UNIT 5 Flashcards
Definition of tipping point
Point at which someone begins showing signs and symptoms of the strain/burden of perceived stress. The tipping point will be different for each individual; what might be your tipping point will be different than others
How to conceptualize the idea of tipping point?
Stress diathesis model
Stress definition in the stress diathesis model
Triggers several interconnected biological systems. The process by which the body adapts to changed I the body such as stress is called allostasis
Diathesis definition in the stress diathesis model
refers to the concept of vulnerability. Specifically, a persons predisposition or vulnerability to a medical condition.
What is a diathesis
biological though genetic inheritance, a psychological vulnerability created by exposure to a stressor early in life, or a vulnerability created by the interaction between hereditary (genetic) and environmental factors (GxE)
What does the stress diathesis model explain?
A disorder or behaviour through an interaction between genetic predisposition and a stressful exposure
does the tipping point vary depending on each individual?
Yes! - Because there is so much variability across the presence of risk factors, the “tipping point” at which someone begins showing signs and symptoms of the strain of perceived stress varies a lot between individuals – just like sensitivity to pain or temp
What is central in the stress diathesis model?
The brain and regulation
What does the brain do in the stress diathesis model?
Determines what are threatening/adverse and what are positive experiences/exposures. The brain is responsible for regulating an individual’s physical, emotional, behavioural, and cognitive response to stressor, events and experiences
Stress in the stress diathesis model
Must be balanced. Stress, if manageable, can lead to positive growth and adaptation (steeling effect) which promotes resilience and good health
- Steeling effect: refers to evidence of more resistance to later stress having successfully coped with a stress or challenge
Stress and Health in the stress diathesis model?
Too much stress, either chronic (cumulative) or acute overwhelming stress, takes a toll on the brain and body, and is associated with poor mental and physical health outcomes
Brain structure in the stress diathesis model
When stressed, the brain changes its structure in an adaptive or maladaptive way in response, In fact, the loss of resilience (physiologically, neurologically, and behaviourally) is a key feature of disorders related to stress (i.e anxiety and depression)
According to the stress diathesis model does stress influence how you think and feel both emotionally and physically?
Yes
What does the stress diathesis model have to do?
System checks and balances and adapts
how does the brain process information?
From internal (hydration and hormonal state) and external (work, family, friends) environment
What affects how the brain reacts?
Your genetics and life experience affects how the brain reacts to the same stress.
What do genetics and life experiences do together?
Determine your individual perceived level of stress
Physiological response
Brain controls and coordinated the physiological, psychological and behavioural response to perceived stress
What are some Physiological responses
Influencing metabolism, heart rate, anxiety levels, emotions, what you tell yourself, and how you behave
What do Physiological responses result from
signalling of various systems including the HPA axis, the autonomic nervous system, the metabolic system, the gut and the immune system
What does allostatic load refer to?
the wear and tear on the body and brain resulting from chronic dysregulation or overactivity/strain related to the process of allostasis
What are interventions that alleviate allostatic load?
healthy diet, regular cardiovascular exercise, social support, connectedness (sense of belonging), and good quality sleep
What is the benefit of participating in ways to alleviate allostatic load?
help develop resilience in the event of adversity
What does genetic make-up interacting with life experience determine?
individual sensitivity to certain experiences
Reduces risk: genetic make-up
interacts with life experiences good and bad to determine resiliency and sensitivity to stress
Benefits of developing healthy ways to cope with stress and adversity
can reduce the risk of feeling overwhelmed and developing symptoms
Young people and important of flourishing
Young people are at a particularly important time in development when a healthy lifestyle together with accelerated brain development increases the likelihood of positive effects in well-being
what are the two most common mental health disorders in Canada
anxiety and depression
Depression and anxiety in males vs females
More prevalent in females than males
What types of identifying signs and symptoms are there for mental health problems?
Variety of early warning signs and symptoms of emergent mental health problems
What are many of the signs and symptoms of anxiety disorders?
Emotional/cognitive, physical and behavioural in nature
What are anxiety disorder symptoms associated with?
Tend to persist and are associated with distress and/or impairment
Emotional signs and symptoms of anxiety?
- Feeling on edge
- Feeling irritable
- Not fully enjoying things
Physical signs and symptoms and anxiety?
- Restlessness
- Chest tightness
- Muscle tension
- Shortness of breath
- GI upset
- Headaches
- Sweaty palms
- Butterflies
- Changes in appetite
- Blushing/flushing
- Fatigue or low energy
- Rapid pressured speech
Behavioural signs and symptoms of anxiety?
- Avoidance of feared situations
- 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
- create a change from normal function and are associated with distress and/pr impairment in functioning
Emotional signs and symptoms of depression
- Feeling sad
- Non-reactive mood
- Feeling despair
- Loss of enjoyment of normally enjoyable experiences
Physical signs and symptoms of depression?
- Changes in sleep
- Changes in appetite
- Feeling slowed down in your movements, or agitated and restless
- Pain, headaches
Behavioural signs and symptoms of depression?
- Withdrawing from friends and family
- Staying in more, missing work or school
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 thinking
4 main indicators that may suggest someone is experiencing stress over mental health disorder
1.Disproportionate reaction: Severity or intensity of symptoms and level of distress are disproportionate to the situation
2.Time: Symptoms persistent for an extended period of time
3.Impairment: symptoms are associated with impairment and interfere with day-to-day life
4.Out of character: others notice that the person does not seem themselves or is “off”
Assessment for mental health concerns and conditions
Require assessment by a mental health professional who takes into account the whole person
what other predictive information does a diagnostic assessment consider?
- Developmental history: (ex. Learning, communication, and or neuromotor problems, childhood adversity)
- Family history: To identify a predisposition, or genetic and familial vulnerability
- Symptoms: The clinical course of distressing and impairing symptoms, in terms of onset and nature and relationship to context/stressors
- Treatment: The response or paradoxical worsening to any treatment tried to date and other physical or medical problems that might be contributing
- Other factors: Lifestyle, misuse of alcohol and/or recreational/illicit drugs, current stressors, etc
- Relational and Social factors: The nature of the relationship, social connectedness, and environment
What is a helpful strategy to deal with mental health?
Talking to your peers
Student first contact for mental health concerns
- on campus at student health or wellness services
- family practice
- less commonly, referred to specialized psychological therapy or psychiatric consultation/care
Circle of mental health: psychiatry
- particularly well-suited for assessing and treating moderate to severe mental, health conditions or disorders that require a combined psychological and pharmacological treatment approach
Circle of mental health: counselling
- provided through student wellness services is often short-term and problem-focused, addressing healthy coping during periods of stress, strengthening problem-solving skills, and managing emotional responses to an identified stressor
Circle of mental health: Primary care provider
- should be thought of as central to coordinating your health and mental health care. Primary care providers are a first line for assessment of a mental health concern and provide continuity and coordinate your care. As such, ideally your primary care provider should be kept up to date with any health or mental health support or care you receive
Circle of mental health:
- Often well-suited to help with and support young people with emotional, social and mental health problems typically of moderate severity
Circle of mental health: peer-support
- Being able to talk to other students going through - or who have been through - similar experiences can be helpful support. peer support or peer mental groups
Circle of mental health: self-help
- Using available resources to work through a problem or difficulty. Number of good self help guides
Aim of a stepped care approach
aims to match individual patients to the level of service indicated on
Who provides mental health support?
- OT
- Counsellor
- Psychotherapist
- Clinical Psychologist
- Psychiatrist
What does the OT do
- 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
- help with learning approaches and improving performance in the context of learning activities, and achieving a healthy schedule/study life balance
what does a counsellor do?
- can support healthy coping, emotional and behavioural regulation, and healthy lifestyle choices, as well as achieving a good study life balance
What does a psychotherapist do?
- support individuals with emotional, social, and mental health problems of mild to moderate severity
What does a clinical psychologist do?
-Get training in psychological, cognitive, and psychoeducational assessments, and in providing manualized effective group and individual therapeutic approaches to help with a variety of mental health problems and conditions.
What does a psychiatrist do?
- Diagnosis and treatment of mental disorders, integrating pharmacological treatment with other aspects of educational, psychological, and social family care
- Assessments are rooted in medical approach, takes into account developmental
Ideal mental health system model
- start with a welcoming clinic visit to determine each student’s support need, followed by referrals to the appropriate level of service and support
-This is a stepped care model
-Ideally there would also be a seamless flow between levels of service and between community-based and campus-based services
-This is one proposed model of organized student mental health care.
Resources at Queen’s
-Queens student health and wellness services
-Queens student accessibility services
-Psychology clinic at Queen’s University )provides assessments, treatment and consultation for Queen’s students and members of the Kingston Community – it operates on a fee-for-service mode,
List the Community-based services
- Hospital-based services
- Publicly funded community-based services
- Private and fee-for-service options
Hospital-based services
- Include emergency or urgent care and various subsequently programs which have defined criteria for admission
Publicly funded community-based services
- High demand plus limited funding often means that publicly funded community-based services have long waitlists and prioritize the most ill people. Often hospital-based services and publicly funded community services do not lime up with the university student demographic or the specific needs of university students.
Private and Fee-for-service options
- many people have to rely on private and fee-for-service options. As noted previously, some insurance companies offer coverage, and those under 25 years you might qualify under your parents’ coverage but in many cases this coverage is limited
Stigma-related barriers
- Fear of being evaluated negatively as a result of a mental health problem presents a significant barrier in accessing mental health services and supports
Additional barriers
It isn’t uncommon for people to invalidate their own or others mental health concerns or diagnosis as there is not a clear diagnosable test
Practical barriers
- Long wait times: High demand plus limited funding for resources often means that there are long wait times for accessing mental health services
- Financial barriers: Finance can limit timely access and access to certain specialized services
- Challenges navigating the system: It can be difficult to known what level of services you need and where you can best access those services. This can make it confusing and challenging to navigate the mental health system, creating additional barriers in accessing services
Prevention and early intervention
-Stop 1: No symptoms (prevention and health promotion)
-Stop 2: Mild symptoms (self-help for targeted signs and symptoms)
-Stop 3: Mild to moderate symptoms (social and/or psychological approaches)
-Stop 4: Moderate to severe symptoms (pharmacological and psychological approaches)
What helps reduce risk of mental health problems
-Having a healthy study-life balance, getting good quality sleep, and making healthy lifestyle choices helps maintain well-being and resiliency
-Taking time to feel connected to others, spending time in nature, and involving yourself in hobbies and activities that are enjoyable are all part of mental health promotion
-Regular cardiovascular exercise, reducing use of alcohol and caffeine, and avoiding recreational drugs is also very important to ensuring restorative sleep and preventing the onset of mental health problems
self-help resources
- workbooks and apps that allow for self-directed treatment
What foes U-flourish & nurture-U do
-collaboratively test out digital interventions to reduce anxiety, stress, and low mood to tackle worry, self-criticism, and low confidence
- resources for free to interested, eligible and will consenting students
- student controlled electronic took to monitor well-being and behaviour and to support well-being plans
Social approaches
- Mild mental health symptoms may benefit from social approaches
-Variety of supports that can improve your social support and well-being. Some of these resources and supports may include social skills workshops, interest groups and clubs, health promotion, and support groups - Idea is that getting out in nature, spending time with others, investing in interests, and taking part in recreation activities all support your well-being and mental-health – two components necessary for effective and efficient learning
Psychological approaches
- If mental health symptoms persist or worsen then this might indicate the need for assessment and additional support
- can be effective in reducing and managing moderate symptoms of anxiety, depression, and sleep problems.
- can be delivered individually or in a group setting, and may include a variety of therapy modalities
Mindfulness-Based stress reduction
- useful for being mentally present, focused and relaxed
Behavioural activation
- evidence-based treatment on increasing your activity level, especially in pleasurable activities to combat low mood
Supportive counselling
- involves having a supportive person to explore current issues and difficulties, gain insight into difficulties, and look for different ways of approaching them
Interpersonal psychotherapy
- focuses on relieving symptoms by improving interpersonal functioning. It focuses on understanding and strengthening your relationship with yourself and others
Cognitive Behavioural Therapy
effective in treating mild-moderate sleep problems, anxiety and depression
What can CBT effectively treat
mental health disorders, including anxiety, depression, eating disorders, and trauma.
- when more severe it can be combines with other psychosocial and educational approaches including meds
Practicing mindfulness
- has sustained positive effects on students well-being and resilience to stress
Mindfulness effects on students
beneficial effects on students average level of psychological distress and further that these effects lasted for at least a year
Medical and pharmacological approaches
- important in assessment of treatment
- Family doctors and psychiatrists are trained to assess the whole person -> assessment of the symptoms in the psychocial, family, and medical context of the individual
Alt medical explanation
- important to see if there is a medical explanation for symptoms
medication
- can be important and sometimes central part of treatment for specific disorders and severity of disorders. Fam doctors work in collaboration with psychiatrists to identify when medication is required and to assess the tolerability and treatment response
Physical and mental health interaction
- Important to consider the interaction - often physical illnesses are associated with mental health problems and visa Versa
- when thinking of assessment and treatment, it is important to take a holistic approach and develop a care plan that considers the whole person
