Stress, Anxiety, Self Harm Flashcards
Who is at most risk of self harm (demographics)
Younger women
Unemployed / divorce
Socioeconomic deprecation
Suicide risk factors
Middle aged men Chronic, painful illness Family Hx Alcohol / drug Hx Depression / personality disorders
What is often reduced in suicide people ? (Hormone)
Brain derived neurotrophic factor
When do 20% of mental health patient suicides occur?
Within 3 months of discharge
3 types of suicide and Eg
Anomic - moral confusion and lack of social direction - Eg unemployment
Egoistic - prolonged sense of not belonging Eg post bereavement
Altruistic - for the good of society Eg kamikaze pilot
Ways to prevent suicide
Detect and treat psych disorders Prescribe safely (eg co-proxamol in small doses / SSRIs instead of tricyclics ) Urgent care of those with intent Eg MHA Management of self harm Target unemployment
Why do people self harm ?
Desire to interrupt events
Need for attention
Attempt to communicate
Wish to die
Management post self harm
MEDIATE Medically stabilise Establish rapport Diagnose and treat illness Iatrogenic risk (prescribing) Assess risk of recurrence Thoughts might return -> make plan Evaluate social problems
Consider psychological therapy
What to do if self harm had suicidal intent
Contact crisis resolution team
Social support
What is anxiety ?
Emotional state with SUBJECTIVE fear, bodily discomfort and physical Sx
When can anxiety be useful? What’s the curve called?
Pre race
Yerkes Dodson curve (basically normal distribution with x - anxiety , y-performance)
Physiological aspects of anxiety
Low levels of GABA, heightened amydala activation
Aetiology of anxiety
Genetic link
Childhood abuse
Stressors -> / financial
Alcohol / drugs can worsen
Define panic disorder
Recurrent severe anxiety (panic) attacks that are unpredictable
What condition has a very high risk of panic attacks?
COPD - breathlessness precipitates panic Sx
