Understanding & ManagingMental Health

Jodie Butler St Vincents Hospital

HIV, Hep C and Mental Health (H2M)

All things are on a Spectrum

“Normal” --------------------------- “Clinical”

What is Clinical? Significant distress or impairment in

functioning: social occupational or other important areas

Rule out other mental health condition, medical condition, drug or medication effects.

CHANGE CHANGE CHANGE

Past Present Future

Depression Anxiety

Depression and Dysthymia Physical Behavioural Emotional

Physical Change in sleep pattern Change in eating pattern Fatigue Loss of energy Body aches and pains (somatic)

Behavioural Loss of interest in pastimes/pleasure* Difficulty concentrating Difficulty making decisions Neglecting responsibilities Neglecting looking after yourself Slowed movements

Emotional Inappropriate guilt Crying Feeling down, apathetic, irritable,

pessimistic, negative, “black” Thinking negatively about yourself Feeling hopeless/helpless/worthless Feeling suicidal or recurrent thoughts of

death

Remember, everyone has down

days.

What you can do

Encourage Encourage Encourage exercise decrease in alcohol, substances balanced diet time in the sun if appropriate decrease in caffeine access to support networks

Label emotions

Listen Use problem solving skills Do relaxation exercises Set boundaries, routine & structure Any activity is helpful Adherence to medications Refocus on valued areas of life GP or specialist referral

Anxiety Social and Specific Phobias

persistent and excessive fear exposure to feared object/situation

provokes immediate response avoidance

Panic physical sensations related to

adrenaline Breathing increases Heart rate increases Dizzy, tingling sensations Nausea, sweaty or clammy

fear of losing control/dying

Generalised Anxiety excessive worry about a variety of

topics difficult to control worry physical symptoms

Restless Irritable Tense Sleep disturbed, tired Poor concentration

Obsessive Compulsive Disorder disturbing, intrusive, inappropriate

thoughts, images, impulses and: attempts to ignore, neutralise or suppress

repetitive behaviours or mental rituals to neutralise obsessions

Acute and Post Traumatic Stress traumatic event response involved fear, helplessness,

horror event is re-experienced by recollection,

dreams, reliving, flashbacks avoidance of things associated with

trauma (thoughts, places, people, memory, detachment)

increased arousal (sleep, anger, concentration, hypervigilance, startles easily)

What you can do Don’t enable avoidance Don’t panic with panic Tell them “It’s ok to be anxious” Patience Ask “what is the threat”

What you can do Don’t fight the panic Don’t Say “don’t be anxious” Assist to stay in the present Concentrate on a simple task Relaxation Label emotions, sensations

Psychosis Inability to distinguish what is real — there is a loss of

contact with reality

Confused thinkingdisordered thinking, confused, disjointed, paranoid

Delusionsfalse belief, which is not held by others of the same cultural background

Hallucinationsseeing, hearing, feeling, smelling or tasting something that is not actually there

What you can do Ensure safety of all Don’t agree with them Acknowledge that is how they see the

world Move to a less stimulating

environment Refer to GP or local community

mental health

Mindfulness of Yourself

Past PresentFuture

General Head Works Minimal to no drug use Exercise Balanced diet Sleep Regular social interactions Regular meaningful activities Say Yes!!! The matter test

Know your Local Resources Community Mental Health Team Local GP’s HIV specific services Lifeline

131 114 Other Helplines

GLBT Counselling Line 1800 184 527 Mensline 1300 78 99 78

Know your Local Resources Websites:

www.blackdoginstitute.org.au www.crufad.org www.sane.org moodgym.anu.edu.au www.glccs.org.au