Caring for Your Mind

An Invitation to Health Caring for Your Mind Prepared by: Richard C. Krejci, Ph.D. Professor of Public Health Columbia College 1.20.16

Chapter Objectives List the key structures of the brain and describe the role of neurons in communication within the brain. Recognize gender and age-based differences in the brain Explain the differences between mental health and mental illness and list some effects of mental illness on physical health. Identify the major mental illnesses and their characteristic symptoms.

Chapter Objectives Discuss some of the factors that may lead to suicide, as well as strategies for prevention. Identify risk factors for mental health problems. Describe the treatment options available for those with psychological problems. List the criteria for considering therapy for a mental health problem

In this chapter, you will learn to Key structures of the brain LIST Depression symptoms and treatment Suicide symptoms and prevention Neurons and their role in the brain DESCRIBE Difference between mental health and mental illness Options for yourself in case you experience symptoms

Cerebral cortex Parietal lobe Frontal lobe 1 Corpus callosum Hypothalamus (part of the limbic system) Pituitary gland 2 Occipital lobe Thalamus (part of the limbic system) Cerebellum Brainstem Midbrain Pons 3 1 Cerebrum Medulla Spinal cord Central canal of spinal cord 2 3 Cerebellum Medulla The Brain: Our Last Frontier

The Anatomy of a Neuron Key Structures Nucleus Axon Axon Terminal Dendrites Glia (support cells) Other Terminology Neurotransmitters (chemicals) Synapse (junction) Receptors (molecules)

Neurons Communicate With Each Other At Synapses: WHERE HOW Area between the axon terminal of one neuron and the dendrite of another neuron Through Neurotransmitters: Packets of chemicals released from the axon terminal of the neuron sending the signal

Nucleus Nerve Impulse Axon terminal Dendrite Presynaptic neuron Axon Receptors Transmitted nerve impulse Approaching nerve impulse Postsynaptic neuron Neuron, magnified 3,100 times. Synaptic vesicles (containing neurotransmitters) Released neurotransmitter molecules Synapse Fig. 3-2, p. 59

Are Men s and Women s Brains Different? Men Have bigger brains. Have eyes which are more sensitive to bright light. Retain ability to see well at long distances longer in life. Loses brain tissue more rapidly than women. Women Use more neurons. Hears a broader range of sounds. Hearing remains sharper, longer. Responds more intensely to emotions. The Bottom Line on Intelligence Neither gender s brain is better.

What are the harateristics of a Mentally Healthy Individual? Perceives reality as it is Establishes and maintains close relationships Carries out responsibilities Feels a sense of fulfillment in daily living Accepts own limitations and possibilities Pursues work that suits talents and training Values himself/ herself Fig. 3-3, p. 61

What is a Mental Disorder? A behavioral or psychological syndrome associated with distress or disability with a significantly increased risk of suffering death, pain, disability, or loss of freedom.

Definitions of Mental Illness Clinically significant behavioral or psychological syndrome or pattern that is associated with present distress, disability or significantly increased risk of suffering death pain, disability or an important loss of freedom Diagnostic and Statistical Manual, 4th Ed mental, behavioral or emotional disorders that interfere with one or more major activities in life like dressing eating or working. U.S. Government

Almost half of all Americans will experience a diagnosable mental disorder in their lifetime

Students at Risk What are some of the contributing factors? Poor academic performance Loneliness Relationship problems Gender identity issues Family health issues Peer pressure

Most Common Mental Disorders Mood Disorders Depression Bipolar Disorder Anxiety Disorders Phobias Panic Disorders Substance Abuse Drugs and alcohol

% with any Mental Disorder in Past Year Mental Disorders in America Age Group Figure 3.4 p. 57 Gender

Depression on Campus

Gender and Depression Depression is twice as common in females versus males, but male depression is an under disease underdiscussed, underrecognized, underdiagnosed, and undertreated. Factors Contributing to Depression Genes, brain chemistry, sex hormones, childhood abuse, chronic stress, divorce, job loss, or career setbacks.

Major Depression Characteristic Symptoms Feeling depressed Loss of interest Eating more or less Having trouble sleeping Feeling slowed down Lack of energy Feeling helpless Difficulty concentrating Difficulty thinking clearly Persistent thoughts of death Withdrawal from others Headaches, digestive problems, aches and pains

Depression Has Inequitable Impact Groups More Likely to Experience Major Depression Women Racial and Ethnic Minorities Those Without a High School Education Divorced or Never Married Jobless Those Without Health Insurance

Depressive Disorders Treatments Psychotherapy Cognitive-behavior therapy Interpersonal therapy Medications Antidepressants Exercise Electroconvulsive Therapy (ECT)

Bipolar Disorder Manic Depression Characteristics Mood swings that take individuals from manic states of feeling euphoric and energetic to depressive states of utter despair. Involves mood swings, changes in thinking, changes in behavior, and changes in physical condition. Treatment Mood-stabilizing medications Psychotherapy

Phobias Anxiety Disorders Intense fear of objects or situations Irrational, intense, and persistent fears Panic Attacks and Panic Disorders Racing heart Rapid breathing Most peak within 10 minutes Generalized Anxiety >10 million adults Irrational or unwarranted response to harmless objects or situations Obsessive Compulsive Disorder Estimated 1 in every 40 Americans Violence, contamination, doubt

Anxiety Disorders Phobias Definition An anxiety disorder masked by an inordinate fear of an object, a class of objects, or a situation, resulting in extreme avoidance behaviors. Treatment Behavior therapy including systematic desensitization. Common Phobias Involve animals (dogs, snakes, insects, and mice); sight of blood; claustrophobia (closed spaces), acrophobia (heights); and agoraphobia (cannot escape)

Anxiety Disorders Panic Attacks and Panic Disorder Panic Attack A short episode characterized by physical sensations of lightheadedness, dizziness, hyperventilation, and numbness of extremities, accompanied by an inexplicable terror, usually of a physical disaster such as death. Panic Disorder An anxiety disorder in which the apprehension or experience of recurring panic attacks is so intense that normal functioning is impaired.

Anxiety Disorders Generalized Anxiety Disorder (GAD) Definition An anxiety disorder characterized as chronic distress. Common Symptoms Faster heart rate, sweating, increased blood pressure, muscle aches, intestinal pains, irritability, sleep problems, and difficulty concentrating. Treatment Psychotherapy. Behavioral therapy. Antianxiety drugs.

Anxiety Disorders Obsessive-Compulsive Disorder (OCD) Definition An anxiety disorder characterized by obsessions and/or compulsions that impair one s ability to function and form relationships. Obsession A recurring idea, thought or image. Compulsion Repetitive behavior performed according to certain rules or in a stereotyped fashion Treatment Cognitive therapy Behavioral therapy Medications

Attention Disorders Attention Deficit/Hyperactivity Disorder (ADHD) Definition A spectrum of difficulties in controlling motion and sustaining attention, including hyperactivity, impulsivity, and distractibility. Potential Complications Academic difficulties, poor concentration, difficulty making decisions, relationship difficulties, sleep problems, increased risk of depression, anxiety disorders and substance abuse. Treatments Medications Stimulants: Ritalin Nonstimulants: Strattera Psychotherapy

Autism Spectrum Disorder Found in all ethnic groups 4X more likely to occur in boys Occurs in 1:50 children between age 6-17 Age of child s grandfather (>age 50) Benefits of folic acid supplements Treatments Behavioral therapy Speech language therapy Antidepressants (to ease repetitive behavior)

Schizophrenia Symptoms Hallucinations; delusions; inability to think in a logical manner; talking in rambling or incoherent ways; making odd or purposeless movements; mimicking gesture or words; showing few, if any, emotions; lacking will or motivation; and functioning at a much lower level. Causes Failure in brain development early in life and genetics. Not due to upbringing, social conditions, or traumatic experience. Treatment Antipsychotic medications

Suicide Is Increasing in the U.S. Who Attempts Suicide? Who Commits Suicide? Sex Female Male Age Under 35 Under 20 or over 60 Means Less deadly, such as wrist slashing More deadly, such as a gun Circumstances High chance of rescue Low chance of rescue

Eight Predictors of Suicide 1. previous suicide attempts 2. inadequate treatment 3. medical illness 4. family history of suicide or other emotional disorder 5. exposure to suicidal behavior 6. family violence 7. availability of firearms 8. major stress in life circumstances

What Can Lead to Suicide? Mental Disorders Antidepressant Medications Substance Abuse Hopelessness Family History Physical Illness Brain Chemistry Access to Guns Life Crises

Suicide Prevention Encourage your friend to talk. Don t offer trite reassurances. Suggest solutions or alternatives to problems. Don t be afraid to ask whether your friend has considered suicide. Don t think that people who talk about killing themselves never carry out their threat.

Types of Therapists Psychiatrists Licensed medical doctor with additional training in psychotherapy, psychopharmacology, and treatment of mental disorders.

Types of Therapists Psychologists Mental health-care professionals who have completed doctoral or graduate programs in psychology and are trained in a variety of psychotherapeutic techniques, but who are not medically trained and so not prescribe medications.

Types of Therapists Certified Social Workers A person who has completed a twoyear graduate program in counseling people with mental problems.

Types of Therapists Psychiatric Nurses A nurse with special training and experience in mental health care.

Types of Therapists Marriage and Family Therapists A psychiatrist, psychologist, or social worker who specializes in marriage and family counseling.

Types of Therapies Psychodynamic Psychotherapy Cognitive-Behavioral Therapy Interpersonal Therapy (IPT) Cranial Electrotherapy Stimulation (CES) & ECT Psychiatric Drugs Alternative Mind-Mood Products

Surviving and Thriving Accept yourself. Respect yourself. Trust yourself. Love yourself. Stretch yourself. Look at challenges as opportunities for personal growth. Think not only where but also who you want to be a decade from now.