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

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

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

4. 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”

5. 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”

6. 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

7. PHYSICAL AND PSYCHOLOGIAL RESPONSES TO STRESS

8. 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

9. 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

10. 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

11. 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

12. 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.

13. 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.

14. 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

15. 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.

16. 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.

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

18. 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)

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