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The Health Science Modules of the Science & Technology Curriculum Learning and Teaching Resources Theme: Topic: Healthy Lifestyle Mental Health The purpose of this set of teaching resources is to provide teachers with some teaching ideas and updated information on individual themes. The content of the topics is built on those in S1-3 Science Curriculum. It is not expected that every detail in this set of materials is to be covered in class teaching, as some of the materials only serve as references/ enrichment for teachers. To enhance the effectiveness of learning and teaching, teachers may need to modify the resources to suit the needs, abilities and interests of their students. Teachers also have to note that the materials included are by no means exhaustive, and should feel free to employ other resources if appropriate. Table of Contents Page Introduction 1 Learning Objectives 1 Scheme of Work 2-6 Lesson Plans 7-9 Teacher Notes Period 1 Period 2 What is mental health? How do I manage mental health? What are mental problems or illness? Table of Psychosis and Neurosis Psychotic disorders Schizophrenia Dementia Alzheimer Disease Parkinson’s Disease 10 10-12 13 14-15 16 17-18 19 20-21 Neurotic disorders Mood Disorder 22 Major Depression 23 Manic-Depressive Disorder 24 Anxiety 25 Phobia 26-27 Obsessive-compulsive Disorder 28 Somatoform Disorder 29 Period 3 Generalized Anxiety Disorder 30 What is Stress? Examples of positive and negative stress on mental, emotional and physical being 33 The causes and symptoms of stress 34-35 The physiological response of stress: General Adaptation 36-43 31-32 Syndrome (GAS) Stress-related personality types 43-44 The possible disorders that caused by stress 44-45 Ways to coping with stress 46-47 Treatment of mental illness 48 Substance misuse on mental health 49-50 Current misconception 50-51 Our attitude towards mental illness and how can we help them 52 What is mental health? 53 How do I manage my mental health? 53 What is mental problems or illness? 53 Psychosis Disorders 56-57 Neurosis Disorders 58-62 What is stress? 63 Causes of stress 64 Symptoms of stress 65 Physiological response to stress Student Notes Period 1 Period 2 65-67 Coping with stress 68 Treatment of mental illness 68 Substance misuse on mental health 69 Current misconception Current attitudes towards mental illness and how we can help them Worksheet Group discussion Reflective journal from newspaper clippings 74-75 School program 76-78 69-71 71 Suggested Activities Glossary 72-73 74 79-80 Supplementary Resources References for Teachers 81-85 Mental Health Introduction According to the National Mental Health Association in America, approximately 1 in 5 people may be affected by mental disorders during the course of any given year. Therefore, mental health conditions can affect anyone regardless of age, race, or economic status. In the past decades, mental illness has always been a subject that nobody wants to talk about and is often misunderstood. It carries a social stigma and a widespread of misconceptions that can often makes the people who suffered from mental illness more difficult to gain acceptance as well as respect in the society. Health information changes very quickly and there are numerous scientific new findings we ought to know for our own growth. In this module, you have the opportunity to gain understanding and to explore the concept of “Mental health”. Learning Objectives: After this series of classes, the students will be able to: 1. Define Mental Health. 2. Discuss various ways to maintain individual well-being. 3. Recognize various symptoms and types of Mental illness. 4. Discuss how substance misuse affects mental health. 5. Look at society's attitude to mental illness and discuss ways to overcome this problem. 6. Define Stress. 7. Describe the various types of stress. 8. Explain the body’s physiological response to stress e.g. homeostasis mechanism. 9. Compare the short- and long-term health effects of stress. 10. Learn to use various stress-management techniques. 1 Scheme of work for Mental Health Scheme of work for Mental Health (Healthy Lifestyles theme ~ Health Science Module) Topic Mental Health Time Learning Objectives (40 mins) Suggested Activities Resources Period 1 Introduction to Mental Health . 1. Define “What is mental health”? Group discussion News articles, 1. Case-studies from newspaper websites and clippings textbooks (see “Reference”) 2. Brainstorm with students to discuss the areas in life that contribute to good mental health 2. Suggest several ways to manage good Activity mental health Design an exhibition board to promote good mental health in 3. Define “What is mental problems or school illness?” 4. Recognize two types of mental illnesses: Neurotic illness Psychotic illness 2 Scheme of work for Mental Health Scheme of work for Mental Health (Healthy Lifestyles theme ~ Health Science Module) Topic Time Learning Objectives (40 mins) Suggested Activities Resources Mental Health Period 2 Mental Illness of Disorders . 1. State various types, causes and symptoms Group discussion: News articles, of mental illness: Case-studies from newspaper websites and Mood Disorder clippings textbooks (see i. Major Depression Current misconceptions about “Reference”) i. Manic-Depressive Disorder or mental illness or disorders Biopolar Disorder Discuss ways to promote Anxiety Disorder mental health i. i. Generalized Anxiety Disorder ii. Phobia Activity iii. Obsessive-Compulsive Disorder Design an exhibition board or do (OCD) group assignment on mental health Somatoform Disorder promotion Schizophrenia and other psychotic disorders b) 2. Describe the treatment of mental illness: Medication Psychotherapies 3 Scheme of work for Mental Health 3. Recognize how substance misuse affects mental health For example, negative effects of specific drugs on mental health. 4. Address current attitudes towards mental illness: Clarify the ideas on mental health misconceptions Promote individual and public awareness on mental health 4 Scheme of work for Mental Health Scheme of work for Mental Health (Healthy Lifestyles theme ~ Health Science Module) Topic Time Learning Objectives (40 mins) Suggested Activities Resources Mental Health Period 3 Stress . 1. Define “What is stress?” 2. Identify two types of Stress: Eustress – positive stress Distress – negative stress 3. State some examples of “positive” and “negative” stress and explore how stress affects mental, emotional and physical well-being. Group discussion News articles, 1. Case-studies from newspaper websites and clippings textbooks (see 2. Brainstorm with students the “Reference”) possible methods in dealing with stress Activity Fill up “Response to Stress” worksheet and compare 4. Identify the causes and symptoms of Stress. results among small groups. Write a reflective journal on 5. Describe the physiological response of stress-related news articles Stress and recognize the possible psychosomatic symptoms develop during Design an exhibition board in promoting the three stages of General Adaptation “Stress-management Syndrome (GAS) identified as: Techniques” as a school i. Alarm stage program ii. Resistance stage iii. Exhaustion stage 5 Scheme of work for Mental Health 6. Types of Stress/disease-related personality patterns Type A personality Type B personality Type C personality 7. Identify the possible disorders that can be caused or aggravated by Stress For example, Migraine 8. Suggest ways to cope with Stress 6 Lesson Plan for Mental Health Lesson Plans for Mental Health (Healthy Lifestyles theme - Health Science Module) Suggestions for teaching and activity sequence with time allocation Lesson 1: Introduction to Mental Health Sequence (40 mins) Content and Activity Resources Time Motivation Shows students some mental health-related news article and to recognize the importance to maintain good mental health. Newspaper (PowerPoint) 5’ Theme Teaching Introduce to students: 1. Concept of Mental Health. 2. Types of mental problems or illness. PowerPoint lecture 20’ Consolidation Group discussion: 1. Case studies from newspaper cuttings Review 15’ 2. Brainstorm with students (or in form of a small group) to discuss the areas in life that contribute to good mental health? 7 Lesson Plan for Mental Health Lesson Plans for Mental Health (Healthy Lifestyles theme - Health Science Module) Suggestions for teaching and activity sequence with time allocation Lesson 2: Mental Illness or Disorders (40 min) Sequence Motivation Content Resources Shows students some newspaper cuttings on Stress/Ask some Time Newspaper (PowerPoint) 5’ PowerPoint lecture 20’ PowerPoint 15’ general questions related to Stress Theme Teaching Introduce to students: 1. Example of types of mental illness 2. Recognize the possible causes and symptoms of mental illness* 3. Treatment and rehabilitation of mental illness 4. How substance misuse may lead to mimicking of mental illness symptoms or worsen ongoing mental illness. **. Consolidation Group discussion: 1. Case studies from newspaper cuttings 2. Brainstorm with students (or in form of a small group) to discuss: Current misconceptions towards mental illness What should be done about the stigma surrounding mental problems. * ** It may not be necessary to ask the students to memorize the symptoms/treatment of mental illness or disorders. You may refer to “Substance Abuse” for the various drugs effect that acts on human brain 8 Lesson Plan for Mental Health Lesson Plans for Mental Health (Healthy Lifestyles theme - Health Science Module) Suggestions for teaching and activity sequence with time allocation Lesson 3: Stress (40 min) Sequence Motivation Content Resources Shows students some stress-related news article and to recognize Time Newspaper (PowerPoint) 5’ PowerPoint lecture 20’ PowerPoint 15’ the importance to stay emotionally, mentally and physically “balance” in life. Theme Teaching Introduce to students: 1. Examples of one common mental problem: Stress 2. Compare the emotional, mental, and physical effects of Stress 3. Recognize the possible causes and symptoms of Stress 4. Consolidation Introduce the physiological response to Stress GAS (eg. Flight and fight response) Group discussion: 1. Case studies from newspaper cuttings 2. Distribute “Response to Stress” worksheet and compare results. 3. Brainstorm with students (or in form of a small group) to discuss ways to cope with stress 9 Teacher Notes of Mental Health LESSON ONE What is Mental Health? (a) Absence of mental illness (b) Individuals with good mental health. Develop emotionally, creatively, intellectually and spiritually Sustain mutually satisfying personal relationships Confront their own problems, resolve and learn from them Are confident and assertive Respect self and others Make good and positive decisions Are able to enjoy life How do I manage mental health? Activity: Group Discussion Brainstorm with students to discuss the areas in life that contribute good mental health. Some suggestions: Good Self Esteem: Maintain positive view and attitudes of self. Ability to feel secure Ability to communicate effectively Respect self and others Enjoy life Feel confident Be decisive and assertive 10 Teacher Notes of Mental Health Well-balanced Diet Needs of essential nutrients like glucose, vitamins, minerals, essential fats and protein for both physiological and intellectual growth. Our diet has a major affect on our general health both physically and mentally. For Physical and mental rejuvenation and repair. People tend to sleep more during periods of stress e.g. changing job, increase workload etc. (Maas, 1998). Sleep seems to help us recover from stress. The amount of sleep and rest varies from person to person. Being able to express your feelings, disappointments and joys is a good start towards good mental health. How we feel about ourselves has a direct impact on how we relate to others. Close relationship is a great source of comfort and support in times of stress/difficult situations. Enough Sleep Open Communication Close Relationships 11 Teacher Notes of Mental Health Avoid Alcohol A depressant that decreases the response of the Central Nervous System (impaired coordination and thinking). People with excessive drinking are often defensive about the extent of their problem. Alcohol is the most frequently used substance abuse among people. Harmful to health and is known to be associated with cancer, heart and lung disease. Smoking not only affects the health of our family members (passive smoking), it also leads to nicotine addiction. Helps to reduce stress and muscle tension. Stimulates the release of brain chemicals called endorphins, which give a natural feeling of health and well being. Participate in sport activities also improve social circle and can be a great way to meet new friends with a common interest. Finding time to exercise and relax. Use relaxation techniques include deep breathing, meditation, listen to music, massage therapy, yoga, aromatherapy, time Management etc. Avoid Smoking Regular Exercise Relaxation 12 Teacher Notes of Mental Health What are mental problems or illness? Mental health problems range from worries and grief that we experience as part of everyday life, to the most bleak, suicidal depression or complete loss of touch with every day reality. On average one in three of us will experience a mental health problem in the course of a year regardless of age, race or gender. The risk to develop a mental illness can be genetically inherited and can be caused by other “contributing” factors like problem in development prior to birth, chemical imbalances in the brain, or traumatic personal experiences as well. Mental illnesses can be separated into two main groups: i. Psychoses ii. Neuroses 13 Teacher Notes of Mental Health LESSON TWO Table of Psychosis and Neurosis Psychosis Definition Neurosis Psychosis is one of a group of mental disorders that feature loss of contact with reality. Characterized by impaired functioning in the brain and cause changes in thinking, emotion and behavior. Neurosis is any long-term mental or behavioural disorder in which contact with reality is retained and the condition is recognized by the sufferer as abnormal. It is a less severe form of mental illness than People with psychosis are unaware psychosis and apparently of the problem. not caused by any injury to the brain. Characterized by an abnormal thought pattern or emotional disorder of the mind. People with neurosis are fully aware of the problem. Cause Illness include Depending on the type of disorder it is presenting, psychosis can be caused by: Depending on the type of disorder it is presenting, neurosis can be caused by: Physical or chemical damages; or By purely social factors, with no biological component. “Psychological” in origin Emotional or social cause e.g. stress. Schizophrenia Parkinson disease Brief psychotic disorder (e.g. trauma and stress) Mood disorder Anxiety disorder Generalized Anxiety Disorder (GAD) Organic psychotic disorder (e.g. brain injury) Drug-induced psychotic disorder (e.g. recreational/party drugs) 14 Obsessive compulsive disorder Depression Phobia Somatoform disorder Teacher Notes of Mental Health Symptom Treatment Loss touch with reality Symptoms are often not Seeing, hearing, or perceiving things that are not there Hallucinations Delusions Disorganized speech and behavior. evident to others and cause considerable personal distress (e.g. anxiety, depression) Anti-psychotic medications Psychotherapy Hospitalization 15 Psychotherapy Counseling Cognitive behavior therapy. Drug therapy Teacher Notes of Mental Health Psychotic Disorders Schizophrenia A group of disorders that cause distorted thought and perception. Symptoms of Schizophrenia: Two or more of the following occur for at least 1 week: Delusions Hallucinations Lack of facial expression Incoherence Trouble functioning at work especially in social interactions and with personal hygiene. Schizophrenia in general has positive and negative signs. Negative signs may appear early in the disease and signs include lack of expression; laughing while expressing terrifying images; speaking with a dull monotone. Positive signs includes hallucinations and delusions In men, schizophrenia typically emerges in the teens or 20s in men and in the 20s or early 30s in women. Cause of Schizophrenia: Several factors may play a role: Genetic cause Trigger life events Psychological and social factors Chemical or structural abnormalities in the brain Illnesses may exist alone or in combination with other psychiatric or medical conditions Treatment of Schizophrenia: Anti-psychotic medications Psychotherapies Hospitalization if required 16 Teacher Notes of Mental Health Dementia A progressive disease of the brain which cause a decline in cognitive and intellectual function such as memory, comprehension, learning capacity, the ability to think and calculate, as well as language and judgment. In Hong Kong, according to a local study published in 1998, dementia affects about 4% of people aged over 65, with increase in incidence with advancing age. Symptom of Dementia: Memory problem and disorientation Aggression Sleep disturbance Constipation Communication difficulties Depression Malnutrition Failure to recognize family members and surroundings Epilepsy Stages of dementia and common presentations: Early stage Memory loss with decreased ability to think. Intermediate stage Easily get lost Mood changes and behavioral problems Need assistance with daily activities. Late stage Language impairment Cannot recognize relatives May become dependent. 17 incontinent and totally Teacher Notes of Mental Health Cause of Dementia: Impair blood vessels and nerves structure of the brain Several diseases or conditions that cause dementia. Alzheimer’s Disease: about 65% of dementia is Alzheimer’s disease (the most common type). Other causes: e.g. brain tumor, head injury, vitamin b12 deficiency, drug and alcohol abuse, Parkinson’s disease, Aids-related dementia, alcohol dementia, hypothyroidism and depression. Treatment of Dementia: NO CURE or PREVENTION But many of the symptoms can be treated or managed so the patient can remain comfortable and function independently for as long as possible. 18 Teacher Notes of Mental Health Alzheimer’s Disease (AD) A slow progressive disease, which cause a decline in cognitive and intellectual function of the brain. Symptom of Alzheimer’s disease: Early symptoms include: Memory decline Forgetfulness Loss of concentration People often missed easily because they resemble natural signs of aging. Getting lost on familiar routes Repeating statement frequently Later stage symptoms include: Cognition diminish Personality change Inability to function occur Forgetting events in their life history – lose awareness of who they are. Hallucinations and violent behavior Delusions, depression, agitation Cause of Alzheimer’s disease: UNKNOWN and it is not part of normal aging. There are two types of Alzheimer’s Disease: Early onset: Symptoms first appear before age 60. Some early onset disease runs in the families. Late onset: Most common form of the disease develops in people 60 and older. Late onset may less likely to run within families. Treatment of Dementia: NO CURE or PREVENTION But many of the symptoms can be treated or managed so the patient can remain comfortable and function independently for as long as possible. 19 Teacher Notes of Mental Health Parkinson’s Disease A progressive neurological disorder that results in degenerative of nerve cells in a regions of the brain that controls movement. This degeneration creates a shortage of the brain-signaling chemical (“neurotransmitter dopamine”) causing impaired movement. Although there are different types of Parkinson’s disease, the most common condition today is the one first recognized in 1817 by James Parkinson. Most researchers suspect the cause of Parkinson’s disease is a combination of genetic susceptibility and environmental exposure, and that the genetic and environmental contributions will vary among different people. Incidence of Parkinson’s increases with age and is uncommon in people younger than forty. Although it is not a regular feature, intellectual impairment may occasionally occur in the later stages of the disease. Symptom of Parkinson’s disease: Tremor in the arms and legs Muscular stiffness Rigidity Slowness of movement Cause of Parkinson’s disease: UNKNOWN but it is known that progressive destruction of nerve cells in the brain can lead to the depletion of a brain-signaling chemicals. In some case, it may occur within families. It can be divided into idiopathic type and those with secondary causes: Most Parkinson’s disease among the elderly is idiopathic. 20 Teacher Notes of Mental Health Secondary causes of Parkinson’s disease include long-term use of drugs like certain anti-emetics, brain trauma, brain infection and recurrent stroke. Treatment of Parkinson’s disease: NO CURE or PREVENTION Drug therapy – there is no “right” strategy for what drug to be used at a particular stage. The symptoms can be substantially or sometimes completely alleviated at early stages with medications. Non-pharmacological treatment Physical therapy Exercise Occupational/Speech therapy Diet and Nutrition Education, support and counseling Surgery 21 Teacher Notes of Mental Health Neurotic Disorders Mood Disorder A prolonged and disturbed emotional state that affects almost all of the person’s thoughts, feelings, and behaviors. Causes of Mood Disorder: Mood disorders are associated with imbalance of the brain-signaling chemicals e.g. dopamine. Researchers believe hereditary and psychosocial factors, such as stress or physical illness may play a role. Treatment of Mood Disorder: Combination of medication and psychotherapy. REMARK: Electro-convulsive therapy (ECT) is sometimes used when depression fails to respond to treatment or when patient is in a high risk of suicide. ECT is a “shock treatment” (apply a low-level electric current through) to the brain to cause a brief convulsion, which use as a treatment of chemical imbalance in the brain. The side effect of ECT is mild, short-term memory loss. There are two types of Mood Disorder: Major Depression (or “Uni-polar Disorder”) Manic-Depressive Disorder (or “Bipolar Disorder”) 22 Teacher Notes of Mental Health Major depression (Unipoloar) Marked as at least 2 weeks of continually being in a bad mood, having no interest in anything, and getting no pleasure from activities. Symptom of Major Depression: A person must have at least 4 of the following symptom: Problems with eating, sleeping, thinking, concentrating, or making decisions. Lack of energy Suicidal thoughts Feeling worthless or guilty Cause of Major Depression: Exact cause is not known but chemical imbalances (hormones or brain-signaling chemicals) in the brain. Seems to be related stressful/upsetting life events e.g. relationship difficulties, physical illness or job/money worries. At least 10 times more common to the nearest relatives of people with depression. Treatment of Major Depression: Antidepressant drugs Antidepressant drugs Interpersonal therapy Counseling Electro convulsive therapy 23 Teacher Notes of Mental Health Manic-Depressive Disorder OR Bipolar Disorder Characterized by an alternating pattern of emotional highs (mania) and lows (depression). Symptom of Manic-Depressive Disorder: A person must have at least 3 of the following symptom: Great self-esteem Little need for sleep Speaks rapidly and frequently Has racing thoughts Is easily distracted Pursues pleasurable activities Cause of Manic-Depressive Disorder: Unclear but contributing factors might include: 10 to 15 per cent of the nearest relatives of people with a bipolar disorder have a mood disorder. Biochemical changes in hormones and brain-signaling chemicals that are found during the manic and depressive phases. Stressful life events such as death of a family member, redundancy or break up of an important relationship. Treatment of Manic-Depressive Disorder: Antidepressant drugs Mood stabilizing drugs Cognitive behavioral therapy Counseling 24 Teacher Notes of Mental Health Anxiety Characterized by physiological signs of anxiety and subjective feelings of tension, apprehension, or fear. Anxiety is associated with a wide range of physical illnesses, medication side effects, and other psychiatric disorders. Illnesses from anxiety include Phobia Obsessive-Compulsive Disorder (OCD) Generalized Anxiety Disorder (GAD) 25 Teacher Notes of Mental Health Phobia It is a persistent, extreme or irrational fear of a specific object or situation. Three general categories of Phobia: Social – fear of social encounters Panic Disorder – occasional nonspecific bouts with fear Specific – fear of natural environments, of injury or blood, of animals or insects or of dangerous situations Cause of Phobia: UNCLEAR. Some researchers believe that there may be a strong correlation between your phobias and the phobias of your parents as children may learn phobias by observing a family member's phobic reaction to an object or situation. Symptom of Phobia: Phobic reactions can include: Racing heart Short, shallow breaths Sweating Fear of death May accompanied by a variety of other health problems: Depression – avoid to participate in activities Substance abuse – When comes in stress, people with phobias turn to alcohol or other drugs. Physical disorders – Fear/Stress of Phobia may contribute to high blood pressure, asthma or other physical discomforts. 26 Teacher Notes of Mental Health Treatment of Phobia Medications Behavioral therapies Combination of medication therapies 27 and behavioral Teacher Notes of Mental Health Obsessive-compulsive disorder (OCD) Characterized by obsessive thoughts and/or compulsive behaviors that significantly interfere with normal life. The obsessive and compulsive rituals can occupy many hours of each day. Symptom of OCD: Obsessions are unwanted, recurrent, and disturbing thoughts that the person experience involuntary and which can cause overwhelming anxiety. The common obsession includes: Fear of dirt or contamination Concern with order, symmetry and exactness. Constantly thinking about certain sounds, images, words or numbers. Fear of harming a family member or friend. Fear of thinking evil or sinful thoughts. Compulsions are repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of the obsessions. The common compulsions includes: Excessive hand washing Checking repeatedly that doors are locked and appliances turned off Arranging items in a precise order Counting over and over to a certain number Touching certain objects several times Cause of OCD: UNKNOWN but insufficient level of one of your brain's chemical messengers (“Serotonin”). The risk factors of developing OCD may include parents or other family members have OCD and stress. Treatment of OCD: Combination of behavior therapy and antidepressant medication. 28 Teacher Notes of Mental Health Somatoform Disorder A group of disorders characterized by physical symptoms that cannot be fully explained by a neurological or generalized medical ("organic") condition. Symptoms of Somatoform Disorder: Frequent headaches Back pain Abdominal cramping Pelvic pain Other symptoms include pain in the joints, legs and arms, and chest or abdominal pain. May also cause gastrointestinal problems, such as nausea, bloating, vomiting, and diarrhea and food intolerance. Cause of Somatoform Disorder: UNKNOWN May be a problem with the nerve impulses that send signals of pain, pressure and other unpleasant sensations to the brain The risk factors of developing may include parents or other family members have Somatoform disorder. Treatment of Somatoform Disorder: No known cure but can be managed Drug therapy Psychotherapy 29 Teacher Notes of Mental Health Generalized Anxiety Disorder (GAD) Characterized by excessive or unrealistic worry about almost everything or feeling that something bad is about to happen. Anxious feelings occur on a majority of days for a period of at least six months. Symptoms of GAD: Restlessness Being easily fatigued Sweating Flushing Insomnia Headaches Muscle tension Cause of GAD: May run in families and it may also grow worse during stress. GAD usually begins at an earlier age and symptoms may manifest themselves more slowly than in most other anxiety disorders. Treatment of GAD: Medication like Tranquilizers and anti-depressant drugs may ease the symptoms. Psychotherapy and relaxation techniques 30