Mental Illness. Advanced Health. Mrs. Jordan

Transcription

1 Mental Illness Advanced Health Mrs. Jordan Updated 03/2012

2 I can Learning Targets Name 4 major types of depressive disorders. Describe at least 3 major symptoms of each of the four types of depression. Describe at least 2 treatment options for each of the four types of depression.

3 Mental Health People who are considered healthy Feel good about themselves Feel comfortable with other people and express respect and compassion toward others Control tension and anxiety Meet the demands of life Curb hate and guilt Maintain a positive outlook Value diversity Appreciate and respect nature

4 What do you think? Read Amy s story. Answer the questions and list any questions you have related to Amy. Be prepared to discuss with classmates.

5 Mental Illness When your psychological health begins to deteriorate Mental illnesses: disorders that disrupt thinking, feeling, moods, and behaviors, and cause varying degrees of impaired functioning of daily life Causes: life events and biochemical or brain dysfunctions Can range from mild to severe

6 4 Types of Depression Major depressive disorder Dysthymia Bipolar disorder Seasonal affective disorder LT #1: I can name 4 major types of depression.

7 Depression 9.5% population (about 1 in 10) American adults suffer from a depressive illness. Most don t seek treatment, although most can be helped Most people don t recognize it as a treatable illness Not a sign of personal weakness or a condition that can be willed or wished away Without treatment, symptoms can last for weeks, months, or years

8 What is a Depressive Disorder? An illness that involves the body, mind and thoughts common cold of psychological disturbances, which underscores its prevalence, but trivializes its impact Most suffering are misdiagnosed, under diagnosed, and not receiving treatment(s) Most common psychiatric disorders in the US, affecting over 15 million Americans Number of college students with depression has doubled in last 10 years Average age of onset is in mid-20 s. 1. Hahn, D., Payne, W., & Lucas, E. (2009) Focus on Health. Boston: McGraw Hill. 2. Donatelle, R. (2010). Access to Health: Green Edition. San Fransico, CA: Benjamin Cummings.

9 Major Depressive Disorder Combination of symptoms that interfere with the ability to work, study, sleep, eat and enjoy once pleasurable activities May only occur once, but more common to occur several times Chronic mood disorder that involves often debilitating symptoms on a day-to-day basis Women 2X as likely as men to experience

10 Major Depression Symptoms On a continuum & depends on the person Depressed or low mood most of the day Frequent crying, or no crying at all Withdrawing, isolating yourself from others Lack of interest in activities once enjoyed Increased or decreased appetite Significant weight gain or loss Insomnia Disturbed or restless sleep Sleeping more than usual Feeling tired most of the time Low self-esteem Hopelessness, worthlessness Difficulty concentrating, remembering things Thoughts of suicide, self-harm

11 Depression Cycle

12 Dysthymia Less severe Involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good

13 Bipolar Disorder Manic-depressive disorder Less common Characterized by cycling mood changes: severe highs (mania) and lows (depression) Affects thinking, judgment and social behaviors in ways that can cause serious problems and embarrassments

14 Bipolar Cycle Symptoms: Depression Persistent sadness, anxious or empty mood Feelings of helplessness, pessimism, guilt, worthlessness Loss of interest or pleasure in hobbies & activities that were once enjoyed, including sex Decreased energy, fatigue, being slowed down Difficulty concentrating, remembering, making decisions Insomnia, early-morning awakening or oversleeping Appetite and/or weight loss or overeating and weight gain Thoughts of death or suicide, suicide attempts Restlessness, irritability

15 Bipolar Cycle Symptoms: Depression cont. Persistent physical symptoms that do not respond to treatment Headaches Digestive disorders Chronic pain

16 Bipolar Cycle Symptoms: Mania Abnormal or excessive elation Unusual irritability Decreased need for sleep Grandiose notions Increased talking Racing thoughts Increased sexual desire Markedly increased energy Poor judgment financial decisions Inappropriate social behavior

17 I can Learning Targets Name 4 major types of depressive disorders. Describe at least 3 major symptoms of each of the four types of depression.

18 Seasonal Affective Disorder Approx. 6% of Americans suffer from SAD Additional 14% experience a milder form known as the winter blues SAD strikes during the winter months & reduced exposure to sunlight Also can occur during summer in warmer climates Possible causes Disruption in the body s natural circadian rhythms Changes in levels of melatonin and serotonin

19 SAD Symptoms Irritability Lack of interest, emotion or excitement Carbohydrate craving Weight gain Increased sleep time General sadness

20 SAD Treatments Light therapy Exposure to lamps that simulate sun light 80% experience relief from symptoms in 4 days! Diet change Increase exercise Stress-management Sleep restriction Psychotherapy medications

21 Review Quizzlet 1. What percentage of the American population suffers from a depressive disorder? 2. What are the four major types of depression? 3. Which gender is twice as likely to experience a major depressive disorder? 4. What is dysthemia? 5. What are the two cycles of bipolar disorder? 6. List two symptoms of each cycle of bipolar disorder. 7. What treatment helps 80% of patients with SAD?

22 Today s topics Causes of depression Gender differences Depression in the elderly population Depression and children

23 Learning Targets I can Identify at least 2 causes of depression. Describe at least 3 gender differences related to depressive disorders. Describe and compare depression symptoms for special populations, i.e. children and elderly

24 Causes of Depression Some types run in families Bipolar disorder Depression rates for a child with a depressed parent are 2 to 4 times greater than children without that heredity No single gene responsible Genetic make-up can simply make you more vulnerable Genetic make-up is NOT a guarantee you will develop depressive disorder Interactions between biology, learned behavioral responses, cognitive factors, environment, and situational triggers & stressors

25 Causes of Depression Life s many stressors What stresses out high schoolers?? Loss of a significant relationship Death of family or friend Physical or sexual abuse/assault Response to a serious illness or health issue Experiencing multiple setbacks and problems simultaneously

26 Depression in Women Twice as many cases as in men Hormonal factors such as menstrual cycle changes, pregnancy, miscarriages, postpartum period, pre-menopause and menopause Multiple responsibilities of life Work, child rearing, single parenthood, household work, and caring for elderly parents Postpartum (after birth of baby) depression from hormonal and physical changes, as well as added responsibility of a new life More than just blues Treatment and support from family are crucial

27 Depression in Men Less likely to admit depression and doctors are less likely to suspect Suicide is 4X higher Often masked by alcohol, drugs, or excessive working Symptoms different from feeling hopeless & helpless, instead are irritable, angry and discouraged Less likely to seek help, but encouragement from family and workplace can help

28 Fun Fact! Although adolescent and adult females have been found to experience depression at twice the rate of males, the college population seems to represent a notable exception, with equal rates experienced by males and females. Equal roles for men and women on campus Women report more negative events in H.S. than college, and males report more negative events in college than in H.S. College women report smaller and more supportive social networks

29 Learning Targets I can Identify at least 2 causes of depression. Describe at least 3 gender differences related to depressive disorders. Identify and describe at least 2 treatment methods for depression. I can identify at least 3 side effects caused by medications used to treat depressive disorders. I can define the 5 types of psychotherapy used to treat depressive disorders.

30 Depression in Elderly Not normal for elderly to feel depressed Symptoms are usually physical Often reluctant to discuss hopelessness, sadness, loss of interest or extremely prolonged grief after a loss Treatment may include medication and/or talk therapy

31 Depression in Children Symptoms include pretending to be sick, refusing to go to school Older children may sulk, get into trouble at school, be negative, grouchy and feel misunderstood Self-mutilation Drugs, alcohol Attempt suicide Difficult to tell whether behavior is a stage or depression Treatment: physician, psychiatrist, social worker and/or psychologist

32 Diagnostic Evaluation & Treatment Physical Exam Psychological evaluation including history or symptoms, alcohol & drug use, thought s about death/suicide, family history Need to determine person s type and degree of depression and possible causes Treatment usually a combination of psychotherapeutic and pharmacological methods

33 Treatment Drugs often aim to relieve the symptoms of depression appetite loss, sleep issues, etc. Psychotherapy can be helpful with improving one s ability to function on a daily basis. Combined approach is often most successful in the beginning

34 Medications SSRIs: selective serotonin reuptake inhibitors Prozac, Zoloft, Celexa First line choice; fewer side effects; safe in overdose TCAs: Tricyclics Sedative; Useful with patients with insomnia MAOIs: monoamine oxidase inhibitors Weight gain prominent Mood stabilizers Lithium, anticonvulsants Bipolar disorder & schizophrenia Must be taken regularly for 3-4 weeks to see results

35 Medication cont. IMPORTANT!! Never stop taking antidepressants without consulting the doctor for instructions on how to safely discontinue the medication Never mix any kind of medications without consulting the doctor Alcohol and street drugs may reduce the effectiveness of antidepressants. This includes wine, beer, and hard liquor

36 Side effects (In some people) Most are temporary and will go away Tricyclics Dry mouth Constipation Bladder problems Sexual problems Blurred vision Dizziness Drowsiness as a daytime problem

37 Side Effects cont. Newer antidepressants Headaches Nausea Nervousness and insomnia Agitation Sexual problems Herbal Therapy St. John s Wort may be useful for milder forms of depression **

38 Learning Targets I can Identify at least 2 causes of depression. Describe at least 3 gender differences related to depressive disorders. Identify and describe at least 2 treatment methods for depression. I can identify at least 3 side effects caused by medications used to treat depressive disorders. I can define the 5 types of psychotherapy used to treat depressive disorders.

39 Psychotherapy Talk Therapy Helps patients gain insight into and resolve their problems through verbal exchange with the therapist Sometimes combined with homework assignments between sessions

40 Psychotherapy Behavior Therapy Helps patients learn how to obtain more satisfaction and rewards through own actions Helps to unlearn the behavioral patterns that contribute to or result from their depression Interpersonal Therapy Focus on patient s disturbed personal relationship that both cause and/or increase the depression

41 Psychotherapy Cognitive/Behavioral Therapy Helps patient change negative styles of thinking and behaving often associated with depression Psychodynamic Therapy Focus on resolving patient s conflicted feelings Usually used with medication of ECT (electric convulsive therapy)

42 How to Help Yourself If You Are Depressed Negative thinking (feeling exhausted, worthless, helpless, hopeless) will lessen as treatment begins to take effect Do the following: Set reasonable goals & assume a reasonable amount of responsibility Try to be with other people; it is usually better than being alone and secretive Participate in activities that may make you feel better Mild exercise, going to a movie, a ball game, or participating in religious, social or other activities

43 How to Help Yourself Cont. Expect your mood to improve gradually, not immediately. Feeling better takes time Postpone important decisions until the depression has lifted Let your friends and family help you

44 Reaching out to someone who is depressed Get an appropriate diagnosis and treatment If possible, accompany patient to doctor Possibly monitor the patient s medication Encourage the patient to follow doctor s orders about alcohol (and drug use) Offer emotional support Be understanding, have patience, show affection and encouragement Report any suicidal tendencies to the therapist

45 Reaching out cont. Invite patient for walks, outings, movies, etc. Encourage activities that once gave pleasure Don t push too much too soon Don t expect him/her to snap out of it Encourage him/her that with time, and help, they will feel better

46 Resources for Help Family doctors Mental Health specialists HMOs Community mental health centers University or medical school-affiliated programs Family Services Social agencies Clergy Employee assistance programs

47 Facts & Fallacies Myth: True depression is a natural response to crisis and loss. Fact: True depression is not a natural response to crisis and loss. Pervasive and systemic biological problem Crisis and loss can lead an already depressed person over the edge to suicide and other problems Myth: People will snap out of depression by using will power Fact: People will not snap out of depression by using a little will power. Telling to snap out of it like telling a Diabetic to produce more insulin. Medical intervention necessary for recovery

48 Facts & Fallacies Myth: Frequent crying is a hallmark of depression Fact: Each person is different. May not cry at all, or may be life of party Some biochemists theorize that crying may actually ward off depression by releasing chemicals that the body produces as a positive stress response. Myth: Depression is a disease of the mind Fact: Depression is not all in the mind Research suggests it originates with an inherited chemical imbalance in brain Thyroid disorders, multiple sclerosis, chronic fatigue syndrome and certain cancers Medications