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What is Mental Health? Lesson 1 https://youtu.be/DdZgPbgBqSg Good? Bad? Does everyone have it? Why is it important? See wheel definitions on separate sheet • How do you define wellness? • When would your wheel be unbalanced? • The World Health Organization defines wellness as: “a complete state of physical, mental, and social wellbeing, not merely the absence of disease or illness.” World Health Organization (WHO), 2015 Common Diagnoses… • • • • Depression Bipolar Disorder/Mania Anxiety Addictive Disorders • Eating Disorders • Personality Disorders • Psychotic Disorders National Alliance on Mental Illness (NAMI), 2015 Treatment is possible… • • • • • • Counseling Medication Exercise Choosing to be in positive environment Reducing Stigma… https://youtu.be/tfnQTleZ3Lc 20% of youth ages 13-18 live with a mental health condition. 50% of all lifetime cases of mental illness begin by age 14 and 75% by age 24 The average delay between onset of symptoms and intervention is 8-10yrs Approx 50% of students age 14 and older with a mental illness drop out of high school 70% of youth in state and local juvenile justice system have a mental illness. About ½ of all Americans will meet criteria for some type of mental disorder sometime in their lifetime, with first onset usually in childhood or adolescence National Institute of Mental Health (NIMH), 2014 8% of youth have an Anxiety Disorder ANXIETY is an emotion characterized by feelings of tension, worried thoughts, and physical changes such as increased blood pressure Those with ANXIETY DISORDERS: • Have recurring, intrusive, uncontrollable thoughts and concerns • Respond to certain objects or situations with fear and dread • The anxious response is typically not appropriate for the situation • The anxiety interferes with normal functioning • May avoid certain situations out of worry • Physical symptoms such as sweating, trembling, dizziness, or a rapid heartbeat National Institute of Mental Health (NIMH), 2015 May begin at any time, however, they often surface in adolescence and early adulthood Most common include: Generalized Anxiety Disorder (GAD) Panic Disorder and Agoraphobia Post Traumatic Stress Disorder (PTSD) Phobias Social Anxiety Disorder (Social Phobia) .. . National Institute of Mental Health (NIMH), 2014 • Do you worry excessively about things that are unlikely to happen, or feel tense and anxious all day long with no real reason? Everyone gets anxious sometimes!! • BUT ,if your worries and fears are so excessive that they interfere with your ability to function and relax, you may have generalized anxiety disorder (GAD). GAD is mentally and physically exhausting. It drains your energy, interferes with sleep, and wears your body out. But you can break free from chronic worrying and learn to calm your anxious mind. Treatment for Anxiety Minor: self help books, tips for managing anxiety Counseling Learn how to change negative thinking Relaxation techniques Ex: Deep breathing Medication Exercise What works for you???? • Stress is simply a reaction to a stimulus that disturbs our physical or mental equilibrium. It is the brains response to any demand. • What is stressful for one person may be pleasurable for someone else. Everyone reacts differently to stress. • A stressful event can trigger the “fight-or-flight” response, causing hormones such as adrenaline and cortisol to surge through the body. Stress is your body’s way of responding to any kind of demand or threat. • When you feel threatened your nervous system responds by releasing stress hormones, adrenaline and cortisol, which alert the body for emergency action. • Your heart pounds faster, muscles tighten, blood pressure rises, breath quickens, and your senses become sharper. • These physical changes increase your strength and stamina, speed your reaction time, and enhance your focus. (Lesson 2) 11 % of youth have a mood disorder •Mood disorders: also called affective disorders, are a category of illnesses that describe a serious change in mood. They typically involve persistent feelings of sadness, losing interest in important parts of life, or fluctuations from extreme happiness to extreme sadness. Currently, the most common Mood Disorders are: 1. Major Depressive Disorder/Major depression 2. Chronic depression (also known as Dysthymia) 3. Bipolar Disorder (also known as manic depression) Lets talk about each… National Institute of Mental Health (NIMH), 2015 Major Depression/Clinical Depression • Most common type of mood disorder • Persistent feeling of sadness and loss of interest – A constant sense of hopelessness and despair – Loss of interest in normal activities and relationships • Requires a diagnosis by a family care doctor or psychiatrist – Symptoms must be present every day for at least 2 weeks • Symptoms include: – Constant fatigue/loss of energy, worthlessness and guilt, impaired concentration, indecisiveness, insomnia or hypersomnia almost every day, restlessness, weight loss or gain, appetite changes, suicidal thoughts • Causes may include chemical imbalance in brain and stressful life events (such as loss of a loved one, family issues, bullying, trauma, abuse, etc.) National Institute of Mental Health (NIMH), 2015; American Psychological Association, 2015 Chronic Depression • Mild to moderate type of long-term depression, also referred to as Dysthymia or persistent depressive disorder – Not as severe as major depression, however, is longer-lasting • Requires diagnosis – A low mood occurring for at least one year if under 18 or two years if order 18), along with at least two other symptoms of depression. • Symptoms may significantly interfere with every day activities: – Loss of interest in normal activities, hopelessness, low selfesteem, overall feeling of inadequacy, appetite and sleep issues, low energy and poor concentration • If you have chronic depression you may described as being unhappy, constantly complaining, or incapable of having fun. National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 Maggie’s story… http://youtu.be/zqb UIM0MrWs Depression SEE THE DIFFERENCE?? THINK ITS SERIOUS? Teen Depression - A Common Problem • It is not unusual for teens to experience “the blues” or feel “down in the dumps” occasionally. • Teen depression is a SERIOUS medical problem that affects how you think, feel, and behave & can cause emotional, functional, and physical problems. • Approximately 20% of teens will experience depression before adulthood. • Between 10 to 15% of teenagers have symptoms of depression at any one time. • Depression increases a teen’s risk for attempting suicide by 12X • 30% of teens with depression develop a substance abuse problem. • Depressed teens usually have a smaller social circle & take advantage of fewer career & educational opportunities. • Depressed teens are more likely to have trouble in school and relationships. Mental Health American (MHA), 2016; American Academy of Child and Adolescent Psychiatry, 2015 Bipolar Disorder (Also known as Manic Depression) Extreme and Rapid Mood Changes: Depressive moods Manic moods Bipolar Disorder • A disorder associated with episodes of mood swings ranging from depressive lows to manic highs called manic or depressive episodes • Each episode usually lasts day to weeks at a time and may occur several times a year or throughout the year • Mania symptoms include periods of elevated mood or irritability. When experiencing a manic episode, a person often has high energy levels with reduced need for sleep • Depression symptoms include feeling sad, low energy and motivation, excessive sleep, loss of interest, and isolation. National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 More on Mania… • A manic disorder is not a disorder in and of itself, but rather is a part of a type of bipolar disorder • Mania- mood of an abnormally elevated arousal energy level, marked by period of great excitement, delusions, and over activity • It’s a state of extreme physical and emotional elation Symptoms are not a result of substances • The word is derived from the Greek ( Mania) meaning “ madness, frenzy”. National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 • There is a common myth that people with Bipolar Disorder shift back and forth from depression and mania very often. • The “Jekyll-Hyde” personality, that can turn on a dime from sad to euphoric, is a myth about Bipolar • Average person with Bipolar is depressed more often than manic • Some will shift back and forth more quickly that others but that is not the typical pattern National Institute of Mental Health (NIMH), 2014 Psychotic Disorders Also called: Psychosis • PSYCHOTIC DISORDER: Mental illness involving disordered thinking and behaviors. – Characterized by a disconnection from reality Symptoms of a psychotic disorder vary from person to person and may change over time based on the specific diagnosis. The major symptoms are hallucinations and delusions. • The person with the disorder usually isn’t aware of his or her behavior • Hallucinations: unusual sensory experiences or perceptions of things that aren’t actually present *seeing things that aren't there *hearing voices *smelling odors *having a "funny" taste in your mouth *feeling sensations on your skin even though nothing is touching your body. National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 • False beliefs that are inconsistent with reality, persistent, organized, and that do not go away after receiving logical or accurate information. • A delusion may involve real-life situations that could be true, such as having a terminal illness or disease, being followed, or being conspired against • Despite medical doctors, family, friends and peers confirming that the individual is not ill, conspired against, or being followed, the individual continues to live and behave as if the delusion is true. • Some types of Psychotic Disorders include: • Schizophrenia, Schizoaffective Disorder, Brief Psychotic Disorder, Substance-induced Psychotic Disorder National Institute of Mental Health (NIMH), 2014 Assignment : Read “Teen Smokers are prone to psychotic Disorders” Read and answer the 5 questions from the article. Lesson 3 Eating disorders involve extreme emotions, attitudes and behaviors surrounding weight and food issues. They cause serious emotional and physical problems that can have lifethreatening consequences. • Highest mortality rate of all mental illnesses • Teenage eating disorders have multiplied over the past 10 years o Anorexia Nervosa o Bulimia nervosa o Binge eating disorder The National Eating Disorders Association (NEDA), 2016 • Anorexia Nervosa: – Inadequate food intake leading to unhealthy weight that is clearly too low for height – Intense fear of weight gain & obsession with weight and persistent behavior to prevent weight gain – Self-esteem overly related to body image and sees self as bigger than actual size • Bulimia Nervosa: – Frequent episodes of consuming very large amounts of food followed by purging behaviors to prevent weight gain – A feeling of being out of control during the binge-eating episodes – Self-esteem overly related to body image The National Eating Disorders Association (NEDA), 2016 • Binge Eating Disorder: – Frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain – Feeling out of control during binge eating episodes – May eat when not hungry, eat to the point of discomfort, or eat alone • Other eating & body-image related Disorders: – Eating Disorder Not Otherwise Specified (EDNOS): An eating disorder that causes significant distress but does not meet the criteria for another eating disorder • For example: Meeting all symptoms of Anorexia, but weight not below normal – Body Dysmorphia: Obsessive focus on a perceived flaw in appearance that is minor or imagined – Muscle Dysphmorphia: Obsessive desire to have a muscular physique. The person does not see self accurately and strives for unattainable physique – Disordered Eating: Chronic dieting, restrictive/binging cycles, poor body image The National Eating Disorders Association (NEDA), 2016 *Read packet on Anorexia, Bulimia and Binge Eating *Answer worksheet on eating disorders. Impulse Control Disorders • People with impulse control disorders are unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others. • Impulsive Control Disorders are similar in terms of when they begin and how they progress. Increasing tension/arousal situation or event occurs person reacts with impulsive behavior Person feels gratification and relief Afterwards, person feels shame and guilt This causes tension and stress to increase Cycle continues… National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 Impulse Control Disorders, continued Some types of Impulse Control Disorders: • • Intermittent Explosive Disorder: Recurrent outbursts of anger that are disproportionate to the situation at hand • Kleptomania: Urges to steal • Pyromania: Urges to set fires for enjoyment and pleasure • Trichotillomania: Repetitive hair pulling that causes noticeable hair loss and significant levels of distress Other types: • Compulsive buying/shopping • Pathological skin picking • Internet Addiction or Mobile phone compulsion • Compulsive sexual behavior National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 Obsessive-Compulsive Disorders • Obsessive-compulsive Disorder (OCD): Persistent, uncontrollable feelings or thoughts (obsessions) and routines or rituals (compulsions) in which individuals engage to try to prevent these thoughts. • Common obsessions: Fear of contamination, fear of causing harm to another, fear of making a mistake, fear self or loved one dying, need for symmetry or exactness, excessive doubt, etc. • Common compulsions: Washing/cleaning, checking, arranging/organizing, collecting/hoarding, counting/repeating, touching or tapping National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 • OCD is the fourth most common mental illness and affects over 4 million people in the U.S. • People with OCD are often anxious and/or depressed National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 • Addiction: Consistent, compulsive dependence on a substance or behavior • Characterized by: – – – – – – Inability to abstain from substance/behavior Feeling out of control Craving the substance or behavior Denial Strained interpersonal relationships Dysfunctional emotional responses • Some addictive substances & behaviors include: – Alcohol, caffeine, nicotine, stimulants, inhalants, prescription pills, sedatives – Gambling – Over exercising – Video games National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 • Involves deeply ingrained and inflexible maladaptive patterns of thought and behavior which cause significant, long-term difficulties functioning within society and relationships – Typically developed by adolescence • The persons patterns of thinking & behaviors significantly differ from the expectations of society and are so rigid that they interfere with normal functioning • The person often believes the conflict/problem is with the external world rather than with his or her self National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 Some types of Personality Disorders: • Antisocial Personality Disorder – Disregard for the rights of others and societal norms, law breaking, repeatedly lie, place others at risk for own benefit, and lack of remorse • Borderline Personality Disorder – Unstable moods, inability to regulate emotions, impulsive and reckless behavior, and unstable relationships • Paranoid Personality Disorder – Paranoia and pervasive suspiciousness and mistrust of others Other types include: • Histrionic personality disorder • Dependent personality disorder • Narcissistic Personality Disorder • Avoidant Personality Disorder National Institute of Mental Health (NIMH), 2014; American Psychological Association, 2015 https://youtu.be/4E1JiDFxFGk Self Harm ( Lesson 4) • What is it? • Why? • Risks? • How to stop? • Up to 37% of Teens cutting!! Cutting epidemic………… • https://youtu.be/ytCDfYhoD8s • Demi Lovato’s Struggle • https://youtu.be/RVq-sLFu6M4 What else impacts mental health? • • • • • LGBTQ issues Self esteem Bullying Family stressors Environment • Grief and loss • Developmental changes/milestones • Trauma/Violence • Medical Issues Mrs. Farina’s Story https://youtu.be/D827iSJPdow Suicidal Thoughts • It’s normal to have sad, anxious, angry, hopeless, or frustrated feelings • It is NOT normal to think about suicide as a stress response Causes: – Feeling great pain – Trouble finding solutions to their problems – Feel as if they do not deserve the time or effort to get help – Personal troubles – Physical or mental health problems – Feel alone – Embarrassed about asking for help Risk Factors and Warning Signs Warning Signs Risk factors • Psychiatric Disorders • • 90% of those who completed suicide had a diagnosable and treatable illness Most common: depression • Past history of attempted suicide (impulsiveness) • Bullying • Low self-esteem • Stressful event (loss of loved one, family issues, etc.) • Making suicide threats or talking about dying • Sudden change in behavior • Signs of making plans: • • • • Giving away prized possessions Saying good bye Sudden purchase of firearm Obtaining other means of killing oneself (medications, poison) • Serious depression • Increased risk taking American Foundation for Suicide Prevention, 2015; Centers for Disease Control & Prevention, 2014 If you or someone you know are having suicidal thoughts… • Take it seriously • Acknowledge pain • Know that others WILL take you seriously • Talk to a professional (see resources) • Find support (friend? cousin? trusted adult?) • Avoid alcohol or drugs – Will increase harm • Know that getting/asking for help will NOT automatically end you up in the hospital Concerning Facebook post? • Facebook created feature with National Suicide Prevention Lifeline allowing users to report content that may indicate suicidal feelings • Notifies them that a friend is concerned and encourages them to connect to the Lifeline or a friend and provides resources. – Also provides reporting user support resources What getting help can do… • Protect person from self harm during the crisis – (Did you know that the mind can take up to 72 hours to process a crisis?) • Provide support for strong emotions • Learn new ways to think so life events won’t feel so overwhelming • Build problem solving skills • Learn to cope with stress • Build confidence and self esteem • Medication for MH issues available • Build HOPE – It doesn't last forever – Life can be better again..and WILL Ways to Cope • Write in your journal; if you don’t have one, start one. • Draw anything with pencils, markers, etc. • Listen to your favorite music. • Spend time with positive people. • Exercise. • Spend time with your family pet. • Play a musical instrument. • Take a few deep breaths. • Talk it out with a trusted person. You are not alone! Stories of HOPE & RECOVERY http://www.mentalhealth.gov/talk/r ecovery/