The document discusses adjustment disorders and strategies to help prevent and manage them. It defines adjustment disorders as short-term disturbances in response to an identifiable stressor. Common symptoms can include depressed mood, anxiety, behavioral changes, and physical problems. Risk factors include life stressors, personality traits, coping skills, and social support. Prevention strategies encourage healthy lifestyle habits, self-care, developing a support system, and seeking help from a healthcare provider if needed.
The document discusses the nature and treatment of various anxiety disorders such as panic disorder, social anxiety disorder, and PTSD. It presents the case of Jason S., a 21-year-old college student experiencing panic attacks, and suggests he meets the criteria for panic disorder. Treatment options discussed include cognitive-behavioral therapy with exposure-based strategies, relaxation techniques, medication, and integrating biological, psychological, and environmental factors.
Suicide Prevention and Addiction - January 2014Dawn Farm
“Suicide Prevention and Addiction” was presented on Tuesday January 28, 2014; by Raymond Dalton, MA; Dawn Farm Outpatient Services Coordinator. There is an alarmingly high prevalence of suicide among people with addiction and people in early recovery. This program will raise awareness of the signs of suicidal thinking and describe ways to offer support and obtain help for people who may be contemplating suicide. Viewers will learn how to recognize suicidal thinking, reach out and offer support to others contemplating suicide, obtain help when suicidal thoughts are present, and access local and national suicide prevention and intervention resources. This program is part of the Dawn Farm Education Series, a FREE, annual workshop series developed to provide accurate, helpful, hopeful, practical, current information about chemical dependency, recovery, family and related issues. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please see http://www.dawnfarm.org/programs/education-series.
This document discusses stress, resilience, and stress management. It provides definitions of stress from historical figures. It describes the body's stress response and how stress can impact health. It discusses signs of chronic stress and adrenal fatigue. The document also outlines lifestyle factors like nutrition, exercise, and sleep that impact stress levels and provides stress management techniques.
This document discusses depression and suicide prevention. It begins with introductions and an icebreaker activity. It then defines depression and lists its symptoms. Risk factors for suicide are outlined, including previous attempts, substance abuse, and family history. Protective factors like family support and problem solving skills are also identified. Early and late warning signs of suicide risk are provided. The document presents two case studies and questions for assessing suicide risk. It concludes by discussing prevention efforts and their effectiveness.
This document discusses chronic pain and its impact on families. It covers topics like what chronic pain is, how substance abuse and mental health issues can be intertwined, and the role of families. Families of those with chronic pain may experience isolation, loss of support systems, and increased daily stress. Chronic pain can disrupt relationships and become the organizing force in a family. The document also discusses trauma and its definitions, as well as qualitative inquiry methods like portraiture and family mapping. Several case examples are provided to illustrate challenges families face and potential treatment strategies.
This document discusses family relationships and communication. It provides advice on listening skills, boundaries, stages of change, and strategies for helping family members make positive changes. The key points are:
1) Effective family communication requires talking, listening, expressing feelings, adapting to change, and spending quality time together. Listening skills like asking open-ended questions and reflecting feelings are important.
2) Setting boundaries regarding physical, emotional, and spiritual interactions helps define appropriate relationships. Ambivalence about changes needs to be explored to increase commitment.
3) The stages of change include identifying issues, learning skills, and getting needs met. Resistance can be overcome by asking evocative questions, exploring goals and values, and coming alongside
This document discusses stress, including its causes, effects on the body, symptoms, management strategies, and the importance of resilience. It notes that over 1/3 of Americans report extreme stress and its health impacts can include heart disease, asthma, obesity and more. Stress responses are controlled by the endocrine system and can result in increased heart rate, sweating and other physical or emotional symptoms. Managing stress involves awareness, balance, and control through assertiveness, organization, social support, and healthy lifestyle habits like exercise and sleep. Developing resilience through relationships and community involvement can also help cope with stressors.
This document discusses teen depression, dispelling myths and providing facts. It begins with an introduction by the school counselor and prompts students to think about what depression looks like. The agenda includes defining depression, discussing diagnostic criteria like duration and intensity of symptoms, potential causes like genetics and life stressors, a wide range of signs and symptoms, preventative strategies like healthy lifestyle habits, ways to help a depressed friend through compassionate listening, treatment options including therapy and medication, and resources for further information. The presentation encourages feedback and questions.
OBJECTIVES:
If I were starting an adolescent treatment center what would I want to make sure adolescents and families learn?
Identify and Describe How Families Arrive at your door.
To Demonstrate the Power of Family Mapping and the Art and Science of Portraiture.
Clinical and Reverse Interventions - what are these and how to do?
Share Standard Vocabulary Families need to know Family Change Agreements - What are these - when to use?
This document contains statistics on suicide rates in India from 1995 to 2008 by age group and year. It also lists various risk factors for suicide such as domestic/economic problems, lack of self-esteem, academic pressure, and health issues. Warning signs of suicide are discussed like giving away possessions or social withdrawal. Strategies to prevent suicide include building self-esteem, seeking counseling, mentoring programs, and addressing stressors.
Teen depression has different symptoms than adult depression. Teens may feel irritable and angry rather than sad, and experience physical pains like headaches. Left untreated, teen depression can lead to problems like failing grades at school, reckless behavior, drug addiction, and even suicide. It is important for parents to seek help from a medical professional if their teen exhibits signs of depression like withdrawal, changes in eating or sleeping, and feelings of worthlessness. Talking to a depressed teen and encouraging them to express their emotions can also provide relief while they undergo counseling and therapy treatment.
The document discusses the key physical, psychological, and social changes that occur during adolescence. It describes the hormonal changes of puberty and their effects on physical development, mood, and sexual desires. It also addresses common problems adolescents face, like anxiety over physical changes, idealizing celebrities, experimenting sexually, and conflicts with parents over independence.
This document discusses stress, what it is, and its effects. It defines stress as a normal reaction to events or thoughts that make one feel anxious or frustrated. Our thoughts about situations, not just the events themselves, determine whether we perceive something as stressful. Stress can be positive in small amounts by motivating us, but too much stress can harm our health. The document outlines common sources of stress including the environment, social roles, physiological factors, and thoughts. It also discusses signs of stress overload and various physical and mental effects stress can have on the body and brain.
This is the guidebook I wish I had when I was first learning about addiction and mental health disorders when I was a young woman.
It’s the book I give to every client who walks through my door. It is Family Focused, Practical, Hopeful and full of real life examples to help you understand and have the courage to change your experience.
OBJECTIVES
To Talk about Family, Friends, & Recovery
To Show Ways in Which Family and Friends May Engage In Healthy Communications
To Demonstrate ways in which Families, Friends can take care of themselves
1. The document discusses lovesickness, which refers to physical and psychological symptoms that arise from rejected, unrequited, or absent love.
2. Lovesickness shares symptoms with mental health issues like depression, OCD, and anxiety but is often misdiagnosed because it is not widely recognized as its own condition. Common symptoms include mania, loss of appetite, insomnia, and obsessive thoughts.
3. The document provides strategies for managing lovesickness, such as maintaining a healthy lifestyle, spending time with others, focusing on personal growth, and seeking medical help if symptoms become severe.
This document discusses childhood depression, including its definition, symptoms, types, stages, treatment, and an example case study. Childhood depression is defined as feelings of depression that persist and interfere with a child's ability to function. Symptoms can include irritability, appetite changes, sleep issues, concentration problems, and suicidal thoughts. Treatment focuses on counseling and therapy rather than medication alone, with the goal of changing negative thoughts to more positive ones. The case study describes a 17-year-old girl's experience with depression since age 12 and her mother's supportive role in her treatment and recovery.
How do you discover joy and gratitude and move forward in life with purpose and hope? We explore these and other issues related to addiction, mental health, chronic pain, and trauma.
This document discusses stigma related to mental illness. It begins by asking the reader questions about their own experiences with stigma and discrimination. It then discusses how stigma affects those with mental health problems, including negatively impacting patients. The presentation goes on to define stigma and explain theories for why it occurs, including stereotyping, media portrayal, and the process of labelling. It provides statistics on how common stigma is and its effects, such as creating barriers to accessing healthcare. Next, it shares stories from two individuals discussing their experiences with mental illness and the stigma they faced. It concludes by asking how stigma can be reduced through doctors, individuals, and society listening without judgment and viewing patients as experts in their own conditions.
The document discusses coping with tragic events in the news and addressing concerns that these events may cause. It provides guidance on talking to children and students about tragedies and signs of concerning behaviors. While mental illness is associated with violence in some cases, it is not a reliable predictor on its own. The document recommends open communication, reassuring children about safety, focusing on helpers after tragedies, and self-care strategies like exercise and talking to a counselor to manage anxiety.
This document discusses ministering to children in crisis and grief situations. It covers the nature of crisis and grief, the phases of grief, and guidelines for ministry. Specific crises covered include child maltreatment, substance abuse in the family, depression and suicide, divorce and separation, children and violence, and death and bereavement. Risk factors, signs, and intervention strategies are provided for each crisis.
This document discusses depression, including its symptoms, causes, and ways to get help. It notes that depression is a common and serious mood disorder that negatively impacts how one feels, thinks and acts. It affects daily life more than just feeling sad. The document outlines emotional, physical and cognitive symptoms of depression. It also discusses various causes like abuse, medications, conflicts and illnesses. Finally, it emphasizes the importance of seeking help from parents, medical professionals and mental health counselors, as depression should not be handled alone. Treatment options may include therapy and medication prescribed by a psychiatrist.
This document provides information on anger management. It discusses understanding stress and its effects, as well as strategies for managing anger. Biological, psychological, and social factors that influence behavior and stress responses are examined. Tools for managing anger include relaxation techniques like deep breathing and progressive muscle relaxation. Maintaining an hostility log, using positive thinking, and seeking social support are also presented as anger management strategies.
[Behav. sci] stress management presentationMuhammad Ahmad
This document discusses stress, its causes, symptoms, and impacts on mental and physical health. It defines stress as the reaction people have to excessive pressures or demands, and notes that stress occurs when pressure is greater than resources. The document outlines Hans Selye's stress response theory involving alarm, adaptation, and exhaustion phases. It identifies common stress triggers and provides self-help strategies for managing stress such as positive thinking, assertiveness, organization, social support, humor, and lifestyle changes like diet and exercise.
Mental health refers to psychological well-being and the ability to think, feel, and act in a positive manner. A healthy mind is capable of experiencing a full range of emotions, deals with reality as it is, accepts oneself and others, and is open to new ideas. Mental illness or disorders affect how a person thinks, feels, and behaves and can be caused by biological, psychological, social and environmental factors. Common signs of mental illness include changes in self-care, mood, sleep, and social interactions. Examples of mental disorders discussed include depression, bipolar disorder, schizophrenia, obsessive-compulsive disorder, and obsessive-compulsive personality disorder.
The document discusses stigma associated with mental illness. It notes that stigma involves negative stereotypes and attitudes that label people with mental illness as less worthy. These attitudes are perpetuated by misrepresentations in media and a lack of understanding. The document outlines various factors that contribute to stigma, including fear, economic issues, lack of treatment facilities, and cultural beliefs. It also discusses the negative impacts of self-stigma, discrimination, and social exclusion that people with mental illness often face. Interventions like social contact and education are mentioned as ways to potentially help address stigma.
Presentation 218 sabrina schalley anticipatory grief in als familiesThe ALS Association
This document discusses anticipatory grief experienced by families facing a terminal illness like ALS. It defines anticipatory grief as the grief felt in response to being aware of a life-threatening illness in oneself or a loved one. The document outlines factors that influence the intensity of anticipatory grief and common symptoms like sadness, fear, anxiety and guilt. It also discusses challenges like witnessing a loved one's decline and benefits like the ability to say goodbye. The document promotes normalizing grief and provides the EASE model for supporting families through education, assessment, support and exploring needs and strengths.
Depression and suicide causes and remedies [autosaved]sajeena81
This document discusses causes and remedies for teen depression and suicide. It notes that depression can cause difficulties functioning and motivation if left untreated. Symptoms may include sadness, hopelessness, and suicidal thoughts. Risk factors for suicide in teens include mental health issues, impulsivity, stressful life events, family problems, and exposure to suicidal behavior of others. Warning signs include changes in behavior, thoughts of death, and making suicide plans. Treatment options include therapy and medication to effectively treat depression and prevent suicide. Schools can support depressed students by developing relationships with them, avoiding negative techniques, making academic adjustments, planning for success, and consulting mental health professionals.
Here are the key points to include in your poster/drawing about the importance of being mentally healthy:
- Good mental health allows you to function comfortably in society and cope with life's realities. It denotes a sound state of mind.
- It's important to deal positively with reality, regardless of whether the situation is good or bad. This is part of emotional health, which is a component of mental health.
- How you feel affects how you think and act. Maintaining a positive mindset can help manage stress and emotions.
- A mentally healthy person can enjoy simple pleasures, experience a full range of emotions, accept themselves and others, and remain open to new ideas.
- Practicing self-care
Mental Health and Coping With Stress in Middle and Late Adolescence.pdfJoyDelaPea5
This document provides information on mental health and coping with stress during adolescence. It defines mental health and discusses various mental health challenges such as depression, anxiety, eating disorders, and others. It also discusses self-esteem, body esteem, and what influences these. The document outlines causes of stress and strategies for coping, including recognizing stress, identifying support systems, and maintaining well-being. Statistics on mental health issues among youth are also presented.
The document discusses mental health and mental illness. It defines mental health as encompassing outlook, relationships, self-image, and ability to handle stress and emotions. Mental illnesses exist on a continuum from mild problems to serious conditions. About 1 in 5 teens experience mental health problems annually and 1 in 17 Americans have a serious mental illness. Common mental illnesses include depression, bipolar disorder, and schizophrenia. The document provides warning signs of mental illness and emphasizes that treatment through medication, therapy, and lifestyle changes can help with recovery. It aims to reduce stigma by noting that mental illness can affect anyone and is not their fault.
1. The document discusses various causes and indicators of stress, both positive and negative. It outlines physical, emotional, and behavioral signs that a person may be experiencing stress.
2. Common sources of stress mentioned include work, family, relationships, negative self-talk, unrealistic expectations, and lack of organization.
3. The document provides tips for managing stress such as being assertive, getting organized, prioritizing tasks, using humor, venting emotions, relaxation techniques, and maintaining a healthy lifestyle. Reducing stress has benefits for both individuals and society.
Mental health includes our emotional, psychological, and social well-being and affects how we think, feel, and act. The document discusses several types of mental illnesses like anxiety disorders, mood disorders, psychotic disorders, and their causes which can include biological and genetic factors as well as life experiences. Symptoms of mental illnesses are described as changes in thinking, mood, and behavior. The negative effects of mental illness on life are also covered. The document concludes with several solutions and ways to maintain positive mental health such as getting professional help, connecting with others, exercising, eating healthy, getting enough sleep, and challenging negative thoughts.
This document discusses childhood depression, including its causes, signs and symptoms, differences from regular sadness or blues, potential prevention methods, and treatment options. Childhood depression is defined as persistent sadness lasting weeks or longer that disrupts a child's life. It can be caused by physical, environmental, genetic or other factors. Signs include changes in appetite, sleep, mood and interests. Treatment involves psychotherapy and may also include antidepressant medication, with the most effective approach being a combination of the two.
This document discusses personal stress, including its causes, symptoms, and management. It defines stress and outlines types of stressors that can be positive or negative. Common physical, mental, behavioral, and emotional symptoms of stress are described. The document also examines stress at work, identifying various organizational and life factors that can act as external stressors. Finally, it provides recommendations for managing stress through techniques like relaxation, exercise, diet, humor, and changing one's thoughts and circumstances.
Similar to Coping With Transitions Short Version Presented To Northwestern 12 08 1 (20)
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A comparative study on uroculturome antimicrobial susceptibility in apparentl...Bhoj Raj Singh
The uroculturome indicates the profile of culturable microbes inhabiting the urinary tract, and it is often required to do a urine culture to find an effective antimicrobial to treat UTIs. This study targeted to understand the profile of culturable pathogens in the urine of apparently healthy (128) and humans with clinical UTIs (161). In urine samples from UTI cases, microbial counts were 1.2×104 ± 6.02×103 colony-forming units (cfu)/ mL, while in urine samples from apparently healthy humans, the average count was 3.33± 1.34×103 cfu/ mL. In eight samples (six from UTI cases and two from apparently healthy people) of urine, Candida (C. albicans 3, C. catenulata 1, C. krusei 1, C. tropicalis 1, C. parapsiplosis 1, C. gulliermondii 1) and Rhizopus species (1) were detected. Candida krusei was detected only in a single urine sample from a healthy person and C. albicans was detected both in urine of healthy and clinical UTI cases. Fungal strains were always detected with one or more types of bacteria. Gram-positive bacteria were more commonly (OR, 1.98; CI99, 1.01-3.87) detected in urine samples of apparently healthy humans, and Gram -ve bacteria (OR, 2.74; CI99, 1.44-5.23) in urines of UTI cases. From urine samples of 161 UTI cases, a total of 90 different types of microbes were detected and, 73 samples had only a single type of bacteria. In contrast, 49, 29, 3, 4, 1, and 2 samples had 2, 3, 4, 5, 6 and 7 types of bacteria, respectively. The most common bacteria detected in urine of UTI cases was Escherichia coli detected in 52 samples, in 20 cases as the single type of bacteria, other 34 types of bacteria were detected in pure form in 53 cases. From 128 urine samples of apparently healthy people, 88 types of microbes were detected either singly or in association with others, from 64 urine samples only a single type of bacteria was detected while 34, 13, 3, 11, 2 and 1 samples yielded 2, 3, 4, 5, 6 and seven types of microbes, respectively. In the urine of apparently healthy humans too, E. coli was the most common bacteria, detected in pure culture from 10 samples followed by Staphylococcus haemolyticus (9), S. intermedius (5), and S. aureus (5), and similar types of bacteria also dominated in cases of mixed occurrence, E. coli was detected in 26, S. aureus in 22 and S. haemolyticus in 19 urine samples, respectively. Gram +ve bacteria isolated from urine samples' irrespective of health status were more often (p, <0.01) resistant than Gram -ve bacteria to ajowan oil, holy basil oil, cinnamaldehyde, and cinnamon oil, but more susceptible to sandalwood oil (p, <0.01). However, for antibiotics, Gram +ve were more often susceptible than Gram -ve bacteria to cephalosporins, doxycycline, and nitrofurantoin. The study concludes that to understand the role of good and bad bacteria in the urinary tract microbiome more targeted studies are needed to discern the isolates at the pathotype level.
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptxAmandaChou9
Seminal vesiculitis can cause jelly-like sperm. Fortunately, herbal medicine Diuretic and Anti-inflammatory Pill can eliminate symptoms and cure the disease.
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...rightmanforbloodline
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
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TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
Descoperă Bucuria Vieții Sănătoase cu Jurnalul Fericirii Life Care - Iulie 2024!
Gata să te bucuri de o vară vibrantă și plină de energie? Life Care îți vine în ajutor cu Jurnalul Fericirii din Iulie 2024, un ghid complet pentru o viață armonioasă și echilibrată.
Pe parcursul a cateva de pagini pline de informații utile și inspirație, vei descoperi:
Sfaturi practice pentru o alimentație sănătoasă:
Rețete delicioase și ușor de preparat: Bucură-te de preparate gustoase și nutritive, perfecte pentru zilele călduroase de vară.
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Hepatocarcinoma today between guidelines and medical therapy. The role of sur...Gian Luca Grazi
Today more than ever, hepatocellular carcinoma therapy is experiencing profound and substantial changes.
The association atezolizumab (ATEZO) plus bevacizumab (BEVA) has demonstrated its effectiveness in the post-operative treatment of patients, improving the results that can be achieved with liver resections. This after the failure of the use of sorafenib in the already historic STORM study.
On the other hand, the prognostic classification of BCLC is now widely questioned. It is now well recognized that the indications for surgery for patients with hepatocellular carcinoma are certainly narrow in BCLC and no longer reflect what is common everyday clinical practice.
Today, the concept of multiparametric therapeutic hierarchy, which makes the management of patients with hepatocellular carcinoma much more flexible and allows the best therapy for the individual patient to be identified based on their clinical characteristics, is gaining more and more importance.
The presentation traces these profound changes that are taking place in recent years and offers a modern vision of the management of patients with hepatocellular carcinoma.
Pharmacotherapy of Asthma and Chronic Obstructive Pulmonary Disease (COPD)HRITHIK DEY
This PowerPoint presentation provides an in-depth overview of the pharmacotherapy approaches for managing asthma and Chronic Obstructive Pulmonary Disease (COPD). It covers the pathophysiology of these respiratory conditions, the various classes of medications used, their mechanisms of action, indications, side effects, and the latest treatment guidelines. Designed for students, healthcare professionals, and anyone interested in respiratory pharmacology, this presentation offers a comprehensive understanding of current therapeutic strategies and advancements in the field.
Case presentation of a 14-year-old female presenting as unilateral breast enlargement and found to have a giant breast lipoma. The tumour was successfully excised with the result that the presumed unilateral breast enlargement reverting back to normal. A review of management including a photo of the removed Giant Lipoma is presented.
Chair, Benjamin M. Greenberg, MD, MHS, discusses neuromyelitis optica spectrum disorder in this CME activity titled “Mastering Diagnosis and Navigating the Sea of Targeted Treatments in NMOSD: Practical Guidance on Optimizing Patient Care.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/4av12w4. CME credit will be available until June 27, 2025.
Coping With Transitions Short Version Presented To Northwestern 12 08 1
1. Karla E.A. Steingraber, Psy.D. Licensed Clinical Psychologist Karla Steingraber, Psy.D. - Wolfson Psychological Services
2. General Outline Types of Change Extreme Reactions Understanding Adjustment Disorders Identifying Contributing Factors Grief Theory Self-Esteem Assessment, Intervention, & Treatment Karla Steingraber, Psy.D. - Wolfson Psychological Services
3. Change -- A part of life “ The only constant is change.” --Unknown A problem with this reality is that most people don’t like change, nor do we always know how to deal with it well. Over the last centuries, life has become more complex and requires us to adapt to more things more quickly than ever before. We are not born with all the essential life survival skills, so we have to learn them along the way. What if we struggle to do this? Karla Steingraber, Psy.D. - Wolfson Psychological Services
4. Types of Change: The Good, the Bad, & The Ugly Loss of Employment Starting a New Job Moving Getting Married/Divorced Having a Baby Aging Loved Ones Passing Away Declining Healthy Others ? Karla Steingraber, Psy.D. - Wolfson Psychological Services
5. Dealing with Change While we all struggle to deal with change to varying degrees, sometimes our emotional resources become too taxed and overwhelmed. This can result in an adjustment disorder. Adjustment disorders are very common and can affect anyone, regardless of gender, age, race, or lifestyle. Karla Steingraber, Psy.D. - Wolfson Psychological Services
6. Adjustment Disorder: General Definition Adjustment disorder (AD) is a stress-related, short-term , nonpsychotic disturbance. overly intense responses to given stimuli. these responses manifest as emotional or behavioral reactions to an identifiable stressful event time-limited, usually beginning within 3 months of the stressful event, and symptoms lessen within 6 months upon removal of the stressor or when new adaptation occurs. Karla Steingraber, Psy.D. - Wolfson Psychological Services
7. Types of Adjustment Disorders Adjustment disorder with depressed mood. Symptoms mainly include feeling sad, tearful and hopeless, and a lack of pleasure in the things you used to enjoy. Adjustment disorder with anxiety. Symptoms mainly include nervousness, worry, difficulty concentrating or remembering things, and feeling overwhelmed. Children who have adjustment disorder with anxiety may strongly fear being separated from their parents and loved ones. Adjustment disorder with mixed anxiety and depressed mood. Symptoms include a mix of depression and anxiety. Adjustment disorder with disturbance of conduct. Symptoms mainly involve behavioral problems, such as fighting, reckless driving or ignoring your bills. Youngsters may skip school or vandalize property. Adjustment disorder with mixed disturbance of emotions and conduct. Symptoms include a mix of depression and anxiety as well as behavioral problems. Adjustment disorder unspecified. Symptoms don't fit the other types of adjustment disorders but often include physical problems, problems with family or friends, or work or school problems. Karla Steingraber, Psy.D. - Wolfson Psychological Services
8. Adjustment Disorder Statistics 5-20% of people in outpatient treatment have AD as principle diagnosis 0.05% (6,290) of hospital consultant episodes were for reaction to severe stress and adjustment disorders 95% of hospital consultant episodes for reaction to severe stress and adjustment disorders required hospital admission 50% of hospital consultant episodes for reaction to severe stress and adjustment disorders were for men 50% of hospital consultant episodes for reaction to severe stress and adjustment disorders were for women 80% of hospital consultant episodes for reaction to severe stress and adjustment disorders required emergency hospital admission 18.3 days was the mean length of stay in hospitals for reaction to severe stress and adjustment disorders 9 days was the median length of stay in hospitals for reaction to severe stress and adjustment disorders 90% of hospital consultant episodes for reaction to severe stress and adjustment disorders occurred in 15-59 year olds 3% of hospital consultant episodes for reaction to severe stress and adjustment disorders occurred in people over 75 (Hospital Episode Statistics, Department of Health, England, 2002-03) Karla Steingraber, Psy.D. - Wolfson Psychological Services
9. AD Symptoms Emotional Behavioral Sadness Hopelessness Lack of enjoyment Crying spells Nervousness Thoughts of suicide Anxiety Worry Desperation Trouble sleeping Difficulty concentrating Feeling overwhelmed Withdrawing from family and Friends Fighting Reckless driving Ignoring bills Avoiding family or friends Poor school or work performance Skipping school Vandalism
10. Risk Factors Why is one person more likely than another to develop an AD? Personal Components Environmental Components
11. Risk Factors: Personal Components Age & Gender Temperament Pre-existing Personality Disposition, Constitution Early Life Experiences History of Mental Healthy Difficulties Coping Strategies & Resilience Connectedness to others – Social Karla Steingraber, Psy.D. - Wolfson Psychological Services
12. Risk Factors: Environmental/Life Experiences Support System Overprotective or abusive parenting, Family disruptions and frequent moves early in life Exposure to wars or violence without development of PTSD Disadvantaged life circumstances Timing Form & Presentation of Stressor Recent changes, difficulties or losses at work or in your family life Karla Steingraber, Psy.D. - Wolfson Psychological Services
13. Complex Cases Most people experience multiple stressors and/or losses simultaneously. For some, it is the accumulation of a variety of problems which serve to overwhelm their otherwise sufficient resources. Important to do a differential diagnosis, e.g. complicated bereavement, depression, etc. For example: 1) Declining health 2) Loss of spouse 3) Loss of driving privileges 4) Loss of previous home These common traumas create a very intimidating situation Karla Steingraber, Psy.D. - Wolfson Psychological Services
14. Kubler-Ross Grief Stage Theory Denial Anger Bargaining Depression Acceptance Healthy grieving lessens potential for an AD Karla Steingraber, Psy.D. - Wolfson Psychological Services
15. Psychosocial Development Erik Erickson Trust Versus Mistrust. From ages birth to 1 year, children begin to learn the ability to trust others based upon the consistency of their caregiver(s). Autonomy vs. Shame and Doubt . Between the ages of 1-3, children begin to assert their independence, by walking away from their mother, picking which toy to play with, and making choices about what they like to wear, to eat, etc. (development of self-esteem) Initiative vs. Guilt. Around age 3-6 children assert themselves more frequently. They begin to plan activities, make up games, and initiate activities with others. Industry vs. Inferiority. From age 6 years to puberty, children begin to develop a sense of pride in their accomplishments. They initiate projects, see them through to completion, and feel good about what they have achieved. Identity vs. Role Confusion. During adolescence, the transition from childhood to adulthood is most important. Children are becoming more independent, and begin to look at the future in terms of career, relationships, families, housing, etc. Intimacy vs. Isolation. Occurring in Young adulthood, we begin to share ourselves more intimately with others. We explore relationships leading toward longer term commitments with someone other than a family member. Generativity vs. Stagnation. During middle adulthood, we establish our careers, settle down within a relationship, begin our own families and develop a sense of being a part of the bigger picture. We give back to society through raising our children & being productive at work,. Ego Integrity vs. Despair. As we grow older and become senior citizens, we tend to slow down our productivity, and explore life as a retired person. It is during this time that we contemplate our accomplishments and are able to develop integrity if we see ourselves as leading a successful life. Karla Steingraber, Psy.D. - Wolfson Psychological Services
16. Defense Mechanisms Denial ; an outright refusal or inability to accept some aspect of reality that is troubling. For example: "this thing has not happened" when it actually has. Splitting ; a person cannot stand the thought that someone might have both good and bad aspects, so they polarize their view of that person as someone who is "all good" or "all bad". Any evidence to the contrary is ignored. For example: "My boss is evil", after being let go from work, when in reality, the boss had no choice in the matter and was acting under orders herself. Splitting functions by way of Dissociation, which is an ability people have in varying amounts to be able to wall off certain experiences and not think about them. Projection ; a person's thought or emotion about another person, place or thing is too troubling to admit, and so, that thought or emotion is attributed to originate from that other person, place or thing. For example: "He hates me", when it is actually the speaker who hates. A variation on the theme of Projection is known as "Externalization". In Externalization, you blame others for your problems rather than owning up to any role you may play in causing them. Passive-aggression ; A thought or feeling is not acceptable enough to a person to be allowed direct expression. Instead, that person behaves in an indirect manner that expresses the thought or emotion. For example: Failing to wash your hands before cooking when you normally would, and happen to be cooking for someone you don't like. Acting out ; an inability to be thoughtful about an impulse. The impulse is expressed directly without any reflection or consideration as to whether it is a good idea to do so. For example: a person attacks another person in a fit of anger without stopping to consider that this could seriously wound or disfigure that other person and/or possibly result in legal problems. Karla Steingraber, Psy.D. - Wolfson Psychological Services
17. Defense Mechanisms (continued) Displacement; An unacceptable feeling or thought about a person, place or thing is redirected towards a safer target. For example, it may feel unsafe to admit anger towards a parent, but it is perfectly safe to criticize the neighborhood he or she lives in. Isolation/Intellectualization; Overwhelming feelings or thoughts about an event are handled by isolating their meaning from the feelings accompanying the meaning, and focusing on the meaning in isolation. For example, you cope with the recent death of a parent by reading about the grieving process. Repression; A milder form of denial; You manage uncomfortable feelings and thoughts by avoiding thinking about them. You are able to admit that you feel a certain way (unlike in denial), but you can't think of what might have led up to that feeling, and don't really want to think about it anyway. Reaction Formation; You react to uncomfortable, unacceptable feelings or ideas that you have (but aren't quite conscious of really), by forming the opposite opinion. For example; you unconsciously hate your parent, but your experience is to the contrary; you are only aware of loving feelings for your parent. Karla Steingraber, Psy.D. - Wolfson Psychological Services
18. What Can You Do to Help Those at Risk Prevention Strategies for Self-Care Exercise Self-Esteem Team Unity Education Recognition Preparation Treatment Karla Steingraber, Psy.D. - Wolfson Psychological Services
19. Prevention Strategies The essential role of the “family” (nurses & social workers) Develop healthy coping strategies Improve Resilience Create a good support network Seek out humor or laughter Live a healthy lifestyle & Request a healthy lifestyle Think positively & Pass it on Prepare for change Suggest stress management Encourage checking in with health care or mental health care provider to review healthy ways to manage stress. Karla Steingraber, Psy.D. - Wolfson Psychological Services
20. Self-care: Encourage clients to: Talk things over with caring family and friends Try to keep eating a healthy diet Stick to a regular sleep routine Get regular physical activity Engage in a hobby they enjoy Find a support group geared toward their situation Find support from a faith community : Be around those who offer encouragement to talk about feelings Offer support and understanding to others Make choices Avoid Destructive Activities. If they use these kinds of self-care steps but they don't seem to be helping, be sure to refer them to their health care provider. Karla Steingraber, Psy.D. - Wolfson Psychological Services
21. Exercise Improves symptoms of certain mental health conditions Serotonin, dopamine, norepinephrine, and endorphins, have strong effects on mood reducie feelings of anxiety, stress (Cortisol) and depression Help to strengthen immune system. 20 types of endorphins beta-endorphins secreted during exercise reduce pain & muscle tension Helps prevent a relapse after treatment for depression or anxiety Even small amounts - as little as 10-15 minutes at a time - can improve mood in the short term. Improves sleep Increases body temperature, which may have calming effects. If you exercise regularly but depression or anxiety symptoms still interfere with your daily living, seek professional help. Exercise isn't meant to replace medical treatment of depression or anxiety. Karla Steingraber, Psy.D. - Wolfson Psychological Services
22. Self-Esteem Healthy self-esteem promotes confidence, and this can contribute to better managing difficulties, thereby lessening the potential for an AD Karla Steingraber, Psy.D. - Wolfson Psychological Services
23. Self-Esteem Defined Self-Esteem = The degree to which one values him/herself. Self-efficacy = One’s sense of basic confidence in the face of life’s challenges. Self-respect = Extent to which one feels “Worthy of Happiness”. The Six Pillars of Self Esteem by Nathanial Branden (1994) The practice of living consciously The practice of self - acceptance The practice of self - responsibility The practice of self - assertiveness The practice of living purposefully The practice of personal integrity The missing pillar: social connectedness We are social beings! Karla Steingraber, Psy.D. - Wolfson Psychological Services
24. 5 Steps toward Improving Self-Esteem Step 1: Identify troubling conditions or situations Think about what you find troubling and deflates your self-esteem. You may wish to change aspects of your personality or behavior, such as a fear of giving a business presentation or frequently becoming angry You may be struggling with depression, a disability or a change in life circumstances, such as the death of a loved one, a lost promotion or children leaving home. Or you may wish to improve your relationship with another person, such as a spouse, family member or co-worker. Karla Steingraber, Psy.D. - Wolfson Psychological Services
25. Step 2: Become aware of beliefs and thoughts Once you've identified troubling conditions or situations, pay attention to your thoughts. This includes your self-talk — what you tell yourself — as well as your interpretation of what a situation means and your beliefs about yourself, other people and events. Your thoughts and beliefs may be positive, negative or neutral. They may be rational — based on reason or facts — or irrational — based on false ideas. Karla Steingraber, Psy.D. - Wolfson Psychological Services
26. Step 3: Pinpoint negative or inaccurate thinking Your beliefs and thoughts about a condition or situation affect your reaction to it. Inaccurate or negative thoughts and beliefs about something or someone can trigger unhealthy physical, emotional and behavioral responses, including: Physical responses, such as a stiff neck, sore back, racing heart, stomach problems, sweating or change in sleeping patterns. Emotional responses, such as difficulty concentrating or feeling depressed, angry, sad, nervous, guilty or worried. Behavioral responses, such as eating when not hungry, avoiding tasks, working more than usual, spending increased time alone, obsessing about a situation or blaming others for your problems. Karla Steingraber, Psy.D. - Wolfson Psychological Services
27. Step 4: Challenge negative or inaccurate thinking Your initial thoughts may not be the only possible way to view a situation. So test the accuracy of your thoughts. Ask yourself whether your view of a situation is consistent with facts and logic or whether there might be other explanations. You may not easily recognize inaccuracies in your thinking. Most people have automatic, long-standing ways of thinking about their lives and themselves. These long-held thoughts and beliefs feel normal and factual to you, but many are simply opinions or perceptions. Karla Steingraber, Psy.D. - Wolfson Psychological Services
28. Thought patterns that erode self-esteem: All-or-nothing thinking. You see things as either all good or all bad. For example, "If I don't succeed in this job, I'm a total failure." Mental filtering. You see only negatives and dwell on them, distorting your view of a person or situation or your entire life. For example, "I made a mistake on that report and now everyone will realize I'm a failure." Converting positives into negatives. You reject your achievements and other positive experiences by insisting that they don't count. For example, "My date only gave me that compliment because he knows how bad I feel." "I only did well on that test because it was so easy." Jumping to negative conclusions. You reach a negative conclusion when little or no evidence supports it. For example, "My friend hasn't replied to my e-mail, so I must have done something to make her angry." Mistaking feelings for facts . You confuse feelings or beliefs with facts. For example, "I feel like a failure, so I must be a failure." No matter how strong a feeling is, it isn't a fact. Self put-downs. You undervalue yourself, put yourself down or use self-deprecating humor. This can result from overreacting to a situation, such as making a mistake. For example, "I don't deserve anything better." "I'm weak, stupid or ugly." Karla Steingraber, Psy.D. - Wolfson Psychological Services
29. Step 5: Change your thoughts and beliefs The final step is to replace the negative or inaccurate thinking you've identified with accurate thoughts and beliefs. This can enable you to find constructive ways to cope and give your self-esteem a boost. This step can be difficult. Thoughts often occur spontaneously or automatically, without effort on your part. It can be hard to control or turn off your thoughts. Thoughts can be very powerful and aren't always based on logic. It takes time and effort to learn how to recognize and replace distressing thoughts with accurate ones. Karla Steingraber, Psy.D. - Wolfson Psychological Services
30. Patient & Family Education Nurses & Social Workers are often the only point of contact for families. Teach them about what you are doing, such as…. Prevention Attention Care Individual differences AD: One instance or series of stressful events Encourage acknowledgement of the personal significance of the stressful event. Encourage getting support Karla Steingraber, Psy.D. - Wolfson Psychological Services
31. Team Unity Karla Steingraber, Psy.D. - Wolfson Psychological Services
32. The Necessity of Team Unity Team Approach Consistency Communication Commitment Without Team Approach …. Example of team splitting Good cop, Bad cop = failed treatment Solutions Team Meeting Behavior Plans Karla Steingraber, Psy.D. - Wolfson Psychological Services
33. Treatment 2 Treatment Options: Psychotherapy Treatment of choice for adjustment disorders is psychotherapy, also called counseling or talk therapy. Therapy can provide emotional support, help you learn why the stressful event affected you, and healthy coping skills. The form and type of psychotherapy will vary upon the clinician, and the personality features of the patient. This therapy often takes the form of solution-focused, to help the individual deal more effectively with the specific life problem. A focus on guiding the client toward finding new coping mechanisms, or finding a better understanding of issues in their lives. Medications In some cases, medications may help, too. Medications can help with such symptoms as depression, anxiety and suicidal thoughts. Karla Steingraber, Psy.D. - Wolfson Psychological Services
34. Therapeutic Options Individual psychotherapy Crisis intervention Family and group therapies Karla Steingraber, Psy.D. - Wolfson Psychological Services
35. Treatment Overview Treatment of ADs entails psychotherapeutic counseling aimed at: reducing the stressor, improving coping ability with stressors that cannot be reduced or removed, and formatting an emotional state and support systems to enhance adaptation and coping. Goals of psychotherapy should include: Analyze the stressors that are affecting the patient, and determine whether they can be eliminated or minimized. Clarify and interpret the meaning of the stressor for the patient. Reframe the meaning of the stressor. Illuminate the concerns and conflicts the patient experiences. Identify a means to reduce the stressor. Maximize the patient's coping skills. Assist patients to gain perspective on the stressor, establish relationships, attend support groups, and manage themselves and the stressor. Karla Steingraber, Psy.D. - Wolfson Psychological Services
36. ‘ Goodness of Fit’ Theory Goodness of Fit results when the properties of the environment and its expectations and demands are in accord with the individual’s own capacities, characteristics, and style of behaving. ( Apply to ADHD-work=Minimal distractions Spouse=organized, Patient Interactionism - A combined function of inherent and environmental influences. An expression of continuous organism-environment interaction. Individualization – Uniqueness. One’s variability in his/her physiological, psychological, cognitive, and perceptual attributes. Chess, Stella & Thomas, Alexander (1999). Karla Steingraber, Psy.D. - Wolfson Psychological Services
37. Medication Classes & Problems with Typical Use in Special Populations Stimulants/ADHD (e.g. Ritalin, Concerta, Focalin); Alternatives (Strattera, Wellbutrin) Antidepressants/Depression or anxiety (e.g. Prozac, Zoloft, Effexor, Cymbalta) Antipsychotics/Psychosis or PTSD (e.g. Resperidone, Seroquel, Geodone, Abilify) Mood stabilizers/Bipolar Disorder (e.g. Trileptal, Abilify, Depakote) Difficulties Social stigma Team disagreements Karla Steingraber, Psy.D. - Wolfson Psychological Services
38. Challenging the notion of “Toughing it out” An adjustment disorder is a severe emotional reaction to a difficult event. It impacts daily routines and gaining satisfaction out of life. No one should have to tough it out alone. Nurses and Social Workers, who see the these clients very regularly, are in the best position to impact these clients Because they are liked and admired Because they are available Karla Steingraber, Psy.D. - Wolfson Psychological Services
39. Bibliography Kaplan, Harold & Sadock, Benjamin (1988) Synopsis of Psychiatry 5 th edition. Williams & Wilkins, Baltimore, MD DSM-IV-TR American Psychiatric Association, Washington DC Branden, Nathaniel (1994) The Six Pillars of Self-Esteem. Bantam Books, New York, N.Y. Chess, Stella & Thomas, Alexander (1999). Goodness of Fit. Brunner/Mazel, Philadelphia, PA Faulkner, Terry (2008). Personal communication. Kubler-Ross, Elisabeth (1969) On Death And Dying. Macmillan Publishing Co., New York, N.Y. MayoClinic.com eMedicine.com PsyWeb.com wrongdiagnosis.com absolutefitness.co.uk appliedsportpsych.org Karla Steingraber, Psy.D. - Wolfson Psychological Services