1. Overview of Mental Health and Addiction Disorders Thanks to John Mogk, M.A. Clinical Coordinator Maple Ridge Treatment Centre for original version of this power point.

2. Major Mental Health Problems  Psychosis  Mood  Anxiety  Personality  Addiction  Eating Disorders

3. Psychosis, disturbance of thinking  Hallucinations  Delusions  Disorganized Behaviors Thinking Speech (incoherence) Movement - Catatonia

4. Pathways to Psychosis  Mental Illness Schizophrenia, Schizoaffective Disorder Bipolar Mania, Severe depression Paranoid and Borderline Personality Disorders  Substances e.g. Stimulants, Cannabis  Brain Injuries / Medical Disease e.g. Alzheimer's

5. Treatment of Psychosis  Medication  Skill Building Social Activities of Daily Living Medication Compliance Occupational Relapse prevention / Stress Management

6. Mood Disorders  Depression  Mania  Bipolar I & II

7. Depression  Low mood  Anhedonia - lack of pleasure  Unintentional Weight Change  Insomnia or Hypersomnia  Psychomotor Agitation or Retardation  Fatigue or Loss of Energy  Worthlessness or Guilty  Thinking problems  Morbid thoughts

8. Depression  Is very common component of substance use and withdrawal, particularly alcohol, benzodiazepines, opioids, steroids and stimulants.  Typically takes 4-8 weeks of clean time before substance-induced depression can be ruled out  Older adults who abuse substances usually have mood disorders  Depressed persons have some preference for stimulants and alcohol

9. Mania  Grandiosity  Decreased need for sleep  Talkative or fast talking  Flight of ideas  Distractible  Increased activity or psychomotor agitation  Excessive pleasure seeking  Can be brought on by stimulant use or depressant withdrawal

10. Bipolar I and II  Both require having had at least a 2 week episode of depression and a one week episode of mania (I) 4 days of hypomania (II)

11. Continuum of depression  Depression Normal Sadness/ Grieving/Blues Depression  Bipolar Manic Normal Depressed

12. Treatment of Mood Disorders  Medications  Psychotherapy  Occupational Therapy  Exercise

13. Anxiety Disorders  Panic Disorder  Generalized Anxiety Disorder  Social Anxiety Disorder  Phobias  Post Traumatic Stress Disorder  Obsessive-Compulsive Disorder

14. Anxiety Disorders  Anxiety is the most common symptom of substance abusers and is now considered to be a cause of anxiety disorders much more often than as a self- medicating for underlying anxiety disorder  Using chemicals ( benzodiazepines, cannabis) to cope with anxiety can weaken ability to use healthy mechanisms and create avoidance tendencies  Anxiety can be resolved in addiction treatment

15. Panic Attacks  A discreet period (< 30minutes) reaching a peak within 10 minutes with 4 or more of … Palpitations, pounding heart, or fast heart rate Sweating Trembling or shaking Shortness of breath or feeling smothered Feelings of choking Chest pain Nausea Feeling dizzy, light-headed, faint, or unsteady Derealization or depersonalization Fear of losing control / going crazy Numbness Chills or hot flashes

16. Post-Traumatic Stress Disorder  1. Person exposed to trauma  2. Event is persistently recurrently experienced Intrusive memories of event Dreams of the event Feeling as if they are reliving the event As intense distress or physiological reactivity when exposed to cues that resemble or symbolize the event  3. Avoidance of stimuli and numbing responsiveness  4. Persistent symptoms of increased arousal

17. Anxiety Treatment  Medications preferably very short-term  Cognitive Behaviour Therapy  Trauma therapies to reprocess memories

18. Personality Disorders (most commonly disabling)  Borderline Personality Disorder  Antisocial Personality Disorder  Avoidant Personality Disorder  Dependent Personality Disorder  Obsessive Compulsive Personality Disorder

19. Therapy for Personality Disorder  Medications for symptom management  Psychotherapy  Dialectical Behavioral Therapy and other newly developed therapy for persons with personality disorders  Psycho-social Rehabilitation (skill building)

20. Addictions  Alcohol, Heroin and other Opiate use frequently causes symptoms of depression and sometimes depressive illness.  Alcohol, Benzodiazepines, and cannabis often create anxiety disorders by allowing avoidance of anxiety provoking stimuli  Cocaine addiction can resemble or create bipolar mood swings

21. Addiction Therapies  Detox  Outpatient  Inpatient Residential  Support Recovery, Longer Term Residential  Self - Help

22. Eating Disorders  Anorexia Nervosa  Bulimia Nervosa  Eating Disorders NOS

23. Anorexia Nervosa  Refusal to maintain normal body weight for age & height  Intense fear of weight gain  Disturbance in self-evaluation of body shape and size, denial of serious of underweight  Amenorrhea in postmenstrual women

24. Bulimia Nervosa  Recurrent binge eating episodes  Recurrent purging to avoid weight gain  Binge eating and purging occur on average, at least twice a week for 3 months  Self-evaluation influenced by body shape and weight

25. Treatment of Eating Disorders  Medical stabilization  Medication  Individual therapy using several models - Readiness and Motivation Therapy ( RMT) Cognitive Behavioural Therapy (CBT) and Dialectical Behavioural Therapy (DBT); Understanding Feminist theory and role of media; skill building  Family Therapy- several models are being researched  Nutrition Education  Team approach

26. Recovery is Possible, Help is available  Mission Mental Health Centre  Fraserhouse  Mission Indian Friendship Centre