Overview of Mental Health and Addiction Disorders

Thanks to John Mogk, M.A.

Clinical Coordinator

Maple Ridge Treatment Centre for original version of this power point.

Major Mental Health Problems Psychosis Mood Anxiety Personality Addiction Eating Disorders

Psychosis, disturbance of thinking Hallucinations Delusions Disorganized

Behaviors Thinking Speech (incoherence) Movement - Catatonia

Pathways to Psychosis Mental Illness

Schizophrenia, Schizoaffective Disorder Bipolar Mania, Severe depression Paranoid and Borderline Personality Disorders

Substances e.g. Stimulants, Cannabis

Brain Injuries / Medical Disease e.g. Alzheimer's

Treatment of Psychosis Medication Skill Building

Social Activities of Daily Living Medication Compliance Occupational Relapse prevention / Stress Management

Mood Disorders Depression Mania Bipolar I & II

Depression Low mood Anhedonia - lack of pleasure Unintentional Weight Change Insomnia or Hypersomnia Psychomotor Agitation or Retardation Fatigue or Loss of Energy Worthlessness or Guilty Thinking problems Morbid thoughts

Depression Is very common component of substance use and

withdrawal, particularly alcohol, benzodiazepines, opioids, steroids and stimulants.

Typically takes 4-8 weeks of clean time before substance-induced depression can be ruled out

Older adults who abuse substances usually have mood disorders

Depressed persons have some preference for stimulants and alcohol

Mania Grandiosity Decreased need for sleep Talkative or fast talking Flight of ideas Distractible Increased activity or psychomotor agitation Excessive pleasure seeking Can be brought on by stimulant use or depressant

withdrawal

Bipolar I and II Both require having had at least a 2 week

episode of depression and a one week episode of mania (I) 4 days of hypomania (II)

Continuum of depression DepressionNormal

Sadness/

Grieving/Blues

Depression

BipolarManic

Normal

Depressed

Treatment of Mood Disorders Medications Psychotherapy Occupational Therapy Exercise

Anxiety Disorders Panic Disorder Generalized Anxiety Disorder Social Anxiety Disorder Phobias Post Traumatic Stress Disorder Obsessive-Compulsive Disorder

Anxiety Disorders Anxiety is the most common symptom of substance

abusers and is now considered to be a cause of anxiety disorders much more often than as a self-medicating for underlying anxiety disorder

Using chemicals ( benzodiazepines, cannabis) to cope with anxiety can weaken ability to use healthy mechanisms and create avoidance tendencies

Anxiety can be resolved in addiction treatment

Panic Attacks A discreet period (< 30minutes) reaching a peak within 10

minutes with 4 or more of … Palpitations, pounding heart, or fast heart rate Sweating Trembling or shaking Shortness of breath or feeling smothered Feelings of choking Chest pain Nausea Feeling dizzy, light-headed, faint, or unsteady Derealization or depersonalization Fear of losing control / going crazy Numbness Chills or hot flashes

Post-Traumatic Stress Disorder 1. Person exposed to trauma 2. Event is persistently recurrently experienced

Intrusive memories of event Dreams of the event Feeling as if they are reliving the event As intense distress or physiological reactivity when exposed

to cues that resemble or symbolize the event 3. Avoidance of stimuli and numbing responsiveness 4. Persistent symptoms of increased arousal

Anxiety Treatment Medications preferably very short-term Cognitive Behaviour Therapy Trauma therapies to reprocess memories

Personality Disorders (most commonly disabling)

Borderline Personality Disorder Antisocial Personality Disorder Avoidant Personality Disorder Dependent Personality Disorder Obsessive Compulsive Personality Disorder

Therapy for Personality Disorder Medications for symptom management Psychotherapy Dialectical Behavioral Therapy and other

newly developed therapy for persons with personality disorders

Psycho-social Rehabilitation (skill building)

Addictions Alcohol, Heroin and other Opiate use

frequently causes symptoms of depression and sometimes depressive illness.

Alcohol, Benzodiazepines, and cannabis often create anxiety disorders by allowing avoidance of anxiety provoking stimuli

Cocaine addiction can resemble or create bipolar mood swings

Addiction Therapies Detox Outpatient Inpatient Residential Support Recovery, Longer Term Residential Self - Help

Eating Disorders Anorexia Nervosa Bulimia Nervosa Eating Disorders NOS

Anorexia Nervosa Refusal to maintain normal body weight for

age & height Intense fear of weight gain Disturbance in self-evaluation of body shape

and size, denial of serious of underweight Amenorrhea in postmenstrual women

Bulimia Nervosa Recurrent binge eating episodes Recurrent purging to avoid weight gain Binge eating and purging occur on average, at

least twice a week for 3 months Self-evaluation influenced by body shape and

weight

Treatment of Eating Disorders Medical stabilization Medication Individual therapy using several models - Readiness

and Motivation Therapy ( RMT) Cognitive Behavioural Therapy (CBT) and Dialectical Behavioural Therapy (DBT); Understanding Feminist theory and role of media; skill building

Family Therapy- several models are being researched

Nutrition Education Team approach

Recovery is Possible, Help is available Mission Mental Health Centre Fraserhouse Mission Indian Friendship Centre