MENTAL WELLBEING

Mental wellbeing

psychological state, ability to think, process info and regulate emotion.

low levels of mental wellbeing (disorder)

significant and ongoing negative impacts on mental wellbeing
cant function adequately
· emotional distress

moderate levels of mental wellbeing (mental health problems)

temporary negative impacts on mental wellbeing
· not functioning at optimal level
· amplified emotions
· thinking may be less logical, issues with concentration

high levels of wellbeing (mentally well)

· high functioning, effectively managing demands of life
· healthy inter-personal relationshops
· appropriate emotional expression and regulation
· logical thinking

factors influencing well being- internal

biological and psycological

biolgical internal

· genes, gender, substances

psychological interna;

decision making, personality, coping

social external factors

· Level of education/income/employment
Relationships
support

stress

· state of physiological and psychological arousal produced by internal or external stressors, perceived by individual as exceeding ability to cope.

is stress adaptive

· stress can be adaptive, it help us manage a threat and promote survival.

low levels of stress (disorder)

or persistent in nature
exceeds resources to cope
impacts ability to function

moderate

temporary distress
· resources to manage stressor may not be sufficient

high levels

stressor short-lived, limiting impact on mental health
have resources to effectively manage the stressor

anxiety

- psychological and physiological response that involves feelings of worry and apprehension about a perceived threat.

why anxiety?

· future-focused, as we anticipate impending danger or threat (hasn't happened as yet).

anxiety vs stress

anxiety not always in response to a specific concern, whereas stress occurs in response to a specific stressor.

phobia

persistent irrational fear of a particular object, activity or situation, which is avoided or endured with distress"

specific phobia

fear of a single specific object or event that triggers a panic response.

charectoristics of phobia

· fear is excessive, unreasonable and irrational
· fear response outweighs threat posed by phobic stimulus
· avoid the phobic stimulus, organise life so they do not encounter it
· triggers acute stress response

ways to consider mental wellbeing

· Level of functioning
· Resilience
· Social and emotional wellbeing

level of functioning

define - the degree to which an individual can complete day-to-day tasks in an independent and effective manner.

factors reflecting

cognotive skills
school and work place
recreational activitys

resiliance

ability to successfully cope with and manage change and uncertainty.

charectoristics that promote resilience

organisation
problem-solving skills
· Strong communication skills

detirminants of health

conditions people are born, live, grow and work, and the wider set of structural systems that shape everyday life

Historical determinations of health

· - The legacy of colonization and the disruption to the traditional way of life.

Political determinants of health

people have human rights of self-determination, sovereignty, and social justice.

Social determinants of health

Health inequity is a result of social inequity.

Cultural determinants of health

strengths-based perspective, find solutions in connections to community, culture and Country.

self

· One's sense of self is grounded in the collectivist perspective (the tendency to view oneself as a member of a larger family or social group, rather than as an isolated, independent being).

domains

network of relationships (or elements of being) within which the 'self' is situated.

Connection to body and behaviours

· biological indicators of physical health, considers importance of body, health, spirit and mind to be at one's best.

Connection to mind and emotion

mental health disorders and ability to manage thoughts and feelings.

Connection to family and kinship

family and group relations, kinship systems of reciprocity and caring, gender and age roles(respect for Elders.)

connection to community

responsibility and obligation, social inclusion and relationships.

connection to culture

· -cultural knowledges- LELP including language, protocol, lore and ethical practice.
Cultural identity - PBV pride, belonging and values.

connection to country/land

· deep experience of belonging to Country, there is a traditional or spiritual association to kin and culture and a contemporary yearning to heal Country

connection to ancestor and spirituality

· knowledge and belief systems, Dreaming, cultural healing practices, value of wisdom and hope.

Biopsychosocial approach to specific phobias

how biological, psychological and social factors combine and interact to influence a person's mental health and wellbeing.

biological contributing factors

· Long-term potentiation
· GABA dysfunction

· GABA dysfunction

The inability of a person's brain to produce, release or receive the correct amount of GABA needed to regulate neuronal transmission. can be due to a low level or production of GABA, or an insufficient reception or transmission of GABA across the synapse.

what is gaba

primary inhibitory neurotransmitter in the central nervous system - it makes post-synaptic neurons less likely to fire (slows down)

how does gaba dysfuntion lead to phobia

·\= overstimulation of neurons in brain, heightened psychological activity & physiological arousal because individuals cannot 'inhibit' neural activity.
· leads to feelings of heightened anxiety and fear in the individual, which in turn can make the individual more prone to developing a phobia.

causes of gaba dysfuntion

· Genetic inheritance
· Exposure to prolonged stress

· Long-term potentiation define

changes in structure and function of neurons and synapses, increased likelihood of a group of neurons to fire together due to repeated stimulation.

how does LTP lead to phobia

strengthen synaptic connections in the neural pathways formed during the learning process (when the individual first develops the phobia)
· strengthening of association between a phobic stim and a fear or anxiety response

stregnthening of phobia

The more the connection is activated through each encounter with a phobic stimulus, the more the connection is strengthened
· This then increases the efficiency in transferring fear information along the pathway and decreases the likelihood that the fear response can be forgotten.

Psychological contributing factors - Behavioural

· Precipitation by classical conditioning
· Perpetuation by operant conditioning

Precipitating:-

immediately apparent risk factor or event that triggers an individual to experience a mental health symptoms now

Precipitation by classical conditioning

· The phobic stimulus starts out as neutral (NS) The individual has a negative experience with the stimulus (UCS), in response experiences fear (UCR) The individual then associates the UCS with just the sight/thought of the stimulus and experiences anxiety. The phobic stimulus (CS) alone can produce the fear response (CR)

how many accosiations

· Fear conditioning can occur after one single paring of stimulus, if it is traumatic

Perpetuating:

maintain , stop them from recovering from phobia

Perpetuation by operant conditioning

·avaoidant behavior acts as negative reinfroecment, reduces fear therefor making them likley to avoid stimulus in future

example

Antecedent: dog (phobic stimulus)
· Behaviour: avoid the dog
· Consequence: anxiety is reduced \= negative reinforcement therefore Amy avoids dogs in future and her phobia is maintained

Psychological - Cognitive biases

· Memory bias
· Catastrophic thinking

mem bias

error in thinking alter the content of what we remember

how does it contribute to phobia

only recall threat info more than positive info about phobic stimulus
· alter the recalled memory so that it is different to what actually happened.
Example- Someone with horse phobia will remember the one time it bit them, rather than the 100 times it didn't

catasrophic thinking

stimulus is considered to be more dangerous or threatening than it really is (they overestimate the potential danger)
· Example- Someone with a spider phobia will think that a spider bite may result in them being poisoned and dying

Social factors contributing

· Specific Environmental Triggers
· Stigma around seeking treatment

Specific environmental triggers

· negative experience with an object or situation can precipitate the development of a specific phobia. Individuals may "'attribute" their phobia to this trigger event.
· example- someone who is bitten by a dog (environmental trigger) may develop a fear of all dogs.

Stigma around seeking treatment

· nature of phobias and symptoms means sufferers are less likely to seek assistance, as they fear embarrassment and fear stigmatisation if they tell family or friends, let alone a professional.
· Eg. "An allergic reaction to jewellery" instead of "I'm phobic to jewellery.

evidence based interventions

treatments that have been researched and found to be scientifically effective

Biological intervention 1 - Benzodiazepines

· short-acting anti-anxiety medication that act selectively on GABA receptors in the brain to INCREASE the inhibitory effect of GABA, slow down CNS activity
· Symptoms of anxiety are reduced because physiological arousal is lowered and relaxation of CNS promoted.

types

Valium and Xanax

Benzodiazepines are known as agonist

· agonist - substance that imitates a neurotransmitter and works to stimulates or increases a neural response(either excitatory or inhibitory) when it binds to the receptor site

step by step

1. enter the synapse, bind to GABA receptors, GABA then also binds to receptor
2. increase the effectiveness of GABA
3. do NOT actually produce the inhibitory effect themselves.
4. If there is no GABA at a receptor, a benzodiazepine has very little effect on the neuron.
5. Allows for negatively charged ions to enter the post-synaptic neuron,This reduces the net positive charge of the neuron, making it less likely to fire

symptoms

dont recpver, only manage symptims, can be addictive

breathing for people experiencing fear

·shallow breathing, hyperventilation, excessive air into lungs, causing dizziness, light-headedness.
activation of the sympathetic nervous system, increases anxiety.

Biological intervention 2- breathing retraining

· Define - technique that teaches correct breathing habits to people with specific phobia
· maintain correct breathing when faced with a phobic stimulus, so they feel in control of their anxiety

Physiological effects of breathing retraining

· Appropriate breathing patterns - slow, regular breaths as a steady rate. Goal is to slow breathing rate and prevent over breathing.
· Respiration rate influence heart rate, blood pressure, and general arousal. As arousal lowers, stress and anxiety also lower.

steps of breathing retraining

1- Doctor teach person with a specific phobias how to consciously control their breathing
2- learner applies breathing techniques when in the presence of the phobic stimulus.
3- restores the oxygen in their body to an optimum level to help the parasympathetic nervous system become dominate, in turn reducing sympathetic responses

controlled breathing

(Slow and deep inhalations, followed by slow and controlled exhalations. Counting slowly when breathing in, and on breathing out. Breathing slowly in through the nose, and focusing on breathing out slowly from the diaphragm)

Evidence based interventions - psychological

· Cognitive behavioural therapy
· Systematic desensitisation

Cognitive behavioural therapy

· replacing dysfunctional thoughts and behaviours that perpetuate phobia to more adaptive ones.

step by step

identify fear
think about fear as hypotheses which need evaluation.
look for evidence that supports
Gather evidence about their phobic stimulus from reliable resources
learn that thoughts are based on incorrect assumptions,
change thoughts to be more positive and that the perceived threat is unlikely to harm.

2- systematic desensitization

systematic and graduated exposure to the phobic stimulus, replace anxiety response with a relaxation response when encounter the stimulus.

Applies classical conditioning principles

• Unlearning the connection between anxiety and a specific object or situation and Reassociating the feelings of relaxation (and safety) with the object or situation

step 1 of systematic desensitization

· taught relaxation technique- decrease the physiological symptoms of anxiety including breathing retraining or progressive muscle relaxation

step 2 systematic desensitization

· Creating a fear hierarchy: list of feared objects or situations, ranked from least - most anxiety-producing. 10-15 situations, ranked on a 100-point scale as to how much fear it produces

step 3 systematic desensitization

pairing of items in hierarchy with relaxation,
Starting at the bottom of the hierarchy (least anxiety), expose the individual to objects one 'step' at a time, at each step given time to use relaxation techniques. create an association of relaxation with the object, and replace the previously held anxiety response

Social interventions

Psychoeducation for families/supporters

Psychoeducation for families/supporters

Define - Involves teaching families and supporters of individuals with mental health disorders how to better understand, deal with, and treat their disorder.

Challenging unrealistic thoughts

· Acknowledge fear and anxiety
reminding them that anxious thoughts are based on wrong assumptions

Not encourage avoidance behaviour- family and friends can

· encouraging them to not engage in avoidance behaviour
· comfort and reassurance
· (Operant conditioning) Giving positive reinforcements through praise or tangible rewards when they make good progress with confronting their fears

Maintenance of mental wellbeing - protective factors

protect mental wellbeing, reduce likelihood that mental ill-health will occur. reduce the likelihood of mental illness.

Biological protective factors

· Adequate nutrition
· Adequate Hydration
· Adequate Sleep

Nutrition

better wellbeing when we eat well
good physical health\= good mental wellbeing
energy to go about life to adapt to stressors

hydration

eight glasses of water every day

sleep

· inadequate (quality or quantity) sleep leads to poorer mental wellbeing, just as poor mental wellbeing can lead to inadequate sleep,

what does sleep do

· Sleep give brain opportunity to process information and to form or consolidate new neural pathways to help us remember what we learned and experienced during the day.
· prepare the body and mind for the rigours of day-to-day life.
Poor or inadequate sleep can impair affective, behavioural and cognitive functioning

Psychological protective factors

· Cognitive behavioural strategies
· Mindfulness meditation

Cognitive behavioural strategies

identify, assess and correct faulty thinking and problematic behaviours..

Cognitive restructuring

teach themselves to identify, challenge and modify their negative or irrational thoughts (their 'cognitive distortions'.

mindfulness meditation

· individual focuses on their present experience to promote feelings of calm and peace.

Benefits of meditation

· Stress reduction
· Improved working memory
· Improved focus

Social protective factors

· support from family, friends and community that is authentic and energising

types of social support

practical support- services, financial assistance, delivering a casserole for dinner, helping with housework.
Informational-advice from someone with more information than you. eg Careers Counsellor
Emotional-demonstrating empathy and providing reassurance that they are there to support you.

Cultural determinants of mental wellbeing

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

cultural continuity

preservation of Aboriginal culture over time, and the sense of history, identity and belonging

Relationship to mental wellbeing-cultural continuity

Physical and mental health strengthened through ancient healing practices Maintaining connection to culture, Country and community, passing on important cultural knowledge to younger generations
strengthening cultural identity acts as a buffer against psychological stress, the transmission of historical trauma between generations, self-harm and suicide.