Module 5: Mental health awareness Flashcards
Managing distress
Learning how to cope with negative or difficult emotional states; form of self-regulation
The “tipping” point
The point at which someone begins showing signs and symptoms of strain/burden of perceive stress
Diff for each individual
Stress diathesis model
A psychological theory that attempts to explain a disorder or behaviour as an interaction btwn a genetic predisposition (vulnerability) and a risk exposure event (stressor)
Components of stress diathesis model
- Stress
- Diathesis
Stress diathesis model: stress
Triggers several interconnected biological systems
Allostasis
The process by which the body adapts to changes; essential for maintaining balance in face of challenges
Stress diathesis model: diathesis
A concept of vulnerability, a person’s predisposition or vulnerability to a medical condition
What can a diathesis be?
Can be biological through genetic inheritance, a psychological vulnerability created by exposure to stressor early in life or a vulnerability created by the interaction btwn hereditary (genetic) and environmental factors (G x E)
Brain plasticity
The ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by recognizing its structure, functions or connections
Stress and allostasis-induced brain plasticity
Stress can trigger allostasis-induced brain plasticity which suggests that stressful experiences can affect brain structure and function
Findings from publication “Stress and allostasis-induced brain plasticity” by McEwan and Gianaros
- The brain and regulation
- Stress
- Stress and health
- Brain structure
What is the brain central in?
Stress diathesis model; determines what are threatening/adverse and what are positive experiences/exposures
What does the brain regulate?
An individual’s physical, emotional, behavioural and cognitive response to stressors, events, experiences
Findings: stress
Stress must be balance and can lead to positive growth and adaptation (steeling effect)
Steeling effect
Phenomenon where experiencing manageable levels of stress or adversity can strengthen an individual’s ability to cope with future challenges. It is based on the idea that exposure to stress in a controlled or limited way can build resilience.
Findings: stress and health
Too much stress, either chronic or acute overwhelming stress, takes a toll on the brain and body and is associated w poor mental and physical health outcomes
Findings: brain structure
When stressed, the brain changes its structure in an adaptive or maladaptive way ; the loss of resilience is a key feature of disorders related to stress (anxiety and depression)
The brain and perceived stress
The brain processes info from your internal (level of hydration, hormonal state) and external (work, family, friends) environment
Given your genetics and life experience, your brain reacts diff to the same stress and these factors determine your individual perceived level of stress
What does the brain control and coodinate?
Physiological, psychological and behavioural responses to perceived stress
Physiological, psychological and behavioural responses to perceived stress
Influencing metabolism, heart rate, anxiety levels, emotions, what you tell yourself and how you behave
How do the physiological responses result?
Signalling various systems including the HPA axis, the autonomic NS, the metabolic system, the gut and the immune system
Allostatic load
Wear and tear on the body and brain resulting from chronic dysregulation or overactivity/strain related to the process of allostasis (allostatic mediators)
Interventions that alleviate allostatic load
Healthy diet, regular cardiovascular exercise, social support, connectedness and good quality sleep
How GxE interactions appear to influence susceptibility to all experiences, good and bad
- Reduce risks
- Flourish
GxE: reduce risks
Your genetic makeup interacts w life experiences to determine resiliency and sensitivity to stress; developing healthy ways to cope with stress and adversity can reduce the risk of feeling overwhelmed and developing symptoms
GxE: flourish
Young people are at imp time in development where a healthy lifestyle together with accelerated brain development increases the likelihood of positive effects on well-being
Two most common mental health problems in Canada
Anxiety and depression
What gender is depression and anxiety more prevalent in?
Females
Signs and symptoms associated with anxiety
- Emotional
- Physical
- Behavioural
- Cognitive
Emotional signs and symptoms of anxiety
- Feeling on edge
- Feeling irritable
- Not fully enjoying things
Physical signs and symptoms of anxiety
- Restlessness
- Chest tightness
- Muscle tension
- Shortness of breath
- GI upset
- Headaches
- Sweaty palms
- Butterflies
- Changes in appetite
- Blushing/flushing
- Fatigue
- Repaid pressured speech
Behavioural signs and symptoms of anxiety
-Avoidance of feared situations (public speaking)
-Short temper and at times angry
-Difficulty sleeping
-Difficulty concentrating, distracted by worries, forgetfulness
Cognitive signs and symptoms of anxiety
- Apprehension
- Over-worry
- Distracted
Signs and symptoms associated with depression
- Emotional
- Physical
- Behavioural
- Cognitive
Emotional signs and symptoms of depression
- Feeling sad
- Non-reactive mood
- Feeling despair
- Loss of enjoyment
Physical signs and symptoms of depression
-Changes in sleep (sleeping a lot less or a lot more)
-Changes in appetite (eating a lot less or a lot more than usual)
-Feeling slowed down in your movements or agitated and restless
-Pain, headaches
Behavioural signs and symptoms of depression
-Withdrawing from family and friends
-Staying in more, missing work or university
Cognitive signs and symptoms of depression
-Feelings of guilt
-Suicidal thoughts
-Feelings of hopelessness
-Difficulty concentrating
-Dwelling on the negative
-Thinking over past bad memories and experiences
-Difficulty making decisions
-Negative thoughts
Four main indicators that point to a mental health disorder
- Disproportionate reaction
- Time
- Impairment
- Out of character
Four main indicators of mental health disorder: Disproportionate reaction
Severity or intensity of symptoms and level of distress are disproportionate to the situation
Four main indicators of mental health disorder: time
Symptoms persist for an extended period of time
Four main indicators of mental health disorder: impairment
Symptoms are associated w impairment and interfere with day-to-day life
Four main indicators of mental health disorder: out of character
Others notice that the person does not seem themselves or it off
Aspects of a mental disorder diagnosis
Mental health concerns and conditions require assessment by a mental health professional who takes into account the whole person (ie. Life course, family history, current context and symptoms)
What is taken into account during the assessment and diagnosis of a mental health concern
- Bullying
- Academic problems
- Relationship problems
- Substance misuse
- Family history
- Recreation
- Exercise
Diagnostic assessment of a mental disorder
- Developmental history
- Family history
- Symptoms
- Treatment
- Other factors
- Relational and social factors
Diagnostic assessment of a mental disorder- Developmental history
Learning, communication, neuromotor problems, childhood adversity
Diagnostic assessment of a mental disorder- family history
History mental disorders to identify a predisposition or genetic and familial vulnerability
Diagnostic assessment of a mental disorder- symptoms
The clinical course of distressing and impairing symptoms in terms of onset and nature (chronic or episodic) and relationship to context/stressors
Diagnostic assessment of a mental disorder- treatment
The response or paradoxical worsening to any treatment tried to date and other physical or medical problems that might be contributing
Diagnostic assessment of a mental disorder- other factors
Lifestyle (exercise, recreation), misuse of alcohol and or recreational/illicit drugs, current stressors etc.
Diagnostic assessment of a mental disorder- relational and social factors
The nature of relationships, social connectedness and environment
Circle of mental health care: care options
- Psychiatry
- Counselling
- Self-help and peer support
Psyhiatry
Well-suited for assessing and treating moderate to severe mental health conditions or disorders to severe mental health conditions or disorders that require a combined psychological and pharmacological approach
Counselling
Short term and problem-focused addressing healthy coping during periods of stress, strengthening problem-solving skills and managing emotional responses to an identified stressor
Peer support
-Talking to others who are going through or have gone through similar experiences
-Most universities have peer mentor schemes, a buddy system and a confidential listening service where you can talk to other students
Self-help
-Using available resources such as books, websites or apps to work through a problem
Ex. Digital platform Silvercloud is a self-help programme using cognitive behavioural therapy for low mood and anxiety
Psychological therapy
Well-suited to help with and support young people w emotional social and mental health problems, typically of moderate severity
Primary care provider
-Central to coordinating your health and mental health care
-First line for assessment of a mental health concern and provide continuity and coordinate your care
-Should be kept up to date with ant health of mental health support/care you receive
Stepped care
Aims to match individual patients to the level of service indicated based on intensity of need
Pyramid of stepped care
Each step in the pyramid represents a progressive increase in the level or intensity of treatment and the expertise brought to bear into that treatment
Key to safe and effective stepped care
- The level of care an individual receives matches the indicated clinical need
- The steps represent evidence-based effective treatment
Who provides mental health support?
- Occupational therapist
- Counsellor
- Psychotherapist
- Clinical psychologist
- Psychiatrist
Occupational therapist
Regulated health care professionals that specialize in assessment and intervention focused on helping people resume or maintain participation in a variety of activities, including work, school, recreation and activities of daily living
Occupational therapist role in university settings
Help with learning approaches and improving performance in the context of learning activities and achieving a healthy schedule/ study/life balance
Counsellor
Can support healthy coping, emotional and behavioural regulation and healthy lifestyle choices as achieving a good study-life balance
Models of psychotherapy
Cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT) and psychodynamic psychotherapy
Clinical psychologist
Registered healthcare professionals regulated by the college of psychologists of Ontario (CPO); provide psychological support and treatment for mild to moderate mental health problems and disorders and work as part of a multidisciplinary team supporting patients w more moderate to severe mental disorders
Psychiatrist
- Medical doctors w extensive specialty training in the diagnosis and treatment of mental disorders, integrating pharmacological treatment with other aspects of educational, psychological and social and family care
- takes into account developmental and family history, psychosocial context, early adversity, onset and clinical course and nature of symptoms and any contributing risk factors
Current campus resources at queens
- Queen’s student health and wellness services (QSWS)
- Queen’s student accessibility services (QSAS) *part of QSWS
- Psychology clinic at queen’s university
Community based services
- Hospital based services
- Publicly funded community-based services
- Private and fee-for-service options
Hospital based services
Emergency or urgent care and various subspecialty programs (eating disorders, early psychosis) which typically have defined criteria for admission
Publicly funded community based services
High demand plus limited funding means that publicly funded community-based services have long waitlists and prioritize the most ill people
Private and fee-for-service options
Some insurance companies offer coverage and for those under 25 years you might qualify under your parents insurance
Barriers to mental health care
- Stigma-related barriers to mental health care
- Attitudinal barriers
- Practical barriers
Stigma-related barriers to mental health care
The Canadian mental health association is working to combat mental health stigma by education the public on outdated terms and encouraging person first language
Attitudinal barriers
People invalidate their own or others mental health concerns or diagnosis as there is not a clear diagnosable test
Misunderstandings about mental health or fears about others reactions can get in the way of reaching out for help
Practical barriers
Problems related to things such as cost, time or availability of services
Examples of practical barriers
- long wait times
- financial barriers
- challenges navigating the system
Severity of symptoms and distress
- No symptoms
- Mild symptoms
- Mild to moderate symptoms
- Moderate to severe symptoms
No symptoms
Prevention and health promotion
Mild symptoms
Self-help for targeted signs and symptoms
Mild to moderate symptoms
Social and/or psychological approaches
Moderate to severe symptoms
Pharmacological and psychological approaches
Mental health promotion
-Striking a healthy study-life balance
-Getting good quality sleep
-Maintaining healthy lifestyle choices
-Taking time to feel connected to others
-Spending time in nature
-Involving yourself in hobbies and activities that are enjoyable
-Regular cardiovascular exercise
-Reducing use of alcohol and caffeine
-Avoiding recreational drugs
Social approaches
Social skills workshops
Interest groups
Clubs
Health promotion and support groups
**Mild mental health symptoms may benefit from these
Social prescribing
Getting out in nature, spending time w others, investing in interests and taking part in recreation activities all support your well-being and mental health
Examples of therapy modalities and their areas of focus
- Mindfulness-based stress reduction
- Behavioural activation
- Supportive counselling
- Interpersonal psychotherapy (IPT)
- Cognitive behavioural therapy (CBT)
- Cognitive processing therapy (CPT)
Cognitive behavioural therapy: (CBT)
Evidence bases therapy that involves addressing and changing maladaptive thinking patterns and modifying behaviour
What mental disorders are CBT based therapies effective for treating?
Anxiety
Depression
Eating disorders
Trauma
Mindfulness exercises
-Focusing on an object
-Focusing on your breathing
Considerations involved with medical and pharmacological approaches
- Alternative medical explanations
- Medication
- Physical and mental health interaction
Alternative medical explanation
For example thyroid problems may cause depression like-symptoms
Family history
Medication
-Central part of treatment for specific disorders and severity disorders
-Family doctors work in collaboration with psychiatrists to identify when medication is required is required and to assess the tolerability and treatment response
Physical and mental health interaction
Imp to take a holistic approach and develop a care plan that considers the whole person
