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Surgeon General’s Report
Chapter 2: The Fundamentals of
Mental Health and Mental Illness
Josh Alexander
The Basics in Painful Detail
The brain has lots of different neuron types.
Collect them all!
Terminal buttons release
Neurotransmitters across the Synapse to
the Dendrites of the next neuron.
The process it uses is called Diffusion (sold
separately).
More Physio Than You Can
Shake a Stick at!
Signal sent through neurons via electric
impulses
Each neuron is connected to over 1,000
other neurons.
If I Only Had A… Uhh…..
The Brain has lots of
areas.
The Occipital Lobe
handles visual
processing.
The Parietal Lobe
does Tactile
information.
Umm…..
Your Frontal Lobe
controls motor activity
The Prefrontal Cortex
helps with planning
and integrating
cognitions and
emotions
Your Obscure Brain
Amygdala:
controls basic
emotional responses
such as anger and fear
Hippocampus:
consolidates explicit
memories of objects
and events
Your Favorite Mind-Altering
Chemicals
The brain uses more
than 100 different
neurotransmitters,
like:
Dopamine
Serotonin
Norepinephrine
All neurotransmitters
have multiple
receptors that affect
behavior in different
ways.
Where to Find Your Favorite
Drugs
Dopamine is produced in the Substantia
Nigra and the Ventral Tegmental Area.
Norepinephrine comes from the Locus
Coreruleus and the Pons.
Serotonin is made in the [CENSORED]
Mental Disorders
Characterized by weird cognition, emotion,
or mood, as well as odd social interaction
and planning.
Kleptomania 
Anxiety
Fear response, including increases heartbeat
and sweating.
Inappropriate responses: Phobias, panic
attacks, and generalized anxiety
Obsessive/Compulsive Disorder: get
anxious when you can’t complete your
compulsion.
Psychosis (the old Hitchcock
version, not the new one)
Disturbances of perception and thought
processes.
Occurs in Schizophrenia and mood
disorders.
But that’s not all! Free gifts with
Psychosis:
Positive Symptoms: quality of consciousness
not normally present. These are:
Hallucinations: false sensory impressions.
Can be of any sense.
Delusions: false beliefs
Psychotic Thought: disorganized, illogical,
and bizarre.
But Wait! There’s More!
Negative Symptoms: absence of expected
thoughts or behaviors, such as:
Concrete thoughts
Flat affect
Anhedonia
Lowered spontaneity and motivation
My Mood is Swinging Like
Tarzan
Disturbances of Mood: sustained feeling of
sadness or sustained elevation of mood.
Major Depression
Bipolar Disorder
Underlying mechanisms unknown, but all
respond to specific treatments
I Get This Around Test Time
Disturbances of Cognition: disruption of the
ability to organize, process, and recall info
Dementia: progressive deterioration of
cognitive function
Affects attention, concentration, short term
memory, and language skills
Diagnosis of Crazy People
No definitive physical injury always
indicates mental illness.
Diagnosis relies on patient reports, mental
health exams, and observation of their
behavior.
EVERYBODY’S nuts!
Changes in diagnosis
criteria have occurred
over the years.
People now have to
have a cluster of
symptoms to be
diagnosed with an
illness.
Nifty Stats to Make You
Depressed
20% of the U.S. population are affected by a
mental disorder.
28-30% have either a mental disorder or an
addiction.
5.4% of adults have a serious mental illness
2.6% have severe mental illness, including
schizophrenia, bipolar, etc.
And you Thought You Were the
Only One….
20% of children have
mental illness with
functional
impairment.
19.8% of older adults
have a disorder, not
including
Alzheimer’s.
This Is Driving Me Crazy!
Mental Disorders are thought to be caused
by interplay between biological, social, and
psychological factors.
Biopsychosocial model says biology isn’t
enough.
Biology and the Raving Lunatic
Genes, infection, physical trauma, nutrition,
hormones, and toxins can affect mental
health.
Mental illness isn’t caused by single genes,
but interactions of several genes and
environmental factors.
Bet You Didn’t Know….
Mental Disorders can be caused by certain
illnesses
HIV-Associated Dementia
PANDAS
Psychoanalysis (stop me if
you’ve heard this one…)
Much of mentality is unconscious.
Past experiences affect feelings later in life.
Id, Ego, Superego
Mental disorders come from inability of ego
to mediate between Id and Superego.
Psychoanalyst helps client to discover what
is hidden in the unconscious.
Behaviorism (or, What are you
doing to that rat!?!)
Dismisses existence of
unconscious.
Looks at observable,
learned behaviors.
Behavior is shaped by
reinforcement and
punishment, and
disorders are
maladaptive learned
responses.
Breger’s Theory of Development
Behavioral maturation goes from simple to
complex
Future responses are a product of previous
ones
Response to event depends on current
developmental stage.
Other Theories
Piaget
Theory covers Cognitive
development, but not
physical or emotional.
Bowlby
Attachment theory:
security of attachment to
mother lets child organize
development in a coherent
way
Erikson
Psychoanalytic
Series of stages: trust vs
mistrust; autonomy vs
shame; initiative vs guilt;
industry vs inferiority;
identity vs role diffusion;
intimacy vs isolation;
generativity vs stagnation;
ego integrity vs despair
Preventing Mental Illness
Hard to do because of incomplete
knowledge of etiology or inability to affect
the known etiology of disorders.
Successful in preventing Major Depressive
Disorder, Conduct Problems, and HIV-risk
behaviors.
An Ounce of Prevention is Worth
about $25 on Ebay
Primary Prevention: keeping a disease
from occurring
Secondary Prevention: keeping a disease
from coming back or getting worse
Tertiary Prevention: reducing negative
effects of a disease
Psychotherapy (or Night of the
Living Freud)
Psychodynamic therapy: self-understanding
will produce positive change
Humanistic therapy: personal growth and
self-understanding will help
Psychodynamic Therapy
Psychoanalysis
Interpersonal therapy: looks at grief, role
disputes, role transitions, and interpersonal
deficits. In a nutshell, the relationships
between the client and others.
Cognitive-Behavioral Therapy
Mix of behaviorism and
cognitive psychology
Examines the role of
environment as a
behavioral model
Change faulty
cognitions to adaptive
ones.
Humanistic Therapy
Focuses on future development
Emphasizes feelings instead of cognitions
and behavior
Wants to improve subjective experience
regardless of mental diagnosis
(with part one…)