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Chapter 36
Mental Health Problems
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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BASIC CONCEPTS
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Mental relates to the mind.
• Mental health involves the mind.
Mental health and mental illness involve stress.
• Stress is the response or change in the body caused by
any emotional, physical, social, or economic factor.
• Mental health means that the person copes with and
adjusts to everyday stresses in ways accepted by
society.
• Mental illness (mental disorder, emotional illness,
psychiatric disorder) is a disturbance in the ability to cope
with or adjust to stress.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Causes of mental health disorders include:
• Not being able to cope or adjust to stress
• Chemical imbalances
• Genetics
• Drugs or substance abuse
• Social and cultural factors
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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ANXIETY DISORDERS
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Anxiety is a vague, uneasy feeling in response to
stress.
 Often, anxiety occurs when needs are not met.
 Some anxiety is normal.
 Signs and symptoms depend on the degree of
anxiety.
 Anxiety level depends on the stressor.
 Coping and defense mechanisms are used to
relieve anxiety.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Panic disorder
• Panic is the highest level of anxiety.
• Panic attacks occur.
• Panic disorder can last for a few months or for many
years.
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Phobias
• Phobia means an intense fear, panic, or dread.
• The person has an intense fear of an object, situation, or
activity that has little or no actual danger.
• When faced with the fear, the person has high anxiety
and cannot function.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Obsessive-compulsive disorder (OCD)
• An obsession is a recurrent, unwanted thought, idea, or
image.
• Compulsion is repeating an act over and over again (a
ritual).
• Some persons with OCD also have depression, eating
disorders, substance abuse, and other anxiety disorders.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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SCHIZOPHRENIA
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Schizophrenia means split mind.
• It is a severe, chronic, disabling brain disorder.
 Schizophrenia involves:
• Psychosis
• Delusion
• Hallucination
• Paranoia
• Delusion of grandeur
• Delusion of persecution
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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The person with schizophrenia:
• The person has severe mental impairment (psychosis).
• The person has disturbed thinking and behavior.
• Disorders of movement occur.
• Some persons regress.
 In men, the symptoms usually begin in the late
teens or early 20s.
 In women, symptoms usually begin in the mid-20s
and early 30s.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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People with schizophrenia do not tend to be
violent.
 Some persons with schizophrenia attempt suicide.
 If a person talks about or tries to commit suicide:
• Call for the nurse at once.
• Do not leave the person alone.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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MOOD DISORDERS
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The person with bipolar disorder has severe extremes
in mood, energy, and ability to function.
• There are emotional lows and emotional highs (depression and
mania).
• The disorder also is called manic-depressive illness.
• The person may:
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Be more depressed than manic
Be more manic than depressed
Alternate between depression and mania
• If a person talks about or tries to commit suicide:
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Call for the nurse at once.
Do not leave the person alone.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Major depression
• Depression involves the body, mood, and thoughts.
• Symptoms affect work, study, sleep, eating, and other
activities.
• The person is very sad and loses interest in daily
activities.
• Depression is common in older persons.
• Depression in older persons:
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Is often overlooked or a wrong diagnosis is made
Is often thought to be a cognitive disorder
Is often not treated
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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PERSONALITY DISORDERS
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Personality disorders involve rigid and
maladaptive behaviors.
 Those with personality disorders cannot function
well in society.
 Personality disorders include:
• Antisocial personality disorder
• Borderline personality disorder (BPD)
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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SUBSTANCE ABUSE AND ADDICTION
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Substance abuse or addiction occurs when a
person overuses or depends on alcohol or drugs.
• The person’s physical and mental health are affected.
• The welfare of others is affected.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Alcoholism and alcohol abuse
• Alcoholism is a chronic disease, lasting throughout life.
• Lifestyle and genetics are risk factors.
• Some people turn to alcohol for relief from life stresses.
• The craving for alcohol can be as strong as the need for
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food or water.
There is no cure.
Alcoholism can be treated.
Alcohol effects vary with age.
Mixing alcohol with some drugs can be harmful, even
fatal.
Alcohol makes some health problems worse.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Drug abuse and addiction
• Drug abuse is the overuse of a drug for non-medical or
non-therapy effects.
• Drug addition is a chronic, relapsing brain disease.
• Legal and illegal drugs are abused.
• Treatment depends on the type of drug and the person.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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CARE AND TREATMENT
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Treatment of mental health problems involves
having the person explore his or her thoughts and
feelings through various therapies.
 Often, drugs are ordered.
 The care plan reflects the person’s needs.
 Communication is important.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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QUALITY OF LIFE
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Persons with mental health problems have the
right to quality of life.
 Protect the right to privacy and confidentiality.
 Protect the right to personal choice.
 Protect the person from abuse, mistreatment, and
neglect.
 Provide a safe setting.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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