Overview of Mental Health and Addiction Disorders

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Overview of Mental Health and Addiction Disorders

• Thanks to John Mogk, M.A.
• Clinical Coordinator
• Maple Ridge Treatment Centre for original version
  of this power point.

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Major Mental Health Problems

• Psychosis
• Mood
• Anxiety
• Personality
• Addiction
• Eating Disorders

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Psychosis, disturbance of thinking

• Hallucinations
• Delusions
• Disorganized
• Behaviors
• Thinking
• Speech (incoherence)
• Movement - Catatonia

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Pathways to Psychosis

• Mental Illness
• Schizophrenia, Schizoaffective Disorder
• Bipolar Mania, Severe depression
• Paranoid and Borderline Personality Disorders
• Substances
• e.g. Stimulants, Cannabis
• Brain Injuries / Medical Disease
• e.g. Alzheimer's

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Treatment of Psychosis

• Medication
• Skill Building
• Social
• Activities of Daily Living
• Medication Compliance
• Occupational
• Relapse prevention / Stress Management

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Mood Disorders

• Depression
• Mania
• Bipolar I II

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Depression

• Low mood
• Anhedonia - lack of pleasure
• Unintentional Weight Change
• Insomnia or Hypersomnia
• Psychomotor Agitation or Retardation
• Fatigue or Loss of Energy
• Worthlessness or Guilty
• Thinking problems
• Morbid thoughts

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Depression

• Is very common component of substance use and
  withdrawal, particularly alcohol,
  benzodiazepines, opioids, steroids and
  stimulants.
• Typically takes 4-8 weeks of clean time before
  substance-induced depression can be ruled out
• Older adults who abuse substances usually have
  mood disorders
• Depressed persons have some preference for
  stimulants and alcohol

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Mania

• Grandiosity
• Decreased need for sleep
• Talkative or fast talking
• Flight of ideas
• Distractible
• Increased activity or psychomotor agitation
• Excessive pleasure seeking
• Can be brought on by stimulant use or depressant
  withdrawal

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Bipolar I and II

• Both require having had at least a 2 week episode
  of depression and
• a one week episode of mania (I)
• 4 days of hypomania (II)

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Continuum of depression

• Depression
• Normal
• Sadness/
• Grieving/Blues
• Depression
• Bipolar
• Manic
• Normal
• Depressed

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Treatment of Mood Disorders

• Medications
• Psychotherapy
• Occupational Therapy
• Exercise

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Anxiety Disorders

• Panic Disorder
• Generalized Anxiety Disorder
• Social Anxiety Disorder
• Phobias
• Post Traumatic Stress Disorder
• Obsessive-Compulsive Disorder

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Anxiety Disorders

• Anxiety is the most common symptom of substance
  abusers and is now considered to be a cause of
  anxiety disorders much more often than as a
  self-medicating for underlying anxiety disorder
• Using chemicals ( benzodiazepines, cannabis) to
  cope with anxiety can weaken ability to use
  healthy mechanisms and create avoidance
  tendencies
• Anxiety can be resolved in addiction treatment

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Panic Attacks

• A discreet period (lt 30minutes) reaching a peak
  within 10 minutes with 4 or more of
• Palpitations, pounding heart, or fast heart rate
• Sweating
• Trembling or shaking
• Shortness of breath or feeling smothered
• Feelings of choking
• Chest pain
• Nausea
• Feeling dizzy, light-headed, faint, or unsteady
• Derealization or depersonalization
• Fear of losing control / going crazy
• Numbness
• Chills or hot flashes

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Post-Traumatic Stress Disorder

• 1. Person exposed to trauma
• 2. Event is persistently recurrently experienced
• Intrusive memories of event
• Dreams of the event
• Feeling as if they are reliving the event
• As intense distress or physiological reactivity
  when exposed to cues that resemble or symbolize
  the event
• 3. Avoidance of stimuli and numbing
  responsiveness
• 4. Persistent symptoms of increased arousal

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Anxiety Treatment

• Medications preferably very short-term
• Cognitive Behaviour Therapy
• Trauma therapies to reprocess memories

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Personality Disorders (most commonly disabling)

• Borderline Personality Disorder
• Antisocial Personality Disorder
• Avoidant Personality Disorder
• Dependent Personality Disorder
• Obsessive Compulsive Personality Disorder

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Therapy for Personality Disorder

• Medications for symptom management
• Psychotherapy
• Dialectical Behavioral Therapy and other newly
  developed therapy for persons with personality
  disorders
• Psycho-social Rehabilitation (skill building)

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Addictions

• Alcohol, Heroin and other Opiate use frequently
  causes symptoms of depression and sometimes
  depressive illness.
• Alcohol, Benzodiazepines, and cannabis often
  create anxiety disorders by allowing avoidance of
  anxiety provoking stimuli
• Cocaine addiction can resemble or create bipolar
  mood swings

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Addiction Therapies

• Detox
• Outpatient
• Inpatient Residential
• Support Recovery, Longer Term Residential
• Self - Help

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Eating Disorders

• Anorexia Nervosa
• Bulimia Nervosa
• Eating Disorders NOS

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Anorexia Nervosa

• Refusal to maintain normal body weight for age
  height
• Intense fear of weight gain
• Disturbance in self-evaluation of body shape and
  size, denial of serious of underweight
• Amenorrhea in postmenstrual women

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Bulimia Nervosa

• Recurrent binge eating episodes
• Recurrent purging to avoid weight gain
• Binge eating and purging occur on average, at
  least twice a week for 3 months
• Self-evaluation influenced by body shape and
  weight

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Treatment of Eating Disorders

• Medical stabilization
• Medication
• Individual therapy using several models -
  Readiness and Motivation Therapy ( RMT) Cognitive
  Behavioural Therapy (CBT) and Dialectical
  Behavioural Therapy (DBT) Understanding Feminist
  theory and role of media skill building
• Family Therapy- several models are being
  researched
• Nutrition Education
• Team approach

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Recovery is Possible, Help is available

• Mission Mental Health Centre
• Fraserhouse
• Mission Indian Friendship Centre