Chapter 12

Mental Health

Mental Health: What Is It?

One definition: “how we think, feel, and act as we cope with life” (Kellogg, R. (2008). Quoted in What is mental health? [Press Release]).

What is good mental health?

One definition: “a state of well-being that allows someone to be productive, have fulfilling relationships, cope with difficult circumstances, and adapt to change.”

Mental health and physical health are connected.•Mental health affects physical health (being depressed increases the risk for heart disease).•Physical health affects mental health (lack of air can cause a panic attack; regular exercise lowers the risk for depression).

• 1 in 5 adults (45 million Americans) suffer from a diagnosable mental disorder in a given year.

• Half of all Americans will experience some form of mental illness during their lives.

• People with mental illnesses love others, hold jobs, and contribute to society.

Mental illness is common, but it doesn’t mean a person is crazy.

Biology• Some mental illnesses have genetic

components.• Neurotransmitters, hormones, physical health

and other factors can affect mental illnesses and how they are perceived.

Social and Psychosocial Factors• The way women are treated affects their

mental health

What Affects Mental Health?

• Stress– Chronic stress, and the way people react to it,

affect mental health.– Women are more likely than men to

internalize stress. – Traumatic events can cause or contribute to

mental illness.– Coping with stress in a positive manner can

improve mental health.– How do you respond to stress?

What Affects Mental Health?

Undefined burden of mental problems

• Refers to the economic and social burden for families, communities, and countries

Hidden burden of mental problems

• Refers to the stigma and violations of human rights and freedoms associated with mental problems

Costs of Mental Illness to Society

What Mental Illnesses Affect Women

Compared to men, women are more likely to have•Depression (2x)•Seasonal affective disorder (4x)•Anorexia, bulimia (9x)•Phobias, panic disorder (~2x)•Borderline, histrionic personality disorder.

Women are less likely to have schizophrenia, antisocial personality disorder, attention-deficit disorder, and to be violent as a result of mental illness.

• Need for mental health and social services

• Lost employment and reduced productivity

• Financial burden placed on families and caregivers

• Increased levels of crime and threat to public safety

• Negative effects of premature mortality

The Economic Burden of Mental Illness

• Given treatment, people with mental illness are no more likely to commit crimes than the general public.

• Without treatment, however, the mentally ill are more likely to commit crimes and to be arrested.

Legal Dimensions: The Mental Illness/Crime Paradox

Mood Disorders

• Unipolar disorder: depression and dysthymia

• Bipolar disorder: manic depression

Types of depression

• Premenstrual dysphoric disorder (PMDD)

• Postpartum depression

• Seasonal affective disorder (SAD)

Clinical Dimensions of Mental Health

Treatment for depression

• Antidepressant drugs

• Psychotherapy

• Combination of therapy and drugs

DepressionPersistent, inescapable feelings of sadness, low energy and

apathy.

Both highs and lows• Highs: feelings of wonder and euphoria

and/or overly stimulated, easily distracted, and easily irritated

• Lows: deep, persistent feelings of sadness, anxiety, hopelessness, or guilt; they might also have low energy, a reduced sense of pleasure and a lowered sex drive, and thoughts of suicide

Bipolar Disorder

• Generalized anxiety disorder (GAD)

• Phobias

• Panic disorder

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD)

Anxiety Disorders

Treatment for anxiety disorders• Cognitive behavioral

therapy• Antianxiety

medications • Antidepressants• Medication and

therapy together

Anxiety Disorders

Treatment CAN and USUALLY does help. But…• It is difficult. • It takes time.

Treatment can include medications, psychotherapy, or a combination of the two (both together normally work better than either alone).

Treating Mood Disorders and Anxiety Disorders

Anorexia Nervosa• Deprivation of food and a body weight of at

least 15% below the normal weight based on height and age

Symptoms• Refusal to maintain an adequate weight• Intense fear of gaining weight• Distorted body image• In women, absence of three consecutive

menstrual periods

Eating Disorders

Bulimia Nervosa

• Cyclic binge eating followed by purging• Symptoms

– Recurrent episodes of bingeing and vomiting

– Feeling out of control during a binge– Purging after a binge– Extreme concern with body weight and

shape

Eating Disorders

Binge Eating Disorder

Compulsive overeating without purging

Eating Disorders

At least three of the following:•Rapid, continuous eating (thousands of calories)•Eating when not physically hungry•Eating while alone•Eating beyond the point of comfort•Feeling self-disgust after a binge

Treatment for Eating Disorders

• Psychotherapy

• Behavior modification therapy

• Family therapy

• Antidepressants

• Antisocial

• Avoidant

• Borderline

• Dependent

• Histrionic

• Narcissistic

• Obsessive-compulsive

• Paranoid

• Passive-aggressive

• Schizoid

• Schizotypal

Personality Disorders

• Psychosis—severe mental disorder characterized by lack of contact with reality and severe personality changes

• Schizophrenia—type of psychosis; afflicts about 2.5 million Americans, with men and women equally afflicted

• Symptoms include hallucinations, delusions, disordered thinking, and impaired ability to interact with others

• Treatment: antipsychotics and psychotherapy

Schizophrenia

• Unconscious way to protect self from emotional traumas by detaching from a part of one’s personality

• Several types: dissociative identity disorder (multiple personality disorder), dissociative amnesia

Dissociative Disorders

Risk factors• Adverse life events in combination with

depression• Prior suicide attempt• Family history of mental disorder or

substance abuse• Family history of suicide• Family violence, including physical or sexual

abuse• Firearms in home• Incarceration

Suicide

• Watching a funny movie or show, telling and listening to jokes, or other activities that bring laughter

• Exercise (regular activity is best, but any amount of exercise brings benefits)

• Meditation or prayer• Gardening• Spending time with a pet or pets• Getting a massage

Informed Decision Making: Healthful Ways to Cope with Stress

If you have some form of mental illness:

You are not alone.Help is available—and it can make a difference.

Informed Decision Making: Healthful Ways to Cope with Stress

• Visualization (imagining yourself on a calm beach, a quiet meadow, or some other peaceful, relaxing situation)

• Listening to music• Naps or simply lying down, closing one’s eyes

and relaxing• Regular exercise• Creative endeavors (writing, drawing or painting,

dancing, etc.)