Mental Health Session 2 (PDF)

High prevalence mental disorders Things we will cover this session: • What is Depression? • What is Anxiety? • What are the related thoughts, emotions, behaviours and physical indicators? Reduced life expectancy compared to general population Schizophrenia, bipolar, schizoaffective, major affectiv...

High prevalence mental disorders Things we will cover this session: • What is Depression? • What is Anxiety? • What are the related thoughts, emotions, behaviours and physical indicators? Reduced life expectancy compared to general population Schizophrenia, bipolar, schizoaffective, major affective disorders Mortality rates 2.22 times higher 10+ years life lost Patient factors Lower help­ seeking for physical health Clinician factors Less medical care and lifestyle interventions offered to those with SMI Poorer lifestyle behaviours Mental health implications of physical inactivity r Remember: What is Mental Disorder/lllness? Diagnosable medical condition Causes major disturbance/changes in: o Cognition (thinking) o Emotional regulation (feelings) o Behaviour Associated with significant distress/disruption in social, occupational and other important activities American Psychiatric Association, 2023 Depression , ,/' What is Depression? Episodes of unhappiness, low mood and dissatisfaction. Depression is a negative mood state. What is Clinical Depression? o Diagnosed by a medical practitioner (psychologist, psychiatrist, GP) Persistent depressed mood o Implications for functionality (work, relationships, social) Associated with low/ high appetite, lack of energy, poor sleep, poor concentration Feelings of worthlessness, guilt, hopelessness Mental Health Continuum REACTING HEALTHY Normal fluctuations in mood Nervousness, irritability Takes things in stride Good sense of humour Consistent performance INJURED ILL Anxiety, anger Excessive anxiety Sadness, overwhelmed Pervasive sadness, Displaced sarcasm tearfulness, hopelessness, Panic attacks Easily enraged, aggressive Procrastination worthlessness Depressed mood, numb Physically & socially active Forgetfulness Negative attitude Cannot concentrate Confident in self & others Trouble sleeping Difficulty concentrating Inability to make decisions Drinking in moderation Low energy Trouble making decisions Cannot fall asleep/stay Muscle tension, headaches Decreased performance, asleep Missing an occasional class regularly missing Constant fatigue, illness or deadline classes/deadlines, or over Absent from social Decreased social activity work events/classes Drinking regularly or in Restless, disturbed sleep Suicidal thoughts/intent binges to manage stress Avoidance, social withdrawal Unusual sensory experiences Increase used of alcohol- (hearing or seeing things) hard to control Alcohol or other addiction Source: https://arborwellnessmh.eom/c ontinuum-model-mental-health/ Nurture support Recognize limits, take Tune into own signs of systems. breaks, identify distress. Talk to Follow problems early, seek someone, ask for help. recommendations. support. Make self-care a priority. Don't withdraw. care DSM-5 Criteria Table 3.2 Summary of DSM-5 criteria for major depressive episode Category Criteria A At least five of the following symptoms have been present during the same two-week period, nearly every day, and represent a change from previous functioning. At least one of the symptoms must be either (1) depressed mood or (2) loss of interest or pleasure A(l) Depressed mood (or alternatively can be irritable mood in children and adolescents) Markedlv diminished interest or pleasure in all, or almost all, activities Significant weight loss or weight gain when not dieting Insomnia or hvpersomnia A(2) A(3) A(4) A(5) A(6) A(7) A(8) A(9) Psvchomotor agitation or retardation Fatigue or loss of energy Feelings of worthlessness or excessive or inappropriate guilt Diminished ability to think or concentrate Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicidal attempt or a specific plan for committing suicide B Symptoms are not better accounted for by a mood disorder due to a general medical condition, a substance-induced mood disorder, or bereavement (normal reaction to death of a loved one) C Symptoms are not better accounted for by a psychotic disorder (e.g. Schizo-affective Disorder) Depression o 1/7 Australians will experience depression o Third highest burden of disease in Australia and globally o Number 1 cause of non-fatal disability in Australia o By 2030, depression will be the leading risk factor for life expectancy ABS, 2019; WHO, 2020 Signs of Depression Low mood Sad Signs of Depression < A Numb Emotions Guilty < _____________ ) Empty Irritable, short tempered Loss of motivation Loss of enjoyment Chronic feelings of sadness and emptiness Hopeless and helpless Worried Hopeless thoughts "nothing will get better" "nobody cares" Helpless thoughts "I can't do it" Critical thoughts "I'm not good enough" Difficulty concentrating Difficulty making decisions Suicidal thoughts (or "I'm a burden") Signs of Depression Thoughts <___________ ) Withdrawal from friends, family, usual activities Poor performance at school, work Signs of Depression Looking dishevelled Withdrawn Crying Substance use Risk-taking behaviour ehaviours Lack of energy Fatigue Difficulties sleeping Signs of Depression Loss of appetite Increase in appetite Physical V________________ / Weight loss or gain Feeling sick, run down Loss of libido Depression and physical activity More PA, Cross Lower depression Higher depression symptoms, Lower PA sectional and longitudinal studies show More sedentary behaviours, Higher depression PA level established in childhood/adolescence carried through to adulthood > Causes of mood disorders (e.g., depression, anxiety, etc.) o Most psychologists (and psychiatrists) now believe that anxiety and depression (and mood disorders) result from a combination of: • Biological factors • Psychological factors • Social factors > Biological causes of mood disorders (e.g., depression, anxiety, etc.) Q Monoamine Hypothesis o Monoamines: depleted level (prominent but insufficient) Hippocampal Neurogenesis Hypothesis o Brain-Derived Neurotrophic Factors (BDNF): decreased BDNF^^^) and hippocampal volume PHYSIOlogical explanations of why exercise helps decrease depression Endorphin Hypothesis During physical stress = endorphins produced Monoamine and Neurogenesis Hypothesis Exercise changes the rate at which neurotransmitters are produced and more neurons to be produced, which both have an effect on emotion regulation PSYCHOlogical explanations of why exercise helps decrease depression Expectancy Individuals expect to feel better = better mood Mastery The completion of an important effortful task = better mood Distraction "Time out" from worry = better mood @ What is anxiety? o Anxiety is a normal and useful physiological response to real or perceived threat o Episodes of worry, tension or guilt. Might be situation specific. > Fight or Flight Response o Autonomic arousal prepares the organism for to deal with danger O A certain amount of anxiety is important for our functioning Racing Thoughts Vision The brain allows us to rapidly assess danger and make quick decisions Pupils dilate, experience of vision being sharper or more focused, for example, tunnel vision Feeling Dizzy Dry Mouth This happens In response to Increased heart rate and respiration: the feeling of dizziness or light-headedness may increase with hyperventilation Saliva production stops Stomach Reduced blood circulation leading to discomfort, nausea and abdominal distress Adrenal Glands Release hormones that increase blood circulation and sweating Muscles Increased tension as the body prepares to run or fight, sometimes trembling or shaking — Anxiety is a problem when... o It is pervasive and it's intensity is disproportionate to the nature of the stressor/trigger o Feared objects/situations are avoided or endured with intense distress o Anxiety disorder = Anxiety that is severe, long-lasting and interferes with a person s everyday functioning Anxiety Disorders What is Clinical Anxiety? o Diagnosed by a medical practitioner (psychologist, psychiatrist, GP) o Associated with low/ high appetite, lack of energy, poor sleep, poor concentration, weight loss o Implications for functionality (work, relationships, social) o Persistent anxious mood o Includes social anxiety disorder, panic disorder, agoraphobia, generalised anxiety disorder Anxiety Disorders o 1/7 Australians will experience anxiety disorders o Social anxiety disorder (4.7% prevalence) o Higher in females (17.9% vs 10.8% males) o 16-55 years prevalence in females is 1/5 ABS, 2019; WHO, 2020 Signs of Anxiety Emotions Thoughts Physical Behaviours Signs of Anxiety • Scared/Afraid/Worried Emotions <________________ • Restlessness/lrritable • Feeling 'on the edge' • Stressed out • Keyed-up Signs of Anxiety OVERestimating 'threat' in environment UNDERestimating one's ability to cope/manage Mind-racing Going blank Thoughts <_________ F Signs of Anxiety ‘Safety behaviours’, e.g: avoidance of people, places, activities; seeking reassurance; / A withdrawing; checking etc. Ag itated/agg ress ive behaviours Using substances Behaviours k______________J Signs of Anxiety • Increased heart/breathing rate • Muscle tension • Sweats / A Physical v____________/ • Shakes • ‘Butterflies’ in the stomach • Dizziness Anxiety Disorders o Generalized anxiety disorder o Separation anxiety disorder o Selective mutism o Specific phobia, social phobia o Panic disorder o Agoraphobia Obsessive-Compulsive Disorders (obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder) Trauma and Stressor-Related Disorders (reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, and adjustment disorder). V Generalized Anxiety Disorder [GAD] o GAD involves a constant and intense feeling of anxiety regarding anything. o People with GAD struggle to control their worries. o They tend to anticipate some sort of disaster, despite a lack of evidence. Q ■ Social Anxiety Disorder With social anxiety disorder, people have an intense fear of others judging them in social or performance situations. They are terrified of potential embarrassment or humiliation. The anxiety can extreme to the point of inhibiting the ability to socialize, date, or travel. Br Social Phobias People with specific phobias avoid places, situations, objects, and even types of people (e.g., clowns) even if there is no threat or danger. Phobias do not necessarily stem from trauma involving the object in question.