MENTAL HEALTH &

PSYCHIATRIC NURSING I
(NSC 322)
MENTAL HEALTH DISORDERS

ONYEMACHI, B. C
INTRODUCTION

 Mental illness is an illness of the mind that can affect

the thoughts, feelings and behaviors

 preventing the individual from leading a happy, healthy

productive life.

 A mental illness is a health problem that significantly

affects how a person feels, thinks, behaves, and
interacts with other people.
DEFINITION
 A syndrome characterized by clinically significant
disturbance in an individual's cognition, emotion
regulation, or behavior that reflects a dysfunction in the
psychological, biological, or developmental processes.
TYPES OF MENTAL HEALTH DISORDERS

 Anxiety Disorders

 Mood Disorder

 Schizophrenia

 Personality Disorders

 Psycho somatic illness

 Disorders of self-regulation
 ANXIETY DISORDERS
 A group of conditions where the individual experiences
persistent anxiety (real or imagined fears) that are difficult to
control

 This feeling interferes with activities of daily living.

 These feelings may cause physical symptoms body tremors

 Experiencing occasional anxiety is a normal part of life.

 However, people with anxiety disorders frequently have

intense, excessive and persistent worry and fear about everyday
situations
ANXIETY DISORDERS
 Anxiety can be described as an uncomfortable
feeling of vague fear or apprehension
accompanied by characteristic physical sensations

 Anxiety can produce uncomfortable and potentially

debilitating psychological (e.g., worry or feeling of
threat) and physiological arousal (e.g., tachycardia or
shortness of breath).
PATTERNS OF ANXIETY DISORDERS
 Generalized anxiety disorder

 Panic disorder

 Phobic disorder

 Post traumatic stress disorder

 Obsessive compulsive disorders

PATTERNS OF ANXIETY DISORDERS
 Generalized anxiety disorder

 Chronic anxiety state associated with uncontrollable

worry.

 Patients with GAD have persistent, excessive, unrealistic

worry associated with muscle tension, impaired
concentration and insomnia. Poor concentration.

 Alcohol abuse and dependence are common in GAD

patient.
 Generalized anxiety disorder

Risk factors of GAD

 Family members with an anxiety disorder

 Stress

 Exposure to physical or emotional trauma

 Unemployment

 Poverty

 Drug abuse
 Diagnosis/clinical presentation of GAD

 Unrealistic or excessive anxiety and worry for a period of

at least 6 months.

 Difficulty in controlling anxiety or worry.

 Accompanying the anxiety or worry for 6 months with 3 or

more of following symptoms:
--feeling tense or restless
--easily fatigued
--difficulty concentrating
--irritability
--difficulty sleeping
PATTERNS OF ANXIETY DISORDERS
 PANIC DISORDER SYMPTOMS
Panic disorder is defined  Palpitations

by the presence of  Sweating

recurrent and  Trembling or shaking

unpredictable panic  Sensations of shortness of

attacks, which are distinct breath

 Chest pain or discomfort
episodes of intense fear
 Nausea
and discomfort associated
 Feeling dizzy
with a variety of physical
 Fear of dying
symptoms.
 Paresthesia
 Chills or hot flushes
Phobic disorders
 A phobia is a type of anxiety disorder defined by a
persistent and excessive fear of an object or situation.

 Phobias typically result in a rapid onset of fear and are

present for more than six months.

 Those affected will go to great lengths to avoid the

situation or object, to a degree greater than the actual
danger posed

 The client exhibits an anticipatory anxiety followed by a

compelling desire to avoid and dread the object.
 Phobic disorders
 The Patients avoids phobic stimulus and this avoidance
usually impairs occupational or social functioning.

 Common phobias include:

-- Agoraphobia
-- Aerophobia
-- Acrophobia
-- Social phobia
TYPES OF PHOBIA
 Agoraphobia
Agoraphobia involves a fear of being alone in a
situation or place where escape may be difficult.

 This type of phobia may include the fear of crowded

areas, open spaces, or situations that are likely to
trigger a panic attack.

 People will begin avoiding these trigger events,

sometimes to the point that they cease leaving their
home entirely.
TYPES OF PHOBIA

 Acrophobia/Fear of heights

 This fear can lead to anxiety attacks and avoidance of

high places.

 People who suffer from this phobia may go to great

lengths to avoid high places such as bridges, towers, or
tall buildings
 TYPES OF PHOBIA

Aerophobia /fear of flying

 Some of the common symptoms associated with this phobia

include trembling, rapid heartbeat, and feeling disoriented.

 The fear of flying sometimes causes people to avoid flying

altogether.

 It is often treated using exposure therapy in which the client is

gradually and progressively introduced to flying.

 The individual may start by simply imagining themselves on a

plane before slowly working up to actually sitting on a plane and
finally sitting through a flight
 TYPES OF PHOBIA

Social phobia 
 Involves the fear of social situations and can be quite

debilitating.

 In many cases, these phobias can become so severe that

people avoid events, places, and people who are likely
to trigger an anxiety attack.

 People with this phobia fear being watched or

humiliated in front of others.
TYPES OF PHOBIA
Social phobia cont’d
 Even ordinary, everyday tasks such as eating a meal can be anxiety-

provoking.

 Social phobias often develop during puberty and can last throughout
life unless they are treated.

 The most common form of social phobia is a fear of public speaking.

 In some cases, social phobias can cause people to avoid social

situations including school and work, which can have a major impact
on the individual's well-being and ability to function.
POST TRAUMATIC STRESS DISORDERS
 Post-traumatic stress disorder (PTSD) is a mental health
condition that is triggered by a terrifying event either
experiencing it or witnessing it.

 Symptoms may include flashbacks, nightmares and severe

anxiety, as well as uncontrollable thoughts about the event.

 Symptoms usually begin early, within 3 months of the

traumatic incident, but sometimes they begin years afterward.

 Symptoms must last more than a month

OBSESSIVE-COMPULSIVE DISORDER

 OCD is characterized by obsessive thoughts and

compulsive behaviors that impair everyday functioning.

 Fears of contamination and germs

 hand washing.

 Counting behaviors and having to check and recheck

the actions eg: (whether a door is locked)
MANAGEMENT OF ANXIETY DISORDER

 Admission

• Admit in a less stimulating therapeutic environment.

• Remove patient from stress and anxiety provoking

environment.

• Establish nurse/patient relationship to build trust and

rapport.
MANAGEMENT OF ANXIETY DISORDER
 Psychological care
• Reassure patient to allay anxiety and give psychological
support.

• Establish a good channel of communication but avoid

probing.

• Constant communication to encourage patient talk about

his concerns and feelings.

• Attend to patients problem as they unfold to help create a

sense of concern and security in the patient.
MANAGEMENT OF ANXIETY DISORDER
 Observation
• Vital signs, patient’s behavior, sleep pattern etc

 Physical care
• Ensure patient physical needs are met such as
taking regular bath.

 Diet
• Balanced and nourishing diet to help increase
resistance to stress
MANAGEMENT OF ANXIETY DISORDER
 Emotional care
• Nurse should be warm, friendly and empathetic.
• Teach patient stress management techniques.
• Institute relaxation therapy.

 Medication
 Selective serotonin reuptake inhibitor
SSRIs are the first-line treatment for GAD and panic
disorders
MANAGEMENT OF ANXIETY DISORDER
 Anxiolytics; Diazepam

 Hematinic; to increase appetite

MANAGEMENT OF ANXIETY DISORDER

Non pharmacological treatment

 Psychological education.

 Short term counseling.

 Stress management.

 Psychotherapy.

 Meditation or exercise.
Treatment of anxiety disorders

 Psycho therapy:
Psychological therapies (talking therapies) are generally
considered first line treatments in all anxiety disorders
because they provide a longer lasting response and lower
relapse than pharmacotherapy.
Treatment of anxiety disorders
 The specific psychotherapy with the most supporting
evidence in anxiety disorders is cognitive behavioral
therapy

 Therapy usually lasts for 8-16 weeks or longer in more

resistant cases.

 Treatment usually takes at least 4 weeks

Treatment of anxiety disorders
 Advice on discharge

• Psycho-educate the patient

• Avoid stressful situations/triggers

• Avoid use of psychoactive substances

• Encourage social support system

• Adequate/good nutrition /fluid intake

• Rest and sleep to prevent exhaustion

 CBT
• CBT focuses on challenging and changing
unhelpful cognitive distortions (e.g. thoughts, beliefs,
and attitudes) and behaviors, improving emotional
regulation and the development of personal coping
strategies that target solving current problems.

• Originally, it was designed to treat depression but its

uses have been expanded to include treatment of a
number of mental health conditions,
including anxiety
 CBT
• A type of psychotherapy in which negative
patterns of thought about the self and the
world are challenged in order to alter
unwanted behaviour patterns or treat mood
disorders