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Chapter 12 Mental Health Mental Health: What Is It? One definition: “how we think, feel, and act as we cope with life” (Kellogg, R. (2008). Quoted in What is mental health? [Press Release]). What is good mental health? One definition: “a state of well-being that allows someone to be productive, have fulfilling relationships, cope with difficult circumstances, and adapt to change.” Mental health and physical health are connected. • Mental health affects physical health (being depressed increases the risk for heart disease). • Physical health affects mental health (lack of air can cause a panic attack; regular exercise lowers the risk for depression). Mental illness is common, but it doesn’t mean a person is crazy. • 1 in 5 adults (45 million Americans) suffer from a diagnosable mental disorder in a given year. • Half of all Americans will experience some form of mental illness during their lives. • People with mental illnesses love others, hold jobs, and contribute to society. What Affects Mental Health? Biology • Some mental illnesses have genetic components. • Neurotransmitters, hormones, physical health and other factors can affect mental illnesses and how they are perceived. Social and Psychosocial Factors • The way women are treated affects their mental health What Affects Mental Health? • Stress – Chronic stress, and the way people react to it, affect mental health. – Women are more likely than men to internalize stress. – Traumatic events can cause or contribute to mental illness. – Coping with stress in a positive manner can improve mental health. – How do you respond to stress? Costs of Mental Illness to Society Undefined burden of mental problems • Refers to the economic and social burden for families, communities, and countries Hidden burden of mental problems • Refers to the stigma and violations of human rights and freedoms associated with mental problems What Mental Illnesses Affect Women Compared to men, women are more likely to have • Depression (2x) • Seasonal affective disorder (4x) • Anorexia, bulimia (9x) • Phobias, panic disorder (~2x) • Borderline, histrionic personality disorder. Women are less likely to have schizophrenia, antisocial personality disorder, attention-deficit disorder, and to be violent as a result of mental illness. The Economic Burden of Mental Illness • Need for mental health and social services • Lost employment and reduced productivity • Financial burden placed on families and caregivers • Increased levels of crime and threat to public safety • Negative effects of premature mortality Legal Dimensions: The Mental Illness/Crime Paradox • Given treatment, people with mental illness are no more likely to commit crimes than the general public. • Without treatment, however, the mentally ill are more likely to commit crimes and to be arrested. Clinical Dimensions of Mental Health Mood Disorders • Unipolar disorder: depression and dysthymia • Bipolar disorder: manic depression Types of depression • Premenstrual dysphoric disorder (PMDD) • Postpartum depression • Seasonal affective disorder (SAD) Depression Persistent, inescapable feelings of sadness, low energy and apathy. Treatment for depression • Antidepressant drugs • Psychotherapy • Combination of therapy and drugs Bipolar Disorder Both highs and lows • Highs: feelings of wonder and euphoria and/or overly stimulated, easily distracted, and easily irritated • Lows: deep, persistent feelings of sadness, anxiety, hopelessness, or guilt; they might also have low energy, a reduced sense of pleasure and a lowered sex drive, and thoughts of suicide Anxiety Disorders • Generalized anxiety disorder (GAD) • Phobias • Panic disorder • Obsessive-compulsive disorder (OCD) • Post-traumatic stress disorder (PTSD) Anxiety Disorders Treatment for anxiety disorders • Cognitive behavioral therapy • Antianxiety medications • Antidepressants • Medication and therapy together Treating Mood Disorders and Anxiety Disorders Treatment CAN and USUALLY does help. But… • It is difficult. • It takes time. Treatment can include medications, psychotherapy, or a combination of the two (both together normally work better than either alone). Eating Disorders Anorexia Nervosa • Deprivation of food and a body weight of at least 15% below the normal weight based on height and age Symptoms • Refusal to maintain an adequate weight • Intense fear of gaining weight • Distorted body image • In women, absence of three consecutive menstrual periods Eating Disorders Bulimia Nervosa • Cyclic binge eating followed by purging • Symptoms – Recurrent episodes of bingeing and vomiting – Feeling out of control during a binge – Purging after a binge – Extreme concern with body weight and shape Eating Disorders Binge Eating Disorder Compulsive overeating without purging At least three of the following: • Rapid, continuous eating (thousands of calories) • Eating when not physically hungry • Eating while alone • Eating beyond the point of comfort • Feeling self-disgust after a binge Treatment for Eating Disorders • Psychotherapy • Behavior modification therapy • Family therapy • Antidepressants Personality Disorders • Antisocial • Obsessive-compulsive • Avoidant • Paranoid • Borderline • Passive-aggressive • Dependent • Schizoid • Histrionic • Schizotypal • Narcissistic Schizophrenia • Psychosis—severe mental disorder characterized by lack of contact with reality and severe personality changes • Schizophrenia—type of psychosis; afflicts about 2.5 million Americans, with men and women equally afflicted • Symptoms include hallucinations, delusions, disordered thinking, and impaired ability to interact with others • Treatment: antipsychotics and psychotherapy Dissociative Disorders • Unconscious way to protect self from emotional traumas by detaching from a part of one’s personality • Several types: dissociative identity disorder (multiple personality disorder), dissociative amnesia Suicide Risk factors • Adverse life events in combination with depression • Prior suicide attempt • Family history of mental disorder or substance abuse • Family history of suicide • Family violence, including physical or sexual abuse • Firearms in home • Incarceration Informed Decision Making: Healthful Ways to Cope with Stress • Watching a funny movie or show, telling and listening to jokes, or other activities that bring laughter • Exercise (regular activity is best, but any amount of exercise brings benefits) • Meditation or prayer • Gardening • Spending time with a pet or pets • Getting a massage If you have some form of mental illness: You are not alone. Help is available—and it can make a difference. Informed Decision Making: Healthful Ways to Cope with Stress • Visualization (imagining yourself on a calm beach, a quiet meadow, or some other peaceful, relaxing situation) • Listening to music • Naps or simply lying down, closing one’s eyes and relaxing • Regular exercise • Creative endeavors (writing, drawing or painting, dancing, etc.)