Mental Disorders

1. Mental Disorders

2. Defining the problem • Starting in 1952, the American Psychiatric Association created the Diagnostic and Statistical Manual of Mental Disorders, better known as the DSM. • The manual lists and describes all known mental illnesses and disorders. • Attempts to make diagnosis uniform across the mental health profession • Current edition: DSM5 (2013)

3. Mental Health Statistics • 57 Million Americans suffer from a mental health disorder (NIMH). • 49% of adult Americans with serious psychological/substance abuse issues do not get treatment (Substance Abuse and Mental Health Agency). • 20% of Americans believe there is a stigma to receiving mental health treatment (APA). • 100% of all health insurance plans must now offer coverage for mental health treatment (Mental Health Parity Act of 2008, 10/08).

4. What is it? Different ideas exist on what it means to be to be mentally abnormal • Deviance: displaying behavior outside of the norm. • “Problems in living” that cause labeling to occur(Szaz) • Failure to adjust to situations • Inability to function successfully within society

5. Anxiety Disorders • Anxiety: the feeling of fear/discomfort that arises from real or imagined danger. • Those with anxiety disorders feel fear and/or uneasiness out of proportion to the reality. • Symptoms can be mental (worrying, emotional instability) and physical (muscle tension, fatigue)

6. Types of Anxiety Disorders • Generalized: the person feels anxious across a variety of environments • Difficulty sleeping, unable to follow through on everyday tasks • May be a product of learned behavior, as well as inability to adapt to modern life/change. 2. Phobic: a phobia is an irrational fear of something. It becomes an issue when the phobia interferes with the person’s ability to function.

7. Anxiety Disorders, cont. • Unusual Phobias Alektorophobia: fear of chickens Arachibutyrophobia: fear of PB sticking to the roof of your mouth Basophobia: fear of walking Consecotaleophobia: fear of chopsticks Genuphobia: Fear of phobias Hippopomonstrosesquippedaliophobia: fear of long words

8. Anxiety Disorders, cont. • Phobias may have been learned from a past event. • Systematic desensitization helps overcome phobias. • Agoraphobia (fear of the outside world) extremely problematic 3. Panic Disorder: Characterized by extreme terror for no apparent reason. May also feel doom/death imminent Often occurs following stressful event

9. Anxiety Disorders 4. Obsessive-Compulsive Disorders: Obsession: the thoughts that produce the anxiety Compulsion: the behavior repeatedly performed in an effort to ease the anxiety. The person afflicted with OCD has a continuous loop of behavior 5. PTSD (Post-traumatic Stress Disorder) : A survivor of a traumatic event will relive the fear though triggering events, overwhelming that person’s ability to cope.

10. Assignment (50 points) Due 03/14/2013 • Create a montage that in your mind shows the difference between normal/abnormal behavior. • One side normal, other side abnormal. • Be prepared to explain why you put the images where you did. • No fewer than fifteen images a side, very little background should show • Grading: 15 pts: following format 25 pts: creativity 5: use of time 5: oral presentation

11. “Cuckoo’s Nest” Assignment • You are on the panel that determines whether Randall Patrick McMurphy will stay at the mental hospital, or be released back to the Oregon Department of Corrections. Based on Randall’s behavior that we see in the film: • Is he dangerous? Why? • Should he stay or go? Defend your answer through example.

12. Opening Questions • If you were in charge of hiring at a business, and you interviewed a person who was qualified but mentally ill, would you hire that person? • Would you date someone who had a mental illness/disorder? Why? • Agree/Disagree: There is a stigma in having a mental illness in our society.

13. Final exercise • You have been divided into two groups. Those groups are juries. You are to render a decision in the following three cases.

14. People v. McMurphy • Randall Patrick McMurphy had been charged with attempted murder, for his actions against Mildred Ratched. • Note: For this case, assume that McMurphy is alive.

15. People v. Ratched • Mildred Ratched has been charged with manslaughter in the matter of William “Billy” Bibbitt’s death. The State of Oregon contends that her actions led to the death of Mr. Bibbitt.

16. People v. Bromden • The State charges “Chief” Bromden with first-degree murder in the death of Randall Patrick McMurphy.

17. “One Flew over the Cuckoo’s Nest” • Title from a nursery rhyme • Book written by Ken Kesey, who worked for a mental institution. • Film debuted in 1975, winning Academy Awards for Best Film, Best Actor (Jack Nicholson), Best Actress (Louise Fletcher), and Best Director (Milos Forman). • Jack Nicholson is R.P. McMurphy, Louise Fletcher is Nurse Mildred Ratched. • Movie takes place at a state mental hospital on the Oregon coast in 1963.

18. Schizophrenia • Schizophrenia: “split mind” • It is not multiple personality disorder • Symptoms include: • Delusions (false beliefs)/hallucinations • Loss of contact with reality • “word salad” • Emotional flatness/inappropriateness • Difficulty planning/organizing

19. Schizophrenia • Symptoms typically start to appear in males from late teens-20s, females 20-30s. Equally distributed between genders • Those afflicted more likely to attempt/succeed suicide • High use rate of nicotine (75-90%) • Appears to be connected with the neurotransmitters dopamine & glutamate • Drugs are available to lessen the symptoms, but there is no cure

20. Mood Disorders • Depression • Considered to be a chronic illness, although some only have one episode • One of the most common • Symptoms include irritability, loss of interest/energy, feeling of sadness/hopelessness, suicidal thoughts • Bipolar Disorder (Manic Depression) • Moods shift from highs (mania) to lows (depression) • 1-6 % of population • Often treated with medication (e.g. lithium)

21. Personality Disorders • General Characteristics Symptoms present for extended period of time, and cause distress and/or negative consequences for the person Symptoms seen in at least two of the following: • Thoughts 3. relationships • Emotions 4. impulse control Seen in approx. 9% of population, with borderline and antisocial most common

22. Personality Disorders • Paranoid: distrust/suspicion of others • Feeling that others are out “to get you” • Borderline • Characterized by instability of moods and interpersonal relations • Short, intense bursts of emotions • Common for those afflicted to injure themselves purposely • Often victims of physical/sexual abuse • More common in women

23. Personality Disorders • Antisocial (aka sociopath) - characteristics seen early in adolescence • More common in males • Realize the difference between right/wrong, But do not care • manipulative, deceitful, unemotional, lack of personal responsibility - Those with the disorder unlikely to seek treatment, or to succeed with it.