Mental Health and Mental Illness Notes

Mental Health and Mental Illness

Defining Mental Health

• Mental health encompasses emotional, psychological, and social well-being.

• It represents a balance between cognitive, behavioral, and emotional states.

• It includes the ability to handle stress and adversity, relate to others, express feelings, and make healthy choices.

• Mental health is complete when physical, mental, and social well-being are intact.

• Evidence of mental health includes:

  • Ability to function well alone and with others.

  • Making sound judgments and accepting responsibility for outcomes.

  • Ability to love and be loved and to respond with humor.

• Influenced by socioeconomic, biologic, and environmental factors and ability to realize personal abilities.

Defining Mental Illness

• Mental illness involves a change in emotions, thinking, or behavior.

• These changes lead to problems in personal, work, or social relationships or an inability to perform activities of daily living (ADLs).

• Interpersonal relationships are often stressed or ineffective.

• Thinking is often distorted, with misconceptions and thinking errors replacing rational processing.

Warning Signs of a Mental Health Issue

• Changes in eating or sleeping routines.

• Feelings of hopelessness or like nothing matters.

• Increase in drinking or illegal drug use.

• Withdrawing from close family and/or friends and/or activities.

• Hyper or reckless activity.

• Hearing voices that others do not hear.

• Thoughts of self-harm or harming others.

• Neglecting activities of daily living (eating, bathing, dressing, work, or caring for dependents).

• Change in thinking that includes illogical ideas or magical thinking.

Impact and Incidence of Mental Illness

• Mental illness is seen in all cultures, socioeconomic levels, and genders.

• The National Institute of Mental Health (NIMH) estimates that in 2019 there were 51.5 million adults with a mental condition ranging from mild to severe.

• In 2019, the United States spent $225$ billion on mental health services.

• Issues to access of care due to cost and lack of availability of services, compounded by stigma related to seeking, and receiving, mental health care still exist.

Factors Affecting Mental Health

• Stress and anxiety.

• Grief and loss.

  • Unavoidable issues of daily life.

  • Necessary for the individual to be flexible and adaptive.

• Other Influences:

  • Religion.

  • Family.

  • Sleep.

  • Substance use.

  • Exposure to trauma or violence.

• Mental health is achieved as the individual successfully maintains a balance between the ups and downs of everyday life requiring adaptation.

• The ability to re-establish a stable state depends on being able to utilize coping strategies and adapt to:

  • Cultural influences, religion, family issues, sleep disturbances, substance use, exposure to trauma or violence

  • Previously successful coping strategies are utilized

    • Past experiences with stress, anxiety, grief, or loss help shape response to the current situation

Factors Affecting Mental Health - Cultural Heritage

• Cultural Heritage—Beliefs, Norms, and Values

  • Culture describes a common heritage and a set of social practices that are central to a group resulting in a cultural identity for its members

    • Cultural variances with mental health issues

      • Perception, coping, managing (see Table 1.2)

  • Coping

    • Learned from previous unpleasant experiences and by observing how others deal with similar situations

      • Either conscious or unconscious and learned or automatic. It can also be positive or negative

Cultural, Ethnic, and Religious Influences

• Elimination strategies

  • Folk healing customs

  • Magic

  • Traditional medicines, herbs

  • Religious rituals

    • Prayer, touch, candles, eggs, or pollen

    • Weed roots, pictures, medals

    • Religious music, talking to God, meditation

  • Cultural or ethnic traditions may be the first choice for managing mental illness, despite available services

Coping Strategies

• Coping strategies

  • Four categories:

    • Adaptive and palliative result in positive outcomes

    • Maladaptive and dysfunctional result in negative outcomes

  • Promoting adaptive coping strategies

    • Reframing (see Table 1.3)

    • Visualization

• Situational assessment: reality

  • Solution development

    • Positive outcome

      • Adaptive coping

      • Palliative coping

    • Negative outcome

      • Maladaptive coping

      • Dysfunctional coping

Promoting Adaptive Coping Strategies

• Effective coping strategies

  • Positive self-talk and reframing irrational thinking

  • Assertiveness training, problem-solving skills

  • Communication skills, conflict resolution

  • Relaxation techniques, meditation

  • Support systems, practical attitude, sense of humor

  • Self-care: diet, exercise, sleep, leisure, avoiding stress-increasing substances (caffeine, alcohol, etc.)

  • Faith in spiritual power and in yourself

Stress

• Definition: condition resulting when a threat or challenge to our well-being requires us to adjust or adapt to environment

  • Distress: negative stress

    • Demanding exhaustive energy

  • Eustress: positive, motivating stress

    • Can enhance sense of well-being

  • Acute: “fight or flight” response; episodic

  • Chronic: ongoing, continuous

  • Common symptomatic categories: physical, mental, emotional, behavioral

Anxiety

• Definition: feeling of apprehension, uneasiness, or uncertainty occurring in response to real or perceived threat from an unknown source

  • Automatic, unconscious biologic response

  • Normal: necessary for survival; provides energy to manage daily life, pursue goals

  • Acute: short term

  • Chronic: experienced over a long period of time

    • Chronic fatigue, insomnia, poor concentration, social/work impairment

Levels of Anxiety

• Mild: natural; motivating toward productivity

• Moderate: uncomfortable; difficult to tolerate for extended periods

• Severe: physically, emotionally exhausting

  • Desperation: relieve mental, emotional turmoil

• Panic: hysteria, suicide attempts, violence

Contributing Factors to Stress and Anxiety

• External stressors: adverse environmental aspects

  • Abusive relationship

  • Poverty-level living conditions

• Internal stressors: physical or psychological

  • Physical: chronic condition, terminal illness

  • Psychological: continued worry regarding financial issues, impending disaster (which may never happen)

  • Impact of personality type, situational unpredictability

  • Emotional triggers for higher stress levels: events that are uncontrollable, repetitive, unexpected, intense

Grief and Loss

• Grief: emotional process of coping with loss

  • Sense of emptiness, hopelessness, detachment from life’s meaning

  • Sadness/despondency centered on an experience

  • Emotional energy investment corresponds to intensity of grief

• Loss: actual or perceived status change in relationship to valued object or person

  • Associated with death of valued person or pet; losing home to fire/natural disaster

  • Not receiving anticipated promotion; academic failure

• Bereavement: natural, healthy, healing process which emerges in response to any significant loss

• Mourning activities: influenced by beliefs, customs

Types of Grief

• Anticipatory: those expecting a major loss in the near future

  • Terminal illness, loss of body part, change in body functioning

• Conventional: grief experienced following a loss

  • Adolescents and children respond according to their understanding of death

  • Temporary or permanent loss

Grief as a Process

• Grieving process: series of occurrences in the resolution of loss

  • Provides support while working through feelings of loss: anger, hopelessness, futility, fear, guilt

  • Provides time

    • Put events into perspective

    • Place lost things into memory

    • Emerge with newly developed embrace of life

  • Adapting to loss is a learning process

    • Accepting loss as part of life

Stages of Grief

• Dr. Elisabeth Kubler-Ross: dying is a lifelong process

  • Five stages of grief

    • Denial: shock, disbelief

    • Anger: realization loss is real

    • Bargaining: postponing acceptance of loss

    • Depression: persistent, prolonged mood of sadness; normal response to loss

    • Acceptance: begin to experience peace, serenity

Grief

• Dysfunctional grief - failure to complete the grieving process and successfully cope with a loss

• Chronic Sorrow – seen in a situation where the grief resurfaces at times, but never fully goes away.

• Unresolved grief: incomplete grief process resulting in maladaptive symptoms continuing months after loss

  • Contributing factors to unresolved grief

    • Socially unacceptable death

    • Missing person due to war, mysterious disappearance, abduction

    • Multiple losses or losses in close succession

    • Ambivalent feelings toward lost person, object

    • Unresolved grieving from previous loss

    • Guilt regarding circumstances surrounding death

      • Survivor’s guilt

    • Consuming worthlessness with suicidal tendencies

    • Physiologic response: marked decrease in function

    • Delusional thinking/hallucinations

Coping with Grief and Loss

• Those with prolonged bereavement need

  • Clinical attention, treatment

• Strategies

  • Open-ended statements

  • Determine

    • Available support systems

    • Past successful coping strategies

  • Potential interventions

    • Journaling feelings or writing letter to deceased

    • Referral to grief support group

    • Identifying support systems (family, friends, religious groups, etc.)