chapter 38 mental health disorders all items and derived items © 2015, 2011 by mosby, inc., an...

Chapter 38

Mental Health Disorders

All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Basic Concepts Mental relates to the mind.

Therefore mental health involves the mind. Mental health and mental illness involve

stress. Stress is the response or change in the body

caused by any emotional, physical, social, or economic factor.

Mental health means that the person copes with and adjusts to everyday stresses in ways accepted by society.

Mental disorder (mental illness, emotional illness, psychiatric disorder) is a disturbance in the ability to cope with or adjust to stress.

2All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Causes of Mental Health Disorders

Causes of mental health disorders include: Not being able to cope or adjust to stress Chemical imbalances Genetics Physical or biologic factors Psychological factors Drugs or substance abuse Social and cultural factors


Anxiety Disorders

Anxiety is a vague, uneasy feeling in response to stress. Often, anxiety occurs when needs are not met. Some anxiety is normal. Signs and symptoms depend on the degree of anxiety.

Anxiety level depends on the stressor. A stressor is the event or factor that causes stress.

Coping and defense mechanisms are used to relieve anxiety. Some are healthy.

Persons with mental health problems have higher than normal levels of anxiety.


Panic

Panic disorder Panic is an intense and sudden feeling of fear, anxiety,

terror, or dread. It is the highest level of anxiety. The onset of panic is sudden, with no obvious reason. Panic attacks can last for 10 minutes or longer. Signs and symptoms of anxiety are severe during a panic

attack. The person may also have: • Chest pain• Shortness of breath• Rapid heart rate; “heart pounding”• Numbness or tingling in the hands• Dizziness• A smothering sensation• Feeling of impending doom or loss of control

Panic disorder can last a few months or many years.


Phobia Phobias

Phobia means an intense fear, panic, or dread. The person has an intense fear of an object,

situation, or activity that has little or no actual danger.

Common phobias include fear of fire; water; strangers; spiders; night or darkness; the slightest uncleanliness; being in or being trapped in an enclosed or narrow space; being in pain or seeing others in pain; and being in an open, crowded, or public place.

The person avoids what is feared. When faced with the fear, the person has high anxiety and cannot function.


Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) An obsession is a recurrent, unwanted thought,

idea, or image. Compulsion is repeating an act over and over

again (a ritual). Common rituals are hand washing, constant

checking to make sure the stove is off, cleaning, counting things to a certain number, or touching things in a certain order.

Some persons with OCD also have depression, eating disorders, substance abuse, and other anxiety disorders.


Post-Traumatic Stress

Post-traumatic stress disorder Post-traumatic stress disorder (PTSD) occurs after a

terrifying ordeal involving physical harm or the threat of physical harm.

Most people with PTSD have flashbacks. A flashback is reliving the trauma in thoughts during the day

and in nightmares during sleep.• Flashbacks may involve images, sounds, smells, or feelings.• Everyday things can trigger flashbacks.• During a flashback, the person may lose touch with reality.• The person may believe the trauma is happening all over again.

Signs and symptoms may develop a few months after the harmful event, or not until years later.

The person may also suffer from depression, substance abuse, and other anxiety disorders.


Schizophrenia Schizophrenia means split mind.

It is a severe, chronic, disabling brain disorder. Schizophrenia involves:

Psychosis—a state of severe mental impairment Delusion—a false belief Hallucination—seeing, hearing, smelling, or

feeling something that is not real Paranoia—a mind disorder of false beliefs Delusion of grandeur—an exaggerated belief of

one’s importance, wealth, power, or talents Delusion of persecution—the false belief that

one is being mistreated, abused, or harassed


Schizophrenia (Cont’d)

The person with schizophrenia: Has severe mental impairment (psychosis) Has disturbed thinking and behavior Has delusions and/or hallucinations May be paranoid May have difficulty organizing thoughts Disorders of movement occur. Some persons withdraw or regress.

In men, the symptoms usually begin in the late teens or early 20s.

In women, symptoms usually begin in the mid-20s and early 30s.


Schizophrenia (Cont’d)

People with schizophrenia do not tend to be violent.

Some persons with schizophrenia attempt suicide.

If a person talks about or tries to commit suicide: Call for the nurse at once. Do not leave the person alone.


Mood Disorders

Mood or affect relates to feelings and emotions. The person with bipolar disorder has severe

extremes in mood, energy, and ability to function. There are emotional lows and emotional highs (depression

and mania). The disorder also is called manic-depressive illness.

The person may:• Be more depressed than manic

• Be more manic than depressed

• Alternate between depression and mania Become suicidal If a person talks about or tries to commit suicide:

• Call for the nurse at once.

• Do not leave the person alone.


Depression

Major depression Depression involves the body, mood, and thoughts. Symptoms affect work, study, sleep, eating, and other

activities. The person is very sad and loses interest in daily activities. Stressful events and some physical disorders can cause

depression. Depression is common in older persons. Depression in older persons:

• Is often overlooked or a wrong diagnosis is made

• Is often thought to be a cognitive disorder

• Is often not treated


Personality Disorders

Personality disorders involve rigid and maladaptive behaviors.

Those with personality disorders cannot function well in society.

Personality disorders include: Antisocial personality disorder—a chronic disorder in

which the person’s thinking and behaviors show no regard for right or wrong

Borderline personality disorder (BPD)—a chronic disorder in which the person has problems with moods, relationships, self-image, and behavior.


Substance Abuse and Addiction

Substance abuse or addiction occurs when a person overuses or depends on alcohol or drugs. The person’s physical and mental health are

affected. The welfare of others is affected. Substances involved in abuse and addition affect

the nervous system, the mind, and thinking.


Alcohol Abuse

Alcoholism and alcohol abuse Alcoholism is a chronic disease, lasting throughout life. Over time, heavy drinking damages the body’s organs. Life-style and genetics are risk factors. Some people turn to alcohol for relief from life stresses. The craving for alcohol can be as strong as the need for

food or water. There is no cure. Alcoholism (alcohol dependence) can be treated. Alcohol’s effects vary with age; older persons have a lower

tolerance. Mixing alcohol with some drugs can be harmful, even fatal. Alcohol makes some health problems worse.


Drug Abuse

Drug abuse and addiction Drug abuse is the over-use of a drug for non-

medical or non-therapy effects. Drugs interfere with normal brain (mental) function

and social function. Drug addiction is a chronic, relapsing brain

disease. Physical effects can occur from one use, high

doses, or prolonged use.


Drug Abuse (Cont’d)

Legal and illegal drugs are abused. Withdrawal syndrome is the person’s physical and

mental response after stopping or severely reducing the use of the substance that had been used regularly.

Treatment depends on the type of drug and the person.

Treatment is a long-term process.


Suicide

Suicide means to kill oneself. Suicide is most often linked to:

Depression and other mental health disorders Alcohol or substance abuse Stressful events such as separation or divorce

If a person mentions or talks about suicide: Take the person seriously. Call for the nurse at once. Do not leave the person alone.


Care and Treatment

Treatment of mental health problems involves having the person explore his or her thoughts and feelings through various therapies.

The needs of the total person must be met, including physical, safety, security, and emotional needs.

Often, medications are ordered. The care plan reflects the person’s needs. Communication is important. You must take responsibility for your safety.


Quality of Life

Persons with mental health problems have the right to quality of life. They have the same rights as other residents. People do not choose to have physical or mental health

problems. Persons with mental health problems deserve the same

dignity and respect given to persons with physical illnesses. Protect the right to privacy and confidentiality. Protect the right to personal choice. Protect the person from abuse, mistreatment, and

neglect. Provide a safe setting.


chapter 38 mental health disorders all items and derived items © 2015, 2011 by mosby, inc., an...

Documents

derived items

mental disorder mental

symptoms of anxiety

anxiety level

mental health problems

anxiety disordersanxiety

degree of anxiety

high anxiety