Transcript Caring for people with mental illness

CARING FOR PEOPLE WITH
MENTAL ILLNESS
CHAPTER 37
1
WHAT WILL YOU LEARN?
• A MENTAL ILLNESS IS A DISORDER THAT AFFECTS A PERSON’S MIND, CAUSING THE PERSON TO ACT IN
UNUSUAL WAYS, EXPERIENCE EMOTIONAL DIFFICULTIES, OR BOTH. (MENTAL MEANS “MIND.”) IN MANY
SOCIETIES AND CULTURES, MENTAL ILLNESS IS VIEWED AS SOMETHING TO BE ASHAMED OF. A MENTALLY ILL
PERSON’S ODD BEHAVIOR MAY BE FRIGHTENING TO THOSE WHO DO NOT UNDERSTAND IT. IN ADDITION,
MOVIES, TELEVISION, AND BOOKS HAVE CONTRIBUTED TO THE POPULAR IMAGE OF MENTALLY ILL PEOPLE AS
CRAZY, VIOLENT, AND OUT OF CONTROL. ALTHOUGH SOME PEOPLE WHO ARE MENTALLY ILL MAY BEHAVE IN
VIOLENT OR DANGEROUS WAYS, MOST DO NOT. THERE ARE MANY DIFFERENT TYPES OF MENTAL ILLNESS, AND
MENTAL ILLNESS VARIES IN SEVERITY FROM PERSON TO PERSON.
• AS A NURSING ASSISTANT, YOU WILL CARE FOR MANY PEOPLE WITH DIFFERENT TYPES AND DEGREES OF
MENTAL ILLNESS. YOU MAY FIND THE IDEA OF CARING FOR A MENTALLY ILL PERSON FRIGHTENING. LEARNING
ABOUT COMMON MENTAL ILLNESSES CAN HELP YOU TO OVERCOME THIS FEAR. IN THIS CHAPTER, YOU WILL
LEARN ABOUT SEVERAL COMMON MENTAL ILLNESSES, AND HOW THEY AFFECT THE PEOPLE WHO SUFFER
FROM THEM.
2
WHEN YOU ARE FINISHED WITH THIS CHAPTER, YOU
WILL BE ABLE TO:
• 1.
DEFINE THE TERM MENTAL ILLNESS.
• 2.
DESCRIBE SOME OF THE QUALITIES THAT DEFINE GOOD MENTAL HEALTH.
• 3.
DISCUSS METHODS THAT PEOPLE USE TO COPE WITH STRESS EFFECTIVELY.
• 4.
LIST POSSIBLE CAUSES OF MENTAL ILLNESS.
• 5.
DISCUSS THE DIFFERENT TREATMENTS THAT ARE AVAILABLE FOR PEOPLE WITH MENTAL ILLNESS.
• 6.
DESCRIBE COMMON MENTAL ILLNESSES THAT YOU MAY ENCOUNTER IN THE HEALTH CARE SETTING.
• 7.
DISCUSS SPECIAL CONCERNS RELATED TO THE HEALTH CARE SETTING AND AGING THAT MAY AFFECT A
PERSON’S MENTAL HEALTH.
• 8.
DESCRIBE THE RESPONSIBILITIES OF THE NURSING ASSISTANT WHEN CARING FOR MENTALLY ILL
PATIENTS AND RESIDENTS.
3
WHAT IS MENTAL ILLNESS?
4
WHAT IS MENTAL ILLNESS?
•
A MENTAL ILLNESS IS A DISORDER THAT AFFECTS A PERSON’S MIND, CAUSING THE PERSON TO
• ACT IN UNUSUAL WAYS
• EXPERIENCE EMOTIONAL DIFFICULTIES
• OR BOTH
•
IN MANY SOCIETIES AND CULTURES, MENTAL ILLNESS IS VIEWED AS SOMETHING TO BE ASHAMED
OF
•
A MENTALLY ILL PERSON’S ODD BEHAVIOR MAY BE FRIGHTENING TO THOSE WHO DO NOT
UNDERSTAND IT
5
MENTAL ILLNESS AND THE ROLE OF MEDIA
•
MOVIES, TELEVISION, AND BOOKS HAVE CONTRIBUTED TO THE POPULAR IMAGE OF MENTALLY ILL
PEOPLE AS
• CRAZY
• VIOLENT
• OUT OF CONTROL
•
SOME PEOPLE WHO ARE MENTALLY ILL MAY BEHAVE IN VIOLENT OR DANGEROUS WAYS, BUT
MOST DO NOT
•
THERE ARE MANY DIFFERENT TYPES OF MENTAL ILLNESS
•
MENTAL ILLNESS MAY BE TEMPORARY OR PERMANENT AND VARIES IN SEVERITY FROM PERSON TO
PERSON
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MENTAL HEALTH
7
MENTAL HEALTH
• SIMPLY PUT, MENTAL HEALTH IS THE ABSENCE OF MENTAL ILLNESS
• ONE OF THE MAIN QUALITIES OF MENTAL HEALTH IS A STATE OF EMOTIONAL BALANCE
• PHYSICAL HEALTH IS RELATED TO THE BODY’S ABILITY TO MAKE ADJUSTMENTS TO MAINTAIN
A STATE OF PHYSICAL BALANCE, OR HOMEOSTASIS
• SIMILARLY, MENTAL HEALTH IS CHARACTERIZED BY A PERSON’S ABILITY TO MAKE
ADJUSTMENTS TO MAINTAIN A STATE OF EMOTIONAL BALANCE
8
MENTAL STRESS
• LIFE EVENTS THAT CAUSE MENTAL STRESS INCLUDE:
• GETTING MARRIED
• GETTING DIVORCED
• STARTING A NEW JOB
• HAVING A BABY
• LOSING A LOVED ONE
• FOR MOST OF US, STRESS IS A CONSTANT IN OUR LIVES
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PHYSICAL STRESS
• STRESS, WHICH RESULTS FROM ANY CHANGE FROM THE NORMAL ROUTINE, AFFECTS A
PERSON’S ABILITY TO MAINTAIN A STATE OF BALANCE
• CHANGES THAT AFFECT US PHYSICALLY, SUCH AS ILLNESS OR DISABILITY, CAUSE PHYSICAL
STRESS
10
EFFECTS OF STRESS ON OUR SYSTEM
• STRESS THAT IS NOT MANAGED PROPERLY CAN AFFECT A PERSON’S PHYSICAL HEALTH, AS
WELL AS HIS MENTAL HEALTH
• FOR EXAMPLE, NOT BEING ABLE TO MANAGE STRESS CAN PUT A PERSON AT RISK FOR
• CARDIOVASCULAR PROBLEMS, SUCH AS A HEART ATTACK
• DIGESTIVE DISORDERS, SUCH AS ULCERS
11
STRESS: HOW MUCH IS TOO MUCH?
•
EACH PERSON HAS A LIMIT TO THE AMOUNT OF STRESS THAT SHE CAN EFFECTIVELY DEAL WITH AT ANY
GIVEN TIME
•
FATIGUE, ILLNESS, AND EVERYDAY STRESS SOMETIMES AFFECT OUR ABILITY TO COPE WELL WITH
CHANGE
•
MANY TIMES, STRESS DOES NOT COME FROM A SINGLE SOURCE
• A PERSON MAY BE ABLE TO COPE FAIRLY WELL WITH ONE TYPE OF STRESS, SUCH AS THE LOSS OF
A JOB…
• BUT WHEN OTHER STRESSES, SUCH AS A SICK CHILD, ARE ADDED, THE PERSON MAY REACH HIS
“BREAKING POINT”
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SIGNS OF EXCESSIVE STRESS
• THE PERSON MAY:
• CRY
• SLEEP EXCESSIVELY OR BE UNABLE TO SLEEP
• HAVE DIFFICULTY CONCENTRATING
• FEEL DEPRESSED FOR A TIME
• MOST PEOPLE WITH GOOD MENTAL HEALTH ARE ABLE TO EVENTUALLY OVERCOME THESE
FEELINGS AND REGAIN THEIR EMOTIONAL BALANCE
13
SIGNS OF STRESS
• THE MENTALLY ILL CANNOT COPE EFFECTIVELY WITH STRESS AND MAY BECOME UNABLE TO:
• WORK
• CARE FOR THEIR CHILDREN
• MAKE SIMPLE DECISIONS
• THINK CLEARLY, OR EVEN PROVIDE THEIR OWN SELF-CARE
• A MENTALLY ILL PERSON MAY NEED MEDICATION, COUNSELING, OR SUPPORT GROUPS TO
HELP REGAIN EMOTIONAL BALANCE
14
COPING MECHANISMS
• WHAT DO YOU DO WHEN YOU START TO FEEL OVERWHELMED OR “STRESSED OUT”?
• OVER TIME, MANY PEOPLE COME TO KNOW WHAT THEY CAN DO TO MAKE THEMSELVES
FEEL BETTER WHEN THEY START TO FEEL OVERWHELMED BY LIFE’S PRESSURES
• THESE CONSCIOUS AND DELIBERATE WAYS OF DEALING WITH STRESS ARE CALLED COPING
MECHANISMS
• WHEN A PERSON IS UNDER STRESS, THE MIND MAY TRY TO RETURN THE PERSON TO A STATE
OF EMOTIONAL BALANCE BY USING COPING MECHANISMS
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POSITIVE COPING MECHANISMS
• MANY PEOPLE RELY ON POSITIVE COPING MECHANISMS, SUCH AS:
• EXERCISE
• PRAYER
• MEDITATION
• GETTING TOGETHER WITH FRIENDS
• ENGAGING IN A HOBBY
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NEGATIVE COPING MECHANISMS
• OTHER PEOPLE RELY ON NEGATIVE COPING MECHANISMS, SUCH AS:
• NAIL BITING
• PACING
• OVEREATING OR NOT EATING ENOUGH
• SMOKING
• ABUSING DRUGS OR ALCOHOL
• INITIALLY, THESE BEHAVIORS MAY HELP THE PERSON TO REDUCE STRESS, BUT OVER TIME, THEY
PLACE THE PERSON AT RISK FOR SERIOUS PHYSICAL PROBLEMS, MENTAL PROBLEMS, OR BOTH
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DEFENSE MECHANISMS
• OUR BODIES ARE “PROGRAMMED” TO TRY AND RETURN TO A STATE OF BALANCE
• WHEN A PERSON IS UNDER STRESS, THE MIND MAY TRY TO RETURN THE PERSON TO A STATE
OF EMOTIONAL BALANCE BY USING DEFENSE MECHANISMS
• DEFENSE MECHANISMS ARE METHODS OF DEALING WITH STRESS THAT “JUST
HAPPEN”…USUALLY THE PERSON IS NOT EVEN AWARE THAT HE IS USING THEM
• DEFENSE MECHANISMS HELP TO PROTECT US FROM EMOTIONALLY TRAUMATIC EVENTS
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COMMON DEFENSE MECHANISMS
•
COMMON DEFENSE MECHANISMS INCLUDE:
• COMPENSATION
• CONVERSION
• DENIAL
• DISPLACEMENT
• PROJECTION
• RATIONALIZATION
• REGRESSION
• REPRESSION
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DEFENSE MECHANISMS: COMPENSATION
• COMPENSATION: TO MAKE UP FOR A LOSS BY “FILLING IN” OR “SUBSTITUTING” SOMETHING
ELSE
• FOR EXAMPLE, A PERSON WHO FEELS LONELY MAY EAT TOO MUCH (SUBSTITUTING FOOD
FOR AFFECTION)
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DEFENSE MECHANISMS: CONVERSION
• CONVERSION: CHANGING ONE THING INTO ANOTHER
• FOR EXAMPLE, A PERSON WHO IS DEPRESSED (AN EMOTIONAL PROBLEM) MAY DEVELOP A
STOMACH ACHE OR MIGRAINE HEADACHE (A PHYSICAL PROBLEM)
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DEFENSE MECHANISMS: DENIAL
• DENIAL: REFUSING TO BELIEVE SOMETHING THAT IS TRUE, ESPECIALLY IF THE TRUTH IS
UNPLEASANT
• FOR EXAMPLE, A PERSON WHO HAS BEEN DIAGNOSED WITH CANCER MAY TRULY BELIEVE
THAT THE DOCTOR HAS MADE THE WRONG DIAGNOSIS, AND THAT SHE DOES NOT HAVE
CANCER
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DEFENSE MECHANISMS: DISPLACEMENT
• DISPLACEMENT: SHIFTING AN EMOTION FROM ONE PERSON TO ANOTHER WHO IS LESS
THREATENING
• FOR EXAMPLE, A RESIDENT WHO IS ANGRY WITH HER DAUGHTER FOR MOVING HER TO A
LONG-TERM CARE FACILITY—AND WHO IS AFRAID OF EXPRESSING THIS ANGER BECAUSE
SHE FEARS THE DAUGHTER WILL ABANDON HER—MAY TAKE HER ANGER OUT ON THE
NURSING ASSISTANT INSTEAD
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DEFENSE MECHANISMS: PROJECTION
• PROJECTION: BLAMING SOMEONE ELSE FOR YOUR OWN UNCOMFORTABLE OR
UNACCEPTABLE ACTIONS OR FEELINGS
• FOR EXAMPLE, A RESIDENT MAY ACCUSE A NURSING ASSISTANT OF BREAKING A VASE WHEN
IN FACT, THE RESIDENT ACTUALLY BROKE THE VASE HERSELF
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DEFENSE MECHANISMS: RATIONALIZATION
• RATIONALIZATION: MAKING EXCUSES OR CREATING ACCEPTABLE REASONS FOR POOR
BEHAVIORS OR ACTIONS
• FOR EXAMPLE, A STUDENT WHO DOES NOT STUDY FOR A TEST AND THEN FAILS IT MAY TELL
HERSELF THAT THE REASON SHE FAILED IS BECAUSE THE TEACHER IS "TOO HARD"
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DEFENSE MECHANISMS: REGRESSION
• REGRESSION: TO TURN BACK TO A FORMER OR EARLIER STATE
• FOR EXAMPLE, AN OLDER CHILD WHO IS HOSPITALIZED BEGINS TO SUCK HIS THUMB
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DEFENSE MECHANISMS: REPRESSION
• REPRESSION (SUPPRESSION): THE REFUSAL TO REMEMBER OR THINK ABOUT A FRIGHTENING
OR PAINFUL MEMORY
• FOR EXAMPLE, A PERSON WHO WAS A VICTIM OF A TERRIBLE ACCIDENT OR CRIME MAY NOT
BE ABLE TO REMEMBER THE EVENT
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CAUSES AND TREATMENT OF MENTAL ILLNESS
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CAUSES OF MENTAL ILLNESS
•
THERE ARE MANY DIFFERENT TYPES OF MENTAL ILLNESS, AND MANY DIFFERENT CAUSES.
• SOME TYPES OF MENTAL ILLNESS RUN IN FAMILIES (THAT IS, THEY ARE INHERITED).
• OTHERS RESULT FROM CHEMICAL IMBALANCES IN THE CHEMICALS CALLED NEUROTRANSMITTERS.
• SOME MENTAL ILLNESSES MAY BE CAUSED BY A PERSON’S ENVIRONMENT (FOR EXAMPLE, A
PERSON WHO IS ABUSED BY A FAMILY MEMBER MAY DEVELOP INEFFECTIVE COPING OR DEFENSE
MECHANISMS THAT LEAD TO MENTAL ILLNESS).
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TREATMENT OF MENTAL ILLNESS
•
THE WORD PSYCHIATRIC COMES FROM THE GREEK WORDS PSYCHE (THE SOUL) AND IATREIA
(HEALING)
• A PSYCHIATRIST IS A MEDICAL DOCTOR TRAINED IN DIAGNOSING AND TREATING MENTAL ILLNESS.
A PSYCHIATRIST IS ALLOWED TO PRESCRIBE MEDICATIONS
• A PSYCHOLOGIST, WHILE NOT A MEDICAL DOCTOR, HAS EDUCATION AND TRAINING THAT
ALLOWS HIM TO PROVIDE COUNSELING SERVICES TO HELP PEOPLE WITH MENTAL ILLNESS. A
PSYCHOLOGIST IS NOT ALLOWED TO PRESCRIBE MEDICATIONS
•
DEPENDING ON THE PERSON’S SITUATION, HE MAY NEED THE SERVICES OF A PSYCHIATRIST, A
PSYCHOLOGIST, OR BOTH
•
WITH TREATMENT, MANY PEOPLE WITH MENTAL ILLNESSES ARE ABLE TO LEAD HAPPY, PRODUCTIVE LIVES
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TREATMENT FOR MENTAL ILLNESS
• TREATMENT FOR MENTAL ILLNESS HAS CHANGED DRAMATICALLY OVER THE LAST 50 YEARS
• IN THE PAST, MENTALLY ILL PEOPLE WERE USUALLY SENT TO SPECIAL HOSPITALS (“MENTAL
INSTITUTIONS”), WHERE THEY WERE GIVEN LARGE DOSES OF MEDICATIONS TO KEEP THEM
QUIET AND SEDATED
• TECHNIQUES SUCH AS ELECTRO-SHOCK THERAPY (PASSING ELECTRICITY THROUGH THE
BRAIN TO CAUSE A SEIZURE) AND LOBOTOMY (SURGICAL REMOVAL OF PART OF THE BRAIN)
WERE USED FREQUENTLY, OFTEN WITH LITTLE SUCCESS
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TREATMENT FOR MENTAL ILLNESS
•
NOW WE KNOW MORE ABOUT WHY MENTAL ILLNESSES OCCUR AND HOW THEY SHOULD BE TREATED
• MEDICATIONS ARE USED TO RESTORE THE BRAIN’S CHEMICAL BALANCE. RATHER THAN SIMPLY
SEDATING THE PERSON INTO SUBMISSION, THESE NEW MEDICATIONS HELP THE PERSON TO ACT
AND THINK MORE “NORMALLY”
• AND ELECTRO-SHOCK THERAPY, WHILE STILL USED IN SOME CASES, IS USED MUCH MORE
EFFECTIVELY
•
TREATMENT IS IMPORTANT BECAUSE WITH TREATMENT, MANY PEOPLE WITH MENTAL ILLNESS ARE ABLE
TO LEAD HAPPY, PRODUCTIVE LIVES. WITHOUT TREATMENT, THEY MAY SUFFER NEEDLESSLY AND MAY
EVEN BE AT RISK FOR SUICIDE
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TYPES OF MENTAL ILLNESS
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TYPES OF MENTAL ILLNESS
• THE MORE COMMON MENTAL ILLNESSES INCLUDE:
• ANXIETY DISORDERS
• DEPRESSION
• BIPOLAR DISORDER (MANIC DEPRESSION)
• SCHIZOPHRENIA
• EATING DISORDERS
34
MENTAL ILLNESSES: ANXIETY DISORDERS
• ANXIETY IS A FEELING OF UNEASINESS, DREAD, APPREHENSION, OR WORRY
• ANXIETY IS A NORMAL FEELING THAT WE HAVE IN RESPONSE TO SITUATIONS THAT ARE
THREATENING TO OUR BODY, LIFESTYLE, VALUES, OR LOVED ONES
• A CERTAIN LEVEL OF ANXIETY IS NORMAL AND MAY ACTUALLY LEAD US TO DO SOMETHING
POSITIVE ABOUT A BAD OR POTENTIALLY DANGEROUS SITUATION
• BUT TOO MUCH ANXIETY OR PROLONGED PERIODS OF ANXIETY CAN MAKE IT HARD FOR US
TO FUNCTION OR COPE WITH EVERYDAY SITUATIONS
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MENTAL ILLNESSES: ANXIETY DISORDER
• FEELINGS OF ANXIETY CAN CAUSE MANY PHYSICAL SIGNS AND SYMPTOMS, SUCH AS:
• SLEEPLESSNESS
• RESTLESSNESS
• FATIGUE
• CHANGES IN APPETITE
• INCREASED HEART RATE AND BLOOD PRESSURE
• IRRITABILITY
• DIFFICULTY THINKING CLEARLY
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COMMON ANXIETY DISORDERS
• COMMON ANXIETY DISORDERS INCLUDE:
• PANIC DISORDER
• OBSESSIVE–COMPULSIVE DISORDER
• PHOBIAS:
• SIMPLE PHOBIAS
• SOCIAL PHOBIAS
• AGORAPHOBIA
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ANXIETY DISORDER: PANIC DISORDER
•
•
•
•
PANIC IS A SUDDEN, OVERPOWERING FRIGHT
A PERSON WITH A PANIC DISORDER HAS TERRIFYING EPISODES OR “PANIC ATTACKS,” DURING WHICH
SHE EXPERIENCES:
• EXTREME ANXIETY
• FEELINGS OF INTENSE FEAR
A PERSON WHO IS HAVING A “PANIC ATTACK” USUALLY ALSO HAS PHYSICAL SIGNS AND SYMPTOMS,
SUCH AS
• CHEST OR ABDOMINAL PAIN
• A RAPID HEART BEAT
• SHORTNESS OF BREATH
• DIZZINESS
THESE SYMPTOMS MAY BE VERY SIMILAR TO THOSE OF A HEART ATTACK OR OTHER SEVERE PHYSICAL
ILLNESS
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ANXIETY DISORDER: PANIC DISORDER
• PANIC ATTACKS CAN BE VERY BRIEF, OR THEY MAY LAST FOR SOME TIME
• SOME PEOPLE WILL EXPERIENCE THESE ATTACKS RARELY WHILE OTHERS WILL HAVE THEM
QUITE OFTEN
• IT IS IMPORTANT TO REMEMBER THAT EVEN THOUGH THE PHYSICAL SYMPTOMS MAY NOT BE
A SIGN OF A SERIOUS PHYSICAL CONDITION, THEY ARE NO LESS REAL AND FRIGHTENING TO
THE PERSON WHO IS EXPERIENCING THEM
• BE COMPASSIONATE AND SUPPORTIVE (“THIS MUST BE VERY STRESSFUL FOR YOU; LOOK AT
ME AND TRY TO TAKE SOME DEEP BREATHS.”)
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ANXIETY DISORDER: OBSESSIVECOMPULSIVE DISORDER
•
OBSESSIVE–COMPULSIVE DISORDER IS AN ANXIETY DISORDER THAT CAUSES A PERSON TO SUFFER INTENSELY
FROM RECURRENT UNWANTED THOUGHTS (OBSESSIONS)
•
THE OBSESSIONS ARE USUALLY ASSOCIATED WITH RITUALS THAT THE PERSON CANNOT CONTROL
(COMPULSIONS)
•
THE RITUALS MAY INCLUDE ACTIONS SUCH AS:
• HAND WASHING
• COUNTING
• CHECKING
•
THE RITUALS ARE REPEATED OVER AND OVER AGAIN IN HOPES THAT THE OBSESSIVE THOUGHTS WILL GO
AWAY
40
ANXIETY DISORDER: OBSESSIVE–
COMPULSIVE DISORDER
• NOT PERFORMING THE RITUALS INCREASES A PERSON'S LEVEL OF ANXIETY
• WHEN IT IS SEVERE, OBSESSIVE–COMPULSIVE DISORDER TAKES OVER THE PERSON’S LIFE
• THE PERSON BECOMES UNABLE TO PERFORM THE TASKS THAT ARE ASSOCIATED WITH
NORMAL DAILY ACTIVITIES, BECAUSE OF HIS OBSESSIONS AND COMPULSIONS
41
ANXIETY DISORDER: PHOBIAS
•
A PHOBIA IS AN EXCESSIVE, ABNORMAL FEAR OF AN OBJECT OR SITUATION
•
PHOBIAS CAN BE INCREDIBLY DISABLING FOR THE PERSON AFFECTED BY THEM
•
THE PERSON WILL DO ANYTHING TO AVOID THE THING SHE IS AFRAID OF, TO THE POINT WHERE SHE
MAY BE UNABLE TO DO SOMETHING AS SIMPLE AS LEAVING THE HOUSE
•
THERE ARE THREE MAIN GROUPS OF PHOBIAS:
• SIMPLE PHOBIA
• SOCIAL PHOBIA
• AGORAPHOBIA
42
ANXIETY DISORDER: PHOBIAS
• SIMPLE PHOBIAS ARE THE MOST COMMON TYPE
• A PERSON WITH A SIMPLE PHOBIA IS ABNORMALLY AFRAID OF A SPECIFIC THING, FOR
EXAMPLE:
• DOGS OR CATS
• INSECTS
• HEIGHTS
• WATER
• FLYING IN AN AIRPLANE
43
ANXIETY DISORDER: PHOBIAS
• SOCIAL PHOBIAS INVOLVE A FEAR OF BEING HUMILIATED OR EMBARRASSED IN FRONT OF
OTHER PEOPLE
• SOCIAL PHOBIAS MAY BE RELATED TO:
• FEELINGS OF INFERIORITY
• LOW SELF-ESTEEM
• SOCIAL PHOBIAS MAY CAUSE A PERSON TO:
• DROP OUT OF SCHOOL
• AVOID MAKING FRIENDS
• REMAIN UNEMPLOYED
44
ANXIETY DISORDER: PHOBIAS
• AGORAPHOBIA IS THE FEAR OF HAVING A PANIC ATTACK IN A PLACE FROM WHICH THERE IS
NO EASY ESCAPE, AND WHERE HELP IS NOT AVAILABLE
• FOR EXAMPLE, A PERSON MAY BE INTENSELY AFRAID OF HAVING A PANIC ATTACK IN AN
ELEVATOR OR ON A CROWDED BUS
• A PERSON WITH AGORAPHOBIA REFUSES TO LEAVE THEIR HOME
45
POST TRAUMATIC STRESS DISORDER
• POST-TRAUMATIC STRESS DISORDER (PTSD) IS A TYPE OF ANXIETY DISORDER.
• IT CAN OCCUR AFTER YOU HAVE GONE THROUGH AN EXTREME EMOTIONAL TRAUMA THAT
INVOLVED THE THREAT OF INJURY OR DEATH.
46
DEPRESSION
• DEPRESSION IS A FEELING OF EXCESSIVE SADNESS OR HOPELESSNESS
• MANY EVENTS IN LIFE, SUCH AS THE LOSS OF A LOVED ONE, CAN CAUSE TEMPORARY
FEELINGS OF INTENSE SADNESS AND HOPELESSNESS
• IN A PERSON WITH GOOD MENTAL HEALTH, THE PAINFUL EMOTIONS OF AN EVENT-RELATED
DEPRESSION GO AWAY OVER TIME
• SOMETIMES, SHORT-TERM TREATMENT WITH MEDICATION OR COUNSELING MAY BE NEEDED
TO HELP THE PERSON THROUGH THE CRISIS
47
DEPRESSION
• SOME PEOPLE, HOWEVER, EXPERIENCE INTENSE FEELINGS OF SADNESS AND HOPELESSNESS
THAT DO NOT GO AWAY, EVEN WITH TIME
• THESE FEELINGS MAY OR MAY NOT BE BROUGHT ON BY A SAD EVENT, SUCH AS THE DEATH
OF A LOVED ONE
• WHEN DEPRESSION IS SEVERE AND PERSISTENT, IT IS CALLED CLINICAL DEPRESSION
48
CLINICAL DEPRESSION
• CLINICAL DEPRESSION IS ONE OF THE MOST COMMON MENTAL ILLNESSES
• IT AFFECTS MORE THAN 19 MILLION AMERICANS EACH YEAR
• SOME RESEARCH INDICATES THAT A FAMILY HISTORY OF CLINICAL DEPRESSION INCREASES A
PERSON’S RISK OF DEVELOPING THIS MENTAL ILLNESS
• WOMEN SEEM TO EXPERIENCE CLINICAL DEPRESSION ABOUT TWICE AS MUCH AS MEN DO
• CLINICAL DEPRESSION IS ALSO THE MOST FREQUENTLY TREATED MENTAL ILLNESS AMONG
ELDERLY PEOPLE
49
DEPRESSION
• SEVERAL FACTORS CAN LEAD TO THE DEVELOPMENT OF CLINICAL DEPRESSION, INCLUDING:
• CHEMICAL IMBALANCES IN THE BRAIN
• LOW SELF-ESTEEM AND POOR COPING SKILLS
• HORMONAL CHANGES, SUCH AS THOSE THAT AFFECT WOMEN DURING PREGNANCY,
MENSTRUATION, CHILDBIRTH, AND MENOPAUSE
• MEDICATIONS
50
DEPRESSION: SIGNS AND SYMPTOMS
• A PERSON WHO IS DEPRESSED LOSES INTEREST IN ACTIVITIES THAT SHE USUALLY FINDS
PLEASURABLE OR FULFILLING, SUCH AS:
•
•
•
•
EATING
WORKING
SOCIALIZING WITH FRIENDS
PURSUING HOBBIES
• THE PERSON MAY FEEL SAD OR ANXIOUS
• THE PERSON MAY CRY FREQUENTLY
51
DEPRESSION: SIGNS AND SYMPTOMS
• MANY PEOPLE WHO ARE DEPRESSED HAVE PROBLEMS WITH SLEEPING. THE PERSON MAY:
• SLEEP TOO MUCH
• SLEEP NOT ENOUGH
• THE PERSON MAY BE RESTLESS OR IRRITABLE
• INSTEAD OF BEING GRATEFUL WHEN SOMEONE TRIES TO HELP, THE PERSON MAY BECOME
ANGRY AND DEFENSIVE
• THE PERSON MAY HAVE FEELINGS OF GUILT AND WORTHLESSNESS
52
DEPRESSION: SIGNS AND SYMPTOMS
• THE PERSON MAY STRUGGLE WITH THOUGHTS OF DEATH OR SUICIDE
• PHYSICAL COMPLAINTS (E.G., OF PAIN OR A DIGESTIVE DISORDER) ARE ALSO COMMON
AMONG PEOPLE WHO ARE DEPRESSED
• PROMPT TREATMENT IS NEEDED TO HELP A CLINICALLY DEPRESSED PERSON RETURN TO AN
ENJOYABLE, PRODUCTIVE LIFE
53
DEPRESSION AND THE OLDER PERSON
• THE INCIDENCE OF DEPRESSION INCREASES WITH AGE
• ELDERLY PEOPLE ARE LESS LIKELY TO SEEK TREATMENT FOR THIS DISORDER
• MANY OLDER PEOPLE WHO ARE DEPRESSED FEEL THAT THEIR DEPRESSION IS JUST PART OF
GETTING OLDER, BUT THIS IS NOT TRUE!
• IF YOU WILL BE WORKING WITH OLDER PATIENTS OR RESIDENTS, PAY ATTENTION TO
CHANGES IN THEIR BEHAVIORS OR MOODS THAT MAY INDICATE CLINICAL DEPRESSION (SUCH
AS ISOLATION FROM OTHERS AND SLEEPING DIFFICULTIES)
• BY REPORTING THESE OBSERVATIONS TO THE NURSE, YOU PLAY AN IMPORTANT ROLE IN
HELPING TO ENSURE THAT THE PERSON RECEIVES TREATMENT THAT WILL HELP HIM FEEL
BETTER
54
BIPOLAR DISORDER
• BIPOLAR DISORDER (MANIC DEPRESSION) IS A MENTAL HEALTH DISORDER THAT CAUSES
MOOD SWINGS
• PERIODS OF EXCESSIVE HAPPINESS AND EXCITEMENT THAT MAY CAUSE THE PERSON TO
ENGAGE IN IMPULSIVE OR RECKLESS BEHAVIOR (MANIA) ARE FOLLOWED BY...
• PERIODS OF EXCESSIVE SADNESS AND HOPELESSNESS (DEPRESSION)
• EXPERTS BELIEVE THAT BIPOLAR DISORDER IS CAUSED BY CHEMICAL IMBALANCES IN THE
BRAIN THAT AFFECT A PERSON’S MOODS
55
SCHIZOPHRENIA
• SCHIZOPHRENIA CAN BE A VERY DISABLING FORM OF MENTAL ILLNESS
• IT TENDS TO RUN IN FAMILIES AND MAY HAVE A GENETIC BASIS
• SCHIZOPHRENIA MAY BE MILD OR SEVERE
• A PERSON WITH SEVERE SCHIZOPHRENIA THAT IS UNTREATED MAY BE A DANGER TO HIMSELF,
OR TO OTHERS
56
SCHIZOPHRENIA
• A PERSON WITH SCHIZOPHRENIA HAS TROUBLE DETERMINING WHAT IS REAL AND WHAT IS
IMAGINARY
• HE MAY SUFFER FROM DELUSIONS, OR FALSE IDEAS
• FOR EXAMPLE: THE PERSON MAY BELIEVE THAT:
• HE OR SHE IS SOMEONE FAMOUS
• SOMEONE IS SPYING ON HIM OR HER
• SOMEONE IS TRYING TO STEAL HIS OR HER BELONGINGS
57
SCHIZOPHRENIA
• A PERSON MAY EXPERIENCE HALLUCINATIONS, OR EPISODES WHERE HE OR SHE:
• SEES
• FEELS
• HEARS
• SMELLS OR
• TASTES SOMETHING THAT DOES NOT REALLY EXIST
• FOR EXAMPLE:
• THE PERSON MAY HEAR VOICES IN HIS HEAD TELLING HIM TO PERFORM A CERTAIN ACT
58
SCHIZOPHRENIA
•
•
•
•
THE PERSON’S THINKING AND SPEECH BECOMES DISORDERED
HE MAY SWITCH FROM ONE TOPIC TO ANOTHER DURING A CONVERSATION
HE MAY MAKE UP NEW WORDS OR PATTERNS OF SPEECH
THE PERSON MAY SAY OR DO VERY STRANGE THINGS, MAKING IT HARD FOR HIM TO
FUNCTION NORMALLY IN SOCIAL SITUATIONS
• A SCHIZOPHRENIC PERSON’S BEHAVIOR IS OFTEN VERY FRIGHTENING AND CONFUSING TO
OTHERS
• ATTEMPT TO UNDERSTAND WHAT THE PERSON IS EXPERIENCING AT THE MOMENT
• FIRST, ACKNOWLEDGE OR GIVE CONFIRMATION OF THEIR FEELINGS AND DISTRACT BACK TO
REALITY (AN EXAMPLE, “THAT SOUNDS VERY STRESSFUL FOR YOU, WOULD YOU LIKE TO
WALK DOWN TO THE LOUNGE.”)
59
EATING DISORDERS
•
TWO OF THE MOST COMMONLY KNOWN EATING DISORDERS ARE:
• ANOREXIA NERVOSA
• BULIMIA NERVOSA
•
ALL EATING DISORDERS INVOLVE SERIOUS AND POTENTIALLY FATAL CHANGES IN EATING BEHAVIOR, SUCH
AS:
• REDUCING THE AMOUNT OF FOOD EATEN TO ALMOST NOTHING
• SEVERE OVEREATING
•
EATING DISORDERS CAUSE MANY PHYSICAL PROBLEMS, INCLUDING KIDNEY FAILURE AND SERIOUS HEART
PROBLEMS THAT CAN LEAD TO DEATH
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EATING DISORDERS
• LIKE PEOPLE WITH OTHER MENTAL ILLNESSES, PEOPLE WITH EATING DISORDERS CANNOT
VOLUNTARILY CONTROL THEIR IMPULSES, AND THEY NEED TREATMENT TO HELP THEM LEARN
TO EAT NORMALLY AGAIN
• EATING DISORDERS USUALLY START DURING ADOLESCENCE OR EARLY ADULTHOOD
• WOMEN ARE AT HIGHER RISK THAN MEN FOR DEVELOPING AN EATING DISORDER
• MANY PEOPLE WHO SUFFER FROM DEPRESSION OR ANXIETY DISORDERS ALSO SUFFER FROM
EATING DISORDERS
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EATING DISORDERS: ANOREXIA NERVOSA
•
PEOPLE WITH ANOREXIA NERVOSA SEE THEMSELVES AS VERY OVERWEIGHT, EVEN THOUGH THEY
ARE EXCESSIVELY THIN
•
ANOREXIA (LOSS OF APPETITE) IS A KEY FEATURE OF THIS DISORDER
•
THE PERSON SIMPLY DOES NOT EAT ENOUGH FOOD
•
SHE WILL SKIP MEALS, TAKE TINY PORTIONS AT MEAL TIMES, OR MAKE EXCUSES FOR WHY SHE
CANNOT EAT
•
SHE MAY ONLY ALLOW HERSELF TO EAT SMALL AMOUNTS OF VERY "SAFE” LOW-CALORIE FOODS
•
MANY PEOPLE WITH ANOREXIA NERVOSA EXERCISE EXCESSIVELY
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EATING DISORDERS: BULIMIA NERVOSA
• A PERSON WITH BULIMIA NERVOSA REGULARLY EATS HUGE AMOUNTS OF FOOD (BINGING)
AND THEN INDUCES VOMITING OR USES LAXATIVES TO RID THE BODY OF THE FOOD BEFORE
IT IS DIGESTED (PURGING)
• A PERSON WITH BULIMIA NERVOSA OFTEN IS OF NORMAL WEIGHT FOR HER AGE AND
HEIGHT
• A PERSON WITH BULIMIA NERVOSA IS EXTREMELY FOCUSED ON HER BODY WEIGHT AND
SHAPE, AND BELIEVES THAT SHE IS EXCESSIVELY OVERWEIGHT
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CARING FOR A PERSON WITH MENTAL ILLNESS
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TREATMENT FACILITIES FOR THE MENTALLY
ILL
• TREATMENT FACILITIES FOR PEOPLE WITH MENTAL HEALTH DISORDERS DIFFER IN PURPOSE
• SOME FACILITIES PROVIDE A FORM OF LONG-TERM CARE FOR MENTALLY ILL PEOPLE WHO
CANNOT FUNCTION ON THEIR OWN AND NEED ASSISTANCE WITH ACTIVITIES OF DAILY
LIVING (ADLS) AND SAFETY
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TREATMENT FACILITIES FOR THE MENTALLY
ILL
• OTHER FACILITIES SPECIALIZE IN ACUTE CARE SERVICES AND PROVIDE CARE TO A PERSON
WHO IS EXPERIENCING A MENTAL CRISIS THAT MAY RESULT IN:
• ATTEMPTED SUICIDE
• DRUG OVERDOSE
• DANGER TO OTHERS
• AFTER THE CRISIS PHASE HAS PASSED, THE PERSON MAY BE ABLE TO RETURN HOME AND
RECEIVE TREATMENT ON AN OUTPATIENT BASIS
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TREATMENT FACILITIES FOR THE MENTALLY
ILL
• OUTPATIENT MENTAL HEALTH CLINICS SEE PEOPLE ON A REGULAR BASIS AND OFFER SERVICES
SUCH AS:
• COUNSELING
• MEDICATION
• SUPPORT GROUPS
• THEY MAY EVEN HELP THE PERSON TO OBTAIN:
• EDUCATION
• JOB TRAINING
• EMPLOYMENT
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CARING FOR A PERSON WITH MENTAL
ILLNESS
•
EVEN IF YOU CHOOSE TO WORK IN A FACILITY THAT DOES NOT SPECIFICALLY CARE FOR PEOPLE WITH
MENTAL ILLNESS, YOU MAY CARE FOR PEOPLE WHO HAVE OR DEVELOP MENTAL ILLNESS
•
THINK ABOUT THE STRESSES A PERSON IN A HEALTH CARE FACILITY EXPERIENCES:
• HE MAY HAVE FEARS OF BEING DISABLED OR DISFIGURED FROM ILLNESS OR INJURY
• HE IS SEPARATED FROM LOVED ONES AND IN AN UNFAMILIAR PLACE
• HE MAY BE WORRIED ABOUT THE LOSS OF A JOB AND INCOME
• HE MAY BE WORRIED ABOUT HIS CURRENT AND FUTURE HEALTH
•
ANY OF THESE ADDITIONAL EMOTIONAL STRESSES CAN PUSH A PERSON TOWARD MENTAL ILLNESS IF
HE HAS POOR OR INEFFECTIVE COPING MECHANISMS
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CARING FOR A PERSON WITH MENTAL
ILLNESS
•
ELDERLY PEOPLE ARE PARTICULARLY AT RISK FOR MENTAL ILLNESS
• THEY FACE THE LOSS OF SPOUSES, FRIENDS, AND SOMETIMES CHILDREN, OFTEN WITHIN A SHORT
PERIOD OF TIME
• THEY FACE RETIREMENT, WHICH CAN LEAD TO A LOSS OF STRUCTURE, ROUTINE, AND THE SENSE OF
IDENTITY THAT THEIR JOBS GAVE THEM
• THEY MAY FACE WORRIES ABOUT MONEY, ESPECIALLY IF THEY ARE LIVING ON A FIXED INCOME
• THEY FACE THE LOSS OF PHYSICAL ABILITIES AND INDEPENDENCE, EITHER AS A RESULT OF ILLNESS
OR THE NORMAL PROCESS OF AGING
• THEY MAY FEEL THAT THEY ARE A BURDEN TO THEIR FAMILIES
• THEY MAY FEAR THE NEED TO MOVE TO A LONG-TERM CARE FACILITY, BECAUSE OF THE
ASSOCIATED LOSS OF INDEPENDENCE
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CARING FOR A PERSON WITH MENTAL
ILLNESS
• LISTENING AND OBSERVATION SKILLS ARE VERY IMPORTANT WHEN YOU CARE FOR A
PERSON WITH MENTAL ILLNESS
• BE AWARE OF COMMENTS OR ACTIONS THAT MAY INDICATE THAT A PERSON IS THINKING
ABOUT SUICIDE, AND REPORT YOUR OBSERVATIONS IMMEDIATELY TO THE NURSE
• WHEN YOU NOTICE A CHANGE IN A PATIENT’S OR RESIDENT’S BEHAVIOR OR MENTAL STATUS
AND REPORT THIS CHANGE TO THE NURSE, YOU ARE TAKING THE FIRST STEP TOWARD
MAKING SURE THE PERSON GETS THE HELP HE NEEDS
• THE HEALTH CARE TEAM WILL WORK TO DETERMINE THE CAUSE OF THE PERSON’S CHANGE
IN BEHAVIOR, WHICH WILL LEAD TO PROMPT TREATMENT
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CARING FOR A PERSON WITH MENTAL
ILLNESS
• IN AN OLDER PERSON, A PHYSICAL PROBLEM CAN CAUSE BEHAVIOR THAT MAY BE SIMILAR
TO THAT SEEN IN PEOPLE WITH MENTAL ILLNESS
• NEVER JUST ASSUME THAT YOUR ELDERLY PATIENT OR RESIDENT IS JUST “ENTERING HIS
SECOND CHILDHOOD” OR BECOMING SENILE
• THE PERSON MAY HAVE A SERIOUS MENTAL OR PHYSICAL PROBLEM THAT NEEDS TO BE
TREATED
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CARING FOR A PERSON WITH MENTAL
ILLNESS
•
EXAMPLES OF PHYSICAL PROBLEMS THAT CAN CAUSE AN ELDERLY PERSON TO APPEAR TO BE MENTALLY
ILL INCLUDE:
• NERVOUS SYSTEM DISORDERS
• KIDNEY DISORDERS
• CHRONIC ILLNESSES, SUCH AS HYPERTENSION AND DIABETES
• HYPOTHYROIDISM
• ANEMIA
• EARLY SIGNS OF DEMENTIA
• INFECTIONS
• DEHYDRATION
• SIDE EFFECTS OF MANY MEDICATIONS
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CARING FOR A PERSON WITH MENTAL
ILLNESS
• IF YOU WORK IN A FACILITY THAT SPECIALIZES IN CARING FOR MENTALLY ILL PEOPLE, SPECIAL
METHODS OF RECORDING AND REPORTING MAY BE USED
• KNOW WHAT IS EXPECTED OF YOU AND HOW TO REPORT AND RECORD ACCORDING TO
FACILITY POLICY
• WHEN REPORTING AND RECORDING SUBJECTIVE INFORMATION ABOUT PATIENTS AND
RESIDENTS WITH MENTAL ILLNESSES, BE VERY CAREFUL TO:
• USE THE PERSON'S OWN WORDS
• AVOID ADDING YOUR OWN OPINIONS OR JUDGMENTS
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CARING FOR A PERSON WITH MENTAL
ILLNESS
• CERTAIN PHRASES OR WORDS MAY HAVE SPECIAL MEANING FOR A PARTICULAR PERSON
• TO ACCURATELY GAUGE THE PERSON’S MENTAL STATUS, THE HEALTH CARE TEAM WILL NEED
TO KNOW EXACTLY WHAT THE PERSON SAID
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CARING FOR A PERSON WITH MENTAL
ILLNESS
• MENTAL ILLNESS MAY AFFECT A PERSON’S ABILITY TO EAT, SLEEP, REST, OR MANAGE ROUTINE
GROOMING AND HYGIENE
• PEOPLE WITH MENTAL ILLNESSES WILL NEED DIFFERENT LEVELS OF ASSISTANCE WITH THEIR
ADLS, DEPENDING ON THE SEVERITY OF THEIR DISORDERS
• ALWAYS HELP TO PROMOTE THE PERSON'S INDEPENDENCE BY ALLOWING THE PERSON TO
PROVIDE AS MUCH OF HIS OWN SELF-CARE AS POSSIBLE
• SOME MENTAL ILLNESSES AFFECT A PERSON'S ABILITY TO THINK THROUGH THE STEPS OF
ROUTINE CARE. YOU MAY NEED TO GENTLY REMIND THE PERSON OF WHAT STEP COMES
NEXT
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SUBSTANCE ABUSE
• SOME PEOPLE ARE ABLE TO USE RECREATIONAL OR PRESCRIPTION DRUGS WITHOUT EVER
EXPERIENCING NEGATIVE CONSEQUENCES OR ADDICTION.
• FOR MANY OTHERS, SUBSTANCE USE CAN CAUSE PROBLEMS AT WORK, HOME, SCHOOL, AND
IN RELATIONSHIPS, LEAVING YOU FEELING ISOLATED, HELPLESS, OR ASHAMED.
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• PEOPLE EXPERIMENT WITH DRUGS FOR MANY DIFFERENT REASONS. MANY FIRST TRY DRUGS
OUT OF CURIOSITY, TO HAVE A GOOD TIME, BECAUSE FRIENDS ARE DOING IT, OR IN AN
EFFORT TO IMPROVE ATHLETIC PERFORMANCE OR EASE ANOTHER PROBLEM, SUCH AS STRESS,
ANXIETY, OR DEPRESSION.
• USE DOESN’T AUTOMATICALLY LEAD TO ABUSE, AND THERE IS NO SPECIFIC LEVEL AT WHICH
DRUG USE MOVES FROM CASUAL TO PROBLEMATIC. IT VARIES BY INDIVIDUAL.
• DRUG ABUSE AND ADDICTION IS LESS ABOUT THE AMOUNT OF SUBSTANCE CONSUMED OR
THE FREQUENCY, AND MORE TO DO WITH THE CONSEQUENCES OF DRUG USE.
• NO MATTER HOW OFTEN OR HOW LITTLE YOU’RE CONSUMING, IF YOUR DRUG USE IS
CAUSING PROBLEMS IN YOUR LIFE—AT WORK, SCHOOL, HOME, OR IN YOUR
RELATIONSHIPS—YOU LIKELY HAVE A DRUG ABUSE OR ADDICTION PROBLEM.
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• RISK FACTORS THAT INCREASE YOUR VULNERABILITY INCLUDE:
• FAMILY HISTORY OF ADDICTION
• ABUSE, NEGLECT, OR OTHER TRAUMATIC EXPERIENCES IN CHILDHOOD
• MENTAL DISORDERS SUCH AS DEPRESSION AND ANXIETY
• EARLY USE OF DRUGS
• METHOD OF ADMINISTRATION—SMOKING OR INJECTING A DRUG MAY INCREASE ITS ADDICTIVE
POTENTIAL
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COMMON SIGNS AND SYMPTOMS OF DRUG ABUSE
• YOU’RE NEGLECTING YOUR RESPONSIBILITIES AT SCHOOL, WORK, OR HOME (E.G. FLUNKING
CLASSES, SKIPPING WORK, NEGLECTING YOUR CHILDREN) BECAUSE OF YOUR DRUG USE.
• YOU’RE USING DRUGS UNDER DANGEROUS CONDITIONS OR TAKING RISKS WHILE HIGH,
SUCH AS DRIVING WHILE ON DRUGS, USING DIRTY NEEDLES, OR HAVING UNPROTECTED SEX.
• YOUR DRUG USE IS GETTING YOU INTO LEGAL TROUBLE, SUCH AS ARRESTS FOR DISORDERLY
CONDUCT, DRIVING UNDER THE INFLUENCE, OR STEALING TO SUPPORT A DRUG HABIT.
• YOUR DRUG USE IS CAUSING PROBLEMS IN YOUR RELATIONSHIPS, SUCH AS FIGHTS WITH
YOUR PARTNER OR FAMILY MEMBERS, AN UNHAPPY BOSS, OR THE LOSS OF OLD FRIENDS.
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COMMON SIGNS AND SYMPTOMS OF DRUG
ADDICTION
• YOU’VE BUILT UP A DRUG TOLERANCE. YOU NEED TO USE MORE OF THE DRUG TO EXPERIENCE THE SAME EFFECTS YOU USED TO
ATTAIN WITH SMALLER AMOUNTS.
• YOU TAKE DRUGS TO AVOID OR RELIEVE WITHDRAWAL SYMPTOMS. IF YOU GO TOO LONG WITHOUT DRUGS, YOU EXPERIENCE
SYMPTOMS SUCH AS NAUSEA, RESTLESSNESS, INSOMNIA, DEPRESSION, SWEATING, SHAKING, AND ANXIETY.
• YOU’VE LOST CONTROL OVER YOUR DRUG USE. YOU OFTEN DO DRUGS OR USE MORE THAN YOU PLANNED, EVEN THOUGH YOU
TOLD YOURSELF YOU WOULDN’T. YOU MAY WANT TO STOP USING, BUT YOU FEEL POWERLESS.
• YOUR LIFE REVOLVES AROUND DRUG USE. YOU SPEND A LOT OF TIME USING AND THINKING ABOUT DRUGS, FIGURING OUT HOW TO
GET THEM, AND RECOVERING FROM THE DRUG’S EFFECTS.
• YOU’VE ABANDONED ACTIVITIES YOU USED TO ENJOY, SUCH AS HOBBIES, SPORTS, AND SOCIALIZING, BECAUSE OF YOUR DRUG USE.
• YOU CONTINUE TO USE DRUGS, DESPITE KNOWING IT’S HURTING YOU. IT’S CAUSING MAJOR PROBLEMS IN YOUR LIFE—BLACKOUTS,
INFECTIONS, MOOD SWINGS, DEPRESSION, PARANOIA—BUT YOU USE ANYWAY.
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PHYSICAL WARNING SIGNS OF DRUG ABUSE
• BLOODSHOT EYES, PUPILS LARGER OR SMALLER THAN USUAL
• CHANGES IN APPETITE OR SLEEP PATTERNS. SUDDEN WEIGHT LOSS OR WEIGHT GAIN
• DETERIORATION OF PHYSICAL APPEARANCE, PERSONAL GROOMING HABITS
• UNUSUAL SMELLS ON BREATH, BODY, OR CLOTHING
• TREMORS, SLURRED SPEECH, OR IMPAIRED COORDINATION
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BEHAVIORAL SIGNS OF DRUG ABUSE
• DROP IN ATTENDANCE AND PERFORMANCE AT WORK OR SCHOOL
• UNEXPLAINED NEED FOR MONEY OR FINANCIAL PROBLEMS. MAY BORROW OR STEAL TO GET
IT.
• ENGAGING IN SECRETIVE OR SUSPICIOUS BEHAVIORS
• SUDDEN CHANGE IN FRIENDS, FAVORITE HANGOUTS, AND HOBBIES
• FREQUENTLY GETTING INTO TROUBLE (FIGHTS, ACCIDENTS, ILLEGAL ACTIVITIES)
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PSYCHOLOGICAL WARNING SIGNS OF DRUG ABUSE
• UNEXPLAINED CHANGE IN PERSONALITY OR ATTITUDE
• SUDDEN MOOD SWINGS, IRRITABILITY, OR ANGRY OUTBURSTS
• PERIODS OF UNUSUAL HYPERACTIVITY, AGITATION, OR GIDDINESS
• LACK OF MOTIVATION; APPEARS LETHARGIC OR “SPACED OUT”
• APPEARS FEARFUL, ANXIOUS, OR PARANOID, WITH NO REASON
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WARNING SIGNS OF TEEN DRUG ABUSE
• HAVING BLOODSHOT EYES OR DILATED PUPILS; USING EYE DROPS TO TRY TO MASK THESE SIGNS
• SKIPPING CLASS; DECLINING GRADES; SUDDENLY GETTING INTO TROUBLE AT SCHOOL
• MISSING MONEY, VALUABLES, OR PRESCRIPTIONS
• ACTING UNCHARACTERISTICALLY ISOLATED, WITHDRAWN, ANGRY, OR DEPRESSED
• DROPPING ONE GROUP OF FRIENDS FOR ANOTHER; BEING SECRETIVE ABOUT THE NEW PEER
GROUP
• LOSS OF INTEREST IN OLD HOBBIES; LYING ABOUT NEW INTERESTS AND ACTIVITIES
• DEMANDING MORE PRIVACY; LOCKING DOORS; AVOIDING EYE CONTACT; SNEAKING AROUND
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ALCOHOL WITHDRAWAL
• ALCOHOL WITHDRAWAL SYNDROME IS A POTENTIALLY LIFE-THREATENING CONDITION THAT CAN OCCUR IN
PEOPLE WHO HAVE BEEN DRINKING HEAVILY FOR WEEKS, MONTHS, OR YEARS AND THEN EITHER STOP OR
SIGNIFICANTLY REDUCE THEIR ALCOHOL CONSUMPTION.
• ALCOHOL WITHDRAWAL SYMPTOMS CAN BEGIN AS EARLY AS TWO HOURS AFTER THE LAST DRINK, PERSIST
FOR WEEKS, AND RANGE FROM MILD ANXIETY AND SHAKINESS TO SEVERE COMPLICATIONS, SUCH AS
SEIZURES AND DELIRIUM TREMENS (ALSO CALLED DTS). WHICH ARE CHARACTERIZED BY CONFUSION,
HALLUCINATIONS (SEEING CRAWLING BUGS ON ARMS), RAPID HEARTBEAT, AND FEVER.
• BECAUSE ALCOHOL WITHDRAWAL SYMPTOMS CAN RAPIDLY WORSEN, IT'S IMPORTANT TO SEEK MEDICAL
ATTENTION EVEN IF SYMPTOMS ARE SEEMINGLY MILD. APPROPRIATE ALCOHOL WITHDRAWAL TREATMENTS
CAN REDUCE THE RISK OF DEVELOPING WITHDRAWAL SEIZURES OR DTS.
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