Lesson 22

1.Student will be able to list causes of stress and mental health disorders. 2.Student will be able to list and explain the various defense mechanisms used to relieve stress and anxiety. 3.Student will be able to explain mental health disorders and describe the behaviors and symptoms to the following: A.Anxiety Disorders: Panic Disorders, Phobias, OCD, PTSD B.Mood Disorders: Depression, Bipolar Disorder C.Schizophrenia 4. Student will be able to describe interventions, responses, treatment, and role of the NA when caring for residents with mental illness and challenging behaviors. 5. Student will be able to explain the difference between mental health disorders and developmental disorders.

The state of mind in which a person copes with stresses of everyday life in a socially acceptable manner. The following conditions may cause or worsen mental illness: Physical factors: illness, disability, aging, substance abuse, or chemical imbalance Environmental factors: weak family relationships or traumatic childhood experiences Heredity or family influence Stress, including coping abilities

Persons unable to adjust to stressors in a healthy way suffer from mental illnesses Mental Illness- a disease that affects a person’s ability to function at a normal level in the family, home, or community. Anxiety- vague, uneasy feeling that occurs in response to stress, present in all mental health disorders. **Mental illness is a disease like any other physical illness. People who are mentally ill cannot simply choose to be well.

What stress-reducing techniques do you find effective in your own life?

Unconscious reactions that help relieve anxiety in stressful situations. Positive/Harmless Defense Mechanisms: problem-solving, compensations, fantasizing Negative/Problematic Defense Mechanisms: denial, projection, displacement, rationalization, repression, regression

Changes in physical appearance (red eyes, dilated pupils, weight loss) Changes in personality (moodiness, strange behavior, disruption of routines, lying) Irritability Odor of cigarettes, liquor, or other substances on breath or clothes Diminished sense of smell Unexplained changes in vital signs Loss of appetite Inability to function normally Need for money Confusion or forgetfulness Blackouts or memory loss Frequent accidents Problems with family or friends

Panic Disorders- cause sudden, intense feeling of fear, anxiety or dread Symptoms: heart palpitations, chest pain, heavy perspiration, tremors, headache, SOB, difficulty swallowing -Person unable to function, can last a few minutes or hours -Attacks can occur occasionally or several times a week Obsessive-Compulsive Disorder (OCD)- causes uncontrollable need to repeat or perform actions in a repetitive or sequential manner -Generally they are aware the behavior is irrational, but would experience acute anxiety if action is not done

Post-traumatic Stress Disorder (PTSD)- produces anxiety related to a past traumatic experience and characterized by flashbacks, bad dreams, and frightening thoughts. -Words, objects, situations, pictures can trigger an attack so the person tends to avoid them or even withdraw him/herself -Guilt, emotional numbness, depression, and worry are common feelings -Startle easily, have difficulty sleeping, feel “on the edge” most of the time

Phobia- produces intense fear of certain situations, animals, or objects -Person usually realizes the extreme fear, but has overwhelming panic when confronted by the situation Symptoms: sweating, dizziness, choking, dry mouth, racing heart, fatigue, shakiness, muscle aches, cold or clammy sensation, SOB Agoraphobia-fear of crowds, wide open spaces, or public events Claustrophobia-fear of enclosed or narrow spaces Acrophobia- fear of heights Social- fear of social situations

Depression- mild, temporary episodes to severe, persistent and profound episodes or sadness and hopelessness resulting in diagnosis of “Clinical Depression.” AKA: Major Depression, Major Depressive Disorder Symptoms: depressed mood most of day, nearly every day, loss of interest, will not come out of room, significant weight loss or gain, loss of appetite, sleeps to much or not able to sleep, slowed thinking and/or movement, fatigue, low energy, feeling of worthlessness or inappropriate guilt, inability to concentrate or make decisions, recurring thoughts of death or suicide

Bipolar Disorder- associated with mood swings that range from lows of depression to the highs of mania (euphoria). AKA: Manic Depressive Disorder Depressive state= feels hopeless, sad, loses interest or pleasure in most activities Manic State= Euphoric, full of energy, very impulsive, leading to sexual promiscuity, overspending, and delusions of greatness -Mood change may occur a few times a year to as often as several times a day, may be in one state more often than the other, but varies person to person

Brain disorder that affects a person’s ability to think, act, and communicate Myths: Split Personality, All Schizophrenics are dangerous Truths: Many are harmless and with medications, many live relatively normal and controlled lives Characteristics: delusions, hallucinations, apathy, lack of emotion, inability to plan or carry out activities, neglect personal hygiene, social withdrawal, lack of motivation

Remain Calm Don’t punish or treat like a child Be aware of body language Maintain safe distance from resident Use simple and clear language Avoid arguing, embarrassing, or judging the resident Maintain eye contact, listen carefully, be respectful Remove anyone in immediate danger Allow resident time to calm down Regardless of behavior, always treat resident with dignity, respect. DTIP

Psychotropic Drugs- medications used to treat various mental illness Psychotherapy- a method of treating mental illness that involves talking about one’s problems with mental health professionals. Be sure to report any changes in mood to the nurse and take any statements of suicide or self hard seriously and report immediately

Severe, permanent physical or mental disability that occurs before age 22. Intellectual Disability (Mental Retardation)- developmental disability that causes below-average mental functioning Causes- Unknown, prenatal conditions (substance abuse, STI, measles/infections during pregnancy), hypoxia or injuries during birth, high fevers, poisoning, and brain infections in early childhood, hereditary (Down Syndrome)

Mental Retardation Intellectual Disability Mental Illness a. Permanent Condition b. Present at Birth or early childhood c. Affects intellectual ability d. No Cure a. Can be Temporary b. Can develop at any age c. May or may not affect intellectual function d. Most can be cured or controlled with treatment

Common Conditions: Cerebral Palsy, Autism, Epilepsy, Spina Bifida, Hydrocephalus, Down Syndrome NA Role: Have resident do what they can to allow for maximum independence

1.True or False When a resident verbalizes suicidal thoughts, make sure he/she is serious before reporting this to the nurse?