Week 11 Terms: Mental Health; Stigma, Mood Disorders, Schizophrenia, and Anxiety Flashcards
Stigma
A mark of disgrace associated with a particular quality or person
Dangers of Mental Health Stigma
- Discrimination; obvious & direct/subtle and/or unintentional
- Reluctance to seek hlep/treatment
- Fewer opportunities for work, school, socialization and or housing
- Violence or Harrassment
- Limited Health Insurance Coverage
- Diminished hope/belief in recovery
True/False
Mental Health problems are more prevalent than heart disease, lung disease, and cancer combined.
True
Mental health also receives less reasearch $$ and less public support
Half of all mental illness occurs before age…
A. 14
B. 20
C. 24
D. 30
A. 14
Half of all menal illness occurs before age 14.
3/4 begin before age 24
Causes of Mental Illness
There is no SINGLE cause for mental illness
A number of factors can contribute to risk:
* Early adverse life experiences, such as trauma or a history of abuse
* Experiences related to other chronic medical conditions, such as cancer or diabetes
* Biological factors or chemical imbalances in the brain
* Use of alcohol or drugs
* Having feelings of loneliness or isolation
Common Comorbidity in Mental Health
Substance Abuse
Developmental Disorders
Heart Disease
Cancer
Poor mental health increases the risk of chronic conditions & vice versa
Mood Disorder
Expriencing an extreme in the continuum of typical moods
Depression Mania
low/sad/unpleasant Elevated/elated/energized
Types of Mood Disorders
Depressive Disorder
Bipolar Disorders
True/False
Depressive disorders are also called unipolar.
True
Called unipolar as it is only one side of the affective spectrum
Types of Bipolar Disorders
Bipolar I
One or more manic or mixed episodes
Bipolar II
One or more depressive episodes and at lease one hypomanic episode
Cyclothymic disorder
At least 2 years of fluctuating hypomania & depressive symptoms
Major Depressive Disorder
One or more major depressive episode(s) lasting 2 weeks or more
At least 5 of the following symptoms consistently
* diminished interest/pleasure
* depressed mood
* significant weight loss or weight gain
* insomnia or hypersomnia
* psychomotor agitation or retardation
* fatigue or loss of energy
* feelings of worthlessness or excessive/inappropriate guilt
* diminished ability to concentrate/indecisiveness
* recurrent thoughts of death, recurrent SI, a suicide plan or attempt
SIG-E-CAPS
Depression Mnemonic
Sleep Changes (insomnia, hypersomnia)
Interest loss ‘anhedonia’
Guilt or low self-esteem
Energy level (loss of energy, low energy, or fatigue)
Concentration (poor concentration, forgetfulness)
Appetite changes (loss of appetite or increased appetite
Psychomotor changes (agitation/slow physical & emotional reactions)
Suicidal ideations (active or passive thoughts?)
What does depression in older adults look like?
- Fewer complaints of sadness
- Cognitive and psychomotor slowing (or agitation)
- Complain of poor concentration and memory
out of proportion to actual daily life problems or results of cognitive testing - May have physical symptoms, hypochondriasis
More likely to complete suicide over age 65
13% of population, but 25% of suicides
Risk Factors for Suicide
Living alone
Males
Alcoholism
Comorbid physical illnesses
Medical Interventions for Depression
SSRI
SNRI
ECT Electro-Convulsive Therapy; induces a seizure with electricity
Transcranial Magnetic Stimulation; device used to provide a magnetic stim over a certain brain area
Meds are usually the first intervention combined with psychotherapy
Mania
Abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy, lasting at least 1 week
PLUS 3 or more of the following
* Inflated self-esteem or grandiosity.
* Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
* More talkative than usual or pressure to keep talking.
* Flight of ideas or subjective experience that thoughts are racing.
* Distractibility
* Increase in goal-directed activity or psychomotor agitation
* Excessive involvement in high-risk activities
* Marked impairment in functioning, high-risk of self harm or psychotic features
* Episode is not attributable to substance use or other medical condition
What are the types of Bipolar Disorders?
Bipolar I Disorder: One or more manic or mixed episodes
Bipolar II Disorder: One or more depressive episodes and at least one hypomanic episode
Rapid Cycling refers to a rapid shift between the two.
Persistent Depressive Disorder (Dysthymic Disorder)
Less Severe, Chronic Depression
At least 2 years vs/ episodically
Hypomanic Disorder
Elevated, Expansive or Irritable Mood
Less Intense and Without Impaired Functioning
Cyclothymic Disorder
At least 2 years of fluctuating hypomania and depressive symptoms
What are some OT Interventions for Mood Disorders
- Cognitive-behavioral interventions
- Sensory processing
- Re-establishing routines
- Education and/or employment
- Peer support programs
- Exercise & physical activity
- Social participation
- Sleep hygiene
- Spiritual participation
Psychosis
Psychotic-being out of touch with reality
What are the main symptoms of psychosis?
Hallucinations
Delusions
True/False
Psychosis is a symptom that means the client has schizophrenia.
False
An individual with schizophrenia may have psychosis as a symptom but psychosis does not mean someone has schizophrenia.
Hallucination
- False sensory experience
- Any of the five senses
- Auditory is most common
- Visual second most common
Delusion
- False thought or belief
- Paranoid – falsely thinking someone or something is out to get you
- Grandiose- falsely believing you are very important (famous person or religious figure)
What are positive symptoms of schizophrenia?
Positive Symptoms (Not typical in other individuals)
* Delusions and/or hallucinations
* Disorganized speech
* Disorganized or catatonic behavior
* Marked decline in functioning
* At least 2 symptoms
* For at least 1 month
What are negative symptoms of schizophrenia
Negative Symptoms (Absence of typical function)
* Flat affect
* Social withdrawal
* Difficulty initiating activity
* Greater impact on function
* Related to early onset, poor outcomes & cognitive impairment
What are cognitive symptoms of Schizophrenia?
- Core feature of disorder
- Functional impact
- Precede diagnosis
- Persist after psychosis abates
- Memory
- Working memory
- Self-awareness
- Attention
- Language
- Executive function
Etiology of Schizophrenia
We don’t know
BUT
Genetics: Several Genes, No biomarker
Prenatal: O2 Deprivation, Maternal Infections
Neuroanatomy: Enlarged Cerebral Ventricles, Decreased Cortical Gray Matter, Increased Dopamine
Stress: Environment, Minority Status, Urban
Could be the cause
True/False
Schizophrenia has a slightly higher incidence in women than males.
False
Schizophrenia has a slightly higher incidence in men than women.
Women may be diagnosed later in life
What are some side effects of Schizophrenia medicaction?
- Sedation
- Sun sensitivity
- Dry mouth
- Orthostatic hypotension
- Movement disorders
- Older ones: movement disorders
- Weight gain and diabetes
Types of intervention for those with Schizophrenia
- Cognitive remediation or compensation
- Sensory processing
- Social skills training
- Supportive housing
- Peer support
- ADL & IADL training
- Supported education and/or employment
- OT
What are the common types of anxiety disorders?
- Phobias
- Agoraphobia
- Social Anxiety
- Most prevalent; least treated
- Panic Disorder
- Generalized Anxiety Disorder
Anxiety
The anticipation of future threat
- Muscle tension and vigilance in preparation for future danger
- Cautious or avoidant behaviors
- Significant distress and impairment in social and occupational function
Etiology of Anxiety Disorder
- Stress
- Genetic Factors
- Neuroanatomy; dysregulation hypothalmic-pituitary-adrenal (HPA) axis
- Neurochemical Factors; cortisol, GABA receptors, serotonin
- Cognitive & Psychological factors
- Environmental factors; traumatic events, parental temperament, smoking
True/False
Anxiety disorders are more prevelant in females than in males.
True
More common in females due to socioeconomic disadvantage, gender-based violence, subordinate social status, caregiver responsibility
Women are also more likely to seek treatment
What are some treatment options for anxiety disorders?
Medication (anxioytic)
Psychotherapy (Behavioral Cognitive-Behavioral)
OT (Relaxion Activities)
List Obsessive-Compulsive and Related Disorders
Obsessive-compulsive disorder
Body Dysmorphic Disorder
Hoarding
Trichotillomania
Obsession
- Recurrent and persistent thoughts
- Urges or images that are experienced as intrusive and unwanted
Compulsion
- Repetitive behaviors or mental acts
- Compelled to do in response to an obsession
or according to rules that must be applied rigidly
Common Symptoms of OCD
- Cleaning
-Contamination obsessions and cleaning compulsions - Symmetry
-Symmetry obsessions - repeating, ordering
-Counting compulsions - Forbidden or taboo thoughts
-Aggressive, sexual, and religious obsessions and related compulsions - Harm
-Fears of harm to oneself or others and related checking compulsions
What are the functional impacts of OCD?
- Avoid trigger situations
- Task completion
- Time management
- Health management
- Social consequences
-Misunderstood
-Inflexible with changes
-Relationship issues
Those with Body Dysmorphic Disorder have a preoccupation with..
with perceived defects or flaws in physical appearance
not observable or appear only slight to others
Hoarding Disorder
Persistent difficulty discarding or parting with possessions
regardless of their actual value
strong perceived need to save the items
experience distress associated with discarding them
Trichotillomania
Repetitive pullin of one’s own hair
Excoriation Disorder
Recurrent skin picking resulting in skin lesions
What are some functional impacts of obsessive disorders
Social interactions
Relationship issues
Medical treatment
Surgeries
Financial
Time
Clutter impacts living space
-Safety risk
-Difficulty completing tasks
-Sanitary conditions
-Social relationships
-Loss of housing
