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CHAPTER VI

RECOGNISING COMMON PSYCHIATRIC ILLNESSES

FUNDAMENTAL CONCEPTS
MENTAL HEALTH
Is a state of emotional, psychological, and social wellness evidenced by:
-

Satisfying interpersonal relationships


Effective behavior and coping
Positive self-concept
Emotional stability
Self-awareness

Factors Affecting Mental Health:

Mastering the Environment

Reality orientation

Stress Management

Maximizing Ones Potential

Autonomy and Independence

Tolerating Ones Uncertainties

Self-esteem
MRS MATS

STRESS

is any biopsychosocial (external or internal) experiences that one views as demanding,


challenging, and threatening;

Also char as:

STRESSOR

It is recurring.

It is normal.

It cannot be avoided.

It is caused by a stressor.

is any condition, event, or agent that increases the activity of the Sympathetic NS;

Stress Adaptation Syndrome (SAS) A R E


1. Stage I ALARM

Activation of the SNS (or the Fight-or-Flight Response)

Increase epinephrine, NE, and cortisol.

Client is alert with increase anxiety.

2. Stage II RESISTANCE

Hormone readjustment;

Decrease in size and activity of the adrenal


cortex;

Increase use of defense mechanism;

3. Stage III EXHAUSTION

Loss of ability to stop stress;

Exaggerated defense-oriented behavior;

Disorganized thinking and personality;

May show signs of illusion, hallucination and


delusions;

Client may be stuporous or violent (PANIC)

GRIEF

is a powerful emotional reaction to a separation or loss from something that is/are


very valuable;

is SELF-LIMITING;

Stages of Death and Dying (Kubler-Ross) DABDA


a. Denial
b. Anger
c. Bargaining
d. Depression

e. Acceptance

DENIAL

ANGER

God, take me.. Spare her

DEPRESSION

Youre the reason shes dead!!!

BARGAINING

Shes not dead! Shes still alive!

Im not hungry, I just want to be alone.

ACCEPTANCE

At least she no longer have to suffer.

He is in the presence of our Creator.

CONCEPT OF DEATH:
-

TODDLER

No specific concept of death yet.

Reacts more to pain and discomfort;

Separation anxiety may be felt;

Focus is on the feelings of the parents;

Death is like SLEEP;

Or a form of PUNISHMENT;

May use PLAY as a method of therapy;

PRESCHOOL

SCHOOL AGE

Death is personified or as a final stage of life;

May fear mutilation or punishment;

Accept regressive or protest behavior from the client;

Encourage verbalization of feelings;

ADOLESCENT

Have MATURE understanding of death;

May show strong emotions about death (sadness, silence, anger,


withdrawn)

Encourage verbalization of feelings;

Respect need for privacy and expression of grief;

Death is disruption of lifestyle;

Effects of death to significant others;

ADULT

OLDER ADULT (Elderly)

Emphasis on religious beliefs for comfort;

Time for reflection, rest or peace;

Excellent Mental Health Requirement

A sense of self sufficiency, self esteem and self worth.

Ability to trust others

Ability to give and receive friendship, affection and love.

Ability to form enduring emotional attachment.

Ability to experience deep emotions

Ability to forgive others and oneself

Ability to examine oneself and consider change.

Ability to learn from experience.

Ability to tolerate uncertainty and take risks.

The ability to engage in reverie and fantasy.(D.Semple et al 2005. )


Mental Illness

Mental disorders are biologically based brain disorders that variably affect aspects of
cognition, emotion and behaviour leading to disruption in social, occupational,
academical and psychological functioning.

Common Mental Disorders

Schizophrenia

Mood Disorder

Anxiety Disorders

Schizophrenia

Definition
A psychotic disorder in which there is
disturbance in thinking, speech, perception and behaviour, resulting in loss of contact with
reality.
This is manifested in poor groomimg, social withdrawal and abnormal affect (flat,
blunted or inappropriate)
Predisposing factors

Biological factors - Abnormal changes in the chemical make up of the brain mainly an
increase in dopamine.

Genetic factors - Studies have shown that Schizophrenia can be inherited.

Developmental theory - disturbances during psychological development of the child.

Social factors - such as life events (marriage, childbirth, death; economic and cultural
factors).

Subtypes
1. Paranoid type suspiciousness, persecutory ideas
2. Disorganized type disorganized speech, dress, bizarre behavior, flat affect
3. Catatonic type - Psycho - motor retardation (waxy flexibility or stupor), maintenance of a
rigid posture against attempts to be moved
4.

Undifferentiated type not easily differentiated as in the first three

5. Residual type no active delusions, hallucinations, disorganized speech or catatonic


behaviour but have residue of odd beliefs and are able to function
Signs and symptoms

Hallucinations a false sensory perception (affects the 5 senses eg auditory & visual)

Illusions misperception of real external stimuli (eg. Thinking a suit on a chair is a man)

Delusions a false fixed belief not in keeping with reality eg the unrealistic idea of being
followed by the FBI.

Disorganized speech - irrational

Grossly disorganised behaviour

Negative symptoms, eg. flat or dull affect, limited speech, social withdrawal, lack of self
care, poor rapport with others.

Mood disorder
Two main types:

Depressive disorder

Bipolar Disorder

Recognising Depressive illness

Reduced psychomotor activity

Loss of energy

Little or no sleep or excessive sleep

Little or no appetite or excessive eating

Loss of interest in previous areas of interest

Poor attention, concentration and memory

Guilt

Persistent sad or low feeling

Suicidal ideations

Recognising Mania

Feeling elated

Rapid speech

Racing thoughts

Feeling of self importance or overconfidence

Extravagant spending

Too busy to eat or sleep

High Libido or preoccupation with sex

Religiosity
Anxiety Disorder

Excessive and continuous worrying over everyday matters so much that it disrupts
normal day to day functioning.

Recognising Anxiety

Excessive concern and fretting

Feeling nervous

Feeling tired easily.

Unable to sleep.

Feeling irritable

Poor concentration

Muscle tension.

Feeling stifled

Fast heartbeat

Indigestion

Headaches

Twitching
Prognosis

Prognosis is determined by so many factors which include;

Heredity

Early detection and prompt treatment

Gender

Premorbid personality

Family and social support

Good insight

Non use of illicit drugs or substance abuse

Compliance with follow up plans

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