Transcript Signs & Symptoms of Mental Illness & Substance use Disorders

SIGNS & SYMPTOMS
OF MENTAL ILLNESS
& SUBSTANCE USE
DISORDERS
Goal:
 Learn about the different types of mental illness
and substance abuse disorders.
 Identify the signs of mental illness and develop
an effective approach to addressing individuals
who present with these symptoms.
Objectives:
• Learn about and be able to describe anxiety disorders,
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mood disorders, thought disorders, and substance
abuse disorders.
Learn the signs and symptoms of anxiety disorders,
mood disorders, thought disorders, and substance
abuse disorders.
Learn how to respond to suicidal & homicidal threats
Learn effective strategies for approaching an individual
who is experiencing symptoms of mental illness and/ or
substance abuse disorders.
Learn how and where to send an individual for
professional help.
Why is this topic important?
 According to the National Alliance on Mental
Illness, almost two and a half million Ohioans
suffer from a mental disorder in any given year.
 The Global Burden of Disease study, conducted
by the World Health Organization, the World
Bank and Harvard University, reported that
mental illness is second only to cardiovascular
disease in regard to societal burden, including
years of life lost to premature death or disability.
Impact of Disorders
Impact of Disorders
The Cost to Ohioans
The cost of untreated mental illnesses is
immense, with direct and indirect
costs to Ohio totaling more than $6.5
billion a year.
The Cost to Ohioans
 Missed educational opportunities and failure in school
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58% percent of children with mental illness do not graduate from high
school.
 Lost productivity and unemployment
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Employees who are depressed are twice as likely to miss work and seven
times more likely to be less productive on the job.
 Increased crime and incarceration
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More than half of Ohio’s inmates have some type of mental illness; 12
percent are diagnosed with a severe mental illness.
Most youth in juvenile justice facilities have a diagnosable mental health
disorder.
The Cost to Ohioans
 Inappropriate use of hospital emergency departments
 Comprehensive
community-based mental health
services can dramatically reduce public hospital
admissions and lengths of stay.
 Premature death, including suicide
 In
Ohio, more than 1,300 lives are lost to suicide each
year, and the average life span of a person with a
severe mental illness is 25 years shorter than for
someone without this illness.
What is Mental Illness?
A mental illness is a medical condition that disrupts a
person's:
• thinking,
• feeling, mood,
• ability to relate to others and
• daily functioning.
Just like physical illnesses, mental illnesses exist on a
continuum
A Continuum of Health
Mild
Headache
Severe
Headache
Migraine
Brain
Tumor
Prevalence of Disorders
Anxiety Disorders – 18.1%
Mood Disorders – 9.5%
Substance Use Disorders – 3.8%
Schizophrenia – 1.1%
Symptoms
 Symptoms are the internal experience of an illness;
 Feeling
hopeless, worthless, lethargic, & suicidal are
symptoms of depression
 People will often report physical symptoms rather than
emotional symptoms
Signs
 Signs are the external manifestation of an individual’s
symptoms or experience ;
 Significant changes in appetite, mood & sleep, or
irritability & talking about death or dying are signs of
possible depression
 These may be much easier for us to see
Mood Disorders
 Mood disorders are a group of mental illnesses that
cause significant disturbances in a persons mood
 Approximately 9.5% of the population will experience a
mood disorder in a given year
Mood disorders are split into 2 broad categories;
 Depressive Disorders – Can be mild, moderate, or
severe
 Bipolar Disorders
Most Common Mood Disorders
 Major Depressive Disorder
 The
leading cause of disability in the US for ages 15-
44
 Major depressive disorder affects approximately 6.7
percent of the U.S. population age 18 and older in a
given year
 Bi-Polar Disorder
 Bipolar disorder affects approximately 2.6 % of the
U.S. population age 18 and older in a given year.
Major Depressive Disorder
Major depression is an illness that goes well beyond
temporarily feeling sad or blue. It is a serious medical
illness that affects one’s thoughts, feelings, behavior,
mood and physical health.
 The leading cause of disability in the US for ages 15-44.
 Affects approximately 6.7% of the population in a given
year.
Major Depressive Disorder
 SIGNS –
 Depressed mood
 Sadness
 Social withdrawal
 Poor concentration
 Fatigue
 Unexplained physical aches & pains
 Appetite disturbances
 Increasing drug or alcohol use
 Irritability
Major Depressive Disorder
 SYMPTOMS –
 Sadness
 Feelings of worthlessness & hopelessness
 Insomnia
 Lack of motivation
 Excessive guilt
 Thoughts of suicide
 Increasing drug or alcohol use
 Frequent crying
Bipolar Disorder
 Bipolar disorder affects approximately 2.6 % of the U.S.
population in a given year.
 This mental illness causes unusual and dramatic shifts
in mood, energy and the ability to think clearly.
 Bipolar disorder is a chronic illness with recurring
episodes of mania and depression that can last from
one day to months.
Bipolar Disorder
 SIGNS OF MANIA  Extreme irritability and/or euphoria,
 Agitation or anger
 Surges of energy
 Talkativeness
 Risk taking behavior (AOD use, impulsivity)
 Grandiose ideas or delusions
 Rapid speech
 Lack of insight & follow through
Bipolar Disorder
 SYMPTOMS OF MANIA
 Reduced need for sleep
 Euphoria
 Feeling agitated
 Significant increase in energy
 Excitability
Anxiety Disorders
 Anxiety disorders are a group of mental illnesses that
cause people to feel:
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excessively frightened,
distressed, or
uneasy during situations in which most other people would
experience these same feelings.
not
 Approximately 18.1% of the population will experience an
anxiety disorder in a given year.
Most Common Anxiety Disorders
 Panic Disorder
 Obsessive-Compulsive Disorder
 Post-Traumatic-Stress-Disorder
Panic Disorder
 Panic disorder is an anxiety disorder characterized by
frequent panic attacks.
 A panic attack is an uncontrollable panic response to
ordinary, nonthreatening situations.
 Signs & symptoms of a panic attack include sweating; hot or cold flashes; choking or smothering
sensations; racing heart; labored breathing;
trembling; chest pains; faintness; numbness; nausea;
disorientation; or feelings of dying, losing control, or
losing one's mind.
Obsessive Compulsive Disorder
 OCD is an anxiety disorder characterized by the
presence of obsessions (internal) & compulsions
(external).
 Obsessions are intrusive, irrational thoughts;
 unwanted ideas or impulses that repeatedly appear
in a person's mind, i.e. "I may have left the gas stove
on; I need to go check it fast"
 Compulsions are repetitive rituals;
 such as hand washing, counting, checking, hoarding
or arranging
Post Traumatic Stress Disorder
 PTSD is an anxiety disorder than can develop after
experiencing a traumatic event.
 Signs & Symptoms of PTSD;
 Persistent
Re-experiencing; Nightmares, flashbacks,
intrusive thoughts, persistent remembering
 Avoidant/Numbness Responses ; efforts to avoid feelings,
locations or triggers associated with the trauma
 Increased Arousal; Exaggerated startle response, difficulty
sleeping, difficulty concentrating
Thought Disorders
 A thought disorder is evident when an individual has
serious problems with thinking, feelings, and behavior
 The primary cluster of symptoms in a thought disorder
are psychotic symptoms, indicating a loss of contact
with reality
 The most common thought disorder is Schizophrenia,
which affects 1.1% of the population in a given year
Schizophrenia
 1/3 of individuals will experience one episode psychotic
episode, another 1/3 will experience multiple episodes,
with no symptoms in between episodes, and the last
1/3 will experience persistent psychotic symptoms
throughout the lifespan
 Schizophrenia is one of the least common disorders,
but can be the most disabling.
 Without early intervention, long term functioning can
be severely impaired.
Schizophrenia
 SIGNS –
 False belief about self or others (delusions)
 Paranoia
 Hearing or seeing non-existent things (hallucinations),
 Disconnected speech or thinking
 Flat affect
 Feelings that don’t match the situation
 Difficulty in conversations due to incoherance or
disorganization
Schizophrenia
 SYMPTOMS –
 Confusion
 Feeling of mistrust, paranoia
 Hallucinations
 Delusions
 Lack of motivation, depression
Substance Use Disorders
 Addiction/Chemical dependency
 Substance abuse
Substance Abuse
 A maladaptive pattern of substance use leading
to clinically significant impairment or distress.
Substance Abuse
 SIGNS & SYMPTOMS –
 Increasing drug or alcohol use
 Failure to maintain major role obligations
 Substance use when it is physically hazardous
 Substance related legal problems
 Substance use when it causes interpersonal impairment
Addiction / Substance Dependence
 A chronic relapsing condition characterized by
compulsive drug-seeking and abuse and by longlasting chemical changes in the brain
Addiction / Substance Dependence
SIGNS & SYMPTOMS –
Increased use
Tolerance for substance
Withdrawal symptoms
Attempts to quit using
Using more or for longer than intended
Much time/activity to obtain, use, recover
Important social, occupational, or recreational activities
given up or reduced
 Use continues despite knowledge of adverse consequences
(e.g., failure to fulfill role obligation, use when physically
hazardous)
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Withdrawal Symptoms
 Abnormal physical or psychological features that follow
the abrupt discontinuation of a drug that has the
capability of producing physical dependence.
 Common withdrawal symptoms include
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sweating,
tremors,
vomiting,
anxiety,
insomnia, and
muscle pain.
Suicidal Ideation
 Characterized as a spectrum that ranges from
fleeting suicidal thoughts to completed suicide
 Suicidal ideation is more common than suicide
attempts or completed suicide.
General Risk Factors
 Family history of suicide
 Past attempts
 Male, white, age greater than 65 years
 Widowed or divorced
 Living alone; no children under the age of 18 in the
household
 Presence of stressful life events
 Access to firearms
Psychiatric Risk Factors
 90 percent of completed suicides in all age groups are
associated with psychiatric disorders, including
substance abuse.
 The most common psychiatric disorders associated
with completed suicide are major depression and
alcohol abuse
Suicide Rates 1993 - 2010
Suicide Facts
Every 13.7 minutes someone in the United States dies by suicide.
 Nearly 1,000,000 people make a suicide attempt every year.
 90% of people who die by suicide have a diagnosable and
treatable psychiatric disorder at the time of their death.
 Most people with mental illness do not die by suicide.
 Recent data puts yearly medical costs for suicide at nearly $100
million.
 Men are nearly 4 times more likely to die by suicide than
women. Women attempt suicide 3 times as often as men.
 Suicide rates are highest for people between the ages of 40 and
59.
Warning Signs
 Observable signs of serious depression:
 Unrelenting low mood
 Pessimism
 Hopelessness
 Desperation
 Anxiety, psychic pain and inner tension
 Withdrawal/ isolation
 Sleep problems
 Increased alcohol and/or other drug use
 Recent impulsiveness and taking unnecessary risks
Warning Signs
 Threatening suicide or expressing a strong wish to die
• Making a plan:
Giving away prized possessions
• Sudden or impulsive purchase of a firearm
• Obtaining other means of killing oneself such as
poisons or medications
 Unexpected rage or anger
 Improvement in mood
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How To Approach
 Always pick a private time & place when you won’t be
rushed, & the person you are approaching will feel
comfortable
 Do not presume you understand what they are going
through or where they are coming from
 Open the door for the person to speak openly about
what they may be experiencing – listen
 Let them speak about what may be going on
What To Say?
 Share your observations about their behaviors, & any
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signs of mental illness or substance use disorders you
have noticed
Invite them to do most of the talking
Do not judge
Stick to ‘I statements’ – “I’ve noticed you haven’t been
hanging out as much lately, is something going on?”
Use language that is comfortable for you
Have referral information ready for them
Refrain from giving advice
What to Say?
 Be prepared for the person to resist you – they may not
be ready to talk yet.
 Set yourself up as a person who will provide consistent
emotional support & understanding – they may come
back to you later.
 If the person is in a crisis situation – ensure that you
have the appropriate information you may need ready
for them.
Where to Access Help
 211 – Often a good starting point for referrals.
 Mental health agencies – Comprehensive services for
mental health needs, drug & alcohol treatment.
 Private Practices – For individual counseling needs.
Private insurance often needed, some have sliding scale
available.
 Hospitals – Emergency care, crisis situations, stabilization
services, some long term supports.
 Peer support groups – For both mental health & drug &
alcohol needs.
Local Resources
 Mobile Crisis – 216. 623.6888
 ADAMHS Board – 216. 241.3400
 Recovery Resources – 216.431.4131
 NAMI – 216.875. 7776
 CIT Trained Police Officers – For Crisis Situations
Recovery
 The recovery journey is unique for each
individual.
 There are several definitions of recovery; some
grounded in medical and clinical values, some
grounded in context of community and some in
successful living.
 RECOVERY IS A PROCESS, NOT AN EVENT.
Mental Health First Aid
 Over 100,000 people trained since 2008
 Over 500 trained by Recovery Resources
 Adult and Youth versions
 Learn more at www.recres.org
 Contact Johni Fiber at 216.431.4140 for
more information
Other Trainings with Recovery Resources
 Health and Wellness
 Verbal De-escalation Training
 Leadership and teamwork development
 Sexual Harassment Prevention
 Drug Free Safety Program Training
 Employees
 Supervisors
 Train the Trainer
 Policy review and development
 Drug screening