Understanding Mental Illness Understanding Mental Illness A Review of the DisordersA Review of the Disorders

Paul Knoll, PhD, LMHC, CAPPaul Knoll, PhD, LMHC, CAP

DirectorDirector

Recovery Center, TMHRecovery Center, TMH

431-5012431-5012

* Passed in 1971, the Florida Mental Health Act, known as the Baker Act (after Rep. Maxine Baker) went into effect the following year.

* Established Patients Bill of Rights, prohibited placement in county jails, and mandated court appointed attorneys to represent individuals.

* Involuntary admission for individuals with mental health issues (e.g. suicidal or homicidal).

* Ensures due process rights are protected

The Baker Act

* Without care, the person is likely to suffer from neglect; might seriously harm himself or others, based on recent behavior.

* Initiated by family members (ex parte court order), law enforcement officers, medical professionals , psychologists or counselors.

* If at risk, held in a receiving facility for 72 hours.

* After 72 hours, patient re-evaluated and released for outpatient treatment, or continued care if still at risk.

The Baker Act

* Clinically significant behavioral problems* Clinically significant behavioral problems

* Associated with distress (painful symptoms) * Associated with distress (painful symptoms)

* Causes * Causes disability (impairment in functioning)disability (impairment in functioning)* A biological illness that responds to treatment* A biological illness that responds to treatment

* Not to be confused with weakness of character* Not to be confused with weakness of character

Clinical definition :Clinical definition :

Defining Mental IllnessDefining Mental Illness

General Signs of Mental IllnessGeneral Signs of Mental Illness

ObservableObservable

ConfusionConfusion

DisorientedDisoriented

Darting looks Darting looks

Talking to selfTalking to self

Poverty of SpeechPoverty of Speech

Pressured speechPressured speech

Poor hygienePoor hygiene

Inappropriate attireInappropriate attire

Behavior Changes Behavior Changes

Flat Affect Flat Affect

WithdrawnWithdrawn

Sad or anxious moodSad or anxious mood

PanicPanic

Psycho somatic Psycho somatic complaintscomplaints

SchizophreniaSchizophreniaSymptomsSymptoms

* Brain disease * Brain disease

* Includes psychosis* Includes psychosis

* Impacts 1 out of every 100 people. * Impacts 1 out of every 100 people.

Does not differentiate across SEXDoes not differentiate across SEX

* Onset is late teens, early adulthood.* Onset is late teens, early adulthood.

* Positive Symptoms include :* Positive Symptoms include :

- hallucinations- hallucinations

- delusional thinking- delusional thinking

* Negative symptoms include* Negative symptoms include

- apathy - apathy

- withdrawal- withdrawal..

SymptomsSymptoms* Affects 5 percent of the general population* Affects 5 percent of the general population* Sad mood that lasts 2 weeks* Sad mood that lasts 2 weeks* Loss of interest or pleasure in daily activities* Loss of interest or pleasure in daily activities* Changes in sleep, appetite, decreased energy* Changes in sleep, appetite, decreased energy* Thought problems affect concentration, * Thought problems affect concentration,

memory, decisions, feelings of guilt, memory, decisions, feelings of guilt, worthlessnessworthlessness

* Risk of suicide is high* Risk of suicide is high* Important to differentiate mental health * Important to differentiate mental health

from physical problemsfrom physical problems* Responds well to treatment* Responds well to treatment

Mood DisordersMood DisordersMajor DepressionMajor Depression

SymptomSymptom

* Euphoric Mood (elevated, high or happy)* Euphoric Mood (elevated, high or happy) * Irritable Mood (touchy)* Irritable Mood (touchy) * Three Stages of Mania: Hypomania, Acute * Three Stages of Mania: Hypomania, Acute

Mania, PsychosisMania, Psychosis * Bipolar Disorder - mood swings from * Bipolar Disorder - mood swings from depression to maniadepression to mania * Can be Rapid Cycling* Can be Rapid Cycling

Mood DisordersMood DisordersMania/ Bipolar DisorderMania/ Bipolar Disorder

SymptomsSymptoms

* Prevalence is 1 to 2 percent of the population; * Prevalence is 1 to 2 percent of the population; Women twice as high as men.Women twice as high as men.

* Panic attacks occur without warning* Panic attacks occur without warning

* Symptoms include intense fear, heart * Symptoms include intense fear, heart palpitations, chest pain,palpitations, chest pain,

shortness of breath, dizzinessshortness of breath, dizziness

* Person is concerned that the attacks will strike again* Person is concerned that the attacks will strike again

Anxiety DisordersAnxiety DisordersPanic DisordersPanic Disorders

SymptomsSymptoms

ObsessionsObsessions are recurrent thoughts, images, impulses are recurrent thoughts, images, impulses that cause anxiety. They are illogical,at times that cause anxiety. They are illogical,at times repulsive and/or center on violence or harm.repulsive and/or center on violence or harm.

Compulsions Compulsions are behaviors that are repetitive - are behaviors that are repetitive - attempts at reducing the anxiety created by the attempts at reducing the anxiety created by the obsessions.obsessions.

Anxiety DisordersAnxiety DisordersObsessive-Compulsive DisorderObsessive-Compulsive Disorder

SymptomsSymptoms

* Exposure to an extremely stressful event.* Exposure to an extremely stressful event.

* Painful memories, nightmares,, suspicion, * Painful memories, nightmares,, suspicion, anxiety, depression, feelings of guilt and sleep anxiety, depression, feelings of guilt and sleep difficultiesdifficulties

* Symptoms worsen with exposure to similar * Symptoms worsen with exposure to similar eventsevents

* Substance abuse is a common method to cope* Substance abuse is a common method to cope

Symptoms Symptoms

* Lack of privacy and loss of control are issues* Lack of privacy and loss of control are issues

* PTSD can be trigger years after the event* PTSD can be trigger years after the event

Post Traumatic Stress DisorderPost Traumatic Stress Disorder

* Inflexible, maladaptive, * Inflexible, maladaptive, ways of coping and relating ways of coping and relating

* Difficulty in holding steady * Difficulty in holding steady work and relationshipswork and relationships

* Difficult to change* Difficult to change

* Can co -exist with other * Can co -exist with other mental illnessesmental illnesses

* Behavior problems* Behavior problems

precipitate jailprecipitate jail

AntisocialAntisocial

NarcissisticNarcissistic

BorderlineBorderline

AvoidantAvoidant

ParanoidParanoid

DependentDependent

SchizotypalSchizotypal

SchizoidSchizoid

PersonalityPersonality DisordersDisorders

SymptomsSymptoms

85% of population have substance abuse problems 85% of population have substance abuse problems

High correlation of substance abuse and other mental High correlation of substance abuse and other mental illnessesillnesses

Symptoms Symptoms

Monitor risk of OD or withdrawalMonitor risk of OD or withdrawal

Monitor abuse of prescription drugsMonitor abuse of prescription drugs

Can mimic other Mental illnessesCan mimic other Mental illnesses

Long term abuse can cause dementiaLong term abuse can cause dementia

Substance AbuseSubstance Abuse

SymptomsSymptoms

* Memory problems* Memory problems

* Confabulations* Confabulations

* Impaired thinking* Impaired thinking

* Impaired Judgment* Impaired Judgment

* Poor memory and may not follow directions* Poor memory and may not follow directions

* Treat individual as you would any with a* Treat individual as you would any with a disabilitydisability

Dementia Dementia and other Cognitive Disordersand other Cognitive Disorders

* Presence of both a mental * Presence of both a mental illness and substance illness and substance abuse disorderabuse disorder

* High prevalence rates* High prevalence rates

* 60% of persons with a mood * 60% of persons with a mood disorder also have a disorder also have a substance abuse disordersubstance abuse disorder

* 50% of persons with * 50% of persons with schizophrenia also have a schizophrenia also have a substance abuse disordersubstance abuse disorder

Co-occurring DisordersCo-occurring Disorders