M ENTAL H EALTH

“A state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and cope with adversity.” US Surgeon General Report, Dec 1999

W ELLNESS -I LLNESS C ONTINUUM Both health and illness are viewed on a continuum that was dynamic and changing, focusing on levels of wellness. Concepts in the continuum Totality, Uniqueness Energy, Energy-use Self integration, Inner/outer worlds Source: Dunn’s text: High Level Wellness, 1961

P OSITIVE M ENTAL H EALTH Attitudes of individual toward self Presence of growth and development, or actualization Personality integration Autonomy and independence Perception of reality Environmental mastery Marie Jahoda, 1968

M ASLOW ’ S H IERARCHY OF N EEDS Self ActualisationSelf-fulfillment/reach highest potential Self-EsteemSeek self-respect, achieve recognition Love/BelongingGiving/receiving affection, companionship Safety and SecurityAvoiding harm; order, structure, protection PhysiologicalAir, water, food, Maslow

G ENERAL ADAPTATION SYNDROMES (S TRESS ADAPTATION SYNDROMES ) Alarm stage: Immediate fight or flight response to a threat or perceived threat Resistance: Adapts to levels of stress and body returns to homeostasis Exhaustion: With prolonged exposure to stress, body becomes depleted. Illness may develop. Hans Selye, 1976

D IATHESIS S TRESS M ODEL Behaviour is the result of interaction between biological and environmental factors Some illnesses (e.g., mood disorders) are due to genetic predisposition interacting with adverse environmental factors

T HEORIES OF PERSONALITY DEVELOPMENT P SYCHOANALYTIC THEORY Id: Pleasure principle – Primitive and instinctual drives “I want” Ego: Rational mind – Control the instinctual impulses of Id Superego: Conscience of the psyche – exercises self judgement and holds ethical and moralistic values Sigmund Freud

T OPOGRAPHIC MODEL OF MIND Unconscious Mind Preconscious Mind Conscious Mind

D EFENCE M ECHANISMS Denial: Subjects acts as if consciously unaware of a wish or reality Displacement: Thoughts and feelings about one person or object are transferred to another person or object Projection: Repressed thoughts and wishes are attibuted to other people or objects

D EFENCE M ECHANISMS Intellectualisation: Attempt made to explain in a logically consistent way to avoid the feelings associated with a situation Repression: Unacceptable affects, ideas and wishes are pushed away so that they remain in the unconscious Reaction formation: Expressing an opposite feeling from what is actually felt and is considered unacceptable

H EALTHY MENTAL MECHANISMS Sublimation Suppression Anticipation

U NHEALTHY MENTAL MECHANISM Denial Projection and Minimization

M ENTAL ILLNESS A clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering, death, pain, disability, or an important loss of freedom. Must not be a culturally sanctioned response to a event Neither deviant behaviours or conflicts between individual and society are mental disor ders American Psychiatric Association, 2000

C LINICAL MANIFESTATIONS OF MENTAL ILLNESSES (P SYCHIATRIC DISORDERS ) Clinical symptoms may be variations of normal functioning Deviations from normalcy can occur in intensity, duration, timing, content of thoughts, emotions and behaviours may be context dependent When attempts to cope overwhelm the individual capacity to respond, then less adequate, disorganised thoughts and behaviour emerges

B IOLOGICAL ASPECTS OF PSYCHIATRIC DISORDERS Cartesian dualism (Mind-body dualism) Connection between body and mind established through current research Brain is the seat of the mind Many psychiatric disorders are brain disorders Multi disciplinary understanding of psychiatric disorders is proposed