Psychology: Mental Health and Illness

Mental Health and Mental Illness

• Mental health is successful adaptation to internal or external stressors, evidenced by age-appropriate thoughts, feelings, and behaviors congruent with local and cultural norms.
• Mental illness is maladaptive responses, evidenced by thoughts, feelings, and behaviors that are incongruent with local and cultural norms; interfering with social, occupational, or physical functioning.

Biological Implications

• Neurotransmitters are chemicals that convey information across synaptic clefts to neighboring target cells.
• Dopamine: Excitatory, controls complex movements, motivation, cognition, and emotional responses.
• Norepinephrine: Excitatory, causes changes in attention, memory, sleep, wakefulness, and mood.
• Epinephrine: Excitatory, controls the fight or flight response.
• Serotonin: Inhibitory, controls food intake, sleep, wakefulness, temperature regulation, pain control, sexual behaviors, and emotional regulation.
• Histamine: Neuromodulator, controls alertness, gastric secretions, cardiac stimulation, peripheral, and allergic responses.
• Acetylcholine: Excitatory or inhibitory, controls sleep and wakefulness cycle, signals muscles to become alert.

Ethical and Legal Issues

• Statutory laws are enacted by legislative bodies, and common law arises from court cases. Both types have civil and criminal components.
• Civil law protects private rights and property, whereas criminal law protects public welfare.
• Legal psychiatric issues center on confidentiality, informed consent, restraints/seclusion, and commitment.
• Nurses are responsible for their actions related to legal issues, and malpractice lawsuits can arise from violations.

Health Insurance Portability and Accountability Act (HIPAA)

• HIPAA is a federal privacy rule regarding protected health information (PHI) applied to healthcare individuals and institutions.
• Individuals have the right to access medical records, corrections, and decide who shares information.

Psychopharmacology

• Nursing process, which involves assessment, diagnosis, outcome identification, planning, and implementation, is applied in the administration of psychotropic medications.

Antidepressants

• Indications include dysthymia, major depressive disorder, alcohol dependence, schizophrenia, intellectual disability, depressive phase of bipolar disorder, and depression accompanied by anxiety.
• Actions include increasing serotonin, norepinephrine, and/ or dopamine concentration in the body.
• Contraindications vary by medication; common ones include bipolar disorder in a manic phase, bleeding disorders, diabetes, or severe heart, kidney or liver conditions.
• Side effects include nausea, agitation, headache, sexual dysfunction.

Sedative-hypnotics

• Indications include anxiety, insomnia.
• Action includes causing generalized CNS depression.
• Contraindications vary, and caution should be used in cardiac, hepatic, renal, or respiratory insufficiency.
• Side effects include drowsiness, dizziness, and sexual dysfunction.

Anti-anxiety Agents

• Indications include anxiety disorders, anxiety symptoms, acute alcohol withdrawal, skeletal muscle spasms, convulsive disorders, and preoperative sedation.
• Action is depressing subcortical levels of the central nervous system (CNS), especially the limbic system and reticular formation.
• Contraindications include concomitant opioid use, and those with conditions like liver or kidney disease, or alcoholism.
• Side Effects include drowsiness, dizziness, and cognitive problems.

Mood-stabilizing Agents

• Indications include bipolar disorder.
• Actions include altering cellular sodium transport, GABA modulation, and elevating seizure threshold.
• Contraindications include renal dysfunction.
• Precautions include increased risk of sensitivities to the sun.

Antipsychotics Agents

• Precautions include elderly/debilitated clients, cardiac, hepatic, or renal insufficiency, those with seizures or diabetes history.
• Side effects include hormonal (e.g., decreased libido or gynecomastia) and extrapyramidal side effects (e.g., dry mouth or retrograde ejaculation).

CNS Stimulants

• Side effects include restlessness, insomnia, palpitations, tachycardia, anorexia, and weight loss.

Neurotransmitter Reuptake

• Reuptake is the process of neurotransmitter inactivation, which involves the reabsorption of the neurotransmitter into the presynaptic neuron.

Medication Tolerance

• Tolerance is when a specific dose of medication becomes less effective over time due to metabolism, tissue accumulation, and increased excretion rates.

Crisis Intervention

• Differentiate between anger and aggression to identify the appropriate nursing interventions.
• Goals of crisis intervention are immediate crisis resolution and returning to pre-crisis functioning level.

Recovery

• Recovery is based on hope, self-determination, varied pathways, and holistic approaches to care.

Suicide Prevention

• Factors like ideation, substance abuse, purposelessness and hopelessness can indicate potential suicide risk.
• Nursing interventions focus on increasing safety, identifying support systems, and assessing for suicide risk.

Risk Factors For Suicide

• Marital status, sex, age, are commonly associated risk factors.

Relationship Development & Therapeutic Communication

• Therapeutic communication techniques include empathy, rephrasing, low and slow, and non-blaming approaches.

Neurocognitive Disorders

• Delirium is a sudden, fluctuating state of confusion that usually resolves once the underlying cause is addressed, unlike dementia.
• Dementia is a gradual decline in mental status over months to years, presenting as impairment in memory, judgment, and other cognitive abilities and affecting daily life.

Substance Use and Addiction Disorders

• Addiction is a compulsive or chronic requirement, leading to distress upon cessation
• Intoxication is a state of impairment involving cognition, perception, behavior, and consciousness, due to the effect of a psychoactive drug.

Schizophrenia Spectrum & Other Psychotic Disorders

• Disturbed sensory perceptions, including hallucinations, are common.
• Disturbed thought processes are evident in disorganized thinking.
• Loss of contact with reality can occur through delusions or disorganized thought.

Depressive Disorders

• Childhood depression symptoms can differ based on developmental stage.
• Some individuals may display anger, aggressiveness, or running away while others may exhibit withdrawal or somatic complaints.

Bipolar and Related Disorders

• Individual psychotherapy addresses social rhythms, and group therapy facilitates support and discussion among individuals.
• Family therapy aids in resolving relationship issues and promoting adaptive functioning in family dynamics, with cognitive behavioral therapy addressing distorted thinking patterns.

Anxiety and Related Disorders

• Interventions encompass promoting safety, using calming techniques, administering medication, and exploring potential triggers.
• Cognitive behavior therapy focuses on cognitive distortions, while behavioral modification trains alternative responses.

Trauma and Stress Disorders

• Trauma-informed care prioritizes awareness and understanding of trauma, integrating knowledge in policies and procedures.

Eating Disorders

• Interventions focus on restoring nutrition, and for the person with severe starvation, tube feeding along with monitoring of bodily requirements are included.

Pain Management

Assessment considerations

• Assessing risk for suicide, abuse or neglect, or other issues is essential, ensuring appropriate intervention
• Accurate identification of the issue, symptoms experienced and supporting information is required in assessment and diagnosis

Explore the concepts of mental health and mental illness, focusing on their definitions, implications, and the role of neurotransmitters. This quiz covers biological aspects that influence mental health, including the functions of key neurotransmitters like dopamine, norepinephrine, and serotonin.