Dr S. O. Malomo B.Sc, MB.ChB, FWACP Mental Self care Dr S. O. Malomo B.Sc, MB.ChB, FWACP

WACP Update course June 2015 Content Learning objectives Pre - test Introduction Definitions Common mental conditions needing self-care Self Care in Mental Disease Prevention Self Care in Mental Health Promotion WACP Update course June 2015

WACP Update course June 2015 Content Self Care in Mental Disease Management Mental self-care skills Resources for mental self-care Post – test Conclusion References WACP Update course June 2015

WACP Update course June 2015 Learning objectives At the end of this interaction participants should be able to: Discuss the role of self care in mental health Counsel patients on the use of self care in mental health prevention and promotion. Counsel patients on appropriate self care measures in the management of common mental conditions. Discuss common mental self care skills. WACP Update course June 2015

WACP Update course June 2015 PRE - TEST WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015 Introduction When people feel unwell they engage in self care more than 80% of the time. Only in 2-3% of situations do they go to a doctor. So self care has always been the predominant form of health care. Most people go to the doctor when they sense they lack the resources needed to deal with the problem themselves. WACP Update course June 2015

WACP Update course June 2015 Introduction The primary goal of a health system should be to help people take care of themselves. With global rise in health care costs, enhancing and promoting effective medical self care is assuming high priority. Health is a state of physical, social and mental wellbeing. Hence there can be no health without mental wellbeing. WACP Update course June 2015

WACP Update course June 2015 Introduction A mentally healthy person feels good with himself and is comfortable with others. He is also able to cope with demands, challenges and changes of everyday life. However, every healthy person is subject to periods of emotional upset like anger, sadness, anxiety etc. When these become disturbing, interfere with daily life or last for weeks and months, a mental illness may be present. WACP Update course June 2015

WACP Update course June 2015 Introduction Mental illnesses are generally characterized by abnormalities of mood, thought, and/or behaviour One in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from mental disorders. WACP Update course June 2015

WACP Update course June 2015 Introduction With appropriate information and resources people can take greater control of their mental wellbeing. This lecture will discuss the role of self care in mental disease prevention, mental health promotion and management of mental illness. WACP Update course June 2015

WACP Update course June 2015 Definitions Medial Self care can be described as all health decisions and measures taken by individuals for themselves and their families to get well and stay well. It includes decisions on personal hygiene, food choices, exercise, avoidance of health hazards, care of minor ailments and chronic diseases etc. WACP Update course June 2015

WACP Update course June 2015 Definitions Mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, is able to make a contribution to his or her community.” It is estimated that only about 17% of U.S adults are considered to be in a state of optimal mental health. WACP Update course June 2015

WACP Update course June 2015 Definitions Mental illness is defined as “collectively all diagnosable mental disorders” or “health conditions that are characterized by alterations in thinking, mood, or behaviour (or some combination thereof) associated with distress and/or impaired functioning.” WACP Update course June 2015

Common Mental Problems/Disorders Anger Anxiety Stress Burnout Post-traumatic Stress Disorder Obsessive-Compulsive Behavior Grief/Bereavement WACP Update course June 2015

Common Mental Problems/Disorders Phobias Relationship/Marital Problems Parenting Issues Alcohol/Drug Dependence Depression/Bipolar Disorder Sexual Concerns Schizophrenia WACP Update course June 2015

Self Care in Mental Disease Prevention Good prenatal, antenatal and perinatal care to prevent mental disease in children later in life. Maternal education and good parenting practices to reduce child abuse, psychological and behavioural problems Early monitoring of growth development of children by mothers to prevent intellectual disabilities WACP Update course June 2015

Self Care in Mental Disease Prevention Breast feeding Iodine supplement has been found to prevent neurological impairment Avoidance of alcohol during pregnancy to prevent low birth weight, fetal alcohol syndrome and other intellectual disabilities in babies Stimulating home and school environment can improve self esteem and good social behaviour. Early detection of behavioural problems by teachers WACP Update course June 2015

Self Care in Mental Disease Prevention Wearing of helmets and seat belts to prevent head injuries that can lead to mental disorders and disabilities. Improved marital communication to prevent relationship problems. Good retirement plan to prevent depression in the senior citizens and the elderly. WACP Update course June 2015

Self Care in Mental Health Promotion Take good care of your body – personal hygiene, good nutrition, rest and sleep, exercise, avoid health hazards and drugs of abuse. Work – Life balance: pay attention to leisure activities and holidays Impact others positively Learn and do new things – new language, new books, visit museums, travel to new places Explore nature and art WACP Update course June 2015

Self Care in Mental Health Promotion Manage stress Limit unhealthy mental habits Engage in meaningful creative work Make time for contemplation and appreciation Build supportive relationships – real world rather than virtual interactions Connect with people through volunteer work, special interest groups etc WACP Update course June 2015

Self Care in Mental Health Promotion Avoid risk factors for mental health compromise: Poor connection or attachment to primary caretaker early in life. Traumas or serious losses, especially early in life. Learned helplessness. Chronic illness that is disabling, or isolating Substance abuse. Go for strong relationships, a healthy lifestyle, and coping strategies WACP Update course June 2015

Self Care in Mental symptoms/illness The Self Care measures described here are not meant to replace professional care. In any case accompanied with distress that interferes with daily life, the symptoms should be evaluated by a professional. In such cases self care should be used with or after professional care WACP Update course June 2015

WACP Update course June 2015 Anxiety Anxiety is a feeling of dread, fear or distress over a real or imagined threat to one’s mental or physical well-being. Self Care Lessen exposure to the cause of distress Talk about it to someone you can trust Avoid caffeinated drinks, nicotine, stimulants Limit alcohol. Regular physical exercise and daily relaxation exercise WACP Update course June 2015

WACP Update course June 2015 Anxiety Plan your schedule and keep to what you can cope with physically and emotionally. Do stress rehearsals for stressful events that can not be avoided. Help others WACP Update course June 2015

WACP Update course June 2015 Alcohol problems These include alcohol abuse and/or dependence. Alcohol abuse is the repeated use of alcohol that results in daily living problems. Alcohol dependence is characterized by: - Cravings - Loss of control - Physical dependence - Tolerance WACP Update course June 2015

WACP Update course June 2015 Alcohol problems Cut down on parties Avoid drinking if possible Reduce amount of alcohol – mixing, alternating, slow drinking Eat while drinking Don’t drink alcohol if you are pregnant Talk to people you can trust to support your effort Find other hobbies to replace drinking time e.g. relaxation exercise, movies, sport etc. WACP Update course June 2015

WACP Update course June 2015 Alcohol problems Realize your role as a model to your children, students, subordinates etc. Don’t mix drinking with driving, drugs or operating machines Use ‘Now awareness technique’ Join a support group Avoid keeping wine, beer and drugs at home Avoid people and places associated with drinking and drugs WACP Update course June 2015

WACP Update course June 2015 Anger Anger is a natural reaction to frustrating and/or painful events and is most often harmless When excessive or chronic it may be associated with relationship problems, drug and alcohol addiction, headaches, domestic violence, depression etc. Share your angry feelings with a person you trust and feel safe with, such as a friend, spouse, teacher, etc. WACP Update course June 2015

WACP Update course June 2015 Anger Take responsibility for your feelings Make a list of situations in which you feel excessive anger and see if you can change the pattern When angry channel your energy into positive or creative ventures – exercise, writing, painting. Distract yourself when in anger – provoking situations: music, breathing exercise Find humor in situations that result in anger. WACP Update course June 2015

WACP Update course June 2015 Anger When angry don’t respond immediately. Think before you speak or act. Allow anger to go down first and consider the consequences before you respond. WACP Update course June 2015

WACP Update course June 2015 Bipolar Disorder This is a mood disorder and should be diagnosed by a professional. Self care measures are directed to the care giver Help the person realize the unusual behaviour and the need to seek treatment Encourage compliance with medical care Protect the person and others from harm Be observant and make your observations known to the doctor. WACP Update course June 2015

WACP Update course June 2015 Burnout This is a condition of feeling exhausted or worn out which can result from anything that demands more energy than you can give. Presents with fatigue, emotional exhaustion, loss of enthusiasm etc. Self Care in preventing Burnout Don’t spread yourself too thin Be aware of signals that precede burnout – persistent tiredness, headaches, body aches etc WACP Update course June 2015

WACP Update course June 2015 Burnout Reduce long hours of work or study and take regular 5-10 min relaxation breaks. Take daily breaks from work for a lunch outside, a walk, an exercise session etc. Prioritize your work load and manage time Attempt to do well, but don’t try to be perfect. Get enough sleep and exercise everyday Take a vacation at least once a year to relax and do the things you enjoy. WACP Update course June 2015

WACP Update course June 2015 Burnout Self Care for Burnout Take a vacation or leave of absence to renew Get plenty of rest Re-assess your career goals and life priorities Regular aerobic exercise Set up a healthy daily routine including leisure. Get well organized – To do list, time management Eat regular healthy meals at regular intervals everyday WACP Update course June 2015

WACP Update course June 2015 Burnout Self Care for Burnout Take on only what you can manage and learn to say ‘NO’ Delegate tasks at work Make and take time for leisure activity that you enjoy every day Spend time away from situations that cause stress Discuss your feelings and problems with family, friends and colleagues. WACP Update course June 2015

WACP Update course June 2015 Depression Depression is characterized by fatigue, loss of energy, loss of interest and feelings of sadness, guilt, hopelessness etc. Take medications prescribed by the doctor Seek medical advice before taking herbs and other alternative therapies. Avoid un-prescribed and illegal drugs. Regular exercise and healthy foods Avoid isolation – stay with people you can trust. WACP Update course June 2015

WACP Update course June 2015 Depression Talk to someone you trust about your feelings Do things you enjoy – reading, music, warm bath, relaxation exercises etc. Keep an emergency number ready in case you need urgent help or feel desperate. If you notice suicidal thoughts, get professional help immediately. WACP Update course June 2015

Drug abuse and dependence Drug abuse is the repeated use of a drug that results in distress and daily living problems Drug dependence is addiction and is characterized by craving, need for increased amounts and withdrawal symptoms Self Care Use medications only as prescribed and for the intended purpose WACP Update course June 2015

Drug abuse and dependence Before taking more than one drug or taking drug with alcohol, ask your doctor. Don’t use medicines prescribed for someone else Ask your doctor before taking sleeping pills, tranquillizers and strong pain killers. Avoid persons and situations that may lure you into taking drugs. Join self help groups for drug users WACP Update course June 2015

Drug abuse and dependence Talk to people who will listen to your feelings and concerns without judging you. Calm music, breathing exercises Regular vigorous exercises Do things that builds your confidence e.g. volunteer work, martial arts etc. Learn something new Realize you are a role model to your children Use Now awareness technique WACP Update course June 2015

WACP Update course June 2015 Grief/Bereavement Grief is a deep sadness or sorrow that results from a loss. The loss is often related to job situation, property/business, relationships, Health and life matters. Learning that grief is a normal human reaction to a loss and about the stages of grief can help the healing process. WACP Update course June 2015

WACP Update course June 2015 Grief/Bereavement The griever generally goes through four stages: Shock Denial Disorganization Recovery and Acceptance Self Care for the griever Maintain good health habits – eat well, exercise Express your feelings freely. WACP Update course June 2015

WACP Update course June 2015 Grief/Bereavement Allow friends and family to assist. Do not stay alone. Discuss your feelings and concerns. Share and maintain memories of the lost loved one Join a support group for the bereaved. WACP Update course June 2015

WACP Update course June 2015 Parenting Issues Parents face many issues in raising children which includes: - Safety of the children - Physical and emotional care - Knowing right from wrong - Dealing with the stresses of life stages When problems persist and interferes with the lives of parents and their children, professional help may be needed. WACP Update course June 2015

WACP Update course June 2015 Parenting Issues Self Care for parenting problems Learn effective parenting skills Show unconditional love which gives the child a sense of security, belonging and support Condemn wrong behaviour but maintain your love. Set and stick to specific standards of behaviour Discipline should be carried through, don’t issue empty threats. WACP Update course June 2015

WACP Update course June 2015 Parenting Issues Discipline should be consistent, clear, private, reasonable, flexible, independence promoting, and authoritative. Make time for your children Make time for your spouse Teach right from wrong and show example Listen to your children’s ideas and encourage free communication. Guide children by offering suggestions WACP Update course June 2015

WACP Update course June 2015 Parenting Issues Be realistic – expect to make mistakes and allow the children to make theirs. Be aware of outside influences. Praise children when they do something well. Educate children on special issues like drug and alcohol abuse, HIV/AIDS, unsafe sexual practices, random violence Communicate freely and let them know they can count on you in a crisis WACP Update course June 2015

WACP Update course June 2015 Phobias A phobia is an irrational fear of a specific situation, activity or object. It presents with anxiety symptoms when exposed to the feared situation Types include Specific phobias, social phobias and agoraphobia Self Care List the irrational fears and figure out what they mean and how you can deal with them WACP Update course June 2015

WACP Update course June 2015 Phobias Learn and practice relaxation techniques like controlled breathing and tension control. Enroll in appropriate specific courses e.g. public speaking course. Use Now awareness technique. WACP Update course June 2015

Relationship/Marital Problems Common problems in relationship include: Problems with communication Misunderstandings Power struggles Different attitudes to money, sex, work, child rearing, time, in-laws and other family issues Self Care Learn to listen to the other person without interruption. WACP Update course June 2015

Relationship/Marital Problems When discussing problems focus on how to solve the problem and not who is to blame Remind each other and build on the positive strengths of the relationship Seek to understand your partner’s position on issues before seeking to be understood. Discuss each other’s sexual needs and develop areas of compatibility. WACP Update course June 2015

Relationship/Marital Problems Discuss money matters, explore options together and agree on how to develop and fund family budget WACP Update course June 2015

WACP Update course June 2015 Stress Stress is the body’s response to any increased demand. Stress may manifest as increased heart rate, rapid breathing, irritability, lack of concentration, insomnia, lowering of the immune system etc. Self Care Maintain a regular daily programme of healthy eating, good health habits and adequate sleep. Exercise regularly WACP Update course June 2015

WACP Update course June 2015 Stress Balance work and play Laugh a lot. It serves as a relaxation technique Accept what you can not change rather than worrying. When you have troubles talk about it with a friend relative or clergy Reward yourself with things that make you feel good Do relaxation exercise daily. WACP Update course June 2015

WACP Update course June 2015 Stress Budget your time using a ‘To Do List’ Avoid procrastination Do a stress rehearsals by practicing for stressful events WACP Update course June 2015

Mental Self Care Skills Assertive Skills Sleep Hygiene Anger Management Skills Relaxation techniques Cognitive restructuring Breathing exercises Journaling Emotional support WACP Update course June 2015

Mental Self Care Skills Become an expert in your mental illness Identify target symptoms Identify and avoid triggers Take an active role in your treatment Set a goal to live a healthy life Develop a plan for getting well Build a community of people who support and understand you WACP Update course June 2015

Mental Self Care Resources Books – Minding your mental health by the American institute for preventive medicine Online materials – articles, books, websites Short courses on coping skills Support groups – Alcoholics anonymous, Anxiety and depression association, Narcotics anonymous etc. Social support – Family, Friends, Colleagues. WACP Update course June 2015

WACP Update course June 2015 POST - TEST WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015

WACP Update course June 2015 Conclusion Self Care is the predominant form of health care Mental Self Care has a role in preventing mental disease, promoting mental health and managing mental illness. Teaching people appropriate mental self care will empower them to take greater responsibility for their mental health. The Family physician is uniquely positioned to promote appropriate mental self care. WACP Update course June 2015

WACP Update course June 2015 References World Health Organization. Strengthening Mental Health Promotion. Geneva, World Health Organization (Fact sheet no. 220), 2001. Medical Self Care by American Institute for Preventive Medicine. Available at www.healthylife.com Minding your mental health by Don R. Powell, Ph.D. and the American Institute for Preventive Medicine. Available at http://www.healthylife.com/mymh/SecIa.htm WACP Update course June 2015

WACP Update course June 2015 References Improving Emotional Health - Strategies and Tips for Good Mental Health. Available at http://www.helpguide.org/articles/emotional-health Coping Skills for Mental Illness. Available at http://www.mental-illness-resources.com/coping-skills.html Prevention and promotion in Mental Health. http://www.who.int/mental_health WACP Update course June 2015

WACP Update course June 2015 THANK YOU WACP Update course June 2015