Mental Health and

Psychological Well-
being
MODULE 2
https://www.herefortexas.com/mental-health-mental-illness-defined
https://www.herefortexas.com/mental-health-mental-illness-defined
Module Description
● aims to equip the MHPSS providers
with knowledge regarding different
concepts on mental health
● defines stress, trauma, anxiety and
suicidal ideation.
● provides the factors associated with
these concepts and recommend
ways for treatment.
Having background knowledge on
these concepts will help the MHPSS
provider further understand the
psychological well-being of their clients
and respond to them more
appropriately.
Module Objectives
1. Explain neuroplasticity and how it could help in maintaining one’s
mental health
2. Identify signs and symptoms of clients in need of referral to
mental health professionals
3. Enumerate ways on taking care of one’s mental health and
psychological well-being
4. Practice ways in talking with people undergoing concerns on
mental health through the simulation sessions
 Module Topics
Neuroplasticity Fear and Anxiety Trauma and Grief
and the Brain

TOPIC 1 TOPIC 3 TOPIC 5

TOPIC 2 TOPIC 4 TOPIC 6

Stress and Coping Sadness, Depression Suicide and

and other Mood
Disorders
Suicidal Ideation
Neuroplasticity
and the Brain
TOPIC 1
Learning Outcomes
By the end of this session, the MHPSS provider will be able to:
● Explain neuroplasticity and how it relates with maintaining
one’s mental health
● Reflect and write down how the “growth mindset” has been
present in one’s life
● Enumerate ways on how to rewire one’s brain through
neuroplasticity
Video: Neuroplasticity by Sentis Videographic
Rewiring
To “rewire” means changing the
connections in our brain (particularly the
axons in our neurons and synapses) and
our neural pathways.

Neurons are nerve cells that send and

receive signals in the brain. The axon is
the tail-like structure in the neuron that
conduct electrical signals.
Synapses
are the gaps between
neurons that allows the
passage of an electrical
signal
Neural pathway
are the connections among the areas of the
brain especially those that are distant from each
other. Each pathway is associated with a
particular action or behavior.

“Every time we think, feel or do something, we

strengthen a pathway. Habits are well
travelled pathways and our brain finds these
things easy to do” (Pearce, K. 2020).
Neuroplasticity
“When we learn something new, we create new connections
between our neurons. We rewire our brains to adapt to new
circumstances. This happens on a daily basis, but it’s also
something that we can encourage and stimulate.”
(Ackerman, C. E., 2020)

In summary, our brains are actually “plastic” and is able

to change based on our day to day experiences.
7 Benefits of Neuroplasticity on the Brain
1. Recovery from brain events like strokes;
2. Recovery from traumatic brain injuries;
3. Ability to rewire functions in the brain (e.g., if an area that
controls one sense is damaged, other areas may be able to
pick up the slack);
4. Losing function in one area may enhance functions in other
areas (e.g., if one sense is lost, the others may become
heightened);
5. Enhanced memory abilities
6. Wide range of enhanced cognitive abilities
7. More effective learning.
Video: Growth Mindset vs. Fixed Mindset
People with a
FIXED
MINDSET see
problems as
interesting
challenges.
People with a
FIXED
MINDSET see
problems as
interesting
challenges.
People with a
GROWTH
MINDSET believe
that new abilities can
be developed
through practice.
People with a
GROWTH
MINDSET believe
that new abilities can
be developed
through practice.
A simple switch to
how people views a
situation can make a
difference.
A simple switch to
how people views a
situation can make a
difference.
 Activity: The Growth Mindset

Cite 1-2 instances when a “fixed” or “growth mindset”

are manifested in own
your personal and professional life?

List them down in two columns

Share your notes with a seatmate (2 minutes)
 Activity: The Growth Mindset

“A person with a growth mindset believes that he or she can

get smarter, better, or more skilled at something through
sustained effort—which is exactly what neuroplasticity tells
us.”
Neuroplasticity in
Special Groups
Children with Special Needs
For children with special needs,
getting access to intervention as
early as possible will give a child
the best chance of learning
regardless of their condition or
diagnosis.

This is to maximize the brain’s

ability to adapt or rewire itself.
Video: Early Intervention for Kids with Celebral Palsy:

Sonali Explores Neuroplasticity.

Older Persons
As we grow older,
neuroplasticity, or the rate
of change in the brain,
declines but does not stop.
Through neuroplasticity
and brain training, we can
try to slow down the aging
process.
 Activity: Sharing of Experience
● What are your experiences in working with special groups
of people?

● How can you use your understanding about

neuroplasticity in your work as MHPSS providers,
especially in working with older persons or parents of
children with special needs?
 Activity: Sharing
● What habits would you like to
stop or change in your life?

● What daily activities or

exercises can you do to rewire
your brain to accomplish this?
How to Rewire your Brain with
Neuroplasticity
● Intermittent fasting
● Traveling
● Using mnemonic devices
● Learning a musical instrument
● Non-dominant hand exercises
● Reading fiction
● Expanding vocabulary
● Creating artwork
● Dancing
● Sleeping
Empathy Maps
For individuals suffering from any of the following:

1. Stress Highlight

2. Fear and Anxiety • signs and symptoms

3. Depression • ways of coping
• Example of possible
4. Bipolar disorder clients
5. Trauma, adults, kids and teens
6. PTSD
7. Grief
8. Self-harm/Suicidal ideations
 What do they hear?

What do they see? What do they say?

Clients most
What do they think? at-risk What do they do?
What do they feel?

Definition of the Term here:

MHPSS Tool Kit
What to tell them Recommended Care Regimen or Prompts when to do
(sample scripts) Coping Strategies Immediate Referrals
Stress and
Coping
TOPIC 2
Learning Outcomes
By the end of this session, the MHPSS provider will be able to:

● Describe stress and its effects in client’s behavior

● Identify stressors in their life and its effects
● Discuss the healthy and effective ways in handling stress
and coping with problems
Behavioral Signs of Stress
● Eating more or less
● Sleeping too much or little
● Withdrawing from others
● Procrastinating or neglecting
responsibilities
● Using alcohol, cigarettes or drugs to relax
● Other nervous habit such as nail biting,
fidgeting or pacing

How do you know you are stressed?

Stress
● Is the body’s reaction to any
change that requires an
adjustment or response

● A feeling of emotional or
physical tension

● can vary in each person based

on social and economic
circumstances, the environment
one lives in and one’s genetic
makeup
 Stress
Symptom
Checklist
https://bit.ly/StressSymptomChecklist
Stress Ingredients
THREAT EMOTIONS

NOVELTY Something new you have not experienced before

UNPREDICTABILITY Something you had no way of knowing it would occur

THREAT TO THE EGO Your competence as a person is called into question

SENSE OF CONTROL You feel you have little or not control over the situation
 The Stress Continuum
short-lived
physiological responses
that promote growth and
change and are
necessary for healthy
development
Tolerable
Stress
Positive
occurs as the result of a
Stress
more severe, longer-lasting
difficulty, such as the loss of
a loved one, a natural
disaster, or a frightening
injury
associated with prolonged and
intense activation of the body’s
stress response to such an extent
that it can change the very
architecture of a young person’s
brain with problematic long-term
consequences
Traumatic
Stress
Toxic
when a person experiences or witnesses
Stress an event that is overwhelming, usually
life-threatening, terrifying, or horrifying
in the face of helplessness

ACUTE STRESS
short-term and goes away quickly. You
feel it when you slam on the brakes, have
a fight with your partner, or ski down a
steep slope. It helps you manage
dangerous situations. It also occurs when
you do something new or exciting. All
people have acute stress at one time or
another.
2 Types of Stress
CHRONIC STRESS
lasts for a longer period of time. You may have
chronic stress if you have money problems, an
unhappy marriage, or trouble at work. Any type
of stress that goes on for weeks or months is
chronic stress. You can become so used to
chronic stress that you don't realize it is a
problem. If you don't find ways to manage stress,
it may lead to health problems.
Coping with Stress
“Stressed” when spelled backwards can
be read as “desserts” which means that
to alleviate and manage it, one must
know how to enjoy and spend time in
recreation.

Thus, one needs to be equipped with

skills to manage and cope with stress.

What is on your plate of “desserts”?

Ways to Cope with Stress
Ways to Cope with Stress
 Activity: 5 Minute Stress
Reduction
https://www.youtube.com/watch?v=inpok4MKVLM
Fear and
Anxiety
TOPIC 3
Learning Outcomes
By the end of this session, the MHPSS provider will be able to:
● Differentiate fear from anxiety
● Be familiar with anxiety disorders
● Discuss the healthy and effective ways in handling fear and
anxiety
 Activity
List down what makes you worried and
scared in a sheet of paper.

As we define Fear and Anxiety, check

your lists and verify it what was listed
falls under fear and anxiety.
Fear and Anxiety
● Fear relates to a known or understood threat,
whereas anxiety follows from an unknown,
expected, or poorly defined threat.

● Fear and anxiety both produce a similar stress

response. But many experts believe that there are
important differences between the two.
What is Fear?
● an emotional response to a
known or definite threat. The
danger is real, definite and
immediate. A clear object of fear
is present.

● a response to a danger that is

currently detected in the
immediate and present moment
of time.
● When faced with fear, most people
will experience the physical reactions
that are described under anxiety.

● Fear can cause anxiety, and anxiety

can cause fear.
What is Anxiety?
● a diffuse, unpleasant, vague sense
of apprehension.
● associated with a threat that is
anticipated in a future moment of
time
● reflects the anticipation of fear and
represent an adaptive attempt to
prevent the fear-provoking
circumstance from occurring
● often a response to an imprecise or
unknown threat
 Physical
symptom
s
of anxiety
Video: 6 Things that Happen to Your Body When You Experience Anxiety
 Activity

Check your lists and verify it

what was listed falls under
fear and anxiety.
Anxiety
Disorders
Video: The 5 Major Anxiety Disorders
 Activity: Short Quiz
1. Those who suffer from this anxiety disorder aren’t always capable to
give a reason for their symptoms. They may have a general feeling of
restlessness or unease. Sufferers think of their worries in an
obsessive manner and cause other symptoms such as sleep
problems.

a. Social Anxiety Disorder

b. Generalized Anxiety Disorder

c. Panic Disorder

d. Obsessive Compulsive Disorder

 Activity: Short Quiz
2. Symptoms include panic attacks related to social situations. It can also
include a general fear of being around others and severe self-
consciousness. Those with this anxiety disorder might find it hard to
speak when other people are present.

a. Obsessive Compulsive Disorder

b. Social Anxiety Disorder

c. Panic Disorder

d. Post-Traumatic Stress Disorder

Anxiety
Disorders
Social Anxiety Disorder
● Fearful or anxious about or
avoidant of social interactions
and situations that involve the
possibility of being scrutinized
● Worries about being
negatively evaluated by
others, being embarrassed,
humiliated or rejected or
offending others.
Panic Disorder
● An anxiety disorder
where one regularly
have sudden attacks of
panic or fear
Generalized Anxiety Disorder
● Persistent and excessive anxiety and
worry about various domains, including
work and school performance, that the
individual finds difficult to control

● Experiences physical symptoms such as

restlessness, being easily fatigued,
difficulty concentrating or mind going
blank, irritability, muscle tension and
sleep disturbance
Separation Anxiety Disorder
● Developmentally inappropriate and
excessive fear or anxiety concerning
separation from those to whom the
individual is attached

● Lasts for 4 weeks in children and 6

months or more in adults
Selective Mutism
● Failure to speak in specific social
situations in which there is an
expectation for speaking despite
speaking in other situation

● Interferes with educational or

occupational achievement or
with social communication
Specific Phobia
● Marked fear or anxiety about a
specific object or situation (e.g.
flying, heights, animals, injection,
blood) which is out of proportion to
the actual danger posed by the
object or situation typically lasting
for 6 months of more
Agoraphobia
● Marked fear or anxiety about using
public transportation, being in open
spaces or enclosed spaces, standing
in line or being in a crowd or being
outside of the home alone
How to Cope
with Anxiety
Understand your anxiety or
figure out what’s bothering
you
Stay informed but don’t
obsessively check the news
● Stick to trustworthy resources
● Limit how often you check for
updates
● Step away from media if you start
feeling overwhelmed
● Ask someone reliable to share
important updates
● Be careful what you share
Focus on the things you can control.
Stay connected - even when physically isolated.
Take care of your body and spirit.
● Be kind to yourself
● Maintain a routine as best as you can
● Take time out for activities you enjoy
● Get out in nature, if possible
● Find ways to exercise
● Avoid self-medicating
● Take up a relaxation practice
Help others
● Follow guidelines for
preventing the spread of
the virus
● Reach out to others in
need
● Donate to food banks
● Be a calming influence
● Be kind to others
Seek help if
needed
 Activity: Gratitude Jar
● In small pieces of paper, write something
you are grateful for
● After 5 minutes, we will be sharing what
we feel grateful for with others
● After this session, it is encouraged that you
fill up your jars with something you are
grateful for so that you can look back at it
when you feel sad, fearful or worried
Empathy Maps
For individuals suffering from any of the following:

1. Depression & Bipolar Disorder Highlight

2. Trauma, adults, kids and teens • signs and symptoms

3. PTSD • ways of coping
• Example of clients at-
4. Grief, Stress and Axiety risk
5. Self-harm/Suicidal ideations
 What do they hear?

What do they see? What do they say?

Potential
Clients most
Clients
at-risk What do they do?
What do they think?
What do they feel?

Definition of the Term here:

What to tell them Recommended Care Regimen or Prompts when to do
(sample scripts) Coping Strategies Immediate Referrals
Sadness,
Depression and
other Mood
Disorders
TOPIC 4
Learning Outcomes
By the end of this session, the MHPSS provider will be able to:

● Differentiate sadness from depression

● Identify the symptoms of depression
● Understand the risk factors of depression
● Discuss the different types of mood disorders
Sadness
We all feel sadness from time to time. But
only a few are diagnosed with depression.

Sadness is a natural emotion that is

temporary. After moments of sadness, you
may also have moments of joy.
Depression
On the contrary, depression is not an
emotion but a mental illness.

It is a state where it may be hard or

even impossible to enjoy anything
including activities that you used to
enjoy and meeting people that are
close to you.
Video: 6 Differences between Sadness and Depression
 Sadness is BRIEF.
Depression is P - - - - - - - - T.
 Sadness is S - - - - - - C.
Depression is V A G U E.
 Sadness has short term effects.
Depression has L - - - T - - - C - - - - - - - - - - -.
Sadness
and Depression
Depression
● The presence of sad, empty or
irritable mood, accompanied by
somatic and cognitive changes
that significantly affect the
individual’s capacity to function
(DSM5).
Video: Eight Signs Someone is Secretly Depressed
Someone who is
secretly depressed
may overwork
themselves to as a
distraction from the
negativity they feel.
Someone who is
secretly depressed
may overwork
themselves to as a
distraction from the
negativity they feel.
Sometimes,
depression
manifests as anger,
irritability and
sudden changes in
mood.
Sometimes,
depression
manifests as anger,
irritability and
sudden changes in
mood.
Difficulty
concentrating and
remembering is not
a symptom of
depression.
Difficulty
concentrating and
remembering is not
a symptom of
depression.
Those who are
secretly depressed
do not feel things
more intensely than
usual.
Those who are
secretly depressed
do not feel things
more intensely than
usual.
Depression makes
enjoying things one
used to love
difficult.
Depression makes
enjoying things one
used to love
difficult.
Symptoms of
Depression
● constant feelings of sadness
● irritability
● fatigue
● changes in sleeping or eating patterns
● difficulty concentrating
● loss of interest and enthusiasm for things
which used to provide pleasure
● feelings of deep, unwarranted guilt
● physical symptoms, such as headaches or
body aches that do not have a specific cause
● feelings of worthlessness
● constant thoughts about death
● suicidal thoughts or actions
Childhood Depression
❏ Low in energy
❏ Difficulty in concentration
❏ Frequent complaints about stomachaches and
headaches that don’t go away with medication
❏ Difficulty in sleeping
❏ Withdrawal from social interactions
❏ Lack of appetite or eating too much than usual
❏ Becoming sensitive to rejection
❏ Sudden crying or vocal outburst
❏ Lack of interest in participating in school activities or
joining family functions
❏ Poor performance in academics
 Risk Factors for
● Depression
early childhood or teenage trauma
● inability to cope with a devastating life
event, such as the death of a child or
spouse, or any situation that causes
extreme levels of pain
● low self-esteem
● family history of mental illness,
including bipolar disorder or depression
● history of substance abuse, including
drugs and alcohol
Risk Factors for
Depression
● lack of family or community acceptance for
identifying as lesbian, gay, bisexual, or
transgender (LGBT).
● trouble adjusting to a medical condition, such
as cancer, stroke, chronic pain, or heart disease
● trouble adjusting to body changes due to
catastrophic injury, such as loss of limbs, or
paralysis
● history of prior mental health disorders,
including anorexia, bulimia, post-traumatic
stress disorder (PTSD), or anxiety disorder
● lack of a support system, such as friends,
family, or coworkers
Other Mood Disorders
● Depressive Disorders
● Bipolar and Related
Disorders
Video: Bipolar Disorder
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Arlington, V.A.
American Psychiatric Association

Bora, S. (April 2020). Depression: Symptoms, Causes, Risk-factors, Types, Treatment and Prevention. Retrieved November 19,
2020 from https://www.letsmd.com/blog/depression-symptoms-causes/

Devash, M. & Fazel, F. (January 2020). Let’s Talk About Depression. Retrieved November 20, 2020 from
https://www.healthcentral.com/condition/depression

Pepper, L. & Kennard, J. (January 2020). Let’s Talk About Bipolar Disorder. Retrieved November 20, 2020 from
https://www.healthcentral.com/condition/bipolar-disorder

Legg, T. (2017). It is Depression or Sadness? Learn the Signs. Retrieved from

https://www.healthline.com/health/depression/depression-vs-sadness

Schimelpfening, N. & Gans, S. (March 2020). 8 Tips for Living with Depression. Retrieved November 20, 2020 from
https://www.verywellmind.com/tips-for-living-with-depression-1066834
Trauma and Grief
TOPIC 5
Learning Outcomes
By the end of this session, the MHPSS provider will be able to:
● Enumerate ways how to cope with trauma;
● Differentiate the types and how people deal with grief.
Trauma
an exposure to an extraordinary experience
that presents a physical or psychological
threat to oneself or others and generates a
reaction of helplessness and fear.

The exposure may have occurred in the

distant or recent past, and pervasive
symptoms such as intrusive thoughts of the
event, hyperarousal to stimuli in the
environment, negative moods, and
avoidance of cues related to the trauma are
characteristic of both acute and chronic
posttraumatic stress disorders.
 The Stress Continuum
short-lived
physiological responses
that promote growth and
change and are
necessary for healthy
development
Tolerable
Stress
Positive
occurs as the result of a
Stress
more severe, longer-lasting
difficulty, such as the loss of
a loved one, a natural
disaster, or a frightening
injury
associated with prolonged and
intense activation of the body’s
stress response to such an extent
that it can change the very
architecture of a young person’s
brain with problematic long-term
consequences
Traumatic
Stress
Toxic
when a person experiences or witnesses
Stress an event that is overwhelming, usually
life-threatening, terrifying, or horrifying
in the face of helplessness
Trauma
● Emotional and psychological trauma is the result of extraordinarily stressful events
that shatter your sense of security, making you feel helpless in a dangerous world.

● Psychological trauma can leave you struggling with upsetting emotions, memories,
and anxiety that won’t go away. It can also leave you feeling numb, disconnected,
and unable to trust other people.
Trauma
Traumatic experiences often involve a threat to life or safety, but any situation that leaves
you feeling overwhelmed and isolated can result in trauma, even if it doesn’t involve
physical harm.

It’s not the objective circumstances that determine whether an event is traumatic, but
your subjective emotional experience of the event. The more frightened and helpless
you feel, the more likely you are to be traumatized.
Video: How Trauma Affects the Brain
Symptoms of Trauma
Emotional and psychological:
• Shock, denial, or disbelief.
• Confusion, difficulty concentrating.
• Anger, irritability, mood swings.
• Anxiety and fear.
• Guilt, shame, self-blame.
• Withdrawing from others.
• Feeling sad or hopeless.
• Feeling disconnected or numb
Physical symptoms:
• Insomnia or nightmares.
• Fatigue.
• Being startled easily.
• Difficulty concentrating.
• Racing heartbeat.
• Edginess and agitation.
• Aches and pains.
• Muscle tension.
Childhood Trauma
Childhood trauma can result from anything that disrupts a child's sense of safety,
including:
• An unstable or unsafe environment.
• Separation from a parent.
• Serious illness.
• Intrusive medical procedures.
• Sexual, physical, or verbal abuse.
• Domestic violence.
• Neglect.
Causes of Emotional and Psychological
Trauma
• One-time events such as an accident, injury, or a violent attack, especially if it was
unexpected or happened in childhood.
• Ongoing, relentless stress such as living in a crime-ridden neighborhood, battling a
life-threatening illness or experiencing traumatic events that occur repeatedly, such as
bullying, domestic violence, or childhood neglect.
• Commonly overlooked causes such as surgery (especially in the first 3 years of life),
the sudden death of someone close, the breakup of a significant relationship, or a
humiliating or deeply disappointing experience, especially if someone was
deliberately cruel.
How to Cope with Trauma
How to Cope with Trauma
● Give yourself time
● FInd out what happened
● Be involved with other survivors
● Ask for support
● Take some time for yourself
● Get into a routine
● Do some normal things with other people
● Take care
When to Get Professional Help
● Having no one to share feelings with
● Difficulty handling feelings and feeling
overwhelmed by sadness, anxiety or
nervousness
● Feeling not returning to normal after six weeks
● Nightmares and difficulty sleeping
● Getting on badly with people who are close
● Poor work performance
● Help is suggested by people around
● Having accidents
● Drinking or smoking too much or using drugs to
cope with feelings
Trauma Treatments
Resolve the unpleasant feelings and memories long avoided, discharge pent-up “fight-or-
flight” energy, learn to regulate strong emotions, and rebuild ability to trust other people.
● Somatic experiencing focuses on bodily sensations, rather than thoughts and memories
about the traumatic event. By concentrating on what's happening in the body, one can
release pent-up trauma-related energy through shaking, crying, and other forms of physical
release.
● Cognitive-behavioral therapy helps you process and evaluate one’s thoughts and feelings
about a trauma.
● EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of
cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right
stimulation that can “unfreeze” traumatic memories.
Signs of Trauma in Children and Teens
Infants under age 2:
• Fuss more or be harder to soothe.
• Exhibit changes in sleep or eating patterns.
• Appear withdrawn.
Children age 2 to 5:
• Show signs of fear.
• Cling to parent or caregiver more.
• Cry, scream, or whine.
• Move aimlessly or freeze up.
• Regress to earlier childhood behaviors, such as thumb sucking or bedwetting.
Signs of Trauma in Children and Teens
Children age 6 to 11:
• Lose interest in friends, family, or activities they used to enjoy.
• Experience nightmares or other sleep problems.
• Become moody, disruptive, or angry.
• Struggle with school and homework.
• Complain of physical problems such as headaches or stomachaches.
• Develop unfounded fears.
• Feel depressed, emotionally numb, or guilty over what happened.
Signs of Trauma in Children and Teens
Adolescents age 12 to 17 may:
• Have flashbacks to the event, suffer from nightmares or other sleep problems.
• Avoid reminders of the event.
• Abuse alcohol, drugs, or nicotine products.
• Act disruptive, disrespectful, or aggressive.
• Complain of physical ailments.
• Feel isolated, guilty, or depressed.
• Lose interest in hobbies and interests.
• Have suicidal thoughts.
When to Seek Treatment for Children
• Six weeks have passed, and the child is not feeling any better.
• The child is having trouble functioning at school.
• The child is experiencing terrifying memories, nightmares, or flashbacks.
• The symptoms of traumatic stress manifest as physical complaints such as headaches,
stomach pains, or sleep disturbances.
• The child is having an increasingly difficult time relating to friends and family.
• The child or teen is experiencing suicidal thoughts.
• The child is avoiding more and more things that remind them of the traumatic event.
Kids and Trauma Recovery Tips
• Tip 1: Rebuild trust and safety: physical affection, encourage to do activities they
enjoy, speak of the future and make plans, maintain routines, keep promises
• Tip 2: Minimize (media) exposure
• Tip 3: Engage your child: spending time together and talking face to face—free
from TV, phones, video games, and other distractions. Do your best to create an
environment where your kids feel safe to communicate what they're feeling and to
ask questions
• Tip 4: Encourage physical activity, sports and outdoor games
• Tip 5: Feed child a healthy diet: eating plenty of fresh fruit and vegetables, high-
quality protein, and healthy fats, especially omega-3 fatty acids; Limit fried food,
sweet desserts, sugary snacks and cereals, and refined flour.
Post Traumatic Stress Disorder (PTSD)
● A condition that can follow experiencing or witnessing any disturbing event that
makes you fear for your safety.

● PTSD can affect people who personally experience the traumatic event, those who
witness the event, or those who pick up the pieces afterwards, such as emergency
workers and law enforcement officers.
Events that can lead to PTSD
• War • Rape
• Natural disasters • Kidnapping
• Car or plane crashes • Assault
• Terrorist attacks • Sexual or physical abuse
• Sudden death of a loved one • Childhood neglect

Any shattering event that leaves you stuck and feeling helpless and
hopeless
Risk Factors to PTSD
• Previous traumatic experiences, especially in early life.
• Family history of PTSD or depression.
• History of physical or sexual abuse.
• History of substance abuse.
• History of depression, anxiety, or another mental illness.
• High level of stress in everyday life.
• Lack of support after the trauma.
Symptoms
1. Re-experiencing the traumatic event
• Intrusive, upsetting memories of the
event.
• Flashbacks (acting or feeling like the
event is happening again).
• Nightmares (either of the event or other
frightening things).
• Feelings of intense distress when
reminded of the trauma.
• Intense physical reactions to reminders
of the event (e.g. pounding heart, rapid
breathing, nausea, muscle tension,
sweating).
2. Avoidance and numbing
• Avoiding activities, places, thoughts, or
feelings that remind you of the trauma.
• Inability to remember important aspects
of the event.
• Loss of interest in activities and life in
general.
• Feeling detached from others and
emotionally numb.
• Sense of a limited future (you don’t
expect to live a normal life span, get
married, have a career).
Symptoms
3. Increased anxiety and emotional
arousal (hyperarousal)
• Difficulty falling or staying asleep.
• Irritability or outbursts of anger.
• Difficulty concentrating.
• Hypervigilance (on constant “red
alert”).
• Feeling jumpy or easily startled.
• Self-destructive or reckless
behavior.
4. Negative thought and mood
changes
• Feeling alienated and alone.
• Depression and hopelessness.
• Feelings of mistrust and betrayal.
• Guilt, shame, or self-blame.
• Substance abuse.
• Physical aches and pains.
• Suicidal thoughts.
Symptoms
● PTSD develops differently from person to person because everyone's nervous system
and tolerance for stress is a little different.

● PTSD symptoms are most likely to develop in the hours or days following a
traumatic event, it can sometimes take weeks, months, or even years before they
appear.

● Sometimes symptoms appear seemingly out of the blue. At other times, they are
triggered by something that reminds you of the original traumatic event, such as a
noise, an image, certain words, or a smell.
PTSD Symptoms in Children
• Fear of being separated from their parent.
• Losing previously-acquired skills (such as toilet training).
• Sleep problems and nightmares.
• Somber, compulsive play in which themes or aspects of the trauma are repeated.
• New phobias and anxieties that seem unrelated to the trauma (such as fear of
monsters).
• Acting out the trauma through play, stories, or drawings.
• Aches and pains with no apparent cause.
• Irritability and aggression.
Do You Have PTSD?
1. Have you witnessed or experienced a traumatic, life-threatening event?
2. Did this experience make you feel intensely afraid, horrified, or helpless?
3. Do you have trouble getting the event out of your mind?
4. Do you startle more easily and feel more irritable or angry than you did before the event?
5. Do you go out of your way to avoid activities, people, or thoughts that remind you of the event?
6. Do you have more trouble falling asleep or concentrating than you did before the event?
7. Have your symptoms lasted for more than a month?
8. Is your distress making it hard for you to work or function normally?

If three or more answers to the the questions above are YES, one may have PTSD. For an
accurate diagnosis of PTSD, a visit to a qualified mental health professional is recommended.
Complex PTSD
● Caused by prolonged chronic exposure to traumatic events e.g. growing up in an
abusive household, years of sustained domestic violence, slavery or torture
● CPTSD survivors may experience many of the same symptoms of PTSD, such as
hypervigilance, flashbacks, and emotional numbness, as well as:
● Negative thoughts about oneself: struggle with consistent thoughts of worthlessness
and intense shame
● Difficulty controlling emotions. Intense reactions, feeling overly sensitive, and
struggle with anger; experience of dissociation, a feeling of disconnection with the
world around or surrounding environment
● Difficulty with relationships. hard time establishing or maintaining friendships and
nd romantic relationships; sustained feelings of isolation
Getting Help for PTSD
Tip 1: Challenge the sense of helplessness

Tip 2: Get moving

Tip 3: Reach out to others for support

Tip 4: Adopt a healthy lifestyle

Types of PTSD Treatments
● Trauma-focused cognitive-behavioral therapy involves gradual “exposure” to
feelings and situations that remind one of the trauma and replacing distorted and
irrational thoughts about the experience with a more balanced picture.

● Family therapy can help loved ones understand what one is going through and help
work through relationship problems together as a family.

● Medication is sometimes prescribed to people with PTSD to relieve secondary

symptoms of depression or anxiety, although they do not treat the causes of PTSD.

● EMDR (Eye Movement Desensitization and Reprocessing)

Helping Someone with PTSD
• Tip 1: Provide social support
• Tip 2: Be a good listener
• Tip 3: Rebuild trust and safety
• Tip 4: Anticipate and manage triggers
• Tip 5: Deal with volatility and anger
• Tip 6: Support treatment
• Tip 7: Take care of oneself
Communication pitfalls to avoid – DO
NOT
• Give easy answers or blithely tell • Invalidate, minimize, or deny their
them that everything is going to be
okay.
• Stop them from talking about their
feelings or fears.
• Offer unsolicited advice or tell them
what they “should” do.
• Blame all relationship or family
problems on PTSD.
traumatic experience
• Give ultimatums or make threats or
demands.
• Make them feel weak because they
aren't coping as well as others.
• Tell them they were lucky it wasn't
worse.
• Take over them with one’s own
personal experiences or feelings.
PTSD Triggers - External
• Sights, sounds, or smells associated
with the trauma.
• People, locations, or things that
recall the trauma.
• Significant dates or times, such as
anniversaries or a specific time of
day.
• Nature (certain types of weather,
seasons, etc.).
• Conversations or media coverage
about trauma or negative news
events.
• Situations that feel confining (stuck
in traffic, at the doctor's office, in a
crowd).
• Relationship, family, school, work,
or money pressures or arguments.
• Funerals, hospitals, or medical
treatment.
PTSD Triggers - Internal
• Physical discomfort, such as • Strong emotions, especially feeling
hunger, thirst, fatigue, sickness, helpless, out of control, or trapped.
and sexual frustration. • Feelings toward family members,
including mixed feelings of love,
• Any bodily sensation that recalls
vulnerability, and resentment.
the trauma, including pain, old
wounds and scars, or a similar
injury.
How to help someone having a flashback or
panic attack
During a flashback, people often feel a sense • Encourage them to take deep, slow
of disassociation, as if they're detached from
their own body. Help them “ground”.
• Tell them that they're having a flashback
and that even though it feels real, the
event is not actually happening again.
• Help remind them of their surroundings
(for example, ask them to look around
the room and describe out loud what
they see).
breaths (hyperventilating will increase
feelings of panic).
• Avoid sudden movements or anything
that might startle them.
• Ask before touching them. Touching or
putting one’s arms around the person
might make them feel trapped, which
can lead to greater agitation and even
violence.
4Cs of Trauma Informed Care
Calm
Care
Pay attention to how you are feeling when
Practice self-care and self-compassion while
you are caring for the client. Breathe deeply
caring for others
and calm yourself to model and promote
calmness for the patient, yourself, and your
co-workers

Cope
Contain
Emphasize client’s coping skills, positive
Limit trauma history detail to maintain
relationships, and interventions that build
emotional and physical safety.
resilience
Provide education, resources, and referrals
to trauma-specific care without requiring
disclosure of trauma
Grief
● a multifaceted response to loss,
particularly to the loss of someone or
something that has died, to which a
bond or affection was formed
● also has physical, cognitive, behavioral,
social, and philosophical dimensions
● can be categorized as either physical or
abstract
Video: 5 Things About Grief No One Really Tells you
Sympto
ms
of Grief
Sympto
ms
of Grief
Denial
the common defense mechanism that buffers the
immediate shock of the loss, numbing us to our emotions.

Individuals block out the words and hide from the facts and
start to believe that life is meaningless, and nothing is of any
value any longer.

This stage is a temporary response that carries us through

the first wave of pain.
Anger
as the masking effects of denial begin to wear,
reality and its pain re-emerge.

The individual who is in this stage is not yet ready.

The intense emotion is deflected from the

vulnerable core, redirected and expressed instead
as anger.

The anger may be aimed at inanimate objects,

complete strangers, friends or family.
Bargaining
the normal reaction to feelings of
helplessness and vulnerability is often a
need to regain control through a series of “If
only” statements, such as:

● If only we had sought medical attention

sooner…
● If only we got a second opinion from
another doctor…
● If only we had tried to be a better
person toward them…
Depression
Two types associated with mourning:

a. A reaction to practical implications relating to the

loss and is predominated by sadness and regret
b. Subtle and more private
Acceptance
● reaching this stage of grieving is a gift not afforded to
everyone
● not necessarily a mark of bravery to resist the inevitable
and to deny ourselves the opportunity to make our
peace
● marked by withdrawal and calm
● not a period of happiness and must be distinguished
from depression.
Types of
Grief
 Activity: Types of Grief

Sarah knows someone who has a terminal disease and

feels the loss creeping in before they pass away.
 Activity: Types of Grief

Joey carried on with his normal routine despite the

feelings of grief for the loss of his sibling. Although he
experienced acute feelings of bursts days after his
sibling’s death, the intensity of the feeling lessened over
time.
 Activity: Types of Grief

Wally avoids things that remind him of her wife. He has

a constant feeling of being trapped with no end in sight.
He says that the pain is overwhelming that he has
difficulty doing his tasks at work.
 Activity: Types of Grief

Mark focused on taking care of his daughter when his

wife died and after losing their house. He only talked
about his feelings with a friend months after.
 Activity: Types of Grief

Karyl turned her attention to her work and put all her
time and energy into it after losing her son.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Arlington,
V.A. American Psychiatric Association

Bass, H. (2020). Navigating Grief: A Guidebook for Grief Awareness and Understanding. Retrieved from November 20,
2020 from https://www.learnpsychology.org/now/grief/

Gregory, C. (Undated). The Five Stages of Grief: An Examination of the Kubler-Ross Model. Retrieved from
https://www.psycom.net/depression.central.grief.html

Levenson, J. (April 2017). Trauma-Informed Social Work Practice. Social Work, Volume 62, April 2017 pages 105-113.
https://doi.org/10.1093/sw/swx001

Royal College of Psychiatrists. (August 2016). Coping after a Traumatic Event. Retrieved November 20, 2020 from
https://www.rcpsych.ac.uk/mental-health/problems-disorders/coping-after-a-traumatic-event
Suicide and
Suicidal Ideation
TOPIC 6
Learning Outcomes
By the end of this session, the MHPSS provider will be able to:
● Enumerate the factors associated with suicide and suicidal
ideation
● Identify warning signs on people with suicidal ideation
● Demonstrate what to do and not to in talking with someone
who is suicidal
Suicide
According to the World Health Organization (2016), suicide is a global
phenomenon with 79% of suicides in 2016 occurring in low- and middle-
income countries in 2016.

This accounted for 1.4% of all deaths worldwide, making it the 18th leading
cause of death in 2016.

Accordingly, close to 800 000 people die due to suicide every year, which is
one person every 40 seconds. Suicide occurs throughout the lifespan and is
the second leading cause of death among 15-29-year-olds globally.
Suicidal
Ideation
means wanting to take
your own life or
thinking about suicide

a symptom of mental
health disorders like
major depression and
bipolar disorder
 2 Kinds of Suicidal Ideation

Passive ideation is not necessarily less serious than active ideation since it
can immediately turn into an active one.
 Individual Risk Factors
● Leisure-time
sedentary behavior
● Sleep disorders
● Alcohol and substance ● Depression
abuse ● Impulsivity
Biological ● Delinquency
● Anxiety
● Stress
● Hopelessness
● Difficulty regulating emotions
Psychological ● Presence of one or more
mental disorders such as:
● Incapable of
communicating threshold ○ Dysthymia
for accepting ○ Mood and anxiety
responsibilities in the family
Social disorders
● Experienced adversities in ○ Autism Spectrum
dealing with adults and Disorders
families ○ Bipolar I Disorder
● Sexual or physical abuse ○ Attention-Deficit
● Bullying (either as the bully Hyperactivity Disorder
or victim)
 Environmental Risk Factors
● Having only one or
two friends ● Parent-child conflicts,
gender-based treatment,
secretiveness and
Peers
avoidance of conflict and
an emphasis on
obedience
● Frequent parental
Family quarrels and parental
separation
● Low level of satisfaction
with motherly love
● Maltreatment and
neglect
Video:

Fourteen Ways to Tell if S

omeone is Suicidal
How to prevent suicidal
thoughts
● Talk to someone
● Take medications as directed
● Never skip an appointment
● Pay attention to warning signs
● Eliminate access to lethal methods of
suicide
Activity:
● Participants will be divided into a group composing of three (3) members.
Each member will be acting as the Caller, MHPSS Provider and Observer.
● The Caller will act out seeking help for his suicidal thoughts. The
conversation can last for 5 to 10 minutes.
● After the role-playing, kindly discuss with your groupmates what words
you appreciated as helpful for the caller who is experiencing suicidal
thoughts. Which of these helped one deal with suicidal thoughts and
feelings? Which sounded comforting?
How to talk to people who is feeling
suicidal
● Begin the conversation by asking questions in a non-
judgmental and non-confrontational way.
● Make sure you stay calm and speak in a reassuring tone
during the conversation.
● Make sure not to minimize their problems.
● Offer support and encourage them to seek help from a
professional.
● Tell them that help is available and that they can feel better
with treatment.
References
Legg, T. (December 2019). What you Should Know about Suicide. Retrieved from
https://www.healthline.com/health/suicide-and-suicidal-behavior

National Action Alliance for Suicide Prevention. (2018). Recommended Standard Care for People with Suicide Risk:
Making Heath Care Suicide Safe. Retrieved from
https://theactionalliance.org/sites/default/files/action_alliance_recommended_standard_care_final.pdf

Purse, M. (2020). What is Suicidal Ideation? A Look at Dangerous Thought Patterns. Retrieved from
https://www.verywellmind.com/suicidal-ideation-380609

Social Technology Bureau. (Unpublished). Youth with Mental Health Problems and Suicidal Tendencies: A Review of
Related Literature

Weir, K. (August 2019). Better ways to prevent suicide. American Psychological Association. Retrieved from
https://www.apa.org/monitor/2019/07-08/cover-prevent-suicide