Psychological Health

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Psychological Health

• What is Normal?

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What is Normal?

• Psychological Health versus Psychological
  Normality
• Is conforming to social demands a mark of
  psychological health?
• Questioning whats happening around you means
  fulfilling your potential as a thinking,
  questioning human being
• If conforming mental health then disagreeing
  with politics would indicate mental illness
  (i.e., used in history by dictators)

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What is Healthy?

• Seeking help does not equate to mental illness
  any more than seeking help proves one to be
  mentally ill.
• Every psychologist needs his/her own
  psychologist.
• Unhappy people sometimes refuse seeking help for
  fear of what family/friends/coworkers may think
  or say (fear of being labeled)

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Do symptoms define mentally ill or mentally
healthy?

• No.
• Time Life alter our environment as well as our
  minds and bodiesChangeProblems.
• Symptom of Anxiety-can lead us to face and solve
  problem. If person under same anxiety shows no
  symptoms may refuse to recognize a problem or to
  do anything about it.
• Person who acknowledges and faces the problem may
  be viewed mentally healthy compared with one
  who is inappropriately calm.

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Do I look psychologically healthy?

• There are people who are seen as psychologically
  healthy then all of a sudden, take their own
  life.
• Lack of social support such as close friends who
  might have seen some signs.
• We learn at a young age to conceal our
  complaints. While sometimes necessary, this can
  prevent us from asking for help.

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So, What is Psychologically Healthy?

• Is it freedom from disorders?
• Is it fulfilling our own potential?
• Abraham Maslow Hierarchy of Needs
• He said that when urgent needs like the needs for
  food, water, shelter, sleep and safety are met,
  less urgent needs take priority.
• Studies of highly successful people

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Maslows Conclusions

• Maslows conclusions were based on study of
  Abraham Lincoln, Henry David Thoreau, Ludwig van
  Beethoven, Eleanor Roosevelt and Albert
  Einstein---seemed to have lived to their fullest
  potential---
• Maslow stated that these people had achieved
  self-actualization. Maslow stated that they all
  share certain qualities.

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Self-Actualization (The highest)

• Self-actualized people are able to deal and
  accept the world as it is not as they demand it
  should beREALISTIC.
• Knowing the difference between what is and what
  you want.
• Knowing what can be changed and what cannot.
• Unrealistic persons-spend a lot of time and
  energy trying to force the world and others into
  their ideal picture

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Acceptance

• According to Maslow psychologically healthy
  people can largely accept themselves and others.
• This equates to a positive self-concept or
  self-esteem.
• Having a positive but realistic mental image of
  themselves, who they are, what they are capable
  of and what roles they play.
• These people also tend to live up to this
  positive self-image, enjoying success, that in
  turn, reinforces good feelings (tolerating own
  imperfections)

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Autonomy

• Maslow also defined psychologically healthy
  people as those able to direct themselves acting
  independently of their social environment.
• Example Many people do not express their
  feelings for fear of disapproval and rejection.
  This is other-directed behavior.
• Inner-directed people find guidance from
  within, from their own values and feelings.
• They have an internal locus of control and high
  self-efficacy!! (from our discussion in Chap 1)

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Authenticity

• Example child-like qualities.
• Small children have a real quality.
• Their responses are genuine and spontaneous to
  whatever happens.
• Being aware of feelings and being willing to
  express them.
• Being unself-conscious

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Capacity for Intimacy

• Healthy people are capable of physical and
  emotional intimacy.
• They are comfortable with exposing their feelings
  and thoughts to others.
• Open to intimate contact/open communication

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Creativity

• Psychologically healthy people live their
  everyday lives in creative ways.
• They see more and are more open to new
  experiences.
• They do not fear the unknown or avoid uncertainty.

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Ideal Self-Actualization

• We are not failures if we arent
  self-actualized in every aspect.
• This is all an ideal to strive for to reach our
  full potential.

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Erik Eriksons Stages of Development (Table 3.1
pg67)

• Proposed that development proceeds through a
  series of eight stages that extend throughout the
  life span.
• Each stage is characterized by a major crisis or
  turning point a time of increased vulnerability
  and increased potential for growth.
• The mastery of one stage is a basis for mastery
  to the next.
• There are ongoing opportunities for mastering
  these tasks. For instance, trust begins in
  infancy, but is refined as we grow older.

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Adult Identity Development

• Begins in adolescent years.
• A unified sense of self characterized by
  attitudes, beliefs, and ways of acting that are
  genuinely ones own.
• Those with a sense of identity can assess their
  strengths and weaknesses without relying on the
  opinions of others.
• In a world of unlimited options, this can be
  difficult for some.

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Adult Identity Models

• Parents (or the opposite of in rebellious cases)
• Peers
• Rock Stars
• Sports figures
• Religious figures
• In high school and college jocks brains
  slackers cliques, etc.

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Your own identity

• What are some characteristics that a close friend
  might use to describe you?
• Who do you admire want to be like?
• How did this role model aquire these
  characteristics and how might you follow in their
  footsteps?

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Intimacy Development

• Developing intimacy is also part of Eriksons
  developmental stages in establishing an adult
  identity.
• Those with established identities can form
  intimate relationships characterized by sharing,
  open communication, long-term commitment and
  love.
• Those who lack identity experience short-term,
  superficial relationships with others and may
  remain isolated.

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Developing Values and Purpose

• Eriksons last two stages generativity versus
  self absorption and integrity versus despair
  middle and older adulthood.
• Must be re-examined thru life beginning in
  adolescence.
• good behavior immediate and tangible rewards
  bad behavior punishment (as children this is
  established early).
• Your actions and how you justify them to others
  proclaim to others what you stand for.

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Developing Self-Esteem

• Develop a Positive Self-Concept
• Experiences (love and acceptance as child)
• Integration (personality and mannerisms of
  parents)
• Stability (consistent messages from family and
  friends)

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Developing Self-Esteem

• Recognize Patterns of Thinking
• Recognize and test negative thoughts and
  assumptions of yourself and others.
• Dont over-generalize from negative events
  (example your date is late. You assume the worst
  and demoralize yourself with negative thoughts)
• Cognitive Distortions patterns of thinking that
  make things seem worse than they are.

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Self-Esteem (continued)

• Realistic Self-Talk
• Substitute positive thoughts for negative ones.
• Those who demoralize can become so negative that
  they then come true in a self-fulfulling
  prophecy

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Achieving Positive Self-Esteem

• Be less Defensive (see page 71 for defense
  mechanisms)
• Be Optimistic
• Studies have found that pessimism is not only a
  symptom of depression but the root cause as well.
  Pessimists not only expect repeated failure and
  rejection but also accept it as deserved.

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Achieving Healthy Self-Esteem

• Maintaining Honest Communication
• Assertiveness Training expression that is
  forceful but not hostile.
• Communicating your feelings appropriately and
  clearly is important.

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Achieving Healthy Self-Esteem

• Dealing with Loneliness The right balance is
  hard to achieve. Some socialize from fear of
  being alone. Being alone is sometimes interpreted
  as a form of rejection.
• Dealing with Anger Recent studies indicate
  overly hostile people are at a higher risk of
  heart attacks. Damaging important personal and
  professional relationships can produce intense
  feelings of guilt or loss of control. Think
  before you speak!
• Anger Management Strategies

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Anger Management Strategies

• Think of what might be affecting the person who
  has made you angry (i.e., cutting you off in
  trafficlate for interview? Taking sick relative
  to doctor in backseat? Pre-occupied with
  worrymaybe death in family?
• Think before you act! Count to 10 and take 3 deep
  breaths.
• Dont react to anger with anger Diffuse by
  talking and taking a time out.

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A Practical Exercise

• To clarify your values and goals, write a draft
  of your obituary for a local newspaper.
• How would you like to be remembered?
• What would you like to have achieved?
• What will you have done to meet these goals?
• What was most important about your life?
• Then ask yourself, what will I have to change to
  be the person you want to be?

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Psychological Disorders

• Genetic differences in how the brain processes
  info play an important role especially in
  bipolar disorder and schizophrenia.
• Anxiety Disordersa feeling of fear that is not
  directed toward any definite threat.
• Mood Disorders

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Anxiety Disorders

• Simple Phobia (also a specific phobia) fear of
  something definite like spiders, lightening,
  animals or location.
• Most common snakes, spiders and dogs.
• Bad experiences can precipitate the phobia.
• Fear of blood, injections, or seeing injured
  people is a special type of simple phobia.

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Social Phobia

• People who fear humiliation or embarrassment
  while being observed by others.
• Most common is the fear of public speaking.
• People with social phobias may not continue in
  school, restrict themselves to lower paying jobs
  so no contact with new people.

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Panic Disorder

• People who experience sudden surges in anxiety,
  accompanied by symptoms of rapid and strong
  heartbeat, shortness of breath, loss of
  equilibrium and the feeling of losing mental
  control.
• Normally occurs in early 20s age group.
• Fear of being in crowds or closed places/fear of
  driving or flying are common.
• This fear may lead to agoraphobia (person is
  housebound).

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Generalized Anxiety Disorder

• Worry of future events taken to the extreme.
• Everyday worries that result in obsession of
  that worry.
• End result is persistent nervousness, accompanied
  by depression.
• People with this cannot accomplish everyday tasks.

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Obsessive-Compulsive Disorder

• Persons with obsessions, compulsions or both.
• Re-current unwanted thoughts or impulses
• Improbable fears of committing an antisocial act
  or being contaminated with germs.
• Example Parent has impulse to kill their child
  or person obsesses over getting HIV from a
  handshake.
• Compulsions repetitive, difficult to resist
  actions associated with obsessions. Common-hand
  washing/with obsessive fear of dirt
  contamination.
• Returning to the house ten times to check that
  the iron is turned off.
• OCD patients feel anxious, out of control.

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Post-Traumatic Stress Disorder

• People who are reacting to severly traumatic
  events-that produce a sense of terror and
  helplessness-such as physical violence to oneself
  or loved ones.
• Rape, military combat, natural disasters, fires,
  airplane and car crashes.
• Symptoms re-experiencing trauma in
  dreams/intrusive memories/EX Sept 11th

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Treatment for Anxiety Disorders

• Medication
• Interventions (Simple Phobias)Example
  Desensitization Therapy
• Combination of medication and cognitive-behavioral
  therapies effective in panic disorder,
  obsessive-compulsive and generalized anxiety
  disorders.

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Statistics for Anxiety Disorders

• Men versus Women
• Women are more likely to suffer from emotional
  distress than men.
• Panic Disorder is more than twice as common in
  women as men.
• Social Anxiety Disorder is more common in women
  than men, however, men are more likely to seek
  treatment.

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Mood Disorders

• Depression Most common/has forms and degrees.
• Sadness and hopelessness
• Loss of pleasure in usual activities
• Poor appetite and weight loss/or the opposite
• Disturbed sleep/sleeping too long
• Restlessness and fatigue
• Thoughts of worthlessness and guilt
• Problems with concentration or making decisions
• Thoughts of death or suicide

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Depression

• Not all are present in every episode
• In major depression, symptoms are severe and are
  diagnosed, dysthymic disorder
• Some cases are triggered by life event-obvious
  event exogenous
• Internal depression endogenous

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Depression

• Only 35 of those suffering from depression seek
  treatment.
• Best treatment is a combination of drug
  (antidepressant) therapy and psychotherapy.
• The most effective drug therapy usually take a
  couple of weeks to take effect.
• Antidepressants work by affecting the
  neurotransmitters in the brain (i.e., seratonin)

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Therapies for Depression

• Antidepressants
• Psychotherapy
• Electroconvulsive Therapy (seizures induced)
• Light Therapy (in the case of SAD)

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Statistics on Depression

• Over a lifetime, approximately 20 of women and
  12 of men have serious depression.
• Depressed women are also more likely to
  experience feelings of guilt, anxiety, increased
  appetite, weight gain and increased sleep.

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Recognizing Warning Signs of Suicide

• Any and/or all of the signs and symptoms of
  depression.
• Expression of wish to be dead or revealing
  contemplated methods.
• Increasing social withdrawal and isolation
• A sudden lightening of mood (suddenly happy)-can
  be a signal of the decision for suicide.

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Risk Factors for Suicide

• A history of previous attempts
• A suicide by family member or friend
• Readily available means
• A History of substance abuse
• Serious medical problems

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Suicide Rates

• Rates are higher among men than women at all
  ages.
• Rates are higher among whites compared to other
  groups.
• Rates are highest among white men over the age of
  65.
• See Figure 3.2 pg.79

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Suicide Statistics

• Even though depression is more common in women
  than men in U.S., more men commit suicide than
  women.
• Until the age of 9, boys and girls have the same
  rates of suicide.
• From 10-14 yrs old the boys rates are twice as
  high.
• From 15-19, four times as high.
• From 20-24, six times as high.
• Three times as many women as men attempt suicide
  but are less likely to be as lethal as men (due
  to the use of firearms more often by men).

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How to Handle Those who are Suicidal

• It is Imperative to seek help immediately if you
  are someone you know has expressed any suicidal
  thoughts.
• Dont be afraid to discuss it with your
  friend/family member who may be contemplating it.
  
• If you feel there is an immediate danger, do not
  leave this person alone.
• If friend refuses help, you may want to contact
  friends relatives regarding your concern.
• Call or have them call a suicide hotline. These
  are available in most cities.

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SUICIDE HOTLINES

• NATIONAL
• 1-800-SUICIDE (1-800-784-2433)
• LOCAL [phone]
• FOR TEENS (UNDER 18YRS OLD)
• (972) 233-TEEN

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Mania or Bipolar Disorder

• Symptoms Restless, have lots of energy, need
  little sleep, often talk non-stop.
• Spend more money than they can afford.
• Devote themselves to fantastic projects.
• Swing between manic and depressive states, a
  syndrome referred to as Bipolar Disorder.

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Cause of Mania

• Research is ongoing.
• Stressful/Traumatic Life Eventshormone
  imbalances/neurotransmitters become unbalanced
  (dopamine, seratonin, norepinephrine,
  acetylcholine)
• Difficult to pinpoint whether imbalances are the
  cause or the opposite.

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Treatment for Mania

• Tranquilizers may be used for manic episodes
• Salt lithium carbonate daily can prevent future
  mood swings.

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Statistics on Mania

• Mystery
• Although men and women equally suffer from
  bipolar disorder, women are nearly twice as
  likely as men to be depressed.
• 1 of General Population are affected
• 2nd degree relative 3-5 chance
• Sibling 15-25 chance
• One parent 15-30
• Both parents 50-75
• - Identical Twin 70 chance

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Schizophrenia

• 1 in every 100 people has a schizophrenic episode
  in his/her lifetime.
• Episodes commonly begin in adolescence.
• Cause is still not completely understood by
  scientists.
• A combination of genes and environmental factors
  that occur during pregnancy and development is
  the most likely cause.

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Statistics on Schizophrenia

• Children born to older fathers have higher rates.
• Children with prenatal exposure to certain
  infections or medications.

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Characteristics of Schizophrenia

• Disorganized Thoughts thoughts expressed in
  vague or confusing way.
• Inappropriate emotions Emotions are either
  absent or strong but inappropriate.
• Delusions Firmly held false beliefs-may think
  their minds are being controlled by outside
  forces/others can read their minds/or they are
  great personages like Jesus or the U.S.
  President.
• Example Movie A Beautiful Mind

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More Characteristics of Schizophrenia

• Auditory Hallucinations May hear voices when no
  one is present
• Deteriorating social and work functioning Social
  withdrawal and increasingly poor performance at
  school or work so gradual that they hardly notice
  at first.