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mental illness
marked distress, moderate to disabling or chronic impairment
plagued by myths and misconcep ons.
Interferes with func oning- difficult to relate to others
Behavior outside social norms
Ex: stripping in public
is an illness that affects that way people think, feel, behave, or interact with others.
Disabili es related to happiness, control over behavior, appraisal of reality, effec veness in
work, healthy self-concept, sa sfying rela onships, effec ve coping strategies
mental illness is treatable
mental health
our mental well-being: our emo ons, our thoughts and feelings, our ability to solve problems
and overcome difficul es, our social connec ons, and our understanding of the world around
us.
mul faceted: involves our emo onal, psychological, and social well-being
can be affected by gene cs, brain chemistry, and experiences
· No consistent line exists between mental illness and
mental health
DSM-5
The Diagnos c and Sta s cal Manual of Mental Disorders (DSM-5)is the current official
guidebook used by the psychiatric community for categorizing and diagnosing psychiatric
mental health disorders in the United States
DSM-5 lists specific criteria for each psychiatric diagnosis
Mental health disorders are clinically significant behavioral and psychological
syndromes or pa/erns that are associated with distress (painful symptoms) and
,disability (impairment in one or more important areas of func oning)
Must exceed expected and culturally defined responses to par cular events,
such as grief a0er the loss of a loved one.
Diagnos c criteria usually includes a me frame
North American Nursing Diagnosis Associa on Interna onal (NANDA-I) provides a common
language for nursing
-Describes a nursing diagnosis as a clinical judgment about responses to health problems.
-Psychiatric-mental health nursing includes the diagnosis and treatment responses to mental
health problems.
eustress
is considered normal and beneficial.
distress
causes problems emo onally and physically
long term chronic stress
can cause physiologic harm and emo onal difficul es
Fight or flight
SNS
rest and digest
PNS
freezing
an automa c, involuntary response to a threat. In a split second, the brain decides that freezing
(rather than figh ng or running away) is the best way to survive what's happening
deer in headlights
relief behavior
defense mechanisms
individual coping responses
spiritual/cultural supports
social support network
,Alertness heightened: stress
-circula ng adrenaline increases: increased HR, bloodflow, BP, Respira ons,
-brain s mulates hypothalamus, which s mulates ANS, SNS signals adrenal system, epinephrine
(adrenaline) is released, pituitary releases ACTH
Stress signaling system
-SNS: pituitary gland releases ACTH and adrenal cortex secretes cor sol
THEN
-Hormones secreted: adrenal medulla secretes stress hormones (epinephrine) and they travel
through bloodstream to organs
THEN
-stress response: smooth muscle or glands ac vate, pupils dilate, fight or flight
Stress-reduc on techniques
-Elici ng the relaxa on response
-Physical ac vity
-Social supports (e.g., close family es, acquaintances, spouses, friends)
-exercise
-lower caffeine
-reframing
-sleep
Structures involved in the HPA stress response
-epinephrine: subsides as the threat passes
-hypothalamus s mulates the HPA axis
-CRH: travels to the pituitary gland
-ACH: travels to the adrenal glands
-cor sol is released
As anxiety decreases
dysfunc onal behavior will frequently decrease.
anxiety
-Is the most basic emo on.
-Dysfunc onal behavior is o0en a defense against anxiety.
-When behavior is recognized as dysfunc onal, interven ons can be ini ated by the nurse to
reduce anxiety.
, FEAR=
a reac on to a specific danger.
ANXIETY=
a feeling of apprehension, uneasiness, uncertainty, or dread resul ng from a real or perceived
threat whose actual source is unknown or unrecognized.
normal anxiety
Healthy life force necessary for survival
acute anxiety
Precipitated by imminent loss or threat
pathological anxiety
differs from normal anxiety in terms of dura on, intensity, and disturbance in a person's ability
to func on (e.g., dysfunc onal behaviors or extreme withdrawal)."
chronic anxiety
Long-term; thought to be associated with increased risk for cardiovascular morbidity; usually
begins at young age.
defense mechanisms
1.Major means of managing conflict
2.Rela vely unconscious
3.Discrete from one another
4.Hallmarks of major psychiatric syndromes, which are reversible
5.Adap ve as well as pathologic
healthy defense mechanisms
Altruism
Sublima on
Suppression
Humor
Intermediate defense mechanisms
Repression
Displacement
Reac on forma on