Mental Health First Aid Skills

DEPRESSION

Approximately 1 in 4 people in the UK will experience a mental health problem each year. In England, 1 in 6 people report experiencing a common mental health problem (such as anxiety and depression) in any given week. According to the 2013 Global Burden of Disease study, the predominant mental health problem worldwide is depression, followed by anxiety, schizophrenia and bipolar disorder. In 2013, depression was the second leading cause of years lived with disability worldwide, behind lower back pain. In 26 countries, depression was the primary driver of disability. Depressive disorders also contribute to the burden of suicide and heart disease on mortality and disability; they have both a direct and an indirect impact on the length and quality of life.

WHAT IS DEPRESSION?

Depression is a common mental health problem that causes people to experience low mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. Everyone can feel sad or low when things happened in their lives. However, feeling sad or down does not mean that you have depression. The vast majority of periods of low mood will eventually lift and most people can learn to cope with negative feelings and manage their mood. Depression is often used as a blanket term for feeling sad however in this course we will be talking about differences between clinical depression and the short term situational depression.

SITUATIONAL AND CLINICAL DEPRESSION. WHAT ARE THE DIFFERENCES?

Situational and Clinical Depression. What are the differences? A disappointing event or devastating news can lead to short-term symptoms of depression. Some key differences between situational and clinical depression will determine the type of treatment the person needs and the severity of the condition. No type of depression is more “real” than another. Both can present significant challenges and threats to wellbeing. However, knowing which type of depression is at the root of a persistent negative mood can support recovery.

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WHAT IS ANXIETY?

The origin of feelings of anxiety and stress are an instinctive response to pressure. The more intolerable or persistent a person may perceive this pressure to be, the more heightened the anxiety. Anxiety is a survival tool, left over from human evolution. At one time anxiety would make us aware of danger and keep us alert. The problem is we are not in the jungle anymore and feelings of anxiety manifest themselves in everyday situations were a life or death survival instinct is not required. Everyone experiences anxiety at some point in life.

Now in our society, feeling anxious before something like public speaking is perfectly normal. The feeling in the pit of your stomach before you stand up to do that speech is the same feeling that was developed in evolution to tell us we are in danger and should run away! Unfortunately, sometimes that feeling (known as ‘the fight or flight instinct’) can manifest themselves in everyday situations, were they do not belong. This is an anxiety disorder.

In the UK, women are almost twice as likely as men to be diagnosed with anxiety disorders.’ Anxiety can vary in severity, ranging from a low level feeling of being alert to a possible threat all the way up to a crippling panic attack. Anxiety disorder is an umbrella term that includes different conditions:

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BIPOLAR DISORDER

Bipolar disorder is a mental health condition that affects your moods, which can swing from one extreme to another. It used to be known as manic depression. People with bipolar disorder experience varying episodes of:

• Depression – feeling very low and lethargic.

• Mania – feeling very high and overactive.

DEPRESSION

Symptoms of bipolar disorder depend on which mood a person is experiencing. Unlike simple mood swings, each extreme episode of bipolar disorder can last for several weeks (or even longer), and some people may not experience a “normal” mood very often. A person may initially be diagnosed with clinical depression before they have a manic episode (sometimes years later), after which they may be diagnosed with bipolar disorder. During an episode of depression, you may have overwhelming feelings of worthlessness, which can potentially lead to thoughts of suicide.

MANIA

During a manic phase of bipolar disorder, a person may:

• Feel very happy.

• Have lots of energy, ambitious plans and ideas.

• Spend large amounts of money on things you cannot afford and would not normally want. It’s also common to:

• Not feel like eating or sleeping.

• Talk quickly.

• Become annoyed easily.

A person may feel very creative and view the manic phase of bipolar as a positive experience. However they may also experience symptoms of psychosis, where they see or hear things that are not there or become convinced of things that are not true.

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CHRONIC STRESS

WHAT IS CHRONIC STRESS?

Short-lived feelings of stress are a regular part of daily life. When these feelings become chronic, or long lasting, they can severely impact a person’s health. In this section we look at what chronic stress is, how to identify it, and the medical consequences it can have. We also describe ways to manage stress, including medical treatments, and when to see a doctor. ‘The physical effects of stress usually do not last long. However, some people find themselves in a nearly constant state of heightened alertness. This is chronic stress.

Signs of chronic stress can include a range of red flags such as headaches, fatigue, and low self-esteem. Stress is a biological response to demanding situations. It causes the body to release hormones, such as cortisol and adrenaline. These hormones help prepare the body to take action, for example by increasing the heart and breathing rates. When this occurs, a doctor might describe a person as being in a state of heightened alertness or anxiety.

Many factors can trigger a stress response, including dangerous situations and psychological pressures, such as work deadlines, exams and sporting events. The physical effects of stress usually do not last long. However, some people find themselves in a nearly constant state of heightened alertness. This is chronic stress. Some potential causes of chronic stress include:

• High-Pressure Jobs

• Financial Difficulties

• Challenging Relationships

Chronic stress puts pressure on the body for an extended period. This can cause a range of symptoms and increase the risk of developing certain illnesses.

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OBSESSIVE COMPULSIVE DISORDER (OCD)

Obsessive-Compulsive Disorder presents itself in many guises, and certainly goes far beyond the common misconception that OCD is merely a little hand washing or checking light switches, although these are still valid OCD compulsions. Perceptions can fail to acknowledge the distressing thoughts that occur prior to such behaviours and also fails to highlight the utter devastation that constant compulsions (no matter what they are) can cause.

Although there are infinite forms of OCD, it has been traditionally considered that a person’s OCD will fall into one of these five main categories, with themes often overlapping between categories too.

• Checking

• Contamination / Mental Contamination

• Symmetry And Ordering

• Ruminations / Intrusive Thoughts

• Hoarding There are infinite types of OCD, it can impact on any thought, on any subject, on any person, on any fear, and frequently fixates on what’s important in a person’s life. For example, if religion is important to someone, OCD fixates on unwanted intrusive thoughts around religion, perhaps making the sufferer believe their actions/thoughts will offend their God.

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WHAT IS PTSD?

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder which you may develop after being involved in, or witnessing, traumatic events. The condition was first recognised in war veterans and has been known by a variety of names, such as ‘shell shock’. But it’s not only diagnosed in soldiers – a wide range of traumatic experiences can cause PTSD such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault.

However, exposure could be indirect rather than first hand. For example, PTSD could occur in an individual learning about the violent death of a close family. It can also occur as a result of repeated exposure to horrible details of trauma such as police officers exposed to details of child abuse cases. People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended.

They may relive the event through flashbacks or nightmares; they may feel sadness, fear or anger; and they may feel detached or estranged from other people. People with PTSD may avoid situations or people that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as a loud noise or an accidental touch.

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WHAT IS POSTNATAL DEPRESSION?

All parents go through a period of adjustment as they try to handle the huge changes a baby brings. For most people, this time of adjustment will be temporary and will not be overly distressing. Many women experience what’s known as the ‘baby blues’ in the first few days after having a baby. The baby blues usually only last 2 to 3 days and new mothers might feel upset, anxious and moody during that time. The support of a partner, family and friends is usually enough to help a person get through it.

When these feelings last beyond these early days and continue to get worse, it may be a sign of developing depression. Postnatal depression is the name given to depression that develops between one month and up to one year after the birth of a baby. It affects about 1 in every 7 women who give birth each year.

However, it’s not just new mothers who experience postnatal depression. Many new fathers also experience postnatal mental health issues.

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WHAT IS PSYCHOSIS AND SCHIZOPHRENIA?

PSYCHOSIS

Psychosis is a syndrome or group of symptoms. Someone experiencing an episode of psychosis is having a ‘break’ with reality. Major symptoms of psychosis are hallucinations and delusions. Hallucinations are sensations that are not real, such as hearing voices or sounds that aren’t real. Hearing voices is a common hallucination, but hallucinations can be experiences with any sense—hearing, sight, smell, taste, or touch.

Delusions are strong beliefs that can’t possibly be true. Common delusions include the belief that someone is following or monitoring you, or the belief that you have extraordinary powers or abilities. Other symptoms of psychosis include difficulties concentrating, completing tasks, or making decisions. Thoughts may feel ‘jumbled’ or confused. Some people have a hard time following conversations or speaking clearly. Psychosis can even affect the way people move or express their emotions.

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