Crazy Patients

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Mental Health

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Reflects a person's approach to life by communicating emotions, giving and receiving, working alone as well as with others, accepting authority, displaying a sense of humor, and coping successfully with emotional conflict.

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Metal illness

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Reflects a person's inability to cope with stress, resulting in disruption, disorganization, inappropriate reactions, unacceptable behavior, and the inability to respond according to the person's expectations and the demands of society. (Interfers w/ there life)

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Factors that influence Mental Health

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Inherited Characteristics
Nurturing during Childhood
Life Circustances

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Defense Mechanisms
Compensation

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unconscious use of a specific behavior to make up for a real or imagined inability or deficiency, thus maintaining self respect or self esteem,

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Defense Mechanisms
Conversion

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Unconscious expression of a mental conflict as a physical symptom to relieve tension or anxiety. ex..dont want to see an X-rated movie so you wake up the next morning blind.

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With this Defense Mechanisms ou get out of a conflict by having a physical problem?

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Conversion

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Defense Mechanisms
Denial

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Unconscious refusal to face thoughts, feelings, wishes, needs, or reality factors that are intolerable. ...refuse to face the facts.

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Defense Mechanisms
Displacement

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unconscious shifting of feelings such as hostility or anxiety from one idea, person, or object to another,....(Story with kicking the cat)

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Defense Mechanisms
Dissociation

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Separation and detachment of a strong , emotionally charged conflict from one's consciousness.

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Which defense mechanism do you hide under the table and go to your happy place and pretending your not there.

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Dissociation

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Defense Mechanisms
Identification

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unconscious attempt to identity w/ personality traits or actions of another to preserve one's self esteem or to reach a specific goal.

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Defense Mechanisms
Introjection

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unconscious application of the philosophy, ideas, customs, and attitudes of another person to ones self.

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Defense Mechanisms
Projection

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unconscious assignment of unacceptable thoughts or characteristics of self to others.

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Defense Mechanisms
Rationalization

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unconscious justification of one's ideas, action, or feelings to maintain self-respect, prevent feelings or guilt or obtain social approval.

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Defense Mechanisms
Reaction -formation

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unconscious demonstration of the opposite behavior, attitude or feeling of what one would normally show in a given situation.

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Defense Mechanisms
Regression

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Retreat to past developmental stages to meet basic needs.

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Defense Mechanisms
Restitution

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Negation of previous consciously intolerable action or experience

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Defense Mechanisms
Sublimination

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unconscious rechanneling of intolerable or socially unacceptable impulses or behaviors into activities that are personally or socially acceptable.. (like to auger you become a lawyer.)

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Defense Mechanisms
Substitution

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unconscious replacement of unacceptable impulses, attitudes, needs, or emotions with those that are more acceptable,

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Defense Mechanisms
Suppression

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voluntary rejection of unacceptable thought or feeling from conscious awareness.

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Defense Mechanisms
Symbolization

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use of external objects to become an outward representation of an internal idea, attitude, or feeling.

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Mild Depression

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Exhibited by affective symptoms of sadness, an appropriate response to stress.

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Moderate Depression
(Dysthymia)

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individuals verbalize feelings of guilt, inadequacy, & irritability. They exhibit a lack of interest and lack of productivity. They don't have delusions or hallucinations.

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Severe Depression
Clinical symptoms

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depressed mood, significant loss of interest or pleasure, marked change in weight or significant increase or decrease in appetite, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feeling of worthlessness or excessive or inappropriate guilt, reduced ability to concentrate or think, or indecisiveness, recurrent thoughts of death, suicidal ideation, suicide attempts, or plan to commit suicide,

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Severe Bipolar

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Refers to individulas who have one or more manic episodes alternating with major depressive episodes.

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Moderate Bipolar

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Refers to individuals who experience recurrent major depressive episodes with hypomanic episodes occurring with a particular severity frequency or duration.

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Hypomania

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is a mood between euphoria and excessive elation. It characterized by unrealistic optism, pressure of speech, and activity and decreased need for sleep. some pt show increase in creativity during hypomanic states, where as others show poor judgement, irritability.

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Mild Bipolar
(cyclothymic disorder)

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Refers to individuals who experiences numerous periods of hypomania symptoms and depressive symptoms that do not meet the criteria for a major depressive episodes,

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Therapeutic and Nursing Interventions

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Assist with ADLs, monitor I&Os, monitor rest and activity, limit setting when client exhibits hyperactivity, anger, hostility, or demanding, manipulative behavior.

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Medication management

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Depression: SSRI, various other types of antidepressant meds
Bipolar: Lithium carbonate, other mood stabilizing drugs

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Somatic Therapies

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Electroconvulsive therapy, phototherapy to treat seasonal Affective Disorder

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Interactive Therapies:

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interpersonal, family, group, cognitive, or behavioral psychotherapy may be tailored to each client depending on the person's particular conditions and coping capacities.

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Alternative and complementary therapies

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Remedies such as Kava-kava, balerian, St. Johns wort, SAM-e, and black cohash should be used with caution and always with knowledge of the physician because they can potentiate and interact with medically prescribed Antidepressants.

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Client Education

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Ongoing process adjusting to individual needs.

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Remember for test!!

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With psych patients start with maslow basic needs safety.

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Fear

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is the body's physiologic and emotional response to a known or recognized danger.

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Anxiety

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Describes feelings of uncertainty, uneasiness, apprehension, or tension that a person experiences in response to all unknown object or situation.

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Physiologic symptoms of anxiety

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elevated pulse, blood pressure, and resp..Dyspnea or hyperventilation...Diaphoresis...Vertigo or Lightheadedness...Blurred vision...Anorexia, N/V, frequency of urination, HA, insomnia or sleep disturbance, wekaness or muscle tension, tightness in the chest, sweaty palms, dilated pupils.

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Emotional symptoms of anxiety

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Withdrawal, Depression, Irritability, Crying, Lack of interest or apathy, Hypercriticism, Anger, Feeling of worthlessness, apprehension, or helplessness.

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Behavioral symptoms of anxiety

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Pacing, Inability to sit still, Fingering hair continuously, Hypervigilance.

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Intellectual or cognitive symptoms of anxiety

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Decreased interest, Inability to concentrate, Nonresponsiveness to external stimuli, Decreased productivity, Preoccupation, Forgetfulness, Orientation to past rather than present or future, Rumination.

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Levels of Anxiety
Normal

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The client may experience periodic warning of a treat such as uneasiness or apprehension that prompts the client to take necessary steps to prevent a threat or lessen the consequences.

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Levels of Anxiety
Mild

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The client has an increased alterness to inner feelins or the environment. At this level, an individual has an increased ability to learn opportunity to be individualistic.

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Levels of Anxiety
Moderate

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The client experiences a narrowing of he ability to concentrate on only one specific things at a time, pacing, voice tremors, increased reate of speech, physiologic changes, and verbalization, about expected danger occur. (Nurse doing CPR on her mom)

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Levels of Anxiety
Severe

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The ability to perceive is further reduces and focus is o small or scattered details. Inappropriate verbalization or the ability to communicate clearly, occurs d/t increased anxiety and decreased intellectual thought processes. Lack of determination or the ability to perform occurs as the person experiences feelings of purposelessness. Physiologic responses also occur as the individual experience a sense of impending doom.

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Panic State

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Complete disruption of the ability to perceive takes place. Disintegration of the person occurs as the individual becomes immobilized, experiences difficulty verbalizing, is unable to function normally, and is unable to focus on reality. Physiologic, emotional, and intellectual changes occur as the individual experiences a loss of control.

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Panic Disorder

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Is a real illness with both a physical and psychological component.

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Agoraphobia

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Fear of being in places or situations from which escape might be difficult ( or embarrassing) or in which help might not be available in the event that a panic attack should occur.

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When patients aren't having panic issues teach..

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1-relaxation techniques 2- deep breathing 3- meditation 4- exercise (when appropriate)

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Social phobia

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a compelling desire to avoid situations win which others may criticize a person.

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Specific Phobia

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excessive fear of an object an activity, or a situation that leads a person to avoid the cause of that fear.