DP

Mental Health Study Notes (Bullet Points)

Mental Health

  • Definition: Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. \text{Emotional, psychological, and social well-being}. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Mental Illness

  • Mental health disorders, such as depression or anxiety, affect the way we think, feel and behave.
  • There are more than 200 types of mental illnesses.
  • Symptoms of mental health disorders usually improve with treatment, which may include medication, psychotherapy, alternative therapies or brain stimulation therapy.

Diagnostic Categories

  • The National Center for Health Statistics (NCHS), the Federal agency responsible for use of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) in the United States, has developed a clinical modification of the classification for morbidity purposes.
  • The ICD-10 is used to code and classify mortality data from death certificates, having replaced ICD-9 for this purpose as of January 1, 1999.
  • ICD-10-CM is the replacement for ICD-9-CM, volumes 1 and 2, effective \text October 1, 2015.

DSM-5

  • The Diagnostic and Statistical Manual of Mental Illnesses is the latest edition of the American Psychiatric Association’s professional reference book on mental health and brain-related conditions.
  • Also known as the DSM-5, this is the main guide for mental health providers in the U.S.
  • The DSM-5 mainly focuses on mental health conditions. However, because mental health and brain function are inseparable, the DSM-5 also covers conditions and concerns related to how the brain works.

Causes of Mental Health issues

  • Anyone of any age, sex, background or ethnicity can get a behavioral health disorder.
  • People designated female at birth (DFAB) more commonly experience depression, anxiety and eating disorders.
  • While people designated male at birth (DMAB) are more likely to experience substance abuse and antisocial personality disorders.
  • Behavioral problems and ADHD are more common in adolescents.
  • Behavioral health disorders can have many causes. They might be the result of abnormal genes. You may inherit those genes from a parent, or genes can change during your life.
  • Chemical imbalances in your brain can also lead to mental illness.

Your risk of Mental Illness increases if..

  • Use alcohol or recreational drugs.
  • Don’t get proper nutrition.
  • Don’t have a support system of friends or family members.
  • Had a traumatic birth or were born from a high-risk pregnancy.
  • Have a chronic medical condition such as cancer, diabetes or hypothyroidism.
  • Have a family history of behavioral health disorders.
  • Have a neurological disorder such as Alzheimer’s disease or dementia.
  • Have a sleep disorder.
  • Have extreme stress in your life.
  • Have had a traumatic brain injury.
  • Have had a traumatic life event or a history of abuse.
  • Struggle with your spirituality or beliefs.

Nonbiological Causes

  • Childhood abuse, trauma, or neglect
  • Dysfunctional family life, or family breakup
  • Social isolation, low self-esteem or loneliness
  • Bereavement (loss of someone close to you)
  • Severe or long-term stress
  • Having a long-term chronic illness
  • Domestic violence, bullying or other abuse as an adult
  • Traumas such as military combat, being involved in life threatening incident, or being the victim of a violent crime
  • Experiencing discrimination and stigma
  • Poverty, debt, or social disadvantage
  • Unemployment or losing your job
  • Homelessness or unpredictable housing options
  • Being a long-term caregiver for someone

Physical Changes of Stress

  • Increase in heart rate and breathing
  • Tensing of the muscles
  • Short-term memory becoming more effective
  • Improvement in thinking skills

Long-term effects of stress

  • Elevated blood pressure
  • Heart issues
  • Decreased immunity
  • Depression
  • Anxiety
  • Asthma
  • Diabetes
  • Ulcers
  • Chronic headaches
  • Job burnout

Suicide Risk Factors

  • The CDC estimates that 46\% of people who die by suicide have been diagnosed with a mental health condition like depression. But the real number is likely higher, as that estimate doesn’t account for people whose mental illness goes undiagnosed.
  • Adults age 65+ are at much higher risk for completing suicide than adolescents and teens.
  • One in 200 youth who attempt suicide complete it, compared to 1 in 4 older adults. With aging comes increased health issues, which can be a major contributor to depression and suicidal ideation.

Suicide Risk Factors (continued)

  • A prior suicide attempt
  • Depression and other mental health disorders
  • Substance abuse disorder
  • Family history of a mental health or substance abuse disorder
  • Family history of suicide
  • Family violence, including physical or sexual abuse
  • Having guns or other firearms in the home
  • Being in prison or jail
  • Being exposed to others’ suicidal behavior, such as a family member, peer, or media figure
  • Medical illness
  • Family violence, including physical or sexual abuse
  • Having guns or other firearms in the home
  • Being in prison or jail
  • Being exposed to others’ suicidal behavior, such as a family member, peer, or media figure

MA’s Role in Mental Health

  • Room patients with an understanding that they may have mental health concerns and or diagnosis’s
  • Obtain an adequate history including mental health symptoms to be entered into the medical record
  • Process medication prior authorizations and forms as delegated for a variety of mental health medications
  • Complete releases of information with patients
  • Assist with referrals to therapists such as counselors, psychologists, or psychiatrists
  • Perform laboratory such as blood draws to test for therapeutic levels of medications patients may be taking
  • Collect oral swabs for genetic testing

Communicating

  • Use terms and language your patient will understand to avoid causing confusing or making your patient feel uncomfortable
  • Actively listen
  • Watch for nonverbal cues
  • Validate your patient’s feelings
  • When needed, redirect conversations from a discussion of events to talking about the patient’s feelings and emotions

Substance Abuse

  • Uncontrolled use of alcohol, illegal drugs or prescribed drugs that affects normal daily life.
  • Substance abuse differs from addiction. Many people with substance abuse problems are able to quit or can change their unhealthy behavior.
  • Addiction, on the other hand, is a disease. It means you can’t stop using even when your condition causes you harm.

Anxiety Disorders

  • Anxiety disorders are a type of mental health condition.
  • Anxiety makes it difficult to get through your day. Symptoms include feelings of nervousness, panic and fear as well as sweating and a rapid heartbeat.
  • Treatments include medications and cognitive behavioral therapy.
  • There are several types of anxiety disorders, including:
    • Generalized anxiety disorder (GAD).
    • Panic disorder.
    • Phobias.
    • Separation anxiety.
  • Other mental health conditions share features with anxiety disorders. These include post-traumatic stress disorder and obsessive-compulsive disorder.

PTSD

  • Post-traumatic stress disorder (PTSD) is a common mental health condition that can develop after a traumatic event.
  • It involves symptoms like flashbacks, anxiety, negative thoughts and beliefs, hypervigilance and more.
  • The main treatment for PTSD is psychotherapy (talk therapy)
  • Two conditions are closely related to PTSD:
    • Acute stress disorder: short-term mental health condition that can occur within the first month after experiencing a traumatic event. Symptoms lasting longer than four weeks may meet the criteria for PTSD.
    • Complex PTSD (CPTSD): can develop if you experience chronic (long-term) trauma.

Hypochondria

  • People with illness anxiety disorder, also called hypochondria or hypochondriasis, have an unrealistic fear that they have a serious medical condition or fear that they’re at high risk of becoming ill.
  • They may misinterpret typical body functions as signs of illness.
  • Even after medical tests show no problems, people with hypochondriasis are still preoccupied with the idea that they’re seriously sick.
  • Their persistent health worries can interfere with their relationships, careers and life.

Phobias

  • A phobia is when something causes you to feel fear or anxiety that’s so severe it consistently and overwhelmingly disrupts your life.
  • Because phobias, including the feelings of fear or anxiety they cause, affect everyone differently, there’s no set number of fears.
  • However, experts group fears into five main categories.

Dissociative Identity Disorder (DID)

  • Dissociative identity disorder (DID) is a mental health condition.
  • If you are living with DID, it means you have two or more separate identities. These personalities control your behavior at different times.
  • Each identity has its own personal history, traits, likes and dislikes.
  • DID can lead to gaps in memory and hallucinations (believing something is real when it isn’t).
  • Dissociative identity disorder used to be called multiple personality disorder or split personality disorder.

Obsessive Compulsive Disorder (OCD)

  • OCD is a mental health condition in which you have frequent unwanted thoughts that cause you to perform repetitive behaviors.
  • Treatment for OCD usually involves psychotherapy and medication.
  • The sooner OCD is diagnosed and treated, the better the outlook.

Hoarding

  • Hoarding disorder is a mental health condition in which a person feels a strong need to save a large number of items, whether they have monetary value or not, and experiences significant distress when attempting to get rid of the items.
  • The hoarding impairs their daily life.
  • Hoarding disorder often begins during adolescence and gradually worsens with age, causing significant issues by the mid-30s.
  • Hoarding disorder is more likely to affect people over 60 years old and people with other mental health conditions, especially anxiety and depression.
  • Approximately 2\% to 6\% of people in the United States have hoarding disorder.

Bipolar Disorder

  • Bipolar disorder is a chronic mood disorder that causes intense shifts in mood, energy levels and behavior.
  • Manic and hypomanic episodes are the main sign of the condition, and most people with bipolar disorder also have depressive episodes.
  • The condition is manageable with medications, talk therapy, lifestyle changes and other treatments.

Schizophrenia

  • Schizophrenia involves a disconnection from reality, including hallucinations and delusions.
  • It also affects your ability to recognize your symptoms.
  • It’s a severe condition, and while it disrupts how your brain works, it’s treatable.

Antisocial Personality Disorder (ASPD)

  • ASPD is a mental health condition that can affect the way you think and interact with others and lead you to:
    • Manipulate or deceive people.
    • Exploit or take advantage of someone else for your own benefit.
    • Disregard the law or the rights of other people.
    • Feel no remorse for your actions.
  • It’s common for people diagnosed with ASPD to show a lack of respect toward others, break the law, ignore the consequences of their actions or refuse to take responsibility.
  • ASPD can be dangerous since you’re at a high risk of causing physical or emotional harm to yourself and those around you.

Munchausen & Munchausen by Proxy

  • Munchausen syndrome (factitious disorder imposed on self) is when someone tries to get attention and sympathy by falsifying, inducing, and/or exaggerating an illness.
  • They lie about symptoms, sabotage medical tests (like putting blood in their urine), or harm themselves to get the symptoms.
  • Diagnosing and treating Munchausen syndrome is difficult because of the person’s dishonesty.
  • Munchausen syndrome by proxy (also known as factitious disorder imposed on another) is where you act like the person you’re caring for has a physical or mental illness while the person is not actually sick. This is a form of child or elder abuse.

Borderline Personality Disorder

  • Borderline personality disorder (BPD) is a mental health condition marked by extreme mood fluctuations, instability in interpersonal relationships and impulsivity.
  • People with BPD have an intense fear of abandonment and have trouble regulating their emotions, especially anger.
  • They also tend to show impulsive and dangerous behaviors, such as reckless driving and threatening self-harm.

Learning Disabilities

  • Autism, now called autism spectrum disorder (ASD), is a neurodevelopmental disorder. ASD is a developmental disability caused by differences in your child’s brain. People with ASD may behave, interact and learn in ways that are different from other people. They may have trouble with social interactions and with interpreting and using nonverbal and verbal communication. Asperger's syndrome (sometimes called high-functioning autism) is part of a wide diagnosis called autism spectrum disorder (ASD).
  • Dyslexia is a learning disability that makes reading and language-related tasks harder. It happens because of disruptions in how your brain processes writing so you can understand it. Most people learn they have dyslexia during childhood, and it’s typically a lifelong issue.
  • ADHD is one of the most common childhood neurodevelopmental disorders. Children with ADHD often have difficulty with inattention, hyperactivity and impulsivity. Kids usually receive a diagnosis during childhood, and the condition often lasts into adulthood. However, effective treatment is available. While the term ADD is technically an outdated term—and no longer used by medical professionals—it is still sometimes used colloquially to refer to someone who has predominantly inattentive ADHD which causes difficulty staying focused but does not include hyperactivity.

Catatonic Behavior

  • Catatonia is a disorder that disrupts how your brain works, disrupting how a person processes and reacts to the world around them.
  • People with catatonia often don’t react to things happening nearby or may react in ways that seem unusual.
  • Impaired communication, unusual movements or lack of movement, and behavior abnormalities are the most striking features of this condition.
  • Despite almost 150 years of study, experts still don’t know exactly why catatonia happens. However, there are several possible explanations, ranging from chemical imbalances in the brain to genetic causes passed from generation to generation.