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Understanding Mental Disorders: A Holistic Approach to Care and Support

This comprehensive overview explores mental disorders, emphasizing the need for a multidimensional approach that considers psychospiritual, sociocultural, and cognitive factors. It identifies various categories, including anxiety and mood disorders, and discusses co-occurrence or comorbidity. The vital role of community support, psychoeducation, and compassionate pastoral care is highlighted, advocating for preventative mental health strategies. By fostering an understanding and destigmatizing mental health issues, congregations can create therapeutic environments that promote healing and empowerment.

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Understanding Mental Disorders: A Holistic Approach to Care and Support

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  1. Mental Disorders & Our Ministries The Reverend Dr. Kelly Murphy Mason, Psy.D., M.Div., M.S., LCSW-QCSW: Clinical Pastoral Psychotherapist in Private Practice in NYC; Community Minister in Metropolitan New York

  2. Simple Formulas for Complex Phenomena Stressors/ = Psychological Supports Distress Psychological Distress + X = Mental Disorder (Clinical condition-Psychopathology)

  3. Multidimensional Disorder • Psychospiritual* • Sociocultural • Biophysical • Cognitive/Behavioral

  4. Assessment vs. Diagnosis • Assessment accounts for multiple factors and is therefore “multiaxial” • Diagnosis is a medical term • Diagnosis is both organized & coded in the DSM, published by APA • Psychiatrists provide medical management for mental disorders, using prescription psychotropics in their pharmacotherapy

  5. Categories of Disorders • Developmental Disorders • Dementia • Substance Abuse/ Dependence • Schizophrenia & Psychotic Disorders, inc. Paranoia • Dissociative Disorders • Somataform Disorders • Eating Disorders • Sleep Disorders • Sexual/ Gender Identity Disorders • Personality Disorders • Factitious Disorder • Impulse Control Disorders • Adjustment Disorders • Anxiety Disorders • Mood Disorders

  6. Commonly Occurring Disorders • Anxiety Disorders include: Panic; Phobia, including Social; OCD; PTSD; and Generalized Anxiety Disorder • Mood Disorders include: Dysthymia, Major Depressive Disorder, Single Episode or Recurrent; Bipolar Disorder; Mood Disorder due to…

  7. Depressive Disorders, a.k.a. “The Common Cold” • Some disorders are self-limiting • Episodic depression tends to worsen • Self-esteem is often damaged • Social isolation becomes problematic • Neurovegetative symptoms are real • Depression can be “masked”, esp. in males, who are at higher risk for suicide • Mania and psychosis sometimes figure in the disorder

  8. “Comorbidity”, or: The Double Whammies • Depression & Anxiety-Spectrum Disorders frequently are comorbid, sometimes difficult to distinguish • Depression can be secondary to a general medical condition • Substance-induced mood disorders require dual diagnosis and specialized treatment

  9. Substance-Related Disorders • Alcohol Use • Amphetamine Use • Cocaine Use • Hallucinogen Use • Opioid Use • Inhalant Use • Cannabis Use • Sedative/Anxiolytic Use – the “iatrogenic effect” • Polysubstance Dependence • Substance Intoxication • Substance Withdrawal

  10. Common Psychotropics • Antidepressant SSRIs: Prozac, Zoloft, Lexapro, etc. • Atypicals: Wellburtin & Effexor • Anxiolytics, inc. benzodiazapenes: Xanax, Ativan • Mood stablizers, eg. Lithium • Antipsychotics: Abilify, Zyprexa • Psychostimulants: Ritalin, Adderall • Sleep aids: Remeron

  11. Levels of Functioning • People often attempt to self-medicate with substances or self-soothe through the so-called “soft addictions” as a coping strategy • Some people may be higher functioning, others lower functioning • Some internalize, others externalize • Some people are in an acute phase, others in the management stage • Many mental disorders go undiagnosed

  12. The Stressors: Psychosocial & Environmental Problems • Problems with primary support group, i.e., the family or marriage • Problems in the social environment • Educational/Occupational problems • Housing problems • Economic problems • Problems with health care

  13. Spiraling Up or Down: Positive & Negative Feedback Loops • People may need to strengthen their relational skills and coping strategies, as well as adjust their mental schema • Good “hygiene” includes self-care honoring the mind-body-soul connection

  14. Caring Congregations • Strong spiritual community & solid pastoral care can provide protective benefits • Preventative mental health care is optimal • People feel dignified by a holistic approach to themselves & their situations • A healthy congregation can be a therapeutic milieu

  15. Supporting Congregantswith Mental Disorders • Preach compassion • The faith community can work as a collective to both destigmatize and normalize mental disorders • Psychoeducation can be a very important part of church programming & congregant learning • Social justice groups can advocate for mental health parity • Peer support and group work fill significant needs, especially if they are offered in a safe environment

  16. Areas of Pastoral Attention & Psychological Concern • Relational problems • Possible abuse, history of abuse • Spiritual or religious problems • Bereavement or complicated grief • Acculturation • Phase of life problem

  17. Holistic Care • Interpersonal supports need to be enlisted • Psychotherapy is quite effective, both short- or long-term, and in combination with pharmacotherapy • Education and empowerment are linked in such treatments as bibliotherapy • Mental disorders tend to leave marks that last for a time…

  18. Notes for Religious Professionals • Tend to your own mental health! Take good care of yourself… • Acquaint yourself with the spectrum of mental disorders • Know and respect your limits

  19. Limits of Congregational Care • Ministers and religious educators are not generally qualified as providers of mental health care and so must have an understanding of when professional mental health care is needed • Ideally, some sort of referral network is established before it is needed in a time of crisis • Certain conditions are chronic and not necessarily ever “cured”

  20. Managing Personality Disorders • Obsessive-Compulsive Personalities • Histrionic Personalities • Paranoid Personalities • Schizotypal Personalities • Dependent Personalities • Borderline Personalities • Avoidant Personalities • Narcissistic Personalities

  21. Warning Signals to Heed • Grossly disorganized behavior • Delusions or hallucinations • Indications of decompensation • Suicidal statements, threats, or gestures • Menacing actions • Serious expressions of concern

  22. Responding Without Pathologizing • Remember that mental disorders tend to have involved etiologies • Those struggling with mental disorders are much more than a coded diagnosis and may retain their signature strengths • Treatment outcomes for mental disorders continue to steadily improve, even in cases of recurrence • Eliminate us-and-them thinking, since lifetime prevalence is high

  23. Resources Available • The Caring Congregations Program • Online sources such as www.mentalhealth.com • Advocacy groups such as NAMI • Public organizations such as NIMH • Phone services like 1-800-LIFENET • Local counseling centers and hospitals

  24. Questions and Answers Q: ? A: “It depends…”

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