Mental Health and Mental Illness Chapter 1 Mental Health and Mental Illness

Introduction The concepts of mental health and mental illness are culturally defined Individuals experience both physical and psychological responses to stress

Mental Health Maslow identified A “hierarchy of needs” Self-actualization as fulfillment of one’s highest potential

Mental Health (cont.) Defined as “the successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms”

Mental Illness Defined as “maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms and interfere with the individual’s social, occupational, or physical functioning”

Mental Illness (cont.) Horwitz described cultural influences that affect how individuals view mental illness, including Incomprehensibility: the inability of the general population to understand the motivation behind the behavior Cultural relativity: the “normality” of behavior is determined by the culture

PHYSICAL AND PSYCHOLOGIAL RESPONSES TO STRESS

Physical Responses Hans Selye defined stress as “the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system” “Fight-or-flight” syndrome Immediate stress response Sustained stress response

Psychological Responses (cont.) Anxiety A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness Extremely common in our society Mild anxiety is adaptive and can provide motivation for survival

Psychological Responses (cont.) Behavioral adaptation responses to anxiety At the mild level, individuals employ various coping mechanisms to deal with stress, including Eating Drinking Sleeping Physical exercise Smoking Crying Laughing Talking to persons with whom they feel comfortable

Psychological Responses (cont.) At the mild to moderate level, the ego calls on defense mechanisms for protection, such as Compensation Denial Displacement Identification Intellectualization Introjection Isolation Projection Rationalization Reaction formation Regression Repression Sublimation Suppression Undoing

Psychological Responses (cont.) Anxiety at the moderate to severe level that remains unresolved over an extended period can contribute to a number of physiological disorders—for example, migraine headaches, irritable bowel syndrome, and cardiac arrhythmias. Extended periods of repressed severe anxiety can result in psychoneurotic patterns of behaving—for example, anxiety and somatoform disorders.

Psychological Responses (cont.) Extended periods of functioning at the panic level of anxiety may result in psychotic behavior—for example, schizophrenic, schizoaffective, and delusional disorders.

Psychological Responses (cont.) Grief: the subjective state of emotional, physical, and social responses to the loss of a valued entity; the loss may be real or perceived. Elisabeth Kübler-Ross Five stages of grief Denial Anger Bargaining Depression Acceptance

Psychological Responses (cont.) Anticipatory grief: The experiencing of the grief process before the actual loss occurs. Thought to shorten the grieving process Resolution: Length of the grief process is entirely individual. It can last from a few weeks to years and it is influenced by a number of factors.

Psychological Responses (cont.) Resolution of the grief response is thought to occur when an individual can look back on the relationship with the lost entity and accept both the pleasures and the disappointments of the association.

Psychological Responses (cont.) Maladaptive grief responses Prolonged response Delayed/inhibited response Distorted response

DSM-IV-TR Multiaxial Evaluation System** Axis I: Clinical disorders and other conditions that may be a focus of clinical attention (Can be treated with meds) Axis II: Personality disorders and mental retardation (No medication tx) Axis III: General medical conditions (Physiological) Axis IV: Psychosocial and environmental problems Axis V: The measurement of an individual’s psychological, social, and occupational functioning on the Global Assessment of Functioning Scale (GAF)

Example of a Psychiatric Diagnosis Axis I: 300.4 Dysthymic Disorder Axis II: 301.6 Dependent Personality Disorder Axis III: 244.9 Hypothyroidism Axis IV: Unemployed Axis V: GAF = 65 (current)