Understanding Mental Wellness

• Globally, 450 million people are affected by mental health issues according to the WHO.
• 1 in 4 individuals will experience a mental disorder in their lifetime.
• It's important to recognize symptoms of mental disorders and not be embarrassed.
• Developing optimal mental wellness is crucial, just like developing physical wellness.
• Positive psychology is key to decreasing the risk of mental health issues.
• Positive thinking, optimism, facing problems head-on, having a support network, and being physically active are helpful.

Mental Wellness

• Mental wellness includes emotional and psychological health.
• Emotional health involves feelings and moods.
• Psychological health involves thoughts.
• Mental wellness also encompasses having an accurate view of reality.
• It includes the ability to respond to life challenges effectively.
• Mental wellness allows people to develop rational strategies for living.
• It is the capacity to think, feel, and behave in ways that contribute to life enjoyment and managing challenges.

Maslow's Hierarchy of Needs

• In the 1960s, Abraham Maslow described a new ideal of mental health.
• This encourages individuals to fulfill their potential.
• Maslow defined a hierarchy of needs in order of decreasing importance.
• Physiological needs are the most basic (food, water, shelter, etc.).
• The second level is safety.
• Being loved is the third.
• Maintaining self-esteem is the fourth.
• Self-actualization is the highest level.

Defining Psychological Health Components

• Self-actualization: (definition to be provided).
• Autonomy: (definition to be provided).
• Self-concept: (definition to be provided).
• Self-esteem: (definition to be provided).
• Inner-directed: (definition to be provided).
• Authenticity: (definition to be provided).
• Realism: (definition to be provided).
• Acceptance: (definition to be provided).

Qualities of Mentally Healthy Individuals

• They establish and maintain close relationships.
• They perceive reality as it is.
• They experience a sense of fulfillment in daily living.
• They accept their own limitations and possibilities.
• They pursue work that suits their talents and training.
• They value themselves.
• They carry out responsibilities.

Psychological Disorders

• A mental disorder is a persistent disturbance or dysfunction in behavior, thoughts, or emotions.
• This disturbance causes significant distress or impairment.
• Historically, disorders were conceptualized as resulting from religious or supernatural forces, possession by demons or spirits.
• People with mental disorders were often cruelly punished, e.g., institutionalization.
• Current views largely replace these with medical understandings.
• Disorders are now viewed as having biological and environmental causes and can be cured.
• Stigmas surrounding mental illness remain.

Mental Health Disorders in Canada

• 1/5 Canadians will face a mental health issue at some point.
• 1/2 of people who feel they have suffered from anxiety or depression have never seen a doctor about their problem.
• Anxiety and phobic disorders affect ~12% of Canadians.
• Panic disorders affect ~2-4% of Canadians.
• Obsessive-compulsive disorder affects ~2%.
• Depressive and bipolar (mood) disorders affect ~15-20%.
• Psychotic disorders (e.g., schizophrenia) affect ~1%.
• Suicide results in approximately ~4,000 deaths each year.

Anxiety Disorders: Generalized Anxiety Disorder (GAD)

• GAD involves chronic, irrational worry about daily events such as work, social relationships, and finances.
• Symptoms include extreme agitation, fatigue, feelings of sadness and depression; nausea, trembling, muscle tension, and headache.
• GAD affects approximately 2.5% of Canadians.
• Treatments include therapy (e.g., CBT), benzodiazepines, and antidepressants.

Anxiety Disorders: Obsessive-Compulsive Disorder (OCD)

• OCD involves obsessions (e.g., cleanliness) and compulsions (e.g., needing to keep everything clean).
• Rituals are common(e.g., using Lysol in a diagonal pattern or vinegar in a circular motion).
• OCD affects around 2% of North Americans.
• Treatments include CBT and antidepressants.
• Celebrities like Howie Mandel have shared their OCD challenges related to germs.
• Leonardo DiCaprio has talked about dealing with compulsions.

Panic Disorder

• Panic disorder involves recurrent panic attacks without warning.
• Symptoms include chest pain, heart palpitations, shortness of breath, dizziness, and feelings of impending doom.
• Treatments include CBT and anti-anxiety drugs.
• Agoraphobia is a type of panic disorder.
• It leads individuals to avoid social situations (e.g., riding the bus or flying).
• This avoidance is caused by fear of having a panic attack and not being able to escape or access medical aid.

Phobias

• Phobias involve marked, persistent, and excessive fear and avoidance of specific objects, activities, or situations.
• Social phobias involve paralyzing fear related to social situations like public speaking.
• Affects about 8-13% of Canadians.
• Specific (simple) phobias include fear of spiders, heights, dark, or water.
• Phobias can cause extreme anxiety and panic.
• 13% of Canadians will have a phobia.
• The Preparedness Theory suggests that fear benefited our ancestors.

Depressive (Mood) Disorders

• Depressive symptoms include feelings of helplessness, hopelessness, and extreme guilt.
• Other symptoms include disturbed sleep, changes in eating patterns, weight loss, restlessness, or fatigue.
• Anhedonia, or loss of enjoyment of usual activities, is also a symptom.
• Inability to enjoy life and suicidal thoughts are also symptoms.
• 11% of Canadians aged 15 and older are affected.
• Seasonal Affective Disorder (SAD) affects 15% of Canadians.
• Postpartum Depression affects ~1/4 of new mothers.
• Depressive disorders are associated with an imbalance of neurotransmitters.

Bipolar Disorder

• Bipolar disorder (formerly called manic depressive) involves periods of depression followed by mania.
• Mania includes extreme euphoria, rapid speech, lack of need for sleep, and grandiosity.
• Bipolar disorder affects 1-3% of Canadians.
• Typically starts in adolescence or early adulthood.
• Treatments: CBT, lithium carbonate, anticonvulsants, tranquilizers.

Nerve Cell Communication

• Nerve cells communicate through electrical impulses and neurotransmitters.
• Neurotransmitters like serotonin and norepinephrine affect brain responsiveness and psychological states.
• Many disorders are related to neurotransmitter problems.
• Treatments often target neurotransmitters.
• Prozac increases serotonin by slowing its reuptake.

Psychotic Disorders: Schizophrenia

• Schizophrenia ranges from mild to severe
• Schizophrenia is a psychotic (break from reality) disorder that profoundly impairs one's sense of reality.
• Onset is typically between ages 16 and 30.
• It is a complex set of causal factors.
• Genetic factors may predispose one to it.
• Social isolation, drug use, or traumatic events may exacerbate or accelerate progression.
• Symptoms include disorganized thoughts, inappropriate emotions, delusions, hallucinations (e.g., hearing voices), deteriorating function, and sometimes catatonia.
• Schizophrenia affects approximately ~1% of the population.

Symptoms of Schizophrenia

• Positive symptoms: Symptoms present that should be absent such as hallucinations (auditory, visual, taste) and delusions (e.g. false beliefs).
• Example of disorganized speech: "...I am taking a mental rest after a carter assignment of quill. You know, a penwrap. [...] I am made of flesh and blood. See?”
• Examples of grossly disorganized behavior: Childlike silliness or masturbation in public.
• Negative symptoms: Symptoms absent that should be present.
• Negative symptoms include: lack of motivation, blunted feelings, depression and social withdrawal.

Types of Therapists

• Psychiatrists have a medical degree (M.D) and can prescribe drugs.
• Psychologists have an advanced degree in psychology (Ph.D.; M.Sc.) and can offer behavioral therapy (e.g., CBT) but not drugs.
• Social workers have training in counseling and are usually licensed and registered.
• Counselors: Various kinds; often, no set specialized training or licensing required.

Types of Therapeutics

• Antidepressants: (definition and examples to be provided).
• Mood stabilizers: (definition and examples to be provided).
• Antipsychotics: (definition and examples to be provided).
• Anxiolytics: (definition and examples to be provided).
• Stimulants: (definition and examples to be provided).

Other Treatment Options

• Behavioral, cognitive, and psychodynamic models can be useful alone or with therapeutics.
• The behavioral model focuses on what people do; stimulus, response, and (altering) reinforcement.
• The cognitive model focuses on the effect of ideas on behavior.
• Cognitive behavioral therapy (CBT) uses techniques to change negative patterns of thought and action into positive ones.

Suicide

• Suicide is the second leading cause of death for those aged 15-34 in Canada.
• Often associated with depressive disorders or major life crises.
• Feelings of hopelessness, rejection, or lack of self-worth also cause it.
• It is 3x more likely in men and 6x times higher among Indigenous youth.
• Approximately ~15% of Canadian adults report considering suicide at some point.
• Help is available.

Helping Someone Considering Suicide

• Listen without judgment.
• Show love and care.
• Ask about recent events.
• Ask direct questions.
• Do not leave them alone if suicide is imminent.
• Make plans for the next day.
• Recommend counseling.

Stress: Overview

• Stress is any situation that disrupts homeostasis.
• Homeostasis is a state of dynamic equilibrium.
• Stressors shift our body away from homeostasis.
• Stressors can be physiological, psychological, or environmental.
• General Adaptation Syndrome: Describes how our body responds to stress.
• Eustress is positive stress that promotes high-level functioning.
• Distress is negative stress that decreases performance.

Symptoms of Excess Stress

• Physical symptoms: dry mouth, excessive perspiration, frequent illnesses, gastrointestinal problems, grinding of teeth, headaches, high blood pressure, pounding heart, and stiff neck or aching lower back.
• Emotional symptoms: anxiety, crying, depression, edginess, fatigue, hypervigilance, impulsiveness, inability to concentrate, irritability, and trouble remembering things.
• Behavioral symptoms: disrupted eating habits, disrupted sleeping habits, harsh treatment of others, problems communicating, sexual problems, social isolation, and increased use of tobacco, alcohol, or other drugs.

Sleep

• Most adults need 7-9 hours of sleep each night to stay healthy and perform optimally.
• Sleep is an active and dynamic state.
• Individuals cycle between REM (dreaming) and non-REM states several times per night.
• Non-REM sleep occurs in successive stages.
• Sleep is important for: clearing the brain of wastes, learning and memory, proper immune function.

Ways to Minimize Stress

• Ensure you have a support system.
• Improve your communication skills.
• Be kind and nurturing to others.
• Develop healthy exercise, eating, and sleeping habits.
• Develop healthy coping techniques (e.g., meditation, music).
• Learn to identify and moderate stressors and develop resilience.

Eating Disorders

• Eating disorders are serious disturbances in eating patterns or behaviors.
• They are characterized by a negative body image and concerns about body weight/fat.
• There is common feature: dissatisfaction with body image and weight.
• Dissatisfaction often due to distorted thinking, perfectionist beliefs, unreasonable demands for self-control, and excessive self-criticism.
• Among teens, 50% of females and 30% of males use unhealthy behaviors.
• Examples of unhealthy behavior: skipping meals, vaping, vomiting, fasting, taking laxatives.

Anorexia Nervosa

• Individuals do not eat enough to maintain adequate body weight.
• It is associated with distorted body image, intense fear of weight gain, and feeling that food is the enemy.
• There is purging and overexercising.
• Risks: amenorrhea, intolerance to cold, low BP; CV, GI, endocrine, and skeletal disorders.
• Anorexia is a leading mortal psychiatric disorder: 1 in 10 die of starvation.

Bulimia Nervosa

• Involves episodic binge eating followed by purging (vomiting or laxatives).
• Binging is common; often thousands of calories are consumed in secret.
• It involves feeling ashamed, disgusted, and fearful of weight gain, purging.
• Risks: erosion of tooth enamel, damage to esophagus, stomach, dehydration, disturbed salt balance, kidney, liver, and heart damage; depression.

Binge Eating Disorder

• Features recurrent episodes of binge eating.
• Episodes are characterized by eating a large amount of food in a discrete period of time and lacking control over eating.
• Episodes are associated with eating more rapidly, until uncomfortably full, when not physically hungry, eating alone, feeling disgusted or guilty.
• Causes marked distress and occurs on average at least 2 days a week for 6 months.
• Not associated with inappropriate compensatory behaviors (e.g., purging), so it is similar to bulimia, but without compensation (vomiting).

Treatments for Eating Disorders

• Must address problematic eating behaviors and the misuse of food to manage stress and emotions.
• Anorexia- treatment involves averting crisis by restoring body weight and also involves addressing psychological aspects of disorder.
• Bulimia and binge eating- treatment involves stabilizing eating patterns.
• Identifying and changing behaviors that led to disordered eating and improves coping skills.
• Concurrent issues, such as depression or anxiety, must also be addressed.