Mental wellbeing + Phobias + Maintenance of wellbeing

Mental Wellbeing

An individual's state of mind, enjoyment of life, and ability to cope with the normal stresses of everyday life and develop to their potential.

Factors of Mental Wellbeing

- internal factors
- external factors
- biological factors
- psychological factors
- social factors

Levels of Functioning

Refers to how well an individual performs or operates in their environment.

Resilience

The ability to successfully cope with and manage change and uncertainty.

Characteristics of Resilience

- self-efficacy
- high self-esteem
- staying optimistic and hopeful
- being adaptable and flexible
- being organised
- having problem-solving skills
- having the ability to make realistic plans and carry them out

Social and Emotional Wellbeing (SEWB)

Used by Aboriginal and Torres Strait Islander people to describe the physical, social, emotional, spiritual and cultural wellbeing of a person.

Seven Domains of SEWB

- connection to body and behaviours
- connection to mind and emotions
- connection to family and kinships
- connection to community
- connection to culture
- connection to country
- connection to spirit, spirituality and ancestors

Mental Wellbeing as a Continuum

- mentally healthy
- mental health problems
- mental disorders (illnesses)

Mentally Healthy Characteristics

- psychological wellbeing
- able to cope with normal stressors
- able to form positive relationships
- able to manage feelings and emotions
- few sleep difficulties
- physically and socially active

Mental Health Problems

- mild to moderate stress
- temporary impairment
- difficulties in coping
- some changes in sleep patterns
- some changes in appetite
- experience a loss of energy
- difficulty concentrating

Mental Disorders

- psychological dysfunction
- marked distress
- ongoing impairment
- excessive anxiety
- significant changes in sleep patterns and appetite
- withdrawal and avoidance from social functions

Stress

A psychobiological response produced by internal or external stressors.

Anxiety

A state involving feelings of apprehension or uneasiness that something is wrong or something unpleasant is about to happen.

Phobia

Persistent and irrational fear of a particular object, activity or situation causing active avoidance and marked distress.

Phobic Stimulus

A specific object or situation producing the fear associated with a phobia.

Characteristics of Stress

- normal to experience in certain situations
- can contribute to mental health disorders if not managed
- can impact functioning if not managed
- involves physiological responses (fight flight freeze)
- associated with avoidance of certain objects or scenarios
- source of stress is usually known

Characteristics of Anxiety

- normal to experience in certain situations
- can contribute to mental health disorders if not managed
- can impact functioning if not managed
- involves physiological responses (fight flight freeze)
- associated with avoidance of certain objects or scenarios
- source of anxiety is not always apparent

Characteristics of Phobias

- not considered normal
- diagnosable mental health disorder
- significantly impacts functioning
- not adaptive or helpful
- involves physiological responses (fight flight freeze) only towards phobic stimulus
- avoidance of certain objects or situations
- source of phobia usually known

Biopsychosocial Framework to Explain Specific Phobias

Involves biological, psychological and social factors that influence phobias.

Contributing Biological Factors for Phobias

- GABA dysfunction
- long-term potentiation

GABA Dysfunction

- GABA acts like a calming agent to excitatory neurotransmitters that lead to feelings of anxiety
- people with specific phobias are likely to have a lower GABA level
- people with low levels of GABA are more vulnerable to anxiety so their FFF response is more easily triggered by the phobia stimulus

Long-Term Potentiation

- this neurologically strengthens associations between phobic stimuli and a fear/anxiety response through its activity at the synapse
- LTP increases efficiency in transferring fear info along pathway and decreases likelihood for forgetting

Interventions for Biological Factors

- GABA agonists
- breathing retraining

GABA Agonists

Drugs that act on GABA receptors to increase GABA's inhibitory effects, making post-synaptic neurons resistant to excitation.
- slows down CNS activity, relieving anxiety by reducing physiological arousal and promoting relaxation.
- short-acting

Breathing Retraining

Anxiety-management technique that involves teaching correct breathing habits to people with specific phobias.
- helps correct breathing patterns when anticipating or exposed to phobic stimulus to relieve anxiety
- slower respiration rate inhibits fight or flight reaction and returns body to normal state of functioning after activation

Contributing Psychological Factors for Phobias

- precipitation by classical conditioning
- perpetuating by operant conditioning
- cognitive bias (memory bias and catastrophic thinking)

Precipitation by Classical Conditioning

Before Conditioning: NS leads to no relevant response. UCS leads to UCR.
During Conditioning: NS is repeatedly paired with UCS, leading to UCR.
After Conditioning: CS leads to CR.

Perpetuating by Operant Conditioning (Example)

Antecedent: Encounters a spider
Behaviour: Leaves the room
Consequence: Safe from spider (negative reinforcement) and so is less likely to repeat this behaviour.

Cognitive Bias

The tendency to think in a way that involves errors of judgment and faulty decision-making. Two types of cognitive bias are memory bias and catastrophic thinking.

Memory Bias

Distorting influences of present knowledge, beliefs and feelings on the recollection of previous experiences. Often results in 'selective memory'.

Catastrophic Thinking

A thinking style which involves overestimating, exaggerating or magnifying an object or situation and predicting the worst possible outcome.

Interventions for Psychological Factors

- cognitive behaviour therapy (CBT)
- systematic desensitisation

Cognitive Behaviour Therapy

Combines cognitive and behaviour therapies to help manage a mental health problem or disorder.

Cognitive Therapy

Cognitive therapy deals with maladaptive beliefs and thoughts.

Behavioural Therapy

Behavioural therapy deals directly with maladaptive behaviours.

Systemic Desensitisation

Aims to replace an anxiety response with a relaxation response when an individual with a specific phobia encounters a fear stimulus.

Systemic Desensitisation Steps

1. learn relaxation technique to decrease physiological symptoms of anxiety when confronted by phobia stimulus
2. create a fear hierarchy - ranked from least to most anxiety producing
3. systemic, graduated pairing hierarchy items with relaxation for working upwards, one 'step' at a time
4. at every step, individual is encouraged to relax and no advancement is made until relaxation is achieved

Contributing Social Factors for Phobias

- specific environmental triggers
- stigma around seeking treatment

Specific Environment Triggers

A direct, negative and traumatic experience with a particular phobic stimulus in the past.

Stigma Around Seeking Treatment

Individuals with a phobia are particularly vulnerable to experiencing stigma, which affects their willingness to tell family and friends, let alone to seek treatment from a professional.

Interventions for Social Factors

- psychoeducation for families/supporters

Psychoeducation for Families/Supporters

Involves the provision and explanation of info about a MHD to individuals diagnosed with the MHD to increase knowledge and understanding of disorder and its treatment.

Psychoeducation involves:

- challenging unrealistic thoughts or behaviour
- not encouraging avoidance behaviour

Challenging Unrealistic Thoughts or Behaviour

Families and supporters can help a person to cope with or overcome a phobia by encouraging them to recognise and challenge unrealistic or anxious thoughts.

Not Encouraging Avoidance Behaviour

Family and supporters learn about the importance of gently and calmly encouraging and supporting individual not to engage in avoidance behaviour, possibly also challenging the behaviour.

Biological Protective Factors

- adequate diet and hydration
- adequate sleep

Adequate Diet and Hydration

Having adequate nutritional intake and hydration means eating a good amount of a variety of different foods and ensuring we drink enough water to maintain good physical health and feel mentally well as a result.

Adequate Sleep

Adequate sleep helps us think and perform better as well as enhance our enjoyment of life. Poor sleep can adversely affect mental health by impairing functioning, affecting wellbeing

Psychological Protective Factors

- cognitive behavioural strategies
- mindfulness meditation

Cognitive Behavioural Strategies

Techniques drawn from cognitive behavioural therapy (CBT) to identify, assess and correct faulty patterns of thinking and problem behaviours that may be threatening or adversely affecting mental wellbeing.

Cognitive Restructuring/Reframing

The process of identifying, challenging, and modifying or replacing negative, irrational thoughts (or cognitive distortions) with more reasonable, helpful ways of thinking.

Behaviour Activation

Identifying and scheduling activities that promote enjoyment or reduce stress.

Behaviour Activation Steps

- monitor current activities and rate them from a scale of 1-10
- list activities associated with enjoyment
- plan to do enjoyable activities
- complete planned activities
- evaluate the schedule

Mindfulness Meditation

A type of meditation in which a person focuses attention on their breathing, whilst thoughts, feelings, and sensations are experienced freely as they arise.

Types of Cognitive Behavioural Strategies

- cognitive restructuring
- behaviour activation

Social Protective Factors

- support from family, friends and community

Social Support

People who have and seek support from others tend to be more mentally and physically healthy. Supportive interactions also strengthen our relationships, meaning we can use support to shore up our social connections for when we need help down the track.

How to provide more effective social support

- validate first, reframe second
- avoid downward spirals
- be authentic and energising
- listen well
- be responsive, not dismissive

Culture

Refers to the way of life of a particular group, society or community that sets its apart from other groups, communities and societies.

Cultural Determinants

Protective factors that help maintain strong connections to culture, strengthen cultural identity, enhance resilience and contribute to the maintenance of good mental wellbeing.

Protective Factors for Culture

- cultural continuity
- self-determination
- connection to country
- language
- family, kinship and community
- cultural expression
- cultural beliefs
- knowledge

Cultural Continuity

The preservation of Aboriginal and Torres Strait Islander peoples' culture over time, and the sense of history, identity and belonging this provides.

Self-Determination

The right to freely determine or control their political status and freely pursue their cultural, social and economic development.