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Chapter 18: Mental Health Are we all a little bit crazy? Mental Health is a matter of degree Mental Health is a matter of degree abnormal severe mild Psychosis Relatively healthy normal Self actualized Not in touch With reality Anxiety Disorders Somatoform Disorders Types of Disorders Schizophrenia Dissociative Disorders Anxiety: generalized feeling of apprehension Panic Disorder: frequent overwhelming attacks of anxiety Phobic Disorders: disabled by fear in presence of certain objects or situations. Two types: Specific Phobia: snakes, heights, enclosed spaces, etc. Agoraphobia: literal homebodies…will not leave home. Fear of leaving familiar environments. Obsessive Compulsive Disorders Endless preoccupation with urge or thought Symbolic ritualized behavior Recently found that brain chemicals trigger the circuits over and over Continued thoughts about performing a certain act over and over Somatoform Disorders Conversion Disorders Hypochondriasis Serious psychological trauma converts into physical dysfunction. Example: hysterical blindness, paralysis Excessive concern about physical health, often from only receiving positive attention as a child when sick. Dissociative Disorders Amnesia • Dissociative Disorder related to trauma • Memories “disappear”. • Most common psychological amnesia related to war experiences: selective forgetting Usually does not last longer than a year Starts out new somewhere else Amnesia from current life More often in men than in women Dissociative Identity Disorder Dissociative Identity Disorder or Multiple Personality Disorder Haunted, confused personality, upsetting traumatic abuse Sometimes one personality does not know the others Sometimes one personality will know and work with the others History of guilt over unacceptable impulses This is NOT schizophrenia….personalities know reality vs. unreality, can think and communicate and do not believe things that do not exist Mood Disorders DYSRHMIC DISORDER: “low spirits”, moderate depression, general sadness, usually goes away on its own MAJOR DEPRESSION: Slow speech, disturbances in sleep, appetite, energy, hopelessness, thoughts of suicide BIPOLAR DISORDER Combination of mania and Major depressive episodes. When hallucinations are included, diagnosis is manic depressive psychosis MANIA Extreme agitation, restlessness, rapid speech and thoughts “flight of ideas” delusions of all powerful ability Serotonin is a brain chemical that plays a large role in mood disorders: Too much can cause mania Not enough can cause depression Psychotic Disorders Psychosis Thought Disorder Schizophrenia • Severe mental disorder involving major problems with emotional thought processes, distorted perceptions of the world • A serious distortion of the ability to think or speak in a lucid and coherent way • Hallucination: seeing or hearing something not there • Delusion: belief in something that is not true • Most serious mental disturbance involving loss of contact with reality, thought disorders, hallucinations and delusions. • Affects about 1% of population • Some have one episode and get better • Some have many and do not respond to treatment very well all the time • Some spend most of their lives in and out of institutions. • Appears in late adolescence or early adulthood • Word Salad: words are all mixed up incoherently • Clang Associations: Psychotic speech in which words are rhymed • Subtypes of Schizophrenia: • Catatonic: say very little, do not speak, stupor much of the time, very little movement • Paranoid: strong feelings of persecution and suspiciousness, grandiose beliefs. • Disorganized Schizophrenia: extreme thought disturbances, rarely live outside of institutions • Undifferentiated: does not fit other types • Psychotic Episodes: come in cycles Louis Wain pre diagnosis Louis Wain post diagnosis Personality Disorders • Antisocial Personality Disorder: person seems in constant conflict with authority, law and has no conscience, also known as a sociopath • Most criminals do not even fit into this category….they follow some rules! • Borderline Personality Disorder: unstable emotions and relationships, dependency, self destructive behavior Diagnostic and Statistical Manual of Mental Disorders IV • Used by mental health workers to categorize the hundreds of sets of symptoms of mental, emotional, personality, and physical/mental health disorders • • • • • • • • • • • F00-F09 Organic, including symptomatic, mental disorders F10-F19 Mental and behavioral disorders due to psychoactive substance use F20-F29 Schizophrenia, schizotypal and delusional disorders F30-F39 Mood [affective] disorders F40-F48 Neurotic, stress-related and somatoform disorders F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors F60-F69 Disorders of adult personality and behaviour F70-F79 Mental retardation F80-F89 Disorders of psychological development F90-F98 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence F99 Unspecified mental disorder