Mental Health
Disorders
Clinical Depression-What is
it?
O Mood disorder
O feelings of loss, sadness, anger, or
frustration interfere with everyday life
O Effects a person for weeks or longer
http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm
CD-What causes it?
O Exact cause is not known
O Some believe it is caused by chemical
changes in the brain
O Others believe it is a problem due to your
genes
O Some others believe it is a combination
O Anyone can develop depression
http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm
May play a role in depression
O Alcohol or drug abuse
O Certain medical conditions, including underactive
thyroid, cancer, or long-term pain
O Certain medications such as steroids
O Sleeping problems
O Stressful life events, such as:
O
O
O
O
O
O
O
Breaking up with a boyfriend or girlfriend
Failing a class
Death or illness of someone close to you
Divorce
Childhood abuse or neglect
Job loss
Social isolation (common in the elderly)
http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm
CD-How does it affect a
person?
O May change the way you see yourself, your
life, and those around you.
O Tend to be more negative
O Can appear as anger and discouragement,
rather than sadness
O If severe, psychotic symptoms may occur like
delusions and hallucinations
http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm
CD-Symptoms
O
O
O
O
O
O
O
O
O
O
Agitation, restlessness, and irritability
Becoming withdrawn or isolated
Difficulty concentrating
Dramatic change in appetite, often with weight gain
or loss
Fatigue and lack of energy
Feelings of hopelessness and helplessness
Feelings of worthlessness, self-hate, and guilt
Loss of interest or pleasure in activities that were
once enjoyed
Thoughts of death or suicide
Trouble sleeping or too much sleeping
http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm
CD-How is it diagnosed?
O Doctor will ask questions about your medical
history and symptoms
O This will help the doc diagnose and
determine severity
O Blood and urine tests may be done to rule
out other conditions with similar symptoms
http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm
CD-How is it treated?
O Medications called anti-depressants
O Talk therapy called psychotherapy
**Mild depression may only need one of these
treatments
**more severe depression usually needs
combo of both treatments
**people who are suicidal or extremely
depressed may need to be treated in a
psychiatric hospital
http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm
CD-Can it be prevented?
O While there’s not a way to truly prevent it, there
O
O
O
O
O
O
O
are things that can be done to help you feel
better
Don’t use alcohol or use illegal drugs
Take your medication as instructed
Get more exercise
Maintain good sleep habits
Volunteer or get involved in group activities
Surround yourself with people who care about
you and are positive
Participate in activities that you enjoy
http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm
Post-Partum Depression
O Treatable medical illness
O Characterized by sadness, exhaustion,
indifference and anxiety following the birth
of a person’s child
O Effects 1 in every 10 women
http://www.dbsalliance.org/site/PageServ
er?pagename=education_depression_postp
artum&gclid=CNLHz7rd47YCFWQl4god
VHIA3g
PPD-What are the causes?
O Exact cause is not known
O Linked to chemical changes that take place
in your body during and after pregnancy
http://www.dbsalliance.org/site/PageServ
er?pagename=education_depression_postp
artum&gclid=CNLHz7rd47YCFWQl4god
VHIA3g
PPD-Symptoms
O
O
O
O
O
O
O
O
O
O
O
O
O
O
Feelings of sadness or "down"-ness that don't go away
Inability to sleep, even when the baby is sleeping
Changes in appetite-eating much more or much less
Irritability, anger, worry, agitation, anxiety
Inability to concentrate or make decisions
Inability to enjoy things you used to; lack of interest in the baby; lack of
interest in friends and family
Exhaustion; feeling "heavy"
Uncontrollable crying
Feelings of guilt or worthlessness
Feelings of hopelessness or despair
Fear of being a "bad" mother, or that others will think you are
Fear that harm will come to the baby
Thoughts of harming the baby or harming yourself
Thoughts of death or suicide
http://www.dbsalliance.org/site/PageServ
er?pagename=education_depression_postp
artum&gclid=CNLHz7rd47YCFWQl4god
VHIA3g
Risk Factors of PPD
O History of depression during or after previous
O
O
O
O
O
O
pregnancies
History of depression or bipolar disorder at any time
History of depression, bipolar disorder or postpartum
depression in blood relatives
Poor social support
Unpleasant life events happening around the time of
the pregnancy or birth
Instability in your marriage or relationship
Feeling unsure about your pregnancy
http://www.dbsalliance.org/site/PageServ
er?pagename=education_depression_postp
artum&gclid=CNLHz7rd47YCFWQl4god
VHIA3g
PPD Treatments
O Talk with doc about symptoms and any
O
O
O
O
O
O
medications or natural remedies being used
Consider taking meds-will need to look at
medications that are least likely to pass into
breast milk if nursing
Psychotherapy or support groups
Eat balanced meals
Light exercise
Allow family and friends to help you
Look into stress reduction techniques
http://www.dbsalliance.org/site/PageServ
er?pagename=education_depression_postp
artum&gclid=CNLHz7rd47YCFWQl4god
VHIA3g
Manic Depression
O Aka Bipolar Disorder
O Classified as a mood disorder that goes
beyond the day’s ordinary ups and downs.
O Characterized by periodic episodes of
extreme elation, elevated mood, or irritability
then countered with periodic classic
depressive symptoms
O Extreme highs followed by extreme lows
http://medicalcenter.osu.edu/patientcare
/healthcare_services/mental_health/ment
al_health_about/mood/bipolar_disorder/
Pages/index.aspx
Manic Depression-who is
affected?
O Affects more than 5.7 million American
adults
O 2.6% Americans 18 and older
O Affects men and women equally
O Women tend to show more depressive
symptoms than manic symptoms.
O Likely to run in families
O Still researching to identify a specific gene
that is responsible for manic depression.
http://medicalcenter.osu.edu/patientcare
/healthcare_services/mental_health/ment
al_health_about/mood/bipolar_disorder/
Pages/index.aspx
Manic Depression-depressive
symptoms
O
O
O
O
O
O
O
O
O
O
O
O
persistent sad, anxious, or empty mood
loss of interest in activities once previously enjoyed
excessive crying
increased restlessness and irritability
decreased ability to concentrate and make decisions
decreased energy
thoughts of death or suicide, or suicide attempts
increased feelings of guilt, helplessness, and/or hopelessness
weight and/or appetite changes due to over- or under-eating
changes in sleep patterns
social withdrawal
physical symptoms unrealized by standard treatment (i.e.,
chronic pain, headaches)
http://medicalcenter.osu.edu/patientcare
/healthcare_services/mental_health/ment
al_health_about/mood/bipolar_disorder/
Pages/index.aspx
Manic Depression-manic
symptoms
O
O
O
O
O
O
O
O
O
O
O
overly inflated self-esteem
decreased need for rest and sleep
increased distractibility and irritability
increased physical agitation
excessive involvement in pleasurable activities that may result
in painful consequence; this may include provocative,
aggressive, or destructive behavior
increased talkativeness
excessive "high" or euphoric feelings
increased sex drive
increased energy level
uncharacteristically poor judgment
increased denial
http://medicalcenter.osu.edu/patientcare
/healthcare_services/mental_health/ment
al_health_about/mood/bipolar_disorder/
Pages/index.aspx
Manic Depression-diagnosis
O Individual must exhibit both depressive and
manic symptoms to a varying degree.
O Sometimes hard to diagnose because the
manic symptoms tend to resemble other
psychiatric conditions.
O Diagnosis is made after careful psychiatric
examination and medical history performed
by a mental health professional.
http://medicalcenter.osu.edu/patientcare
/healthcare_services/mental_health/ment
al_health_about/mood/bipolar_disorder/
Pages/index.aspx
Manic Depression-Treatment
O Specific treatment based upon:
O your age, overall health, and medical history
O extent of the disease
O your tolerance for specific medications,
procedures, or therapies
O expectations for the course of the disease
O your opinion or preference
http://medicalcenter.osu.edu/patientcare
/healthcare_services/mental_health/ment
al_health_about/mood/bipolar_disorder/
Pages/index.aspx
Manic Depression-treatment
O May include either or a combination of:
O medication (i.e., mood-stabilizing
anticonvulsants and/or antidepressants
O psychotherapy
O most often cognitive-behavioral and/or
interpersonal therapy which focuses on changing
the individual's distorted views of themselves and
the environment around them, working through
difficult relationships, and identifying stressors in
the environment and how to avoid them
O •electroconvulsive therapy (ECT)
http://medicalcenter.osu.edu/patientcare
/healthcare_services/mental_health/ment
al_health_about/mood/bipolar_disorder/
Pages/index.aspx
Manic Depression-what’s
important about the
treatment…
O Recognizing the varied and extreme mood
swings is crucial to obtaining the most
effective treatment for the person
O Helps avoid the potentially harmful
consequences of the manic behavior
O Long term, preventative treatments are
necessary to stabilize the mood swings
associated with the disorder.
http://medicalcenter.osu.edu/patientcare
/healthcare_services/mental_health/ment
al_health_about/mood/bipolar_disorder/
Pages/index.aspx
Seasonal Affective Disorder
(SAD)
O Kind of depression that occurs at a certain
time of the year, usually in the winter
O Usually affects people who live in areas with
long winter nights
O Affects more women than men
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002499/
SAD-symptoms
O
O
O
O
O
O
O
O
O
O
Sad, anxious or "empty" feelings
Feelings of hopelessness and/or pessimism
Feelings of guilt, worthlessness or helplessness
Irritability, restlessness
Loss of interest or pleasure in activities you used to
enjoy
Fatigue and decreased energy
Difficulty concentrating, remembering details and
making decisions
Difficulty sleeping or oversleeping
Changes in weight
Thoughts of death or suicide
http://www.nlm.nih.gov/medlineplus/seas
onalaffectivedisorder.html
SAD-treatments
O antidepressants
O Some take medication only during the time
effected and others elect to take medication
all year
O Light therapy-regular, daily exposure to a
“light box”, which artificially simulates highintensity sunlight.
http://www.nami.org/Template.cfm?Secti
on=By_Illness&Template=/ContentMan
agement/ContentDisplay.cfm&ContentID
=23051
Phobias
O Type of anxiety disorder
O It is a strong, irrational fear of something
O
O
O
O
that poses little or no real danger
There are numerous and specific phobias
Usually start in children and teens
Causes are unknown, but some tend to run
in families
Phobia List
http://www.nlm.nih.gov/medlineplus/phobias.html
Phobias-symptoms
O People try to avoid their fear
O If they can’t, they might experience:
O Panic and fear
O Rapid heartbeat
O Shortness of breath
O Trembling
O A strong desire to get away
http://www.nlm.nih.gov/medlineplus/phobias.html
Phobias-treatment
O Helps most people with phobias
O Treatments include medicines, therapy, or
both
O Self help strategies have also been effective
http://www.nlm.nih.gov/medlineplus/phobias.html
Obsessive Compulsive
Disorder
O Feel the need to check things repeatedly, or
O
O
O
O
have certain thoughts, or perform routines over
and over
Thoughts and rituals cause distress and get in
the way of daily life
Frequent upsetting thoughts = obsessions
In order to control obsessions, people with OCD
feel the overwhelming urge to repeat certain
rituals or behaviors = compulsions
Tends to start in childhood or teenage years
http://www.nimh.nih.gov/health/publicat
ions/obsessive-compulsive-disorder-whenunwanted-thoughts-take-over/what-isocd.shtml
OCD-signs and symptoms
O Have repeated thoughts or images about many different
O
O
O
O
things, such as fear of germs, dirt, or intruders; acts of
violence; hurting loved ones; sexual acts; conflicts with
religious beliefs; or being overly tidy
Do the same rituals over and over such as washing
hands, locking and unlocking doors, counting, keeping
unneeded items, or repeating the same steps again and
again
Can't control the unwanted thoughts and behaviors
Don't get pleasure when performing the behaviors or
rituals, but get brief relief from the anxiety the thoughts
cause
Spend at least 1 hour a day on the thoughts and rituals,
which cause distress and get in the way of daily life.
http://www.nimh.nih.gov/health/publicat
ions/obsessive-compulsive-disorder-whenunwanted-thoughts-take-over/what-are-thesigns-and-symptoms-of-ocd.shtml
OCD-causes
O Sometimes runs in families
O No concrete reason why it occurs
http://www.nimh.nih.gov/health/publicat
ions/obsessive-compulsive-disorder-whenunwanted-thoughts-take-over/what-causesocd.shtml
OCD-treatments
O Doctor should do an exam to make sure that
another physical problem isn’t causing the
symptoms
O Generally treated with medication,
psychotherapy, or both
http://www.nimh.nih.gov/health/publicat
ions/obsessive-compulsive-disorder-whenunwanted-thoughts-take-over/how-is-ocdtreated.shtml
OCD-Psychotherapy
O Cognitive behavioral therapy-a type of
psychotherapy
O Especially useful in treating OCD
O Teaches a person different ways of thinking,
behaving, and reacting to help them feel
less anxious or fearful
O Decreases obsessive thoughts or acting
compulsively
http://www.nimh.nih.gov/health/publicat
ions/obsessive-compulsive-disorder-whenunwanted-thoughts-take-over/how-is-ocdtreated.shtml
OCD-medications
O Most commonly prescribed are anti-anxiety
medications or antidepressants
O Anti-anxiety medications tend to start
working faster but should not be taken for
long periods of time
O Antidepressants take longer to work but
seem to be more effective
O Side effects can occur
http://www.nimh.nih.gov/health/publicat
ions/obsessive-compulsive-disorder-whenunwanted-thoughts-take-over/how-is-ocdtreated.shtml
OCD-What is it like?
O
"I couldn't do anything without rituals. They invaded every aspect of my
life. Counting really bogged me down. I would wash my hair three times
as opposed to once because three was a good luck number and one
wasn't. It took me longer to read because I'd count the lines in a
paragraph. When I set my alarm at night, I had to set it to a number
that wouldn't add up to a 'bad' number."
O
"Getting dressed in the morning was tough, because I had a routine,
and if I didn't follow the routine, I'd get anxious and would have to get
dressed again. I always worried that if I didn't do something, my parents
were going to die. I'd have these terrible thoughts of harming my
parents. I knew that was completely irrational, but the thoughts
triggered more anxiety and more senseless behavior. Because of the
time I spent on rituals, I was unable to do a lot of things that were
important to me."
http://www.nimh.nih.gov/health/publicat
ions/obsessive-compulsive-disorder-whenunwanted-thoughts-take-over/what-is-itlike-having-ocd.shtml
Panic Disorder
O Sudden and repeated attacks of fear that
O
O
O
O
lasts several minutes
Sometimes the symptoms may last longer
Called panic attacks-characterized by fear of
disaster or of losing control even when there
is no real danger
Often begins in late teens or early adulthood
Effects more women than men
http://www.nimh.nih.gov/health/publicat
ions/panic-disorder-when-fearoverwhelms/what-is-panic-disorder.shtml
Panic Disorder-symptoms
O Sudden and repeated attacks of fear
O A feeling of being out of control during a panic
attack
O An intense worry about when the next attack will
happen
O A fear or avoidance of places where panic
attacks have occurred in the past
O Physical symptoms during an attack, such as a
pounding or racing heart, sweating, breathing
problems, weakness or dizziness, feeling hot or
a cold chill, tingly or numb hands, chest pain, or
stomach pain.
http://www.nimh.nih.gov/health/publicat
ions/panic-disorder-when-fearoverwhelms/what-are-the-signs-andsymptoms-of-panic-disorder.shtml
Panic disorder-causes
O Sometimes runs in families
O No known cause
O Researchers have found that several parts
of the brain are responsible for fear and
anxiety
http://www.nimh.nih.gov/health/publicat
ions/panic-disorder-when-fearoverwhelms/what-are-the-signs-andsymptoms-of-panic-disorder.shtml
Panic disorder-diagnosis
O Talk with a doctor about symptoms
O An exam should be completed in order to
make sure that another physical condition is
not causing the symptoms
O Generally treated with psychotherapy,
medication, or both
http://www.nimh.nih.gov/health/publicat
ions/panic-disorder-when-fearoverwhelms/how-is-panic-disordertreated.shtml
Panic Disorder-Psychotherapy
O Cognitive behavioral therapy is very useful in
treating PD
O Helps person develop different ways of
thinking, behaving, and reacting to
situations
O Helps reduce fear and become less anxious
http://www.nimh.nih.gov/health/publicat
ions/panic-disorder-when-fearoverwhelms/how-is-panic-disordertreated.shtml
Panic Disorder-Medications
O Can be prescribed anti-anxiety meds or
antidepressants
O Anti-anxiety med begin working quickly but
should not be taken for extended periods of time
O Antidepressants take longer to work but can be
given in lower dosages
O Beta-blockers can help control physical
symptoms of panic attacks
O Not normally prescribed but can help in situations
that tend to bring on panic attacks
http://www.nimh.nih.gov/health/publicat
ions/panic-disorder-when-fearoverwhelms/how-is-panic-disordertreated.shtml
Post-traumatic stress disorder
(PTSD)
O Anxiety disorder that some people get after
seeing or living through a dangerous event
O In stressful situations, your body goes
through a series of physiological changes
that lead to a “fight or flight” response.
O With PTSD, this reaction is changed or
damaged
O People feel stressed or frightened even when
they are no longer in danger
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/what-is-post-traumatic-stress-disorderor-ptsd.shtml
PTSD-who gets it?
O Anyone at any age
O Common in war veterans and survivors of
physical or sexual assault, abuse, accidents,
disasters, or other serious events
O Some can get it after a friend or family
member experiences danger or is harmed
O Sudden, unexpected death of a loved one
can also cause PTSD
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/who-gets-ptsd.shtml
PTSD-symptoms
O Can cause many symptoms
O Grouped into 3 categories
O Re-experiencing
O Avoidance
O Hyperarousal
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/what-are-the-symptoms-of-ptsd.shtml
PTSD: Re-experiencing
symptoms
O Flashbacks—reliving the trauma over and over,
including physical symptoms like a racing heart or
sweating
O Bad dreams
O Frightening thoughts.
**may cause problems in a person’s everyday routine.
**can start from the person’s own thoughts and
feelings.
**Words, objects, or situations that are reminders of
the event can also trigger re-experiencing.
http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorderptsd/what-are-the-symptoms-of-ptsd.shtml
PTSD-Avoidance symptoms
O Staying away from places, events, or objects that are
O
O
O
O
O
reminders of the experience
Feeling emotionally numb
Feeling strong guilt, depression, or worry
Losing interest in activities that were enjoyable in the
past
Having trouble remembering the dangerous event.
Things that remind a person of the traumatic event
can trigger avoidance symptoms. These symptoms
may cause a person to change his or her personal
routine. For example, after a bad car accident, a
person who usually drives may avoid driving or riding
in a car.
http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorderptsd/what-are-the-symptoms-of-ptsd.shtml
PTSD-Hyperarousal symptoms
O Being easily startled
O Feeling tense or “on edge”
O Having difficulty sleeping, and/or having angry
outbursts.
**usually constant, instead of being triggered by
things that remind one of the traumatic event.
**can make the person feel stressed and angry.
** symptoms may make it hard to do daily tasks,
such as sleeping, eating, or concentrating.
http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorderptsd/what-are-the-symptoms-of-ptsd.shtml
PTSD-symptoms
O Natural to have any of these symptoms after a
dangerous event
O Acute Stress Disorder (ASD)-when a person has
serious symptoms that go away after a few
weeks
O If symptoms last longer than a few weeks or
become an ongoing problem, then it could be
PTSD
O Some people with PTSD do not show symptoms
for weeks or months after the event
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/what-are-the-symptoms-of-ptsd.shtml
PTSD-adults vs children
O Reactions may differ by age
O Symptoms in young children may include:
O Bedwetting, when they’d learned how to use the
toilet before
O Forgetting how or being unable to talk
O Acting out the scary event during playtime
O Being unusually clingy with a parent or other adult
O Symptoms in older children and teens tend to
resemble adult symptoms
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/do-children-react-differently-thanadults.shtml
PTSD-diagnosis
O Mental health professional can diagnose
PTSD
O To be diagnosed with PTSD, a person must
have all of the following for at least 1 month:
O At least one re-experiencing symptom
O At least three avoidance symptoms
O At least two hyperarousal symptoms
O Symptoms that make it hard to go about daily
life, go to school or work, be with friends, and
take care of important tasks.
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/how-is-ptsd-detected.shtml
PTSD-risk factors
O Make a person more likely to get PTSD
O Risk factors include:
O
O
O
O
O
O
O
Living through dangerous events and traumas
Having a history of mental illness
Getting hurt
Seeing people hurt or killed
Feeling horror, helplessness, or extreme fear
Having little or no social support after the event
Dealing with extra stress after the event, such as
loss of a loved one, pain and injury, or loss of a
job or home.
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/why-do-some-people-get-ptsd-andother-people-do-not.shtml
PTSD-Resiliency factors
O May help reduce the risk of PTSD
O Include:
O Seeking out support from other people, such as
O
O
O
O
friends and family
Finding a support group after a traumatic event
Feeling good about one’s own actions in the face
of danger
Having a coping strategy, or a way of getting
through the bad event and learning from it
Being able to act and respond effectively despite
feeling fear.
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/why-do-some-people-get-ptsd-andother-people-do-not.shtml
PTSD-treatments
O Psychotherapy, medication, or both
O Depends on the person since everyone
responds differently to treatments
O Psychotherapy helps a person face their
fears, make sense of bad memories, and
teaches a person how to reduce their
anxiety
O Medications prescribed are antidepressants
to help control symptoms
http://www.nimh.nih.gov/health/publicat
ions/post-traumatic-stress-disorderptsd/medications.shtml
Social anxiety disorder
O Aka social phobia
O People become overwhelmingly anxious and
excessively self-conscious in everyday social
situations
O Have an intense fear of being watched or judged
by others, and of doing things that might
embarrass them
O Can worry days or weeks before a dreaded
situation
O Fear can be so intense that it interferes with
school, work, and other activities
http://www.nimh.nih.gov/health/publicat
ions/anxiety-disorders/social-phobiasocial-anxiety-disorder.shtml
Social Anxiety Disorder
O Can make it hard for someone to make or
keep friends
O Realize that their fears might be
unreasonable or excessive, but cannot
overcome them
O Can be limited to one situation or may be so
broad that they experience anxiety around
almost anyone
http://www.nimh.nih.gov/health/publicat
ions/anxiety-disorders/social-phobiasocial-anxiety-disorder.shtml
Social Anxiety Disordersymptoms
O Blushing
O Profuse sweating
O Trembling
O Nausea
O Difficulty talking
**When these symptoms occur, people with
social phobia feel as though all eyes are
focused on them.
http://www.nimh.nih.gov/health/publicat
ions/anxiety-disorders/social-phobiasocial-anxiety-disorder.shtml
Social Anxiety Disorder-causes
O No known cause
O Some evidence that a genetic factor is
involved
O Often accompanied by other anxiety
disorders or depression
O Affects 15 million Americans
O Affects men and women equally
http://www.nimh.nih.gov/health/publicat
ions/anxiety-disorders/social-phobiasocial-anxiety-disorder.shtml
Social Anxiety Disordertreatments
O Successfully treated with certain kinds of
psychotherapy and/or medications
http://www.nimh.nih.gov/health/publicat
ions/anxiety-disorders/social-phobiasocial-anxiety-disorder.shtml
Multiple personality disorder
O Now known as Dissociative Identity Disorder
(DID)
O Disturbance of identity in which two or more
separate and distinct personality states
control the individual’s behavior at different
times
O When under the control of one identity, a
person is usually unable to remember some
of the events that occurred while other
personalities are in control
http://www.nami.org/Content/ContentGr
oups/Helpline1/Dissociative_Identity_Di
sorder_(formerly_Multiple_Personality_
Disorder).htm
DID
O The different identities may exhibit differences in
speech, mannerisms, attitudes, thoughts, and
gender orientation
O Referred to as alters
O May even differ in physical properties such as
left or right handedness, allergies, the need for
Rx lenses
O Person can have as few as 2 alters or as many
as 100 alters
O Average is 10 alters
http://www.nami.org/Content/ContentGr
oups/Helpline1/Dissociative_Identity_Di
sorder_(formerly_Multiple_Personality_
Disorder).htm
DID
O People are typically unaware that they have
this disorder
O Report episodes of amnesia or time loss
O May encounter unfamiliar people who claim
to know them, find themselves somewhere
without knowing how they got there, or find
things in their possession and don’t know
how they obtain the items
http://www.nami.org/Content/ContentGr
oups/Helpline1/Dissociative_Identity_Di
sorder_(formerly_Multiple_Personality_
Disorder).htm
DID-cause
O Believed to be caused by physical or sexual
abuse during childhood
O Use the dissociation as a defense
O Child makes it seem like the abuse is
happening to someone else
O Research shows that the average age of
initial development of alters is 5-6 years of
age
http://www.nami.org/Content/ContentGr
oups/Helpline1/Dissociative_Identity_Di
sorder_(formerly_Multiple_Personality_
Disorder).htm
DID-symptoms
O Depressive tendencies
O Anxiety
O Conduct problems
O Episodes of amnesia
O Hallucinations
O Difficulty focusing in school
**sometimes children get misdiagnosed with
schizophrenia
http://www.nami.org/Content/ContentGr
oups/Helpline1/Dissociative_Identity_Di
sorder_(formerly_Multiple_Personality_
Disorder).htm
DID-treatment
O Psychotherapy with hypnosis
O Therapist seeks to make contact with as many
alters as possible and to understand the
roles/functions of each alter.
O Seeks to form a relationship with any
personalities that are responsible for any violent
or destructive behavior, and then curb this
behavior
O Therapist goal is to help the patient achieve a
breakdown of the personalities and unify them
into one personality.
http://www.nami.org/Content/ContentGr
oups/Helpline1/Dissociative_Identity_Di
sorder_(formerly_Multiple_Personality_
Disorder).htm
Schizophrenia
O Severe, chronic, and generally disabling
brain and behavior disorder
O Affects how one thinks, feels, and acts
O Have trouble distinguishing reality from
fantasy and expressing/managing emotions
O May hear imaginary voices and believe
others are reading their minds, controlling
their thoughts, or plotting to harm them
http://bbrfoundation.org/frequently-asked-questions-about-schizophrenia
Schizophrenia-symptoms
O Different symptoms for different people
O The way the disease progresses in a person
depends on:
O Time of onset
O Severity and duration of symptoms-3
categories
**relapse and remission cycles can occur
(person gets better, worse, and then better
again)
http://bbrfoundation.org/frequently-asked-questions-about-schizophrenia
Schizophrenia- positive
symptoms
O Delusions-lead people to thinking they are
being monitored, threatened, or controlled
O Hallucinations-causes person to hear, see,
feel, or smell things that aren’t really there
O Thought disorders-difficulty putting thoughts
together or making sense out of speech
O Psychomotor problems-clumsiness, unusual
mannerisms, repetitive actions, motionless
rigidity
http://bbrfoundation.org/frequently-asked-questions-about-schizophrenia
Schizophrenia-negative
symptoms
O Loss of functioning in areas such as emotion or
motivation
O Loss or reduction to initiate plans, speak,
express emotion, or find pleasure in life
O Lack of expression
O Inability to begin and sustain a planned activity
O Social withdrawal
O apathy
**can be mistaken for laziness or depression.
http://bbrfoundation.org/frequently-asked-questions-about-schizophrenia
Schizophrenia-cognitive
symptoms
O Problems with attention and memory
O Especially planning and organizing to achieve
a goal
O Most disabling for people trying to lead a
normal life
http://bbrfoundation.org/frequently-asked-questions-about-schizophrenia
Schizophrenia-stats
O Affects men and women equally
O Occurs at similar rates in all ethnic groups
O Symptoms typically begin between ages 16-30
O Men tend to experience symptoms earlier than
women
O People typically do not get schizophrenia after
the age of 45
O Rarely seen in children but this number is rising
http://bbrfoundation.org/frequently-asked-questions-about-schizophrenia
Schizophrenia-diagnosis
O Symptoms present for 6 months
O Two or more symptoms must be significant and
last for at least 1 month
O Only one symptom is needed if delusions are
bizarre enough or if hallucinations involve a
voice constantly commenting on the person’s
behavior/thoughts or if two or more voices are
conversing
O Social or occupational problems can also be a
part of the diagnosis
Schizophrenia-treatment
O No cure
O Can be treated and managed with
medication and therapy, especially if caught
early and treated continuously
O Antipsychotic medications help control the
symptoms
O Cognitive or behavioral therapy help patient
retrain the brain once symptoms are
controlled
http://bbrfoundation.org/frequentlyasked-questions-about-schizophrenia
Suicide
O Intentional taking of one’s own life
O 11th most common cause of death in the US
O Often considered when one is hopeless and
can’t see any other solution to their problem
O Also related to serious depression, alcohol,
substance abuse, or major stressful events
O White men have the highest risk of suicide
O Women and teens report more suicide
attempts
http://www.nlm.nih.gov/medlineplus/suicide.html
Suicide-warning signs
O Threatening to hurt or kill oneself
O Talking about wanting to hurt or kill oneself
O Looking for ways to kill oneself
O Talking or writing about death, dying, or
suicide
O Feeling hopeless
O Increasing alcohol or drug use
O Withdrawing from friends and family
http://store.samhsa.gov/shin/content//SVP05-0126/SVP05-0126.pdf
Suicide-warning signs
O Acting reckless or participating in dangerous
O
O
O
O
activities
Feeling anxious and agitated
Experiencing dramatic mood changes
Seeing no reason to live
Giving away of personal belongings
Suicide-risk factors
O Previous suicide attempts
O History of depression or other mental health
O
O
O
O
issues
Alcohol or drug abuse
Family history of suicide or violence
Physical illness
Feeling alone
http://www.cdc.gov/ViolencePrevention/pdf/Suicide-FactSheet-a.pdf
Eating Disorders
O Serious illnesses that can be life-threatening
O Complex disease that can arise from a
variety of biological, psychological, and
social factors
O Include extreme emotions, attitudes, and
feelings surrounding food and weight issues
O Affect both males and females
O 3 major categories: anorexia, bulimia, binge
eating
http://www.nationaleatingdisorders.org/general-information
Anorexia-what is it?
O Characterized by self-starvation and extreme
weight loss
O About 90-95% of sufferers are females
O Has one of the highest death rates of all
mental health issues
O Between .5%-1% of American women suffer
from anorexia
http://www.nationaleatingdisorders.org/anorexia-nervosa
Anorexia-symptoms
O Resistance to maintaining body weight at or
above a normal weight
O Intense fear of gaining weight or being “fat”
O Loss of menstrual periods in girls or women
post-puberty
O Distorted view of body = body image
distortion
http://www.nationaleatingdisorders.org/anorexia-nervosa
Anorexia-warning signs
O Dramatic weight loss
O Preoccupation with weight, food, counting
O
O
O
O
calories, etc
Refusal to eat certain foods
Frequent comments about being fat or
overweight
Anxiety about gaining weight
Development of food rituals (excessive
chewing, rearranging food on plate, etc)
http://www.nationaleatingdisorders.org/anorexia-nervosa
Anorexia-health consequences
O Abnormally slow heart rate and low blood
O
O
O
O
O
pressure
Reduction in bone density
Muscle loss and weakness
Fainting and fatigue
Dry hair and skin
Growth of a downy layer of hair called lanugo
http://www.nationaleatingdisorders.org/a
norexia-nervosa
Bulimia-what is it?
O Cycle of bingeing (eating a lot of food) and
O
O
O
O
compensatory behaviors (self-induced vomitting,
over-exercising, etc).
Affects 1-2% of adolescent and young women
Approx. 80% of bulimics are female
Most people who struggle with bulimia appear to
be of average weight
Frequently associated with depression or
changes in social adjustment
http://www.nationaleatingdisorders.org/bulimia-nervosa
Bulimia-symptoms
O Regular intake of large amounts of food
O Regular use of inappropriate compensatory
behaviors
O Laxative abuse
O Diuretic abuse
O Self-induced vomiting
O Fasting
O Compulsive exercise
O Extreme concern with weight and body shape
http://www.nationaleatingdisorders.org/bulimia-nervosa
Bulimia-warning signs
O Evidence of binge eating
O Evidence of purging behaviors
O Unusual swelling in cheeks and jaws
O Calluses on back of hands and knuckles
O Discoloration/staining of teeth
O Creation of lifestyle schedules or rituals to
make time for binge and purge sessions
http://www.nationaleatingdisorders.org/bulimia-nervosa
Bulimia-health consequences
O Dehydration
O Irregular heart beat
O Inflammation of esophagus
O Rupture of esophagus
O Chronic irregular bowel movements and
constipation
O Gastric rupture
http://www.nationaleatingdisorders.org/bulimia-nervosa
Binge eating-what is it?
O Recurrent periods of eating a lot of food and
O
O
O
O
not using any type of compensatory
methods
Affects 1-5% of the population
Can be of normal or heavier weight
Associated with signs of depression
Often express distress, shame, and guilt
over eating behaviors
http://www.nationaleatingdisorders.org/binge-eating-disorder
Binge eating-symptoms
O Eating large amounts of food in a short
O
O
O
O
amount of time
Feeling out of control during a binge
Feeling disgusted, depressed, or guilty about
behavior
Eating when not hungry
Eating alone due to embarrassment
http://www.nationaleatingdisorders.org/binge-eating-disorder
Binge eating-health
consequences
O High blood pressure
O High cholesterol levels
O Heart disease
O Diabetes
O Gallbladder disease
O Musculoskeletal problems
http://www.nationaleatingdisorders.org/binge-eating-disorder
Eating disorders-treatment
O Early diagnosis and intervention enhance
recovery
O Most effective treatment: some form of
psychotherapy or counseling paired with careful
attention to medical and nutritional needs
O Treatment needs to be tailored to the individual
O Some people benefit more from outpatient care
while others benefit more from inpatient care.
http://www.nationaleatingdisorders.org/treating-eating-disorder
Something to remember
O You never know who is dealing with a mental
health disorder (either personally or with a
family member or friend)
O They might be smiling on the outside but
crying on the inside
O A joke to you might be offensive to someone
else
O Treat others the way you want to be treated