. Alternatively, Sally may opt for convenient, high caloric food such as takeaway as she can get this delivered to the home. • The foods an individual consumes along with their lifestyle choices can affect how they feel and in turn contribute negative to their mental health. Studies show that a diet higher in processed foods with excess salt, sugar and fat, can be more likely to lead to symptoms of depression and anxiety. • In view of all lifespan stages, eating a balanced diet (i. rich in vegetables and nutrients) may be associated with feelings of positive wellbeing. For example, research has illustrated high levels of wellbeing in individuals who eat more fruit and vegetables (Stranges, Samaraweera, Taggart, Kandala, & Stewart-Brown, 2014). In particular, a Mediterranean-style diet (a diet high in vegetables, fruits, legumes, nuts, beans, cereals, grains, fish, and unsaturated fats such as olive oil), supplemented with fish oil, led to a reduction in depression (Parletta, Zarnowiecki, Cho, Wilson, Bogomolova, Villani, Itsiopoulos, Niyonsenga, Blunden, Meyer, Segal, Baune, & O’Dea, 2017). • Given the potential correlation between diet and wellbeing highlights the importance of nutritional intake at an early age – creating healthy habits! In 2014, researchers found that a poor diet (with high levels of saturated fat, refined carbohydrates and processed food products) was linked to poorer mental health in children and adolescents
Week 4- Psychological Disorders
Course: Individual Determinants Of Health (PHE1IDH)
University: La Trobe University
