Mental Illness

An Understanding of Depression,
Mania and
Schizophrenia

Meghan M. Mc Keough
Linfield College School of Nursing
 What is a mental illness?

It is when someone lacks the ability to

manage day to day events and/or
control their behavior so that basic
physical and emotional needs are
threatened or unmet.
These disorders can affect persons of any
age, race, sex, religion, or income.

Mental illnesses are not the result of a

personal weakness, lack of character, or poor
upbringing.
 Why should I care?
 Because understanding of mental health
issues brings awareness to the community
and our surrounding environment.

 We will become a society that is accepting

of others who do not fit our idea of a
perfect population.
What is mental illness like?
Mental illness is a
physical condition just
like asthma or arthritis.

But still society believes

that a person who is
mentally ill needs to
show more willpower -
to be able to pull
themselves out it.
…..It is also like
telling a person
who has an
amputated leg to
run across the
room.

But a person who has mental health issue

has a “broken brain”.
 Myths of Mental Illness
 Mental illness is caused by bad parenting.
Fact: Most diagnosed individuals come from
supportive homes.

 The mentally ill are violent and dangerous.

Fact: Most are victims of violence.

 People with a mental disorder are not smart.

Fact: Numerous studies have shown that many
have average or above average intelligence.
 Mental Illnesses
in our Community

 Depression
 Mania
 Schizophrenia
Depression
 What is Depression?
Depression is a medical issue that affects
a persons mood to be down, blue and/or
fed up.

Depression is the most common mood

disorder, affecting approximately 20 million
people each year.
 Signs and Symptoms of
Depression
 Fatigue or loss of energy  Persistent sad, anxious or
 Thoughts of death or empty mood
suicide, including suicide  Sleeping too much or too
attempts little; odd time of waking
 Feeling guilty, hopeless  Reduced or increased
or worthless appetite which results in
 Difficulty concentrating, weight gain or loss.
remembering or making  Irritability or restlessness
decisions
 What factors causes
depression?
There is no single cause of
depression.

But here are some factors

that may contribute to it’s
development:
 Psychological
 Biological
 Environment
 Evidence also suggests.
Scientists have also found evidence which makes some people
with a genetic predisposition to major depression vulnerable to
the disorder. However not everyone with a family history
develops depression.

Some life event that may trigger episodes of depression:

 Death of a loved one
 Major loss or change
 Chronic stress
 Alcohol and drug abuse
 Heart disease and cancer
 medications
 How does depression work?
The way we respond to situations (with thoughts
of hopelessness, anxiety, anger, etc.) effects
the emotions we feel, which in turn, effects the
chemicals that are released within our body.

And all emotional responses have a chemical

consequence. Serotonin, a neurotransmitter
(body chemical), is a major contributor in the
depression cycle.
 Serotonin
When a person is depressed, their serotonin level
is low, which causes several changes to the
body:

1. Pain Threshold Lowered: A depressed person feels more pain

from no apparent source.
(back pain is very common amongst sufferers)

2. Sleep Disturbance: A depressed persons day runs on an average

of 22 hours, not 24. And there are many spikes in temperature
throughout the night which causes a person to wake many times,
resulting in not getting any REM sleep.
The Cycle of Depression
How Can I Help A Person With
Depression?
Be sensitive to their feelings, and validate those
feelings.
Teach emotion-coping skills:
 Acknowledge and express emotions.
 Remind the person to challenge irrational thoughts and write them
down in a journal.
 Teach that for every one negative thought they need to think of two
positive thoughts.
Teach problem-solving skill:
 Help determine importance of problem while keeping down their
stress and anxiety
 Break problem into small chunks
 Remind the person that it is ok to ask for help
 Mania
(bipolar disorder)
 What is Mania?
Mania is part of a condition called bipolar
disorder, also known as manic-depression.

Bipolar disorder usually causes a person’s mood

to alternate between symptoms of depression
and mania, a heightened energetic state.

This mood disorder affects more than two million

Americans.
 Signs and Symptoms of
Mania
 Increased physical and  Racing speech and
mental activity & energy thoughts; flight of ideas
 Excessive irritability,  Impulsiveness, poor
aggressive behavior judgment
 Decreased need for  Reckless behavior: erratic
sleep; without driving, sexual
experiencing fatigue indiscretions, spending
 Exaggerated optimism sprees
and self-confidence  Grandiose delusions
 What Causes Mania?
 The neurotransmitters: Norepinephrine, dopamine, and
serotonin, have been studied since the 1960s as factors
in mania and depression.

 For example, during a manic episode, clients with bipolar

disorder have a significantly higher Norepinephrine and
epinephrine levels than a depressed or euthymic (normal
mood) person.

 Norepinephrine and epinephrine

are responsible for
“fight or flight” responses.
How Can I Help a Person Who
is Manic?
 Use a firm and calm  Firmly redirect energy
approach when into more appropriate
communicating: and constructive
“Lower your voice behavior.
Don, or you will lose
______ privilege.”  Do not yell or sound
threatening, the goal
 Remain neutral; avoid is to try to keep
power struggles and anxiety down in a
don’t cast judgments. person who exhibits
mania.
Schizophrenia
 What is Schizophrenia?
Schizophrenia is a chronic and severe brain disorder.

It is a disease that makes it difficult for a person to tell

the difference between real and unreal experiences, to
think logically, to have appropriate emotional
responses to others, aspects of memory and to act
appropriately in social situations.

The World Health Organization (WHO) has identified

schizophrenia as one of the ten most debilitating
diseases affecting all human beings.
Symptoms of Schizophrenia
The severity of
symptoms varies from
one person to
another, and typically
symptoms will decline
and then reappear.

Symptoms are divided

into Positive and
Negative symptoms.
 Positive Symptoms
Positive symptoms are characterized by abnormal thoughts,
perceptions, language and behavior.

 Delusions: False beliefs/thoughts win no basis in reality

 Hallucinations: Disturbances of sensory perception (hearing, seeing or
feeling things not there)
 Disorganized Thinking/Speech: Jumping from topic to topic,
responding to questions with unrelated answers or speaking incoherently
 Disorganized Behavior:Problems in performing directed daily
activities.
 Catatonic Behavior: Lowered environmental awareness,
unresponsiveness, rigid posture, resistance to movement or instructions and
inappropriate postures.
 Negative Symptoms
Negative symptoms are characterized by restrictions in
range and intensity of emotional expression,
communication, body language and interest in normal
activities.

 Blunted (or flat) Affect: Decreased emotional expressiveness,

unresponsive immobile facial appearance, reduced eye contact and body
language.
 Alogia: Reduced speech. Responses are detached and speech is not
fluid.
 Avolition: Lacking motivation, spontaneity, initiative. Sitting for lengthy
periods or ceasing to participate in work or daily activities.
 Anhedonia: Lacking Pleasure or interest in activities that were once
enjoyable.
 Attention Deficit: Difficulty in concentrating
What Causes Schizophrenia?
There is no one cause to this
complex and puzzling illness, but
it is believed that some
combination of genetic, biological
(virus, bacteria, or an infection)
and environmental factors play a
major role.
John Nash, a famous
Schizophrenic. His life
There is currently no reliable way to story made into a film,
A Beautiful Mind.
predict whether a person will
develop the disease.
 What Occurs in the Brain of
Someone with Schizophrenia?
Researchers believe an imbalance of
neurotransmitters may cause the symptoms of
schizophrenia. Two neurotransmitters that have
most been implicated as abnormal in
schizophrenia are dopamine and serotonin.

The ability to produce images have helped in

identifying structural and functional differences in
a schizophrenic brain versus a normal brain.
 From The Looks of It
Schizophrenic brain Normal brain

Ventricles

Brian imaging has shown a difference in:

 Enlargement of the ventricle
 Decrease in the hippocampus (controls emotional and
working memory)
 Decrease in overall size
 Abnormal development of pre-frontal cortex (forehead
region; controls information process, motivation, problem solving,
decision making, and thinking speed)
How Can I Help a Person With
Schizophrenia
The following guidelines may be useful when talking to a
person whose speech is confused and disorganized.

1. Do not pretend that you understand the persons words or

meaning when you are confused
2. Tell the person that you are having difficulty understanding what
they are trying to communicate
3. Place the difficulty of understanding upon yourself “I’m having
trouble following what you are saying.” not “You are not making
any sense.”
4. Tell the person what you do understand; reinforce clear
communication.
5. Keep their anxiety down by: a calm voice and firm direction
 Treatment
With all three of these illnesses,
treatment, with the right
combination of medications
and/or therapy, can help
stabilize the
moods that
interfere with
a productive
life.
 Conclusion
Overall, mental health is an
issue that effects
everyone.

And hopefully, throughout

the years, education will
curve the sigma of these
brain disorders so that
hate, bias judgment and
discrimination will be
gone.
 For More Information
Web sites that are worth a visit.

 National Alliance for the Mentally Ill:

http://www.nami.org
 National Alliance for Research on Schizophrenia and Depression:
http://www.narsad.org
 American Foundation for Suicide Prevention: http://www.afsp.org
 American Psychiatric Association:
http://www.psych.org
 Anxiety Disorders Association of America: http://www.adaa.org
 Bazelon Center for Mental Health Law:
http://www.bazelon.org
 National Institute of Mental Health: http://www.nimh.nih.gov