Mental Health 101 - NAMI-NYC Metro · Symptoms of Binge-eating Disorder Episodes of binge eating...
Transcript of Mental Health 101 - NAMI-NYC Metro · Symptoms of Binge-eating Disorder Episodes of binge eating...
Mental Health 101WLDF Session 1
April 3, 2018
Diagnoses
Session 1
Mood Disorders
Major Depressive Disorder
Bipolar Disorder
Eating Disorders
Schizophrenia and Psychotic
Disorders
Psychosis
Schizophrenia
Session 2
Anxiety Disorders
Generalized Anxiety Disorder (GAD)
Post Traumatic Stress Disorder
(PTSD)
Panic Disorder
Obsessive Compulsive Disorder
(OCD)
Co-occurring Substance Use
Disorders
Agenda: Session 1
Check In
Basics about Mental Illness
Stigma
Mood Disorders
Major Depressive Disorder
Bipolar Disorder
Eating Disorders
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Schizophrenia and Psychotic Disorders
Psychosis
Schizophrenia
Empathy Exercise
Check-in
What things come to mind when you think of or hear “mental illness”?
What is mental illness?
Mental Illnesses Are:
Biological brain disorders that interfere with normal brain chemistry.
Genetic factors may create a predisposition in some people, and life
stressors may trigger the onset of symptoms.
Very common. In any given year, approximately 57.7 million American
experience a mental health disorder. 1 in 17 people live with a serious
mental illness such as schizophrenia, major depressive disorder, or
bipolar disorder. About 1 in 10 children live with a serious mental or
emotional disorder.
Equal opportunity diseases, striking people from all walks of life,
regardless of age, race, income, religion, or education.
Treatable! Appropriate medical care and rehabilitation enable many
people to recover enough to live productive lives.
Mental Illnesses Are Not
Anybody’s fault. They are not caused by weak character or poor
parenting.
Preventable or curable at this time. Great advances have been made
in understanding brain functioning, but not enough is known yet to
prevent or cure serious brain disorders (mental illnesses).
Hopeless. These illnesses present difficult challenges, but help is
available. Support, education, and a community of friends who
understand can make everyone’s lives satisfying and meaningful again.
All Mental Illnesses are on a Continuum
--------------------------------------------------------------------------------------------------------------
Some people Some people fluctuate Though rare, some
experience mild from less to more severe people are seriously ill
symptoms and may stay that way
their entire lives
How a person does, depends on many factors including:
Biological severity of the mental illness
Social stressors
Personal stressors
Resources the person has: support system, finances, access to care, etc.
Participation in treatment
Success of treatment
Diagnosis takes time…
Many times symptoms of one mental
illness can overlap with symptoms of
another mental illness.
Anxiety disorders and depression often
co-occur.
A person may have more than one
illness at the same time and only be
getting treatment for one, which can
delay or prevent recovery.
…and can be complex
Diagnostic categories can change and are
periodically revised.
It is common to be improperly diagnosed
at least once, and maybe several times,
before arriving at something that makes
sense.
Certain mental illnesses include a “lack of
insight” meaning that a person’s brain
blocks the ability to recognize responses
and behaviors as different from others
(unable to “see” symptoms).
Recovery is possible and complex
No one can predict the path and outcome for a person.
Hope is not only reasonable, but it is essential.
Believing in the possibility of recovery has been proven to make
recovery more likely, even when all other things remain the same.
With serious mental illnesses, medication is often key, HOWEVER…
…medication alone is NOT a treatment plan: it is part of a treatment
plan.
Effective treatment plans are customized to the
individual’s needs and may include a number of things
such as:
• Psychoeducation
• Family involvement
• Supported employment
• Housing
• Talk therapy (psychotherapy)
• Behavioral therapy
• Diet and exercise
• Meditation and yoga
Mood Disorders
Major Depressive Disorder
Affects about 6.7% of the population (21.6 million people in the U.S.).
Individuals who are between 18 and 29 years of age experience higher
rates of major depression.
Females, beginning as early as adolescence, present these symptoms at a
rate of 1.5 to 3 times higher than males.
Without treatment, the number of episodes and severity of each episode
of major depressive disorder tend to increase over time.
60% of people with major depressive disorder experience anxiety or panic.
Major depressive disorder is the leading cause of disability in the U.S.
and many other developed countries.
Symptoms of Depression
Persistently sad or irritable mood
Pronounced changes in sleep, appetite, and energy
Difficulty thinking, concentrating, and remembering
Lack of interest in or pleasure from activities that were once enjoyed
Low self-esteem
Feelings of guilt, worthlessness, hopelessness, and emptiness
Recurrent thoughts of death or suicide
Movement changes; either “slowed down” or overly activated and agitated
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.
What Depression Looks Like In The
Workplace:
Increasing frequency of sick days or tardiness
Loss of motivation
Memory difficulties
Incomplete duties or tasks
Fatigue, tiredness, excessive yawning
Sluggish movements
Irritability
Treatment For Depression
Medications often effectively control the serious symptoms of
depression. It generally takes two to four weeks for antidepressant
medication to have their full effect.
Psychotherapy:
Cognitive behavioral therapy (CBT)
Interpersonal therapy (IPT)
Acceptance and commitment therapy (ACT)
Problem-solving therapy
Psychodynamic therapy
Options For Treatment Resistant Depression
Meaning that medications and therapy have not been
successful and the person experiences severe or life
threatening depression, including:
Electroconvulsive therapy (ECT)
Vagus Nerve Stimulation (VNS)
Repetitive Transcranial Magnetic Stimulation (rTMS)
Depression
Nick:
“During a deep depression things just feel really dark. I get real tired, like things are in a deep hole. I don’t have much energy. I either eat a lot or very little. I used to isolate, especially when I lived alone without a husband and family. It was easier to be alone. I didn’t want to bring anyone into my world because it seemed so dark. Usually when I am severely depressed I don’t work, or I miss a lot of work. I was also hospitalized a lot, which made it hard to hold a job.”
Let’s Talk About It…
What is something new you learned about Major Depressive Disorder?
Was there anything that surprised you?
How will this information be useful to your work?
Bipolar Disorder
Affects about 2.6% of the adult population (8.4 million people in the
U.S.).
Most often begins in adolescence or early adulthood, but occasionally
develops during childhood.
The illness affects both men and women equally.
A medical condition that causes extreme shifts in mood, energy, and
functioning. These changes may be subtle or dramatic and typically
vary greatly over the course of a person’s life.
Bipolar Disorder is characterized into episodes of mania and episodes
of depression.
Symptoms of Bipolar Disorder
Symptoms of Mania:
Either an elated, happy mood or an irritable, angry, unpleasant mood
for an extended period of time
Increased physical and mental activity and energy
Racing thoughts and flight of ideas
Increased talking, more rapid speech than normal
Ambitious, over confidence, inflated self-esteem; often grandiose
plans
Engaging in risk taking behaviors and impulsive activities such as
spending sprees, sexual indiscretions, and alcohol abuse
Decreased sleep without experiencing fatigue
What Bipolar Looks Like In The
Workplace:
Accelerated periods of productivity
Irritability
Rapid speech
Inability to interact productively with others
Inflated self esteem
Difficulty staying on topic
Same signs as depression as well as:
Treatment For Bipolar
Effective treatment plans for Bipolar Disorder usually include
medication, psychotherapy, education, self-management strategies,
and external supports such as family, friends, and formal support
groups.
The most useful psychotherapies include:
Cognitive Behavioral Therapy (CBT)
Interpersonal and Social Rhythm Therapy (IPSRT)
Family Focused Therapy (FFT) was originally created for family members of
people living with Bipolar but has since been expanded to all types of mental
health conditions.
Bipolar Disorder
Lisa:
“Sometimes ideas come to me so quickly that I feel incredibly smart, to the point of thinking ‘I am the perfect person for this task,’ as if no one else can do it as well as I can. I also spend money, and I justify it by saying ‘I deserve this,’ or ‘I’ll be beautiful in this.’ It is very egocentric. In addition to the mania, I also deal with hypomania. It’s hard not to love it, because I get a lot done. On the other side, when I’m depressed I tend to isolate. I feel that I am a burden to others, and it is hard to do the things I need to do to get by.”
Let’s Talk About It…
What is something new you learned about Bipolar Disorder?
Was there anything that surprised you?
How will this information be useful to your work?
Eating Disorders
Eating disorders
The three most common eating disorders:
Anorexia Nervosa (0.6%)
Bulimia Nervosa (0.6%); and
Binge-eating Disorder (2.85%), affect about 12.7 million
Americans.
Obsessions with food, body weight, and body shape may also signal an
eating disorder.
Eating disorders frequently co-occur with depression, substance
abuse, and anxiety disorders.
Anorexia Nervosa has the highest mortality rate of any psychiatric
disorder.
Symptoms of Anorexia Nervosa
Extremely restricted eating
Extreme thinness (emaciation)
A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
Intense fear of gaining weight
Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight
Other symptoms may develop over time, including:
Muscle wasting and weakness
Growth of fine hair all over the body (lanugo)
Low blood pressure, slowed breathing and pulse
Multi-organ damage and possibly failure
Drop in internal body temperature, causing a person to feel cold all the time
Lethargy, sluggishness, or feeling tired all the time
Symptoms of Bulimia Nervosa
Recurring episodes of binge eating including BOTH of the following:
Eating in a specific amount of time (e.g. within a 2 hour period) large amounts of
food
A sense of lack of control over eating during this time-period. Feeling like one
cannot stop eating or control what or how much one is eating.
Recurring inappropriate behaviors to prevent weight gain (e.g. purging)
A person’s sense of self is overly based on body shape and weight.
Other symptoms may develop over time, including:
Chronically inflamed and sore throat
Worn tooth enamel and increasingly sensitive and decaying teeth as a result
of exposure to stomach acid
Acid reflux disorder and other gastrointestinal problems
Severe dehydration
Symptoms of Binge-eating DisorderEpisodes of binge eating
Eating within a specific amount of time (e.g. within a 2 hour period) large amounts of food
A sense of lack of control over eating during this time-period. Feeling like one cannot stop eating or control what or how much one is eating.
Binge-eating episodes can involve the following:
Eating must faster than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone because of embarrassment over how much one is eating
Feeling disgusted with oneself, depressed, or very guilty afterwards
The binge-eating is not connected with the unique symptoms of another eating disorder (e.g. purging afterwards – which is indicative of bulimia nervosa)
What Eating Disorders Look Like In The
Workplace:Dresses in layers
Preoccupation with weight, food, calories, dieting
Refuses to eat certain foods
Makes frequent comments about feeling “fat”
Denies feeling hungry
Makes excuses to avoid mealtimes or situations involving food
Strong need for control
Shows inflexible thinking
Feels ineffective
Treatment for Eating Disorders
Adequate nutrition, reducing excessive exercise, and stopping purging
behaviors are the foundations of treatment. Treatment plans are tailored to
individual needs and may include one or more of the following: Individual,
group, and/or family psychotherapy; Medical care and monitoring; Nutritional
counseling; and/or Medications.
Psychotherapies:
Nutritional counseling
Cognitive behavioral therapy (CBT)
Interpersonal Therapy
Dialectical Behavioral Therapy
Eating Disorders
Eric:
“I am a man who battled against bulimia. It all started in high school. I was quiet, walked with my head down, and didn’t engage in any activities or social outings. But food was always around, easily accessible and I found comfort subliminally in it. I have always wanted to be an actor, but when I’d share my dream, I received the same response; “Nobody wants to hire the fat kid”. So I innocently started to work out and eat better. After the compliments started coming in, I had the love and respect from my peers that I had always wanted. At this point, I began engaging in dangerous lengths to become thing. I was frail and everyone around me thought I was using drugs. I would rather have them think that about me than admit I was a boys with an eating disorder. All the research I did talked about female self-help groups, tips for young women, and you’d hear about female celebrities admitting their issues. So as bad as I wanted and needed the help, I hid my disorder. When I finally spoke up, it was hard but so worth it. A scale number does not define me or my talents.”
Let’s Talk About It…
What is something new you learned about Eating Disorders?
Was there anything that surprised you?
How will this information be useful to your work?
Psychosis
Psychosis
Delusions: believing in things that are not real or true (or outside of
cultural norms)
Belief that a person can read my thoughts or the thoughts of others
Belief that people are plotting against me
Belief that others are secretly monitoring or in some way threatening me
Belief that others can control my mind or the minds of others
Hallucinations: hearing, seeing, or feeling things that are not real
Seeing something that isn’t really there
Hearing something that isn’t really there (includes “voices”)
Smelling something that isn’t really there
Feeling something that isn’t really there
Schizophrenia
Affects about 1% of the adult population (3.2 million people in the
U.S.)
An estimated 40% of individuals with schizophrenia go untreated
Can interfere with a person’s ability to think clearly, distinguish
reality from fantasy, manage emotions, make decisions, and relate to
others
It is severe in how it affects the brain; it affects more domains of the
brain than any other mental illness.
The first signs of Schizophrenia typically emerge in the teenage years
or early twenties, often later for females.
The signs and symptoms of schizophrenia have been noticed for
centuries and are universal.
Symptoms of Schizophrenia
Positive Symptoms: These are mental experiences that are imposed on
the person, or behaviors that are added to the person that were not
there before the illness.
Delusions
Hallucinations
Negative Symptoms: This refers to valuable aspects to the person’s
personality that have been taken away by the illness.
Emotional flatness
Lack of expression
Inability to start and/or follow through
Lack of pleasure or interest in life
Symptoms of Schizophrenia
Cognitive Symptoms: These are symptoms related to thinking processes.
Difficulty prioritizing tasks, memory, and organizing things
Anosognosia (ano·sog·no·sia \ˌa-nō-ˌsäg-ˈnō-zh(ē-)ə\), or lack of insight,
being unaware of having an illness
Disorganized speech or an inability to generate a logical sequence of ideas
What Schizophrenia Looks Like In The
Workplace:
Difficulty with multitasking
Suspiciousness or uneasiness with others
Inability to think clearly or concentrate
Seeing or hearing something that no one else does
Decline in hygiene
Sudden decline in work performance
Treatment for Schizophrenia
The treatment of schizophrenia requires an all-encompassing
approach that includes medication, therapy, and psychosocial
rehabilitation. Medication is often an important part of symptom
management.
Antipsychotic medication often helps to relieve the hallucinations,
delusions, and to a lesser extent, the thinking problems people can
experience.
Psychotherapy:
Cognitive Behavioral Therapy for Psychosis (CBTp)
Cognitive Enhancement Therapy (CET)
Psychosocial rehabilitation
Schizophrenia
Ellen:
“When my schizophrenia was full blown, I suffered a lot. Every day felt like a year to me. I heard voices and I saw things that weren’t there. I couldn’t be by myself. I needed people near me. It felt like my head was really heavy and like I was seeing through tinted glasses. There was a lot of chatter in my head with all those voices and I shut myself off and didn’t communicate.”
Let’s Talk About It…
What is something new you learned about Schizophrenia?
Was there anything that surprised you?
How will this information be useful to your work?
Empathy Exercise
Mental Health 101WLDF Session 2
April 5, 2018
Agenda: Session 2
Quiz
Stigma
The Power of Language
Anxiety Disorders
Generalized Anxiety Disorder
Panic Disorder
Post Traumatic Stress Disorder
Obsessive Compulsive Disorder
Co-occurring Substance Use Disorders
Check In
Survey
Fact or Fiction?
Mental health disorders are like other medical conditions.
Fact: Brain disorders, like heart disease are legitimate medical illnesses. Research shows that there are genetic and biological causes for psychiatric disorders and they can be treated effectively.
People with serious mental illness, such as schizophrenia, are usually dangerous and violent.
Fiction: Individuals with a mental illness are far more likely than those without to be victims of violence. Some psychiatric conditions if left untreated may have a higher incidence of violence but only 3-5% of all violence (including but no limited to firearm violence) is attributed to serious mental illness.
People can recover from mental illness
Fact: The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.
Fact or Fiction?
Mental illness usually strikes individuals in the prime of their lives.
Fact: Symptoms often begin during adolescence and young adulthood. All ages are susceptible but the young and old are especially vulnerable.
Mental illness is passed on genetically.
Fact, well partially: Having a family history of mental illness makes a person more susceptible but some people who develop a mental illness have no family history. Causes of mental illness are highly complicated and can include: genetics, environmental exposures before birth, brain chemistry, childhood trauma or loss, etc.
I can’t do anything for a person with a mental health problem.
Fiction: Only 38% of adults with diagnosable mental health problems receive needed treatment. Teachers, family, friends, and support networks are key to encouraging an individual to seek treatment and services.
Stigma: a mark of disgrace that sets a person apart.
Stigma erodes confidence that mental disorders are real, treatable health
conditions.
Avoidance of seeking help or treatment
Fear, mistrust, and violence against people living with mental illness and their families
Family and friends turn their backs on people with mental illness
Prejudice and discrimination
Poor funding for and inadequate mental health services
Limited insurance coverage for mental health services
Why is this important?
Only 38% of people who need help actually get it.
Social (and self-) stigma,
Fear of repercussions at work or at school, and
Lack of access to quality, affordable treatment.
Early detection and intervention lead to a significantly
improved trajectory of mental health across the lifespan.
Language Matters in Mental Health:
Language shapes how we see the world. The words we choose
and the meanings we attach to them influence our feelings,
attitudes and beliefs. Our language choices have a powerful
effect on how we view mental health and people living with
mental health conditions.
Labelling can be harmful, but in some circumstances it may be
necessary. It is important that we use respectful language,
which literally means putting reference to the person first in a
phrase. For example, instead of calling someone “mentally ill”
a more respectful, people-first way of phrasing it is to say “a
person living with a mental health condition.”
Language Matters:
Don’t Say This:
That’s crazy, psycho, insane, nuts
It drives me crazy
He is a schizophrenic
She’s OCD
Suffering from mental illness
Consumer
Mentally Ill
Say This When Necessary:
That’s wild, bizarre, odd, eccentric
It annoys me
He has schizophrenia
She has obsessive-compulsive
disorder
Living with (or experiencing)
mental illness
Person living with a mental illness
Person living with a mental health
condition
Anxiety
Disorders
Anxiety Disorders are the most common mental
health disorder
Generalized Anxiety
Disorder (GAD)
Post Traumatic Stress
Disorder (PTSD)
Panic Disorder
Obsessive Compulsive
Disorder (OCD)
28%Of the total population
suffer from a form of
anxiety.
Generalized Anxiety Disorder (GAD)
Affects about 3% of the adult population (9.7 million people in the
U.S.).
Women are twice as likely to experience GAD as men.
The average age of onset is 31 years old.
Common to experience excessive worry about everyday things (money,
health, family, work, or other issues).
60% of people with major depressive disorder experience anxiety or
panic.
Symptoms of GAD
Excessive worry about everyday things (unable to control feelings)
Constant apprehension
Muscle tension
Fatigue
Restlessness
Difficulty sleeping
Irritability
Edginess
What Generalized Anxiety Disorder
Looks Like In The Workplace:
Appears distracted
Psychomotor agitation: tapping, biting finger nails, hair pulling, etc.
Preoccupation over fear instead of focusing on work
Turning down assignments because of fear of failure
Memory problems
Treatment for GAD
Effective treatments for GAD include psychotherapy and/or
medication. In most cases, a combination of therapy and
medications is beneficial for people with GAD. Two types of
medications are commonly used to treat GAD—anti-anxiety
medications and antidepressants.
Psychotherapy:
Cognitive-behavioral therapy (CBT)
Acceptance and commitment therapy (ACT)
Problem-solving therapy (PST)
Psychodynamic therapy
Generalized Anxiety Disorder
Danielle:
“I feel a lot of confusion, oversensitivity, and insecurity. Sometimes it feels like I want to run away from where I am. There are times that I want to be with people, but then I feel nervous to be around them – anxious – so it is like feeling trapped. There’s a lot of confusion. My heart beats fast, I get headaches, and sometimes by body feels really hot. These feelings can come on suddenly and I might have no knowledge of what the reason is. It comes and goes on its own schedule.”
Let’s Talk About It…
What is something new you learned about Generalized Anxiety
Disorder?
Was there anything that surprised you?
How will this information be useful to your work?
Panic disorder Affects about 2% of the adult population (6.8 million people in the U.S.)
Women are almost twice as likely to experience Panic Disorder as men.
Panic attacks often begin in late adolescence or early adulthood, but not
everyone who experiences panic attacks will develop panic disorder.
The occurrence of panic attacks with other mental illnesses are so common
that the DSM-5 (diagnostic manual used by mental health professionals to
make mental health diagnoses) has an option for clinicians to add a “panic
attack specifier”.
A panic attack is an uncontrollable panic response to ordinary, non-
threatening situations. It typically reaches a peak within a few minutes then
begins to subside, but a person may feel anxious and jittery for many hours
after experiencing a panic attack. As you look at the checklist below it
becomes easy to understand why so many people fear they are having a heart
attack, as so many physical symptoms are involved.
Symptoms of Panic Disorder
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, light-headed or faint
Chills or heat sensations
Trembling or shaking
Fear of dying or losing control
Sensations of shortness of breath or smothering
Palpitations, pounding heart or accelerated heart rate
Sweating
What Panic Disorder Looks Like In The
Workplace:
Avoiding situations that may trigger an attack such as public speaking and deadlines.
Have a panic attack during work
Fear and anxiety
Trouble concentrating
Treatment for Panic Disorder Effective treatments for panic disorder include psychotherapy and/or
medication. Stress management techniques, meditation, self-help groups,
support groups, family, and friends are all important elements to living in
recovery with panic disorder.
Psychotherapy:
Acceptance and commitment therapy (ACT)
Cognitive behavioral therapy (CBT)
Exposure therapy
psychodynamic therapy
In most cases, a combination of therapy and medication is beneficial for
people with panic disorder. Two types of medications are commonly used to
treat panic disorder are anti-anxiety medications and antidepressants.
Panic Disorder
Cameron:
“Sometimes a panic attack comes out of nowhere and other times it will be triggered by something. One trigger is being in a situation where I’ve had a previous attack. Another is being in a situation where I don’t feel in control – like if an elevator stops between floors, or a train stops in the middle of a tunnel, or a plane goes through turbulence. My heart starts racing, and I feel like electrical charges or flashes are moving throughout my body. It also feels like my mind is outside of my body – as if my mind and body are two different things.”
Let’s Talk About It…
What is something new you learned about Panic Disorder?
Was there anything that surprised you?
How will this information be useful to your work?
Post Traumatic Stress Disorder (PTSD)
Over a lifetime, approximately 8.7% of individuals living in the U.S.
will be diagnosed with PTSD (27.8 million people in the U.S.).
Rates of PTSD are higher among veterans and members of the military
as well as others whose vocations increase their risk of traumatic
exposure (like police, fire fighters, and emergency personnel).
PTSD can occur at any age, beginning after the first year of life.
Symptoms usually begin within the first 3 months after the trauma,
but there may be a delay of months or even years before the
diagnostic requirements are met.
Symptoms of PTSD
Persistent re-experiencing of the event:
Recurrent, involuntary and intrusive memories of the traumatic event (including flashbacks and dreams)
Psychological distress and/or physiological reactions when exposed to cues that resemble any aspect of the traumatic event
Negative changes in thoughts and moods:
Inability to remember an important aspect of the trauma
Persistent and exaggerated negative beliefs about oneself, others, or the world (“I am bad”, “no one can be trusted”, “the world is completely dangerous”)
Persistent, distorted thoughts about the cause or consequences of the trauma that lead to blame
Persistent negative emotional state (fear, horror, anger, guilt, or shame)
Feelings of detachment or estrangement from others
Symptoms of PTSD
Persistent avoidance:
Avoidance or efforts to avoid memories, thoughts, or feelings associated with
the trauma
Avoidance or efforts to avoid activities, places, or people that are reminders
of the trauma
Increased arousal and reactivity:
Difficulty falling asleep or staying asleep
Outbursts of anger/irritability
Difficulty concentrating
Hyper-vigilance
Exaggerated startle responses
What PTSD Looks Like In The Workplace:
Memory problems and difficulty retaining information
Lack of concentration on tasks
Fear and anxiety
Physical difficulties
Unreasonable reactions to situations that trigger memories
Trouble staying awake
Panic attacks
Treatment For PTSD
Psychotherapy: that includes structured intervention and is very supportive
seems to work best for people with PTSD.
Cognitive Behavioral Therapy (CBT)
Exposure Therapy and Eye Movement Desensitization and Reprocessing (EMDR)
Acceptance and commitment therapy (ACT)
exposure therapy
psychodynamic therapy
Group therapy with other survivors of trauma is supportive and uplifting.
Service dogs and Animal-assisted Therapy are becoming increasingly
common, especially for veterans.
Post Traumatic Stress Disorder
Robert:
“Summer is the worst time of year for me. Because of my Vietnam War experience I don’t like loud sudden noises, and this is the time of year there are severe thunderstorms. When the flash of lightning and clap of thunder are almost simultaneous, it is similar to the sound and sight of an explosive going off. It rings my bell every time. I never know how I am going to react. This has a major impact on my quality of life during the summer months. I might be invited to an event somewhere, but if there is a chance of a thunderstorm that day I may not show up because I don’t want to freak out in front of a lot of people.”
Let’s Talk About It…
What is something new you learned about Post Traumatic Stress
Disorder?
Was there anything that surprised you?
How will this information be useful to your work?
Obsessive Compulsive Disorder (OCD) Affects about 2% of the adult population (6.8 million people in the U.S.) and
over 400,000 children have OCD
Most people are diagnosed by about age 19, typically with an earlier age of
onset for boys than in girls, but onset after age 35 does happen.
People with Obsessive-Compulsive Disorder (OCD) experience:
Obsessions recurrent, persistent thoughts, urges, or images that are intrusive,
unwanted, and won’t go away.
Compulsions: repetitive behaviors or mental acts in response to the tension
associated with the obsessions.
Obsessions and the rituals connected to them can interfere greatly with a
person’s quality of life. In general, people with OCD may spend several hours
per day thinking about obsessions or acting out compulsions.
Obsessive Compulsive Disorder
Obsessions
Fear of contamination
Excessive concern about objects “having to be” in a certain order
Thinking one has injured someone else
Fear of having left something turned on or even unlocked
Frightening impulses to hurt a loved one
Gross sexual imagery
Compulsions
Compulsive hand washing or showering
Excessive arranging
Repeated checking and re-checking
Repetitive counting
Touching and activity rituals
What OCD Looks Like In The Workplace:
Preoccupation with details, rules, lists, schedules etc
Perfectionism that interferes with completing tasks
Excessive devotion to work and productivity to the exclusion of leisure activities
Difficulty delegating tasks
Reluctant to work with others unless they submit to exactly their way of doing things
Shows rigidity and stubbornness
Treatment for OCD
Antidepressants are the most commonly prescribed medication to
help reduce OCD symptoms.
Psychotherapies are the most effective for people with OCD.
Research shows that two types of
Cognitive behavioral therapy (CBT)
Exposure and response prevention (EX/RP)
Habit reversal training
Exposure therapy
Psychodynamic therapy
Obsessive Compulsive Disorder
Candice:
“When I have symptoms of OCD it can take me a half an hour to get to my car in the morning to go to work. I have to check the door, the lights, the stove, everything. Sometimes I don’t leave the house because I don’t want to have all the checking before leaving. The ironic thing is that I never have trouble with difficult things. After all, I went to law school. At the same time, I have a lot of trouble just mailing an envelope because of the checking.”
Let’s Talk About It…
What is something new you learned about Obsessive Compulsive
Disorder?
Was there anything that surprised you?
How will this information be useful to your work?
Co-Occurring Substance Use Disorders
(formerly Dual Diagnosis)
Co-Occurring Substance Use Disorders
Affects about 2.5% of the adult population (7.9 million people in the U.S.).
People with a mental health disorder are more likely to experience an alcohol
or substance use disorder. Approximately 31% of people living with a serious
mental illness have a co-occurring substance use disorder (13% of people
diagnosed with a substance use disorder have a co-occurring mental health
condition).
This may occur because both mental and substance use disorders can have
biological, psychological, and social components.
The consequences of undiagnosed, untreated, or undertreated co-occurring
disorders can lead to a higher likelihood of experiencing homelessness,
incarceration, medical illnesses, suicide, or even early death.
People with co-occurring disorders respond less well to treatment, due to the
complications added on by the substance use.
Symptoms of Co-occurring Substance Use Disorders
Developing a tolerance to the drug.
Experiencing withdrawal after stopping use.
Consuming more of the drug than originally planned
Worrying about stopping or consistently failed efforts to control use
Spending a lot of time using drugs, or doing whatever is needed to get
them
Craving the drug
Repeatedly unable to carry out major obligations at work, school, or
home due to drug use
Continued use despite health problems caused by or worsened by it.
Continued use despite its having negative effects on relationships.
Repeated use of the drug in a dangerous situation.
What Co-occurring Substance Use
Disorders Look Like In The Workplace:
Erratic mood change
Disappearing for periods of time
Unexplained behavior
Tired all the time
Frequent accidents or injuries
Increased tardiness or absenteeism
Isolating
Treatment for Co-occurring Disorders
A major complication to treatment is that the mental health service
system is generally not prepared to work with people who have co-
occurring disorders. Often only one of the two problems is identified;
they may want to treat the substance use disorder and not the mental
illness, or vice versa.
Integrated Dual Disorder Treatment, where the same clinician or
treatment team treats both the mental illness and the substance use
disorder at the same time.
There are also 12-step programs help with the road to recovery from
addictions. One of the best known is Alcoholics Anonymous (AA).
Because AA is focused on sobriety and not the co-occurring mental
illness, there are also groups called Double Trouble in Recovery,
which were specifically created for people with co-occurring mental
health and substance use disorders.
Co-occurring Disorders
Carlos:
“I felt powerless, alone and sad, and experienced deep despair and feelings of worthlessness. I just wanted to get rid of those feelings – to escape – so I used to overeat, steal, have unhealthy relationships, and then started drinking alcohol and taking drugs. There was a sense of belonging and having less pain when I did those things, but in actuality it didn’t help. It wasn’t lasting. It didn’t have any true meaning or long lasting value.”
Let’s Talk About It…
What is something new you learned about Co-occurring Substance Use
Disorders?
Was there anything that surprised you?
How will this information be useful to your work?
Check-in
What things come to mind when you think of or hear “mental illness”?