1
Q
managing distress
A
learning to cope with negative or difficult emotional states
- form of self-regulation
2
Q
“tipping point”
A
point when stress becomes too much (stress=harmful)
- begin showing S&S of strain/burden of perceived stress
- different for everyone
3
Q
2 components of the stress diathesis model
A
- stress
- diathesis
4
Q
stress
A
triggers several interconnected biological systems
5
Q
allostasis
A
process by which the body adapts to changes in the body (such as stress)
- essential to maintain balance during challenges
6
Q
diathesis
A
vulnerability or predisposition to a medical condition
caused by…
- biological (genetic inheritance)
- psychological (exposure to stressor)
- interaction between genetic and environmental
7
Q
brain plasticity
A
ability of nervous system to change its activity in response to intrinsic or extrinsic stimuli by recognizing its structure, functions or connections
(Stressful experiences can affect brain structure and function)
8
Q
the brain and regulation
A
brain determines what are threatening and what are positive experiences
- brain is responsible for regulating physical, emotional, behavioural and cognitive response to stressors, events and experiences
9
Q
what happens if stress is manageable?
A
can lead to positive growth and adaptation (steeling effect)
10
Q
steeling effect
A
more resistance to later stress having successfully coped with a stress or challenge
11
Q
brain structure and stress
A
when stressed, brain changes structure in an adaptive or maladaptive way
12
Q
how does the brain process information?
A
- from your internal (ex. hydration, hormones) environment
- from your external (ex. work, friends, family) environment
13
Q
perceived stress
A
based on the way your brain processes information from your environment as well as genetics and life experiences
- everyone reacts differently to the same stress
14
Q
the brain and physiologic responses
A
the brain controls and coordinates the physiological, psychological and behavioural response to perceived stress
- metabolism, HR, anxiety levels, what you tell yourself and how you behave
15
Q
what do physiologic responses result through?
A
signalling of systems such as HPA axis, ANS, metabolic system, the gut, and immune system
16
Q
what interventions alleviate allostatic load?
A
- healthy diet
- regular cardiovascular exercise
- social support
- connectedness (belonging)
- good quality sleep
17
Q
how do genotype x environment (GxE) influence susceptibility to all experiences?
A
- determines resiliency and sensitivity to stress
- increase likelihood of positive effects on well-being if healthy lifestyle
18
Q
What are the two most common mental health disorders in Canada?
A
anxiety disorders and depressive disorders
19
Q
prevalence of anxiety disorder and/or mood disorder in Canada
A
3 million
- 1/4 have not sought treatment
20
Q
emotional signs and symptoms associated with anxiety
A
- on edge
- irritable
- not fully enjoying things
21
Q
physical signs and symptoms associated with anxiety
A
- muscle tension
- restlessness
- shortness of breathe
- chest tightness
- changes in appetite
- fatigue
- headaches
22
Q
behavioural signs and symptoms associated with anxiety
A
- avoidance of feared situations (public speaking)
- short temper and at times angry
- difficulty sleeping
- difficulty concentrating, distracted by worries, forgetfulness
23
Q
cognitive signs and symptoms associated with anxiety
A
- apprehension
- over-worry
- distracted
24
Q
emotional signs and symptoms associated with depression
A
- sad
- non-reactive mood
- feeling despair
- loss of enjoyment of normally enjoyable experiences
25
physical signs and symptoms associated with depression
- changes in sleep (sleeping a lot or less)
- changes in appetite (more or less eating)
- feeling slowed down in your movements, or agitated and restless
- pain
- headaches
26
behavioural signs and symptoms associated with depression
- withdrawing from friends snd family
- staying in more, missing work or university
27
cognitive signs and symptoms associated with depression
- guilt
- suicidal thoughts
- difficulty concentrating
- negative thinking
- thinking over past bad memories and experiences
28
4 indicators that point to a mental health disorder
1. disproportionate reaction
2. time
3. impairment
4. out of character
29
disproportionate reaction as an indicator of a mental health disorder
severity or intensity of symptoms and level of distress are disproportionate to the situation
30
time as an indicator of a mental health disorder
symptoms persistent for an extended period of time (past the stressor)
31
impairment indicating a mental health disorder
symptoms are associated with impairment and interfere with day-to-day life
32
out of character indicating a mental health disorder
others notice the person does not seem themselves or is "off"
33
aspects of a mental disorder diagnosis
required assessment by a mental health professional who takes into account the whole person (life course, family history, current content and symptoms)
34
what is taken into account during the diagnosis of a mental health concern or disorder?
- bullying
- academic problems
- relationship problems
- substance misuse
- family history
- recreation
- exercise
35
information important for assessing mental health status
1. developmental history
2. family history
3. symptoms
4. treatment
5. other factors (lifestyle, misuse of alcohol, drugs and stressors)
6. relational and social factors (relationships, social connectedness, environment)
36
developmental history
- learning
- communication
- neuromotor problems
- childhood adversity
36
family history
family history of mental disorders to identify a predisposition, or genetic and familial vulnerability
37
5 Mental health support - circle of care
1. psychiatry
2. counselling
3. self-help and peer support
4. primary care provider
5. psychological therapy
38
Psychiatry
assess and treat moderate to severe mental health conditions or disorders that require combined psychological and pharmacological treatment approach
39
Counselling
short-term and problem-focuses
- addresses healthy coping during periods of stress
- strengthens problem-solving skills
- manages emotional responses to an identified stressor
40
Peer support
helpful to talk to other students going through or have been through similar experiences
- "buddy" system
41
Peer mentors
student volunteers
- can help by empathizing, sharing information and resources and sharing personal experiences
- easier and less daunting to speak to
42
Self-help
using available resources such as books, websites or apps, to work through a problem
- can be beneficial for some people
43
Primary care provider
CENTRAL to coordinating your health and mental health care
- first line for assessment of a mental health concern
- provide continuity and coordinate your care
- should be kept up to date with any health or mental health support/care
44
Psychological therapy (psychotherapy)
help with and support young people with emotional, social and mental health problems - moderate severity
45
Aim of a stepped care approach
match individual patients to the level of service indicated based on intensity of need (pyramid)
- as you go up pyramid, intensity increases and smaller subgroup of patients
46
bottom of pyramid for stepped care approach
entry level services
47
Entry level services - stepped care
lowest intensity treatment required to meet the individuals needs
- not based on quality, but intensity
48
key to effective stepped care
1. the level of care an individual receives matches the indicated clinical need
2. the steps represent evidence-based effective treatment
3. care provided is acceptable to patients so each level is convenient, accessible and has flexibility (so if clinical needs change, patient can slide up and down pyramid)
49
stepped care pyramid - university experience
bottom to top
1. campus-based health promotion
2. self-guided well-being resources
3. student mental health care teams or family medicine
4. mental health services in community
5. hospital-based services (emergency and urgent care services)
50
What does the stepped care approach do?
want individuals to have indicated level of treatment, but not more than they need
- reserves highest intensity treatments for those patients with more serious/chronic illnesses
51
Who provides mental health support?
1. occupational therapist
2. counsellor
3. psychotherapists
4. clinical psychologist
5. psychiatrist
52
Occupational therapist in University settings
help with learning approaches and improving performance in context of learning activities, and achieving a healthy schedule/study-life balance
53
Counsellor
- support health coping
- support emotional and behavioural regulation
- support healthy lifestyle choices
- achieving a good study-life balance
54
Psychotherapists
group and individual psychological talking therapies
- support individuals with emotional, social and mental health problems of mild to moderate severity
55
Different models of psychotherapy
- CBT
- interpersonal psychotherapy (IPT)
- psychodynamic psychotherapy
56
Clinical Psychologist
provide manualized effective group and individual therapeutic approaches to help with mental health problems and conditions
- provide psychological support and treatment for mild to moderate MH problems
- work as part of multidisciplinary team supporting patients with more moderate to serve MH disorders
57
Psychiatrist
medical doctors
- diagnose and treat mental disorders, integrating pharmacological treatment with other aspects of educational, psychological and social and family care
- referral from a family doctor
58
what does psychiatric assessment take into account?
- developmental and family history
- psychosocial content
- early adversity
- onset and clinical course and nature of symptoms
- any contributing risk factors (stress, substance use, co-morbid medical illness, meds)
59
ideal mental health system model
- welcoming clinic visit to determine support need
- referrals to appropriate level of service and support (stepped care model)
- seamless flow between levels of service and between community-based and campus-based service
60
Triage - ideal model
single point of contact
- sorting out what is going on, nature of the problem, and what the indicated level of care should be
- should be delivered by seasoned MH professionals who are empathetic and can immediately point students to whats needed at the first contact
61
Queen's Student Health and Wellness Services (QSWS)
supports personal, academic and social health development of students
- provides a range of programs and services, including physical and mental healthcare
62
Queen's Student Accessibility Services (QSAS) (part of QSWS)
supports personal and MH of students and their academic success through providing a range of resources and services
63
Psychology Clinic at Queen's University
provides psychological assessments, treatments, and consultation for Queen's students and members of Kingston
- fee-for-service model (based on income)
64
Community-based services
1. Hospital-based services
2. Publicly funded community-based services
3. Private and fee-for-service options
65
Hospital-based services
emergency or urgent care and various sub-speciality programs (eating disorders, early psychosis) which have defined criteria for admission
66
Publicly funded community-based services
high demand + limited funding
- means long waitlists and prioritize the most ill
- do not line up with student demographic or needs of students
67
Private and fee-for-service options
many people rely on these, and OHIP does not cover psychotherapy outside of what is offered on campus
- sometimes insurance coverage
68
Barriers to mental health care
1. stigma-related barriers
2. attitudinal barriers
3. practical barriers
69
Stigma-related barriers to mental health care
stigma and fear of being evaluated negatively stops people from getting help
70
how to reduce stigma-related barriers?
person-first language (no outdated terms)
71
Attitudinal barriers to mental health care
people often invalidate their own or other's mental health concerns or diagnosis if there is not a clear diagnosable test to provide clear proof and validation of MH disorder
- misunderstandings about MH or fears about others reactions get in way of getting help
72
Practical barriers to mental health care
1. long-wait times
2. financial barriers (limit timely access to certain specialized services)
3. challenges navigating the system (difficulty to know what level of services you need and how to access)
72
4 categories of severity of symptoms/distress
1. no symptoms (prevention and health promotion)
2. mild symptoms (self-help for targeted S&S)
3. mild-moderate symptoms (social &/or psychological approaches(
4. moderate-severe symptoms (pharmacological and psychological approaches)
73
mental health promotion
- study-life balance
- good quality sleep
- connection to others
- spend time in nature
- involve yourself in hobbies and activities you enjoy
- regular exercise
- reducing alcohol and caffeine
- avoiding drugs
74
exercise for health promotion
getting HR up into cardiac training zoe (can still talk), regularly for 20-30 minutes several times a week
- helps maintain well-being, emotional MH and academic performance
75
social support network
prevents anxiety and depressive symptoms
76
self-help workbooks and apps
1. Mind over Mood (WB)
2. Headspace
3. SliverCloud
4. iSpero
77
Social approaches
variety of supports that can improve social support and well-being -benefit mild MH symptoms
- social skills workshops
- interest groups and clubs
- health promotion
- support groups
78
Social prescribing
supports well-being
- getting out in nature, spending time with others, investing in interests and taking part in recreation activities all support WB and MH (necessary for effective and efficient learning)
79
Psychological approaches
can be effective in reducing and managing moderate symptoms of anxiety, depression and sleep problems
- can be delivered individually or in a group setting
80
when is psychological therapy needed?
if MH symptoms persist or worsen
81
examples of therapy modalities
1. Mindfulness-based stress reduction
2. Behavioural activation
3. Supportive counselling
4. Interpersonal Psychotherapy (IPT)
5. CBT
6. Cognitive Processing Therapy (CPT)
82
Mindfulness-based stress reduction
useful for being mentally present, focused and relaxed
83
Behavioural activation
evidence-based treatment based on increasing activity level, especially in pleasurable activities to combat low mood
84
Supportive counselling
involved having a supportive person to explore current issues, gain insight into difficulties, and look for difference ways of approaching them
85
Interpersonal Psychotherapy (IPT)
focuses on relieving symptoms by improving interpersonal functioning
- focuses on understanding and strengthening your relationship with yourself and others
86
CBT
effective in treating mild-moderate sleep problems, anxiety and depression
87
Cognitive Processing Therapy (CPT)
another type of CBT that focuses on evaluating and changing upsetting thoughts
- used to reduce symptoms of PTSD
88
CBT explained
evidence-based therapy that addresses and changes maladaptive thinking patters (cognitions) and modifies behaviour
- anxiety, depression, ED's and trauma
- often useful when combined with other psychosocial and educational approaches including medication
89
practicing minfulness
shown to have sustained positive effects on students well-being and resilience to stress
- beneficial effects on students' average level of psychological distress (effects lasted for at least a year)
90
Mindfulness exercises
1. focusing on an object
2. focusing on your breathing
91
medical approach
medication
- important component of assessment and treatment
- family doctors and psychiatrists are trained to assess whole person - symptoms in psychosocial, family and medical context
92
Alternative medical explaination
considered when there might be a medical explanation for symptoms ex. thyroid problems can have significant impact on well-being, mood and energy and can cause depression-like symptoms
93
medication
can be central part of treatment for specific disorders and severity of disorders
- fam doctors work with psychiatrists to identify when meds are required and to assess tolerability and treatment response
94
physical and mental health interaction
must consider
- often physical illnesses are associated with mental health problems and vice versa
IDIS 199
flashcards
Decks in class (6)
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