1. What is Mental Illness?

2. Not just highs & lows in feelings Disease of the mind Disorder of thought, mood, perception, orientation and memory

3. Classifications - DSM-IV 1. Disorders of Childhood or Adolescence 2. Dementia & Cognitive Disorders 3. Disorders Due to a Medical Condition 4. Substance-Related Disorders 5. Schizophrenia & Other Psychotic Disorders 6. Mood Disorders 7. Anxiety Disorders 8. Somatoform Disorders

4. Classifications (cont’d) 9. Factitious Disorders 10. Dissociative Disorders 11. Sexual & Gender Identity Disorders 12. Eating Disorders 13. Sleep Disorders 14. Impulse Control Disorders 15. Adjustment Disorders 16. Personality Disorders 17. Other

5. Anxiety Disorders Affect 1 in 10 people (Somers et al 2006) Chronic, overwhelming anxiety and fear Phobias, Panic Disorder, and Obsessive Compulsive Disorder (OCD) Symptoms: Body: heart palpitations, shortness of breath, dizziness, nausea, chest pain Thoughts: irrational fear/worry, fear of losing control or dying Treatment: Medication, therapy, and stress management

6. Depression Affects 8 in 100 people Affects the body, mood and thoughts Symptoms last for weeks, months or years Symptoms include: Body: appetite changes, weight gain/loss, sleep disturbance and fatigue Mood: feeling sad, empty, hopeless, worthless, guilty or trapped Thoughts: difficulty concentrating/thinking, loss of pleasure in activities, thoughts of death/suicide Treatment: Medication, therapy, or stress management

7. Reverend Isabella Ross - Depression “When I’m really ill, I hear what’s like a tape recorder in my head saying really horrible negative things: Your life isn’t worth anything. It would be better if you weren’t here any more. You’re destroying other people’s lives. You’re worthless. That’s what consumes me. I don’t have any ability to shut it off.”

8. Bipolar Affective Disorder Extreme, spontaneous, mood swings alternating between depression and mania. Mania: elated, euphoric mood, increased energy, rapid thoughts and speech, lack of inhibitions, grandiose beliefs. Treatment: Medication, therapy, and stress management Affects 1 in 100 people

9. Andrea Woodside – Bipolar Disorder “I wake up – maybe weeks, sometimes months later – I wonder if I’ll get a Visa bill informing me that I am the owner of four new dishwashers and $1,800 worth of shoes. All inhibitions, all sense of self-preservation, go out the window when I am manic.”

10. Schizophrenia Affects 1 in 100 people Symptoms include: Mind: delusions, hallucinations – auditory/visual, lack of insight into illness Thought: disorganized thought and/or speech, flat affect, reduced speech, low energy Treatment: Medication, therapy, and stress management

11. Diane F. - Schizophrenia “During my second semester, I went on an out-of-town trip with my boyfriend. As we were driving back home, I started seeing animals leaping out in front of the car. A few weeks later, I was walking on campus and saw people in front of me suddenly disappear.”

12. Quick Facts 24% of boys and 17% of girls between the ages of 4 and 11 have one or more emotional or behavioural disorders Estimated economic burden of $14.4 billion puts mental health problems among the most costly conditions in Canada (Health Canada)

13. More Quick Facts Mental illness knows no boundaries. Anyone can develop a mental illness regardless of age, gender, economic background, geographical area or race. If you have a BRAIN…you can have a mental illness.

15. Trephination (or Trepanation) Driving out the evil spirits and demons from the ill (Bard & Bard 2002) First surgery ever done (In the Late Stone Age) Cut, scrape or drill skull with hard, dense obsidian (volcanic) rock

16. The Witch Hunts (15 th –19 th Centuries) Girls’ symptoms of convulsions, contortions, and outbursts of gibberish were determined by their doctors to be caused by witchcraft (nationalgeographic.com) Demon possession as explanation for mental illness Witches not mentally disturbed, confessions likely due to torture

17. “Madhouse” 16th-18th Centuries “Lunatics” Shackles Secure cells Beatings and starvation as a means of sedation Sunday penny tours for the public London Hospital of St. Mary of Bethlehem - “Bedlam” 1547 (LaJeunesse 2002)

18. “Asylum: Place of Peace, Shelter” 18th – 20th Centuries Medical “treatment” more like punishment until early 1800’s Moral treatment – Philippe Pinel Madness caused by disease of body or brain or social and personal problems “Unchained” in Paris (Davison et al 2002 )

19. New Brunswick 1834 First Canadian institution “…put to bed in boxes filled with hay; wooden slats nailed on top.” (LaJeunesse 2002) Two patients as “trustees” left to quiet noisy inmates at night by urinating on them

20. Brandon, Manitoba 1906 Known as “The Mental” Physical restraints Locked in cupboards Straightjackets for days Shackled in chains Metal grills over beds Overcrowding = forced to sleep on wooden shelves (LaJeunesse 2002)

21. Medical Model 1945 Insulin shock therapy, 1938 ECT, 1945 Psychosurgery, 1950 -1968 Sexual sterilization, 1928 -1971 Medications, 1950’s (LaJeunesse 2002)

22. ECT: Electro-Convulsive Therapy Cerletti & Bini, Europe 1938 No standards or controls over voltage levels ‘Ticklers’ – small jolts to make patients behave Caused seizures Still used today – voluntary as a last resort Memory loss biggest side effect

23. Frontal Lobotomies Egas Moniz, Portuguese Neurologist, 1936 Surgery with ice pick-like instrument Severed nerves of frontal lobe by going through eye socket Caused brain damage – unable to speak or think clearly Moniz received Nobel prize (LaJeunesse 2002)

24. Medications Anti-psychotic drugs, 1950’s – caused disabling side effects Patients discharged after 3 months “Revolving door” syndrome as patients would stop meds and end up back in asylums