Module 2: The Role of a Servant in Dealing with Mental Health

Introduction

See recording.

Human Psyche

Three components in the Human Psyche, and the three are very much connect.

• Intellect or Cognition
• Affect or Mood
• Behavior or Will

If intellectually, I feel that someone will attack me. Emotionally, I will be scared or angry. And then behaviorally, I may run or fight (fight or flight). The intellect affects the emotion which affects the behavior.

Cognitive Behavior Therapy treats the three components.

Psychiatric Symptoms

Why should we understand the psychiatric symptoms? As leaders, we will be presented with many problems. 

A parent with a child who has a fever, who does not act, and the child is hospitalized or dies, the parent will be charged with neglect.

• We know much about physical problems - nausea, stomach ache, etc. I will go to the doctor.
• We know much about spiritual problems - sin, lying, etc. I will go to the priest.
• The problems of the soul (psyche) are not well known to most of us. As we are well versed in the physical and spiritual, so too must we become well versed in the psychiatric.

Mood

• Mood refers to how I'm feeling now. Affect refers to what people see.
  • A disconnect between the mood and the affect is common in schizophrenia
• Mood can be high or low (depression)
• Depression
  • Depression means "down"
  • Diagnosing depression requires two weeks of continuous non-stop symptoms
    • Depressed mood most of the day, nearly every day
    • Diminished interest or pleasure
    • Significant weight loss when not dieting, or weight gain
    • Insomnia or hypersomnia
    • Psychomotor agitation or retardation
    • Fatigue or loss of energy
    • Feeling of worthlessness or excessive inappropriate guilt
    • Diminished ability to think or concentrate, or indecisiveness
      • Remember that the mood is related to the intellect/cognition, so it can affect it
    • Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
• Mania
  • Opposite of Depression
  • Opposite Symptoms
    • Inflated self-esteem or grandiosity
    • Decreased need for sleep (e.g. feels rested after only 3 hours of sleep)
    • More talkative than usual or pressure to keep talking
      • Circumstantial speech
      • Talking for several hours (even through text, emails, YouTube, etc.)
    • Flight of ideas or subjective experience that thoughts are racing
      • Giving extreme details, losing track of what he's saying
    • Distractibility (i.e. attention too easily drawn to unimportant or irrelevant external stimuli)
    • Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
    • Excessive involvement in pleasurable activities that have a high potential for painful consequences
      • Buying sprees
      • Sexual indiscretions
      • Foolish business investments)
• Causes of Mood Disorders
  • Genetic predisposition
    • Most common cause
    • Exterior Stressors may bring up the issue
  • Hormonal
  • Neurotransmitters
  • Medical Problems
    • e.g. Low thyroid or high thyroid
  • Stressors
  • Drugs
    • Stimulants can bring manic disorders
    • Some medications can cause depression
• Treatment of Mood Disorders
  • Mania/Bipolar: Mood stabilizers
  • Depression: Antidepressants

Psychosis (Intellect)

• Psychosis is anything related to a disturbance in reality testing
• Biggest Symptoms
  • Delusions
    • False and fixed belief that does not conform with culture, circumstances, etc.
    • Paranoid Delusions
      • Persecutory (someone is after me)
        
      • Grandeur (e.g. someone who thinks they are St Mary)
      • Influence (e.g. someone who believes that his thinking is being controlled by some satellites, some agency, etc.)
    • A delusion, by definition, is FIXED - you cannot talk them out of it
  • Hallucinations 
    • I can have a hallucination in any of the five senses
      • Auditory
        • Most common
      • Visual
        • Usually from drugs, delirium
      • Tacticle
        • E.g. feel things crawling on your skin (like with cocaine use)
      • Gustatory
      • Olfactory
        

ADHD (Attention Deficit/Hyperactivity Disorder)

• 10% of kids have ADHD (some measures say 20%)
• 85% of cases caused by genetics. Other 15% is caused by medical illness (e.g. brain infection, head injury, etc.) 
• ADHD is NOT overly diagnosed. This is a theory
• Symptoms
  • Inattention (six or more of the following)
    • Often fails to give close attention to details or makes careless mistakes
    • Often has difficulty sustaining attention
    • Often does not seem to listen when spoken to directly
    • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
    • Often has difficulty organizing tasks and activities
    • Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
    • Often loses things necessary for tasks or activities
    • Is often easily distracted by extraneous stimuli
    • Is often forgetful in daily activities
  • Hyperactivity/Impulsivity (six or more of the following)
    • Often fidgets with or taps hands or feet or squirms in seat
    • Often leaves seat in situations when remaining seated is expected
    • Often runs about or climbs in situations where it is inappropriate, or, in adolescents or adults, often feels restless
      
    • Often unable to play or engage in leisure activities quietly
    • Is often "on the go" acting as if "driven by a motor"
    • Often talks excessively
    • Often blurts out an answer before a question has been completed
    • Often has difficulty waiting his or her turn
    • Often interrupts or intrudes on others
• ADHD when mistreated leads to anxiety and low self-esteem
  • Imagine driving a car without brakes... and everyone is telling you to hit the brake, or putting you in time-out or yelling at you because you're not hitting the brakes.
  • Kids without treatment end up in very big trouble after:
    • Anxiety
    • Low Self-Esteem
    • Rebellion
  • We have to break the cycle