HEALTHY MINDS Stage 2 Psychology HEALTHY MINDS A

HEALTHY MINDS Stage 2 Psychology

HEALTHY MINDS A ‘healthy mind’ is free from the distressing symptoms of mental illness or a mental disorder. Particular focus on resilience – building mental resilience so our mental health is better. This topic brings together all four levels of explanation: Biological Basic processes Person Socio-cultural

HISTORY OF MENTAL ILLNESS Healthy Minds

HISTORY OF MENTAL ILLNESS Treatment for mental illness traced back as early as 1550 BC in Ancient Greece and Egypt. Mainly lists of combinations of plants and animals. Evidence suggests not enough distinction between physical and mental illness known. Middle of 19 th century saw push for more humane asylums for mentally ill as psychology advanced. By the mid 1940 s, electric shock therapy, insulin shock therapy and lobotomies common to treat mental illness. Treatment of mental illness today far more ethical and based on scientific research.

HISTORY OF MENTAL ILLNESS Lobotomy procedure Early electroconvulsive therapy (ECT) Historic insane asylum conditions Insulin shock therapy

INTRODUCTION TO MENTAL ILLNESS Healthy Minds

Ariana Grande Famous singer. Diagnosed with Post Traumatic Stress Disorder (PTSD) after Manchester bombings at her concert.

Daniel Johns Lead singer of the band Silverchair. Diagnosed with anxiety, depression and anorexia. Has struggled with panic attacks and addiction.

Mariah Carey Famous singer. Diagnosed with bipolar disorder. Had a mental breakdown in 2001.

Dustin Martin AFL player for Richmond Tigers. Diagnosed with anxiety and depression in 2018.

Lance ‘Buddy’ Franklin AFL player for Sydney Swans. Has struggled with depression for many years. Stepped away from AFL in 2015 to get professional help.

Kristen Bell Famous actress and singer. Diagnosed with depression and anxiety and has taken medication from a young age.

Ian Thorpe Former Olympic swimming champion. Diagnosed with depression as a teenager.

Brooke Shields Famous actress. Suffered from post -natal depression in the early 2000 s. Was a member of the Church of Scientology but was ‘removed’ due to taking medication to help illness.

Robin Williams Famous actor and comedian. Suffered from depression and addiction to alcohol and cocaine for many years. Was also diagnosed with early Parkinson’s Disease before his death.

MENTAL ILLNESS Characterised by behaviours, thoughts and emotions that significantly impair work, study or social functioning. Usually diagnosed by investigating the symptoms that the person reports, observing their behaviour and gaining further evidence from others (family members, GP etc. )

HOW ARE MENTAL DISORDERS DIAGNOSED? Professionals around the world use the DSM-V (Diagnostic and Statistical Manual of the American Psychiatric Associations Manual 5 th edition) to diagnose mental illness. The DSM-V outlines the main diagnoses and related characteristics and statistics relating to all types of mental illness. Diagnosis can only be made by a qualified health professional.

HOW ARE MENTAL DISORDERS DIAGNOSED? People need to have the following to be considered mentally unhealthy Maladaptive behaviour Everyday behaviour is impaired or affected i. e. drugs and alcohol consumed in excess Deviance Clients stage. social and cultural context, as well as developmental Personal Frequent stress. from normal distress diagnosis made on basis of report of great personal

DEPRESSION Healthy Minds

DEPRESSION An extended experience of negative emotions, thoughts, behaviours and functioning for at least two weeks. One of the most common mental health disorders. Each symptom of depression fits into one of the four levels of explanation of behaviour.

DEPRESSION FROM THE 4 LEVELS OF EXPLANATION Healthy Minds

DEPRESSION – BIOLOGICAL Whilst no one is sure how depression develops, change in the brain chemistry is likely. Reduced levels of serotonin (associated with feeling content). Common amongst families, thought to be hereditary. Overuse of substances such as alcohol and drugs is associated with higher vulnerability to depression.

DEPRESSION – BIOLOGICAL Biological Symptoms of Depression Headaches Digestion issues Chronic pain Insomnia Increase or decrease in appetite Imbalance of neurotransmitters (serotonin) Inactive left frontal lobe of brain (during the depression) Genetic inheritance Increased daytime fatigue

DEPRESSION – BASIC PROCESSES Many people with depression have difficulty concentrating and making decisions. Memory is often poorer than normal. Appear to access negative thoughts and emotions more readily than positive ones.

DEPRESSION – BASIC PROCESSES Basic processes symptoms of Depression Feelings of increase sadness/unhappiness Low self esteem Unclear thinking Learned helplessness Depressive thinking styles – pessimistic Thoughts of suicide and/or self harm in serious cases

LEARNED HELPLESSNESS Learning

LEARNED HELPLESSNESS Results when a person or animal is prevented repeatedly from avoiding some aversive stimulus and becomes passive and depressed. Main researcher was Martin Seligman in the 1970 s. Conducted research on dogs where they were continuously exposed to electric shocks that were unavoidable.

LEARNED HELPLESSNESS Eventually the dogs were given the opportunity to escape the shocks by jumping over a barrier, however most dogs did not and simply lay down and took the shocks. Seligman argued that the dogs had learned to be helpless. Similar observations in humans who have depression > reduced motivation.

DEPRESSION - PERSON Research shows people who develop depression have personality types which include: Less flexibility Strongly emotional Worriers Women more likely to be diagnosed with depression than men – vulnerable at beginning of adolescents, childbirth and menopause. Men appear to be more vulnerable at retirement, during long periods of unemployment and following separation from a partner.

DEPRESSION - PERSON Person symptoms of Depression Loss of once pleasurable activities Inflated/deflated sense of self importance Poor judgement Lowered comprehension Impulsivity

DEPRESSION – SOCIO-CULTURAL People without supportive social networks are more vulnerable to depression. In some cultures, depression is considered ‘shameful’ and stigma of mental illness is very apparent.

DEPRESSION – SOCIO-CULTURAL Socio-cultural symptoms of Depression Diminished involvement with others Strained relationships with family and friends Loss of social skills Inappropriate/maladaptive social behaviour Abuse

TREATMENTS OF DEPRESSION FROM THE FOUR LEVELS Healthy Minds

BIOLOGICAL TREATMENTS Anti-depressant medication Several different types of anti-depressants. Most common ones in Australia are Selective Serotonin Reuptake Inhibitors (SSRIs) – these help to enhance the function of nerve cells in the brain that regulate emotions. Electric shock therapy (also known as electroconvulsive therapy ECT) Involves passing a carefully controlled electric current through the brain which affects the brains activity with the aim of reducing severe depressive symptoms. Modern day ECT is very safe however has risk factor of reducing memory, so is only used when absolutely necessary.

BASIC PROCESSES TREAMENTS Cognitive Behavioural Therapy (CBT) Structured psychological treatment which recognises the way we think (cognition) and act (behaviour) affects the way we feel. Involves a professional therapist to identify thought and behaviour patterns that make someone more likely to be clinically depressed. One of the most effective treatments of depression and is useful for all age groups. Interpersonal Therapy (IPT) Focuses on problems with personal relationships and the impact they can have on developing depression. IPT helps to recognise patterns in relationships that make people more vulnerable to depression, and by identifying patterns can help client improve on these relationships, hence, reduce symptoms of depression.

PERSON TREATMENTS Assertiveness training Depression can develop due to lack of trait confidence in the workplace, at home or in social situations. Assertiveness training aims to help clients become more assertive without becoming aggressive with the aim of reducing depressive symptoms. Role playing exercises conducted with ‘I’ statements. Minimal risk involved – very ethical treatment

SOCIO-CULTURAL TREATMENTS Support groups Belonging to a recognised support group for depression seen to have positive results. Hearing and talking to other who know what client is going through promotes feelings of belonging and not being alone. Can do this both in person and online.

ANXIETY Healthy Minds

ANXIETY Many different types of anxiety disorders, however all of them have the experience of strong and/or frequent anxiety or fear. Different anxiety disorders include: Phobias Panic disorder Obsessive-compulsive disorder (OCD) Post traumatic stress disorder (PTSD) Generalised anxiety disorder (GAD) Social phobia

ANXIETY FROM THE 4 LEVELS OF EXPLANATION Healthy Minds

ANXIETY - BIOLOGICAL Flight or fight response much more active. Some research suggests that there are genetic markers for vulnerability to anxiety disorders. Evidence to also support it is genetic.

ANXIETY - BIOLOGICAL Biological Symptoms of Anxiety Headaches Trembling Nausea Muscle tension Dizziness Insomnia Genetic factors Heart palpitations Chest pain Sweating Tingling sensations Hot flushes

ANXIETY – BASIC PROCESSES Classical conditioning can shape some aspects of anxious responses. Anxious people often have interpretation bias where they perceive information form others as negative towards themselves. Often memory is impaired due to inattention to task and worry about other aspects.

ANXIETY – BASIC PROCESSES • Basic Processes Symptoms of Anxiety • Magnify threats and failures • Fear, worrisome thoughts. • Irrational fears • Fear of panic and public scrutiny • Hypersensitive to criticism • Worried about potential mistakes • Avoidance • Persistent unwanted thoughts • Feelings of anxiety, confusion, resentfulness

ANXIETY - PERSON Takes into account an individuals past experiences, personality style, attitudes and beliefs and stress management skills. Women more likely to be diagnosed with anxiety disorders than men.

ANXIETY - PERSON Person Symptoms of Anxiety • Unable to cope • Not confident, focus on perceived threats • High stress levels • Neuroticism

ANXIETY – SOCIO-CULTURAL Anxiety disorders can develop from a traumatic event based a persons social, socio economic, political, religious or cultural affiliation. Examples include: War Abuse Poverty

ANXIETY – SOCIO-CULTURAL Socio-cultural Symptoms of Anxiety • Fast paced lives • Environmental stressors • Decreased job security • Lack of family support • Avoidance of groups, work colleagues etc. • Avoidance of social contact, crowds • Social phobias • Difference between cultures

TREATMENT OF ANXIETY FROM THE FOUR LEVELS Healthy Minds

BIOLOGICAL TREATMENTS Anti-anxiety medication Most common type are benzodiazepines – type of tranquillizers and/or sleeping pills (depends on type). Promote relaxation and reduces muscle tension. Should only be used for short amount of time as they become addictive. Should also be used in conjunction with other treatments, not as only treatment for anxiety. Anti-depressant medication Some types of anti-depressants effective for anxiety, even if client is not experiencing depression symptoms. Correct the imbalance of chemical messages between nerve cells and the brain.

BASIC-PROCESSES TREATMENTS Cognitive behavioural therapy (CBT) Structured psychological treatment which recognises the way we think (cognition) and act (behaviour) affects the way we feel. Involves a professional therapist to identify thought and behaviour patterns that make someone more likely to be anxious. By making client more aware of the thoughts and behaviours, client can start to make changes to thoughts, which will in turn improve coping skills. One of the most effective treatments of depression and is useful for all age groups.

PERSON TREATMENTS Assertiveness training Anxiety can develop due to lack of trait confidence in the workplace, at home or in social situations. Assertiveness training aims to help clients become more assertive without becoming aggressive with the aim of reducing anxious symptoms and thoughts. Role playing exercises conducted with ‘I’ statements. Minimal risk involved – very ethical treatment

SOCIO-CULTURAL TREATMENTS Support groups Belonging to a recognised support group for anxiety seen to have positive results. Hearing and talking to other who know what client is going through promotes feelings of belonging and not being alone. Can do this both in person and online.

RISK FACTORS Healthy Minds

RISK FACTORS Research has suggested that there is no one cause of mental illness, alternatively the more risk factors that are present in ones life the greater the chance of that person developing a mental illness Risk factors exist at the biological, person, basic processes and socio-cultural level.

RISK FACTORS

PROTECTIVE FACTORS Healthy Minds

PROTECTIVE FACTORS Protective factors are factors present in one’s life that reduces the likelihood of developing a mental illness Protective factors exist at the biological, person, basic processes and socio-cultural level

PROTECTIVE FACTORS

STIGMA Healthy Minds

STIGMA OF MENTAL ILLNESS There is still great stigma in society towards mental illness in general, largely because people misunderstand what it is. There is no evidence to suggest there is a link between mental illness and violence, and this notion should not be used to reinforce stigma and discrimination against people. Episode of ‘You Can’t Ask That - Schizophrenia’ will reveal a lot of this discrimination.

STIGMA OF MENTAL ILLNESS Significant amount of stigma regarding gender expectations in society, especially in men's health. Statistics from 2017 show that on average, six men will take their own lives in Australia every day. Leading cause of death in Australian men aged between 15 -44. More than double the national road toll. More recent advertising campaigns targeting men and boys.

COPING STRATEGIES/ STRESS MANAGEMENT THERAPY Healthy Minds

COPING STRATEGIES Psychological interventions such as CBT, medication etc. deal directly with mental illness. However there are coping strategies that people can employ to deal with everyday symptoms of depression and anxiety. Coping strategies are things that you can do to help yourself, before seeking help from professionals (if needed)

COPING STRATEGIES Collectively known as ‘Stress Management Therapy. ’ Strategies use in treating depression and/or anxiety both in and outside of therapy sessions. Psychologists will identify triggers, causes and accelerators of mental illness symptoms, then recommend several coping strategies. Some may include including yoga, meditation, exercise, time management techniques, proper nutrition, saying ‘no’ more often, and many more.

BIOLOGICAL COPING STRATEGIES Physical exercise Can be helpful for depression and ‘down’ emotional state. Can also be helpful for anxiety as it burns away stress chemicals of cortisol and epinephrine. Increases self esteem. Proper Nutrition Lowering fat, salt and sugar intake and increasing protein, vitamin and mineral intake. Circadian rhythms not affected, therefore more energy. Physically feel better.

BASIC PROCESSES COPING STRATEGIES Challenging negative thoughts Often we make predictions of ourselves and we are our own worst enemy. Such thoughts can be challenged by thinking of helpful or beneficial ways of thinking about the situation > make us realise they are just perceptions and not reality. E. g. Invitation to a party > ‘No one will talk to me’ > Challenge: I don’t know they wont talk to me; I could invite my friend along; I could just start talking to people etc. ’ > situation does not seem as daunting > more positive outlook. Planning and problem solving Writing down how you plan to tackle problems/goals is helpful. Helps to prioritise what is most important and what is not as important at the time. Decide which task/s you can do on your own and which you need help with.

PERSON COPING STRATEGIES Will depend on the individual differences of each person and their individual needs. Common person coping strategies include: Art/colouring books Reading books Video games Music – listening and/or playing Etc.

SOCIO-CULTURAL COPING STRATEGIES Social involvement People with network of friends and family are less likely to experience mental disorders. Sense of belonging. Discussion helps us feel more supported and might help our perception of issue. Can come in many forms such as: Sporting clubs Dance/drama/clubs Music bands Online groups and chat rooms Friendship groups Support network of parents, family, teachers, counsellors etc.

RESILIENCE Healthy Minds

RESILIENCE Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors. It means "bouncing back" from difficult experiences. Three types: Overcoming the odds Sustained competence under stress Recovery from trauma

RESILIENCE Being resilient does not mean that a person doesn't experience difficulty or distress. Emotional pain and sadness are common in people who have suffered major adversity or trauma in their lives. In fact, the road to resilience is likely to involve considerable emotional distress. Resilience is not a trait that people either have or do not have. It involves behaviours, thoughts and actions that can be learned and developed in anyone.

FACTORS THAT INFLUENCE RESILIENCE Healthy Minds

FACTORS AFFECTING RESILIENCE - BIOLOGICAL Biological Level of Explanation Factors affecting resilience (The biological, chemical, and physical processes underlying behaviour e. g. drugs, hormones, nervous system damage etc. ) • Sleep – having a healthy amount of sleep enhances physical health and supports mental health. • Adrenaline – protective factor aimed at keeping us strong in times of immediate stress. • Cortisol – helps us to handle longer term stress howevever…. as long as stress doesn’t lead to GAS. • Exercise – releases endorphins. • Eating – healthy, balanced diet. • Minimal use of drugs/alcohol as a coping strategy. • Linked to Altered States of Awareness topic

FACTORS AFFECTING RESILIENCE – BASIC PROCESSES Basic Processes Level of Explanation Factors affecting resilience (The psychological processes underlying behaviour e. g. cognition, emotion, memory, perception, learning etc. Universal to all human beings. ) • Cognition– positive mindset, seeing the optimistic side of life. • Perception– the belief we can perform behaviours necessary to cope. The belief that things will turn out positively. • Emotions – finding meaning in stressful life situations. • Learning – school achievement, IQ, problem solving. • Memory – remembering you are supported and how you have coped well before etc. • Linked to Learning topic.

FACTORS AFFECTING RESILIENCE – PERSON Person level of Explanation Factors affecting resilience (The individual differences in behaviour e. g. personality traits, age and gender. ) • Eysenck’s theory: Protective factors more likely to be provided by someone who shows stable and impulse control traits. • Good problem solving skills. • Good communication skills. • Individual coping strategies i. e. reading, video games, listening/playing music etc. • Linked to the Personality topic.

FACTORS AFFECTING RESILIENCE – SOCIO-CULTURAL Socio-cultural Level of Explanation Factors affecting resilience (The influence that other people • Relationships – caring and exert on behaviour in a socio-cultural supportive relationships within context. , External factors to the self. ) and outside of the family. • Socio-economic advantage – • Linked to the Social Cognition steady income, access to support topic. services. • School/work – positive school/work environment. • School achievement – recognition of achievements in school or work. • Cultural pride – active, positive involvement in cultural and community pride.

PSYCHOLOGICAL INTERVENTIONS FOR MENTAL ILLNESS Healthy Minds

PSYCHOLOGICAL AND BIOLOGICAL INTERVENTIONS There a range of psychological and biological interventions used to treat mental illness. Many of the interventions you have looked at throughout the year. Review the following interventions CBT (basic processes) Assertiveness Training (person) Systematic Desensitisation (basic processes) ECT (biological) Drug Treatment (biological)

ADVANTAGES AND DISADVANTAGES OF PSYCHOLOGICAL TREATMENTS Healthy Minds

COGNITIVE BEHAVIOURAL THERAPY (CBT) Advantages Evidence for longer, more extended success Can use strategies again if symptoms resurface Applicable to all age groups and demographics, men and women. Disadvantages Sometimes difficult to change thought process for severe depression and/or anxiety. Can be very confronting being diagnosed. Can be very expensive.

SYSTEMATIC DESENSITISATION Advantages Gradual process of extinguishing strong conditioned response. Can be more ethical due to gradual approach. Disadvantages Can be very slow process. Can be expensive due to the time it can take for some clients. Risk of it not being effective.

ASSERTIVENESS TRAINING Advantages Minimal risk involved – seen to be a very ethical treatment. Very practical form of therapy using role plays – can be more successful due to this. Disadvantages People can still find therapy intimidating – may make depression/anxiety worse. Not relevant if cause of mental illness is not in the work place. Not as widely available/well known as otherapies.

ADVANTAGES AND DISADVANTAGES OF BIOLOGICAL TREATMENTS Healthy Minds

IMPORTANT! Electric shock therapy and medication for depression and/or anxiety are NOT considered psychological therapies. Considered biological therapies. Why is this?

ELECTRIC SHOCK THERAPY (ECT) Advantages Modern day ECT very safe – delivered by trained health professionals. Can be very effective in treating severe mental illness. Disadvantages Is an intrusive procedure. Can cause memory problems due to changes in brain. May not work for everyone.

MEDICATIONS Advantages Can allow people to function day to day far more effectively. Used in conjunction with psychological therapy > typically more successful in reducing mental illness. Readily available in Australia. Disadvantages May have negative side effects. Can become addictive. May take several trials of different medications to find the right one, as well as the right dosage. Can take a long time to work i. e. more than two weeks.

METHODS OF INVESTIGATION Healthy Minds

Methods of collecting data Clinical interviews Uses qualitative data to gain more information and make possible diagnosis. Self-reports Diaries, rating scales etc. Uses subjective quantitative and qualitative data. Objective quantitative methods EEG machines, heart rates, blood pressure, blood tests etc.

ETHICS Healthy Minds

Ethics There is a duty of care and ethical code for professionals working with people who have a mental illness to protect their rights and dignities Diagnosis of mental illness is far from straightforward and adequate evidence needs to be compiled before a diagnosis should be made Diagnosis of a mental illness can be both helpful and harmful.

Ethics Diagnosis is fraught with difficulty, so to is treatment and what is most effective for patients There are laws in place to protect people with a mental illness, this may mean involuntary admission to a psychiatric ward if people are considered a danger to themselves or others, however most psychiatric wards in Australia have a majority of patients that are there on a voluntary basis.