Mental wellbeing

• WHO mental health definition

  A state of wellbeing in which the individual realises his or his own abilities, can cope with normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community
• Dual - continuum model

  • our subjective sense of mental wellbeing, and
  • whether or not we are living with a mental disorder
• Mental wellbeing and mental disorders are each experienced along a continuum - a range of experiences from low to high levels
• Components of dual continuum model:

  1. Emotional wellbeing - how a person feels
  2. Psychological wellbeing - how a person thinks about (perceives or appraises) themselves and their goals
  3. Social wellbeing - a person's sense of belonging to a community and their sense of being able to contribute meaningfully to society
• Flourishing

  A state of optimal wellbeing in which a person both feels good (emotional wellbeing) and functions effectively (psychological wellbeing)
• Languishing

  Experiencing low levels of psychological and social functioning
• Mental disorder

  Clinically significant conditions of mental ill-health that have a range of different presentations characterised by a combination of abnormal thoughts, perceptions, emotions behaviour and relationships with others
• A mental disorder usually causes distress to the person experiencing the disorder and impairs their ability to function effectively in personal, family, social educational and occupational domains of life
• A person who is experiencing some symptoms of mental disorder but does not meet all the criteria for a specific diagnosis is said to be experiencing a mental health problem
• Mental health problem

  Disruption to an individuals usual levels of social and emotional wellbeing
• Resilience

  Describes a person's ability to respond adaptively to stressful life events and cope with uncertainty
• Internal factors - personal characteristics

  • coping strategies
  • biological characteristics (physical health)
• External factors - social and environmental influences

  • access to supportive relationships
  • access to health and social services
• Resilience not the same as mental wellbeing

  reciprocal relationship = influence eachother
• Suggestions for building resilience

  • contribute/build a community - get support
  • challenge yourself to learn a new skill or hobby - meeting a goal
• Internal factors are influences on our wellbeing that come from sources within ourselves including:

  • family history
  • dietary choice
  • coping strategies
• External factors are influences on our wellbeing from sources outside ourselves

  1. Physical environment - poor quality housing
  2. Biological environment - drugs and alcohol
  3. Social environment -financial stability interpersonal relationships
• Stress is the combination of physiological and psychological responses we experience when confronted with a situation that is threatening or challenging, we experience stress when the demands on us exceed our perceived ability to cope
• Anxiety describes the emotional state we feel when we anticipate threat or danger
• Phobia - is a form of anxiety disorders

  Person experiences an intense and irrational fear of a specific object, activity or situation
• Contributing factors:

  Biological:

  GABA dysfunction

  • people with phobias tend to have low levels of GABA = makes them more vulnerable to anxiety and therefore specific phobias
  • GABA's role is to calm/slow neural transmission to make neurons less likely to fire
• Contributing factors

  Biological:

  LTP

  • Long-term strengthening of connection between the pre-synaptic and post-synaptic neurons
  • Specific phobia is learnt
  • Brain regions involved: hippocampus (explicit memories) amygdala (emotions) neocortex (storage)
• Contributing factors

  Psychological:

  Classical conditioning

  Before conditioning

  NS - rat - no response

  UCS (bang) - UCR (fear due to loud bang)

  During conditioning

  NS + UCS = UCR (fear due to bang)

  After conditioning

  CS - rat - CR (fear due to rat)
• Contributing factors

  Psychological:

  Operant conditioning

  Antecedent - phobic stimulus

  Behaviour - avoidance

  Consequence - negative reinforcement
• Contributing factors

  Psychological:

  Cognitive bias - systematic error in decision-making

  Catastrophic thinking: an individual repeatedly overestimating the potential dangers and assumes the worst of an object or event (outcome of a future event - considered unrealistic + irrational)
• Contributing factors

  Psychological:

  Cognitive bias - systematic error in decision-making

  Memory bias: tendency to remember information of one kind at the expense of another kind; including negative and threat-related experiences associated with specific phobias
• Contributing factors

  Social:

  Specific environmental trigger

  • traumatic event
  • modelling: observe someone else's behaviour + consequence
• Contributing factors

  Social:

  Stigma around seeking treatment

  • most phobias involve irrational fear - people feel embarrassed to seek help
• Interventions

  Biological:

  GABA agonists - benzodiazepine

  • mimics the role of GABA - inhibitory/calming response
  • short-term, anti-anxiety
  • works by slowing down the central nervous system
  • act by facilitating the binding of the inhibitory neurotransmitter GABA at various GABA receptors throughout the CNS
• Interventions

  Biological:

  Breathing retraining

  • process of identifying incorrect breathing habits and replacing them with correct ones
  • breathing techniques are learned to counter the sympathetic NS response to a phobic stimulus
• Interventions

  Psychological:

  CBT

  C - identify irrational thinking and replace with realistic thoughts

  B - modify unhelpful behaviours (avoidance) that have developed due to irrational thinking
• Interventions

  Psychological:

  Systematic desensitisation

  • type of behaviour therapy that uses counterconditioning to reduce the anxiety a person experiences when in the presence of thinking about a feared stimulus
  • learning relaxation techniques and practising these while the psychologist exposes the client to experiences with the feared stimulus by systematically increasing the intensity of the experience
• Interventions

  Social:

  Psychoeducation

  • a psychosocial approach in which a person experiencing a mental health problem or disorder and their family are provided with information to help them understand the condition and how to manage it
• Interventions

  Social:

  Psychoeducation - challenging unrealistic thoughts

  • Sufferers know their fear is excessive but feel powerless to control it
  • Families and supporters can help to challenge unrealistic thoughts
• Interventions

  Social:

  Psychoeducation - not encouraging avoidance behaviours

  • Avoidance behaviours try to prevent exposure to the phobic stimulus - maladaptive because it does attempt to remove fear response
  • Family and supports should not criticise or encourage the use of avoidance behaviours
• Protective factors: decrease the likelihood of a person developing a particular mental health problem or disorder
• Protective factors

  Biological:

  • adequate nutrition - directly through nutrients, indirectly through emotional impact if having a physical condition caused by an unhealthy diet
  • adequate hydration - mind dehydration can lead to irritability and restlessness
  • Adequate sleep - adequate ABC, sleep hygiene strategies
• Protective factors

  Psychological:

  • Cognitive behaviour strategies - recognise our negative or unproductive patterns of thinking and behaviour affect on emotions

  Examples of strategies:

  • Relaxation and breathing techniques
  • Identifying situations that are often avoided and confronting these through systematic desensitisation
• Protective factors

  Psychological:

  Mindfulness meditation - focuses attention on breathing with thoughts, feelings and sensations being experienced freely aas they arise without judgement

  Attention: turning into your experiences to focus on what's happening in the present moment

  Acceptance: observing feelings and sensations without judgement
• Protective factors

  Social:

  • energising - support provides with enthusiasm and determination to complete a task, try something new or reach a goal
  • authentic - authentic people behave with truth and integrity towards others, truly listen to and connect with the experience of another person