Transcript Module 13 Signs and Symptoms of Mental Illness Powerpoint

Module 13
Signs and Symptoms
of Mental Illness
Geriatric Aide Curriculum
NC Division of Health Service Regulation
Adapted from PowerPoint by Alison Rieber, LCSW, Johnston County Geriatric and Adult Mental Health Specialty Team
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Signs and Symptoms of
Mental Illness
Objectives
1. Define mental health and mental
illness.
2. Describe 3 major mental illness
categories.
3. Recognize symptoms of mental
illness.
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Signs and Symptoms of
Mental Illness
Objectives
3. Discuss possible causes for
symptoms.
4. Develop an understanding of what the
resident experiences
5. Discuss the nurse aide’s role in
helping a resident manage symptoms
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Mental Health and
Mental Illness
• Mental health means that a person copes
with and adjusts to everyday stresses in
ways accepted by society.
• Mental illness is a mild to severe
disturbance in the ability to cope with or
adjust to stress.
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Get to Know the Resident
• What do the symptoms of the resident
look like?
• What is the resident feeling?
• What helps them manage these feelings
and symptoms?
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Myths About Mental Illness
• People who need psychiatric care should
be placed in institutions.
• A person with a mental illness can never
be normal.
• An individual with mental illness is
dangerous.
• People with mental illness aren’t suited
for important, responsible positions.
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Facts About Mental Illness
• A disease that causes mild to severe
problems in thinking, feeling, and/or
behavior.
• Ability to cure a mental illness depends on
the type and severity of the mental illness
• Many mental disorders can be linked to
biological or genetic origin, but many also
have environmental and social causes.
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Facts About Mental Illness
• Anxiety disorders are the most common
mental illnesses.
• Constant stress and lack of using stress
management techniques can lead to
physical, emotional and behavioral problems
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4 Major Categories of
Mental Illnesses
• Anxiety Disorders
• Schizophrenia
• Phobias
• Panic disorders
• Obsessive-compulsive
disorders
• Mood Disorders
• Depression
• Mania
• Bipolar
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Anxiety
• Normal reaction to stressful situations.
The intensity of feelings vary based on the
intensity of the stressor.
Anxiety Disorders
• Anxiety without a specific stressor, a
reaction bigger than the stressor, or
ongoing fear, apprehension from an event
that is over.
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Anxiety Disorders
• Phobias: Extreme fear or dread of an
object or situation
• Panic Disorders: Sudden, intense feelings
of terror
• Obsessive-Compulsive: Repetitive words
or behaviors
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Anxiety Disorders
• Anxiety is overwhelming
• Symptoms can take over a resident’s life
• Very difficult to calm self down
• May avoid situations to avoid symptoms
• May become afraid of being anxious
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Potential Causes of Anxiety
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Genetics
Trauma
Ongoing stressors
Psychological traits
Other psychiatric
conditions
• Depression
• Schizophrenia
• Medical illnesses
• Thyroid problems
• Cardiovascular
conditions
• Respiratory problems
• Medication side
effects
• Alcohol/Drug use or
withdrawal
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Common Symptoms of
Anxiety Disorders
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•
•
•
•
•
Anxious or worried thoughts
Feeling restless or on edge
Feeling irritable
Difficulty concentrating
Problems sleeping
Physical Symptoms
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Physical Symptoms of Anxiety
Disorders
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•
•
•
•
•
•
Shortness of breath
Heart palpitations
Trembling or shaking
Choking
Nausea
Numbness
Dizziness
• Hot flashes or chills
• Feeling of being out
of one’s body or
unreal
• Fear of dying
• Fear of going crazy
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Treatment
• Therapy
• Breathing exercises
• Relaxation techniques
• Medication
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What Staff Can Do
• Assist resident to relax, calm down
• Pay attention to your voice tone
• Calm Voice
• Soothing Tone
• Slow rate of speech
• Provide reassurance
• Address anxious thoughts
• Help resident problem solve
• Remind of past successes
• Encourage ability to address issues
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What Staff Can Do
• Encourage relaxation breathing
• Provide soothing music/sounds
• Be reliable and consistent
• Encourage exercise
• Notice and report changes
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Depression
• Everyone has “down days” or times of
sadness.
• In depression the mood takes over
• The individual feels sad, irritable, guilty, tired,
and unable to experience pleasure or interest.
• Feelings persists for several weeks or longer.
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Facts About Depression
in Older Adults
• It is not a normal part of aging
• Often not recognized, ignored,
misdiagnosed, not adequately treated
• Symptoms are atypical
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Facts About Depression
in Older Adults
• Affects approximately 6 million
American older adults
• Only 10% receive treatment
• Affects 10% to 26% of residents in long
term care facilities (national statistic)
• At greater risk to commit suicide
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Causes of Depression
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Long term stress
Trauma
Genetics
Psychological traits
Chronic illness
• Chronic Pain
• Dementia
• Stroke
• Medications
• Blood Pressure
• Cardiovascular
• Pain
• Alcohol/Drug use or
withdrawal
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Main Causes of Depression
in Older Adults
• Medical conditions
• Loss of physical abilities
• Powerlessness and loss
of control
• Lack of activity
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Common Symptoms of
Depression
• Problems with sleep
• Problems with
appetite
• Depressed or irritable
mood
• Loss of enjoyment or
pleasure
• Loss of interest
• Loss of energy
• Feelings of guilt,
worthlessness
• Suicidal Thoughts
• Problems with
concentration
• Can have psychosis
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Treatment
• 80% of persons identified with
depression can be successfully treated
• Therapy
• Medication
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What Staff Can Do
• Involve withdrawn residents
• Encourage resident to be more active
• Create meaningful activities
• Sunshine and exercise
• Focus on resident’s strengths
• Notice and report symptoms
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Mania
• An abnormally elevated mood state with:
• inappropriate elation (joy)
• increased irritability
• exaggerated self-importance
• racing thoughts
• hyperactivity (restlessness)
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Causes of Mania
• Bipolar disorder
• Stimulant use/abuse
• Medication side
effects
• Medical illness
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Overactive thyroid
HIV infection
Strokes
Brain tumors
• Steroids
• Antidepressants
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Common Symptoms of Mania
• Significantly
decreased need for
sleep
• Grandiose ideas
• Mood very high or
irritable
• Racing thoughts
• More talkative, can’t
stop talking
• Easily distracted
• Involved in
pleasurable but risky
behavior
• May have psychosis
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Early Warning Symptoms
of Mania
• Changes in sleep
• Change in mood; irritable or elevated
• Racing thoughts
• Restlessness, pacing
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Treatment
• Requires psychiatric attention
• May require hospitalization
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What Staff Can Do
• Most residents in long term care with
mania will have a history of these
episodes
• Notice symptoms early
• Report symptoms to a nurse
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Bipolar Disorder
• A brain disorder that causes unusual
shifts in an individual’s mood, energy
level, and ability to function.
• Mood swings from the highs of mania to
the lows of depression
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Causes and Factors
of Bipolar Disorder
• Cause is not known for certain
• Factors
• Heredity
• Chemical imbalance
• Personality
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Common Symptoms of
Bipolar Disorder
• Manic Episode
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Increased energy, activity, restlessness
Excessively “high”, overly good mood
Extreme irritability
Racing thoughts and talking fast
Distracted easily
Little sleep needed
Unrealistic beliefs in one’s abilities and powers
Poor judgment
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Common Symptoms of
Bipolar Disorder
• Depressive Episode
• Lasting sad, anxious, or empty mood
• Feelings of hopelessness
• Feelings of guilt, worthlessness, or
helplessness
• Loss of interest in activities
• Decreased energy – feeling tired
• Difficulty concentrating
• Change in sleep or appetite
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Treatment
• Bipolar disorder is very treatable
• Medication
• Therapy
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What Staff Can Do
• Help resident learn to predict
fluctuation in mood
• Encourage medication compliance
• Recognize symptoms early
• Report observations to a nurse
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Schizophrenia
• A serious and complex mental illness
with symptoms of emotional instability,
detachment from reality, and
withdrawal into the self.
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Causes of Schizophrenia
• There is no definite cause
• Four primary theories:
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Heredity
Chemical defect in brain
Physical abnormality in brain
Complications during pregnancy or
childbirth
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Symptoms of Schizophrenia
• Hallucinations
• Suspicion
• Delusions
• Flat affect
• Disordered
thinking/speech
• Lack of pleasure in
any activity
• Agitation
• Social withdrawal
• Hostility
• Lack of initiative
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Treatment
• Anti-psychotic medications
• Psychotherapy
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Psychosis
• Loss of contact with reality.
• A psychiatric disorder such as
schizophrenia or mania that is marked
by delusions, hallucinations and
distorted perceptions of reality.
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Causes of Psychosis
• Symptom of mental illness
• Depression
• Bipolar Disorder
• Schizophrenia
• Drug use or withdrawal
• Stimulants
• Alcohol
• Medical causes
• Stroke
• Brain tumor
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Common Symptoms of Psychosis
• Visual or auditory hallucinations
• Images are frequently frightening
• Voices often negative
• Hallucinations are very real to the
individual
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Psychosis
• Delusions
• May range from suspiciousness to fear
and paranoia
• May lead to agitation or anxiety
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How to Recognize Psychosis
• Resident appears to be listening to
something inside his/her head
• Resident appears to be looking at, talking
to things that you can’t see or hear
• Resident talks about events, suspicions,
beliefs, visions that are not real
• Resident may appear fearful, agitated
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What Staff Can Do
• Notice resident’s behavior and report
• New symptoms
• Symptoms more intense
• Resident recognizes having hallucinations
or delusions:
• Remind resident that this is part of the illness
• Assure resident of being all right and safe
• Distract resident, involve in activity
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What Staff Can Do
• Resident does not recognize
hallucinations or delusions:
• Reassure resident without buying into
the false belief
• Don’t argue about the delusion or
hallucination
• Try to help the resident move onto
activity in the real world
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General Guidelines for Helping
Residents Manage Symptoms
and Mental Illness
• Symptoms are a part of the illness not
willful behavior
• Staff response to symptoms affects
resident’s quality of life
• Staff actions can help residents
manage symptoms
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General Guidelines for Helping
Residents Manage Symptoms
and Mental Illness
• Notice changes in symptoms
• Think about events surrounding
changes
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Any recent stress
Illness
Change in medication
Possible drug use
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General Guidelines for Helping
Residents Manage Symptoms
and Mental Illness
• Report any changes
• Be specific about what has
changed
• Sleep
• Appetite
• Mood
• Behavior
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General Guidelines for Helping
Residents Manage Symptoms
and Mental Illness
• Pay attention to changes
• Symptoms can be signs of serious
illness
• Responding to symptoms can improve
health of the resident
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References
• Training Manual for Caregivers,
Therapeutic Alternatives, Inc
• The North Carolina Geriatric Specialty
Team Manual: Keys to Success,
Therapeutic Alternatives, Inc
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