History and Modern Mental Health Overview

History of Mental Health

• Crucial for understanding modern psychiatric care
• Societal beliefs evolved from ancient times to present-day practices
• Different cultures viewed mental illness and used inhumane treatments like exorcisms and executions.
• Psychiatric care evolved from supernatural beliefs to scientific approaches
• Hippocrates and Dorothea Dix shifted the understanding of mental illness toward a scientific and humane approach

Key Concepts

• Self-actualization: Fulfilling one's potential
• Maslow proposed a hierarchy of needs where basic needs must be met before self-actualization
• Mental health is a dynamic state, influenced by age, culture, and experiences
• Adaptive capabilities are very important in dealing with stressors

Modern Mental Health

• Focuses on fulfilling potential, managing stress, and aligning thoughts with social norms
• Includes social, cultural, and spiritual factors, not just individual functioning
• Well-being is emphasized, including positive emotions and purpose in life
• Focuses on strengths, resilience, and coping mechanisms
• Acknowledges social factors like poverty and discrimination

Mental Illness

• Establishing a universal definition is difficult due to cultural influences
• Incomprehensibility plays a significant role in labeling it.
• What is considered "normal" or "abnormal" behavior varies across cultures
• Refers to clinically significant disturbances in cognition, emotion regulation, and behavior
• Defined as "maladaptive responses" to stressors

Anxiety

• A common human experience related to fear of the unknown
• Can be both adaptive and maladaptive

Universality of Anxiety

• A prevalent emotion arising from uncertainties and complexities
• Low levels can be helpful, providing motivation and alertness
• Becomes problematic when it interferes with daily functioning

Levels of Anxiety

• Peplau identified mild, moderate, severe, and panic levels
• Each level has its own characteristics and impact on behavior
• Nursing intervention involves recognizing the signs of each anxiety level

Mild Anxiety

• Not typically a major obstacle
• Linked to everyday pressures and challenges
• Can be helpful, preparing individuals for action
• Enhances senses, motivation, and awareness
• Can make learning easier and more efficient

Moderate Anxiety

• Impacts functioning and well-being
• Reduced perceptual field results in individuals missing details
• Reduced alertness to environmental events
• Learning is not optimal, requires more effort
• Decreased attention span and concentration
• Increased restlessness and physiological symptoms
• Changes in speech and feelings of discontent
• Focus on self and discomfort

Moderate Anxiety's effects

• Impairs focus and attention, leading to a narrower perceptual field
• Sigmund Freud believed the ego helps navigate reality, but is challenged by rising anxiety
• Ego uses "ego defense mechanisms" to manage the threat
• Adaptive mechanisms help, while maladaptive ones lead to problems
• Excessive use of mechanisms can disintegrate the ego
• It can have consequences for physical health

Severe Anxiety

• Highly disruptive and significantly impacts functioning and well-being
• Greatly diminished perceptual field and difficulty attending to what's important
• Severely impaired attention span
• Inability to concentrate or problem-solve
• Learning is impossible
• Severe physical and emotional distress
• Self-focus and avoidance

Ego Defense Mechanisms

• Unconscious mental strategies used to protect the ego from anxiety or distress
• Compensation involves making up for a perceived weakness
• Denial involves refusing to acknowledge a painful reality
• Displacement involves shifting negative feelings to a less threatening target
• Identification involves boosting self-esteem by adopting admired qualities
• Rationalization involves creating logical explanations
• Regression involves returning to childish behaviors
• Repression involves unconsciously pushing unpleasant memories
• Sublimation involves channeling unacceptable urges into acceptable activities
• Suppression involves consciously pushing away unwanted thoughts
• Undoing involves trying to make up for a negative action
• These mechanisms are often used unconsciously, but maladaptive use can cause problems

Panic Anxiety

• The most intense level of anxiety
• The individual is overwhelmed with disrupted perception, thought, and behavior
• Inability to focus, misperceptions, and impaired cognitive function
• Physical symptoms include dilated pupils, labored breathing, trembling
• Disorganized behavior, psychotic symptoms like hallucinations or delusions
• The individual often loses contact with reality and experiences psychosis

Panic Anxiety: Loss of reality

• Results in difficulty focusing, misinterpreting surroundings, and erratic behavior
• Characterized by overwhelming terror and beliefs that they are having a life-threatening experience
• It can significantly deplete resources, leading to exhaustion and health risks
• Psychosis can manifest as delusions, hallucinations, and disorganized speech
• People experiencing psychosis may exhibit minimal distress or unawareness
• Potential outcomes include delusions and hallucinations

Grief

• A complex emotional and physical response influenced by cultural norms
• It is a unique experience with feelings of sorrow and sadness
• Grief can be adaptive, where one finds ways to cope and gradually heal
• Maladaptive leads to negative impacts to day-to-day well being
• Judging behavior is influenced by cultural perspectives
• Mental illness is characterized by maladaptive responses that conflict with societal norms
• Anxiety and grief are main psychological responses to stressful situations