chapter promoting and preserving your 2...

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CHAPTER

2 Promoting and Preserving Your Psychological Health

Overview

Psychological health is a critical part of life and contributes significantly to our quality of life, and our ability to appreciate life is directly related to psychological health. Chapter 2 discusses the intellectual, emotional, social, and spiritual qualities of health that make up the very heart of how we perceive our life experiences. This chapter also explores important issues such as depression and suicide, helping the student to understand when to get help or how to recognize when friends need help. Tips for avoiding negative thoughts and focusing on the positive aspects of life are also provided in this chapter.

Learning Objectives

1. Define each of the four components of psychological health, and identify the basic traits shared by psychologically healthy people.

2. Learn what factors affect your psychological health; discuss positive steps you can take to enhance your psychological well-being.

3. Identify psychological disorders, such as anxiety disorders and depression, and explain their causes and treatments.

4. Explain the different types of treatments and mental health professionals, and examine how they can play a role in managing mental health disorders.

Lecture Outline

I. What Is Psychological Health? A. Psychological health is the sum of how we think, feel, relate, and exist in our day-to-day

lives. 1. Psychologically healthy people share many basic elements:

a. They feel good about themselves. b. They feel comfortable with other people. c. They control tension and anxiety. d. They meet the demands of life. e. They curb hate and guilt.

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f. They maintain a positive outlook. g. They value diversity. h. They appreciate and respect nature.

2. Basic needs must be met before we can achieve the characteristics of psychologically healthy people. a. This idea is described by Abraham Maslow’s hierarchy of needs (Figure 2.2).

i. Hierarchy of needs is composed of the following levels: 1. Survival Needs: food, water, sleep, exercise, sexual expression 2. Security Needs: shelter, safety, protection 3. Social Needs: belonging, affection, acceptance 4. Esteem Needs: self-respect, respect for others 5. Self-Actualization: creativity, spirituality, fulfillment of potential

b. According to Maslow’s Hierarchy of Needs, a person’s needs must be met at each level before that person can be truly healthy.

c. Psychologically healthy people are emotionally, mentally, socially, and spiritually resilient (see Figure 2.3).

B. Mental Health 1. Mental health describes the “thinking or rational” part of psychological health. It plays

a role in the way we think, communicate, express emotion, and feel about ourselves. 2. A mentally healthy person perceives life in realistic ways, can adapt to change, can

develop rational strategies to solve problems, and can carry out personal and profes-sional responsibilities.

C. Emotional Health 1. Emotional health refers to the feeling, or subjective, side of psychological health. 2. Emotions are intensified feelings or complex patterns of feelings we experience. 3. Emotionally healthy people are able to respond in a stable and appropriate manner to

upsetting events. 4. Emotional health also affects social health.

D. Social Health 1. Social health refers to our interactions with others on an individual and group basis as

well as our ability to adapt and use social resources and support when needed. 2. Two factors important to social health:

a. Presence of social bonds reflects the level of closeness and attachment we develop with others.

b. Presence of key social support consists of networks or people and services with whom we share ties.

c. Some common descriptions of strong social support include: i. Being cared for and loved, with shared intimacy ii. Being esteemed and valued; having a sense of self worth iii. Sharing companionship, communication, and mutual obligations with others;

having a sense of belonging iv. Having “informational” support—access to information, advice, community

services, and guidance from others


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E. Spiritual Health 1. Spirituality is broader than religion and is defined as a person’s sense of peace,

purpose and connection to others, and beliefs about the meaning in life; it goes beyond material values.

2. Spiritual health refers to the sense of belonging to something greater than the purely physical or personal dimensions of existence. a. See Focus On: Cultivating Your Spiritual Health to explore your spiritual health.

Key Terms: psychological health, mental health, emotional health, emotions, social health, social bonds, social support, spiritual health

Figures and Tables:

Lecture Launcher Video: The Study of Happy Brains

Additional Instructor Resources: PPT slides: 3–12 Digital Transparency Masters: Figure 2.1, Figure 2.2, Figure 2.3

II. Factors That Influence Psychological Health A. The Family

1. Families have a significant influence on psychological development. 2. Healthy, nurturing families produce more well-adjusted adults. 3. Children raised in dysfunctional families may have a harder time adapting to life and

run an increased risk of psychological problems.

B. Social Supports 1. Initial social support may be provided by family members, but as we grow and

develop, the support of peers becomes more and more important. 2. A recent study showed that college students with adequate social support are less like-

ly to experience mental health issues.

C. Community 1. Communities that we live in can have a positive impact on our psychological health

through collective actions.

D. Self-Efficacy and Self-Esteem 1. Self-efficacy refers to a person’s belief about whether he or she can successfully

engage in and execute a specific behavior. 2. Self-esteem refers to one’s sense of self-respect or self-worth.

Figure 2.1 Psychological Health

Figure 2.2 Maslow’s Hierarchy of Needs

Figure 2.3 Characteristics of Psychologically Healthy and Unhealthy People




E. Learned Helplessness versus Learned Optimism 1. Learned helplessness is a response to continued failure where people give up and fail

to take action to help themselves. 2. It is thought that self-help programs can promote the principle of “learned optimism.”

F. Personality 1. Your personality is the unique mix of characteristics that distinguish you from others. 2. Heredity, environment, culture, and experience influence how each person develops. 3. The following personality traits are often related to psychological well-being:

a. Extroversion b. Agreeableness c. Openness to experience d. Emotional stability e. Conscientiousness f. Resiliency

G. Life Span and Maturity 1. Our temperaments change as we move through life. 2. The transition to independence will be easier for those who have successfully

accomplished earlier developmental tasks. Key Terms: dysfunctional families, self-efficacy, self-esteem, learned helplessness, learned optimism Additional Instructor Resources: PPT slides: 13–14

III. The Mind–Body Connection A. Happiness and Health

1. At the core of the mind–body connection is the study of psychoneuroimmunology, or how the brain and behavior affect the body’s immune system.

2. Happiness or related mental states such as hopefulness, optimism, and contentment appear to reduce the risk or limit the severity of cardiovascular disease, pulmonary disease, diabetes, hypertension, colds, and other infections.

3. Subjective well-being (SWB) is that uplifting feeling of inner peace and wonder called happiness, which is defined by three central components: a. Satisfaction with present life b. Relative presence of positive emotions c. Relative absence of negative emotions

4. People with SWB are typically resilient, are able to look on the positive side, get back on track quickly, and do not despair as deeply over setbacks.

5. Some scientists suggest that some people may be biologically predisposed to happi-ness. Others say that we can develop happiness by practicing positive psychological actions a. See the Skills for Behavior Change box for ways to incorporate positive psychology

into your own life. Key Terms: psychoneuroimmunology (PNI), subjective well-being Additional Instructor Resources: PPT slides: 15




IV. Strategies to Enhance Psychological Health A. Attaining self-fulfillment is a lifelong, conscious process.

B. Strategies to enhance psychological health include the following: 1. Find a support group. 2. Complete required tasks. 3. Form realistic expectations. 4. Make time for you. 5. Maintain physical health 6. Examine problems and seek help when necessary. 7. Get adequate sleep.

a. For more information on the importance of sleep, see Focus On: Improving Your Sleep.

Additional Instructor Resources: PPT slide: 16

V. When Psychological Health Deteriorates A. Mental illnesses are disorders that disrupt thinking, feeling, moods, and behaviors and

cause a varying degree of impaired functioning in daily life. B. An estimated 26 percent of Americans aged 18 and older, 1 in 4 adults, suffer from a

diagnosed mental disorder each year. Many suffer from more than one at a time. 1. Mental disorders are the leading cause of disability in the United States and Canada

for people aged 15–44. See Figure 2.4. C. Mental Health Threats to College Students

1. College students face increasing threats from difficulty in relationships, anxiety, depression, sexual assaults, pressure to take drugs, and many social and environmental problems.

2. The National College Health Assessment survey illustrates some of the difficulties college students face today. See Figure 2.5.

D. Health Headlines box: When Adults Have ADHD. For more information about the myths and facts of adults with ADHD.

Key Terms: mental illnesses

Figures and Tables:

Additional Instructor Resources: PPT slides: 17–20 Digital Transparency Masters: Figure 2.4, Figure 2.5

Figure 2.4 Prevalence of Serious Mental Illness Among U.S. Adults by Sex, Age, and Race

Figure 2.5 Mental Health Concerns of American College Students, Past 12 Months




VI. Mood Disorders A. Chronic mood disorders are disorders that affect how you feel, such as persistent sadness

or feelings of euphoria. They include depression, dysthymia, bipolar disorder, and seasonal affective disorder.

B. Major Depression 1. Major depression is the most common mood disorder, affecting approximately 7

percent of the U.S. population. a. See Health in a Diverse World box to learn about differences in depression preva-

lence across different ages, genders, and ethnicities. b. Major depression is characterized by a combination of symptoms that interfere with

work, study, sleep, appetite, relationships, and enjoyment of life. 2. Depression in college students can be a major obstacle to academic success.

a. The American College of Health Association found that the number of students who reported being diagnosed with depression was 8.3 percent.

C. Dysthymic Disorder 1. Many people suffer from dysthymic disorder, a less severe syndrome of chronic, mild

depression.

D. Bipolar Disorder 1. Bipolar disorder (also called manic depression) is a type of depressive mood disorder

characterized by severe mood swings.

E. Seasonal Affective Disorder (SAD) 1. Seasonal affective disorder (SAD) strikes during the winter months and is associated

with reduced exposure to sunlight. People with SAD suffer from irritability, apathy, carbohydrate craving and weight gain, increased sleep time, and general sadness.

F. What Causes Mood Disorders? 1. Mood disorders are caused by the interaction between multiple factors including

biological differences, hormones, inherited traits, life events, and early childhood trauma.

Key Terms: chronic mood disorder, major depression, dysthymic disorder (dysthymia), bipolar disorder, seasonal affective disorder (SAD)

Additional Instructor Resources: PPT slides: 21–26

VII. Anxiety Disorders A. Anxiety disorders are characterized by persistent feelings of threat and worry.

1. Anxiety disorders are the number 1 mental health problem in the United States, affect-ing more than 18 percent of all adults.

B. Generalized Anxiety Disorder 1. Generalized anxiety disorder (GAD) is a common form of anxiety disorder; it can be

severe enough to significantly interfere with daily life. C. Panic Disorders

1. Panic disorders are characterized by the occurrence of panic attacks, a form of acute anxiety reaction that brings on an intense physical reaction.

2. Heredity, stress, and certain biochemical factors may contribute to panic attacks.




D. Phobic Disorders 1. Phobias involve deep persistent fears of objects, activities, or situations. 2. Social phobia is an anxiety disorder characterized by the persistent fear and avoidance

of social situations. E. Obsessive-Compulsive Disorder

1. Obsessive-compulsive disorder (OCD) occurs when people feel compelled to perform rituals repeatedly; are fearful of dirt or contamination; have an unnatural concern about order, symmetry, and exactness; or have persistent intrusive thoughts that they cannot shake.

2. Medication and cognitive behavioral therapy are often keys to treatment.

F. Post-Traumatic Stress Disorder 1. Post-traumatic stress disorder (PTSD) occurs in one-third of people who have

experienced a traumatic life event. 2. PTSD affects 17 percent of soldiers returning from war in Iraq and Afghanistan and

more than 30 percent of those who returned from Vietnam. 3. Symptoms of PTSD include dissociation of the mind from the body and acute anxiety

or nervousness.

G. What Causes Anxiety Disorders? 1. There are no clear reasons as to why a person develops an anxiety disorder. 2. The cause may be biological, environmental, or within cultural and social roles.

Key Terms: anxiety disorders, generalized anxiety disorder (GAD), panic attack, phobia, social phobia, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD)

Lecture Launcher Video: Keeping Obsessive-Compulsive Disorder in Check; The Hoarders


VIII. Personality Disorders A. Personality disorders are “enduring patterns of inner experience and behavior that

deviate markedly from the expectation of the individual’s culture and are pervasive and inflexible.

B. Common types of personality disorders include the following: 1. Paranoid personality disorders: pervasive, unfounded suspicion and mistrust of other

people, irrational jealousy, and secretiveness 2. Narcissistic personality disorders: exaggerated sense of self-importance and

self-absorption 3. Borderline personality disorders: impulsiveness and engaging in risky behaviors

Key Terms: personality disorders Additional Instructor Resources: PPT slide: 33

IX. Schizophrenia A. Schizophrenia is characterized by the alteration of senses; the inability to sort out

incoming stimuli and to make appropriate responses; an altered sense of self; and radical changes in emotions, movements, and behaviors.




B. Schizophrenia is treatable but not curable. C. Treatments include hospitalization, medication, and supportive therapy. Key Terms: schizophrenia Additional Instructor Resources: PPT slides: 34–35

X. Suicide: Giving Up on Life A. Suicide is the third leading cause of death on college campuses.

1. See Student Health Today to consider the suicide rates of LGBT youth

B. Warning Signs of Suicide 1. In most cases, suicide does not occur unpredictably. 2. There are several common warning signs of suicide intent.

C. Preventing Suicide 1. Get involved if someone you know threatens suicide or displays warning signs.

a. Monitor the warning signals. b. Takes threats seriously. c. Let the person know how much you care. d. Listen. e. Ask directly. f. Do not belittle the person’s feelings. g. Help the person think about alternatives to suicide. h. Tell your friend’s spouse, partner, parents, siblings, or counselor.


XI. Seeking Professional Help for Psychological Problems A. Increasingly Americans are turning to mental health professionals and nearly 1 in 5 seek

such help. 1. In addition to seeking help, there are other positive steps you can take now to help pull

yourself out of negative thoughts and feelings. See Skills for Behavior Change and Points of View.

B. Mental Illness Stigma 1. Very few people who suffer with mental illness are dangerous. 2. The stigma of mental illness often leads to feelings of shame, guilt, loss of self-esteem,

and a sense of isolation and hopelessness.

C. Getting Evaluated for Treatment 1. A thorough examination before receiving professional help for a psychosocial problem

includes three parts: a physical checkup, a psychiatric history, and a mental status examination.

D. Mental Health Professionals 1. Several types of mental health professionals offer help and treatment for psychosocial

problems. See Table 2.1.

E. What to Expect in Therapy 1. Many different types of counseling exist, including individual and group therapy. 2. You have the right to find a therapist with whom you feel comfortable.




F. Pharmacological Treatment 1. Psychotherapeutic treatment often combines behavioral therapy with drug therapy.

a. Table 2.2 provides information about the major classes of medications used to treat the most common mental illnesses.

2. Potency, dosage, and side effects of drugs can vary greatly, and it is vital to talk with your health care provider and completely understand the risks and benefits of the med-ication prescribed.

Figures and Tables:


Digital Transparency Masters: Table 2.1, Table 2.2

Discussion Questions

1. What is psychological health? How do you know if you are psychologically healthy? What areas in your life could use improvement? Why do you think the college environ-ment may provide a challenge to your psychological health?

2. Do you know anyone who has high self-esteem? What characteristics does this person possess?

3. Why do you think the number of women with depression outnumbers that of men? 4. How do discrimination and stigma influence depression among LGBT youth? How are

these things related to suicide rates among this population? 5. How might you know if a person is clinically depressed or temporarily sad, lonely,

unhappy, or moody? What might you do? 6. How have psychological disorders been portrayed in movies? What are some specific

examples? Do you think the media has helped remove some of the stigma surrounding these disorders?

7. What actions could you take if a close friend shows some of the warning signals of suicide?

Table 2.1 Mental Health Professionals

Table 2.2 Types of Medications Used to Treat Mental Illness

Table 2.2 continued




Critical Thinking Questions

1. Based on the examples given in the book showing an association between emotions and the immune system, substantiate whether or not you believe in this concept. Describe two separate situations when you think your emotions affected your health.

2. Look at Maslow’s Hierarchy of Needs in Figure 2.2. Explain how each lower level in the pyramid affects the next highest level. Describe how your needs are met at each level. From your personal experience, how does one level being out of balance effect other levels? How might not having needs met at any level influence depression?

3. From your personal experience, describe a situation in your life when you might have experienced learned helplessness. What situation caused you to feel this way? What did you do to overcome this situation?

4. Review the list of personality traits on page 33. Which of these personality traits do you possess? Do you identify with more than one category of personality traits? Give evidence to support your responses.

5. Current research suggests that drugs might be more beneficial in treating a person with SAD than environmental methods such as light treatment. If you had a loved one who experienced SAD, what course of treatment would you encourage that person to follow? What questions would you ask about the proposed pharmacological treatment?

6. What would be the first steps you would take if you suspected that a loved one was suffering from a psychosocial disorder?

Student Activities

Individual 1. Make a list of five short-term goals to complete by the end of this term. Next to each

goal, write the percentage (from 1–100%) of self-efficacy you feel toward that goal. If there are any goals with percentages under 80 percent, rework the goal until you have a high level of self-efficacy toward achievement of the goal.

2. Visit the website for Spirituality & Health: www.spiritualityhealth.com, and find out how to improve your own spiritual health. Write a short paragraph commenting on the site.

3. Select any category of medications used to treat mental illness listed in Table 2.2. Research new drugs available in that category, and explain how the new drugs are better than previous drugs.

Community 1. What resources are available on campus for psychosocial health? Visit the counseling

center and write a short summary of services available and usage rates. 2. Find out how mental health services in your community are suffering from both state and

federal budget cuts. What is being done to bridge the gap between need and services offered? What type of city/county legislation is being proposed to maintain adequate funding for mental health?




Diverse Population/Nontraditional 1. How do people in other cultures regard and care for people with mental illness? Conduct

Internet research for a country of your choice. Find out the rates of psychosocial disorders such as depression, bipolar disorder, and schizophrenia and compare them to rates in the United States.

2. Conduct Internet research to determine if women in other countries disproportionately suffer from depression. Suggest an explanation for your findings.

Lecture Launcher Video Discussion Questions

The Study of Happy Brains 1. Do you agree that life experiences account for only 10 percent of one’s total happiness?

Why or why not? 2. What do you do to make yourself happy? 3. In what ways can you work to increase your happiness level every day?

Keeping Obsessive-Compulsive Disorder in Check 1. Fay says that deep down she knows a doorknob does not pose a risk. Then why do you

think she still fights the urge to use hand sanitizer every time she opens a door? 2. What is “exposure” therapy and how does it work? Dr. Jonathan Grayson took Fay and a

group of people on a virtual camping trip in the video. In what ways do you think this experience helped the participants with their OCD tendencies?

3. What are the benefits for someone with OCD who attends workshops and lectures at a convention like the one the OCD foundation holds annually?

The Hoarders 1. Why might a person develop a hoarding compulsion? Give several reasons. 2. Some hoarders do not believe that they have a debilitating problem or that hoarding is

such a problem. What does this say about the psychological mindset of a hoarder? Why do you think that simply “cleaning up the mess” is more difficult for a hoarder?

3. What are the consequences of being a hoarder? How does being a hoarder affect the hoarder and those around him or her negatively?

Digital Transparency Masters

We have provided transparency masters in PDF format on the Instructor Resource DVD-ROM for this chapter to enhance instruction in your class. This selection of images and tables can be downloaded and printed to transparency acetates.




Additional References

R. H. Aseltine Jr., A. James, E. A. Schilling, and J. Glanovsky, “Evaluating the SOS Suicide Prevention Program: A Replication and Extension.” BMC Public Health, 7, (2007): 161. L. J. Cook, “Striving to Help College Students with Mental Health Issues.” Journal of Psychosocial Nursing and Mental Health Services, 45, (2007): 40–44. S. J. Garlow, J. Rosenberg, J. D. Moore, A. P. Haas, B. Koestner, H. Hendin, and C. B. Nemeroff, “Depression, Desperation, and Suicidal Ideation in College Students: Results from the American Foundation for Suicide Prevention College Screening Project at Emory Univer-sity.” Depression & Anxiety, 25, (2008): 482–488. D. Eisenberg, M. F. Downs, E. Golberstein, and K. Zivin, “Stigma and Help Seeking for Mental Health among College Students.” Medical Care Research and Review, 66, (2009): 522–541. M. D. Rudd, A. L. Berman, T. E. Joinder, Jr., M. K. Nock, M. M. Silverman, M. Mandrusiak, K. Van Orden, and T. Witte, “Warning Signs for Suicide: Theory, Research, and Clinical Applications.” Suicide and Life-Threatening Behavior, 36, (2006): 255–262. D. L. Tosevski, M. P. Milovanevic, and S. D. Gajic, “Personality and Psychopathology of College Students.” Current Opinion in Psychiatry, 23, (2010): 48–52. K. Zivin, D. Eisenberg, S. E. Gollust, and E. Golberstein, “Persistence of Mental Health Problems and Needs in a College Student Population.” Journal of Affective Disorders, 117, (2009): 180–185.

For Further Information

American Association for Suicidology Prevention www.suicidology.org

American Psychiatric Association www.psych.org

Depression and Related Affective Disorders Association www.drada.org

National Empowerment Center www.power2u.org

National Mental Health Association www.nmha.org

Schizophrenia Awareness Association www.schizophrenia.org.in

SAVE: Suicide Awareness Voices of Education www.save.org




Additional Media

Depression in College Students University of Wyoming, 3 minutes A video production of the University of Wyoming. The video discusses what depression is, the prevalence of depression among college students, and why college students may experience depression. www.youtube.com/watch?v=p0cVi3k2NAk

Lidia Bernik on PBS Healthy Minds, 4 minutes A video of the National Suicide Prevention Lifeline. Lidia Bernik shares the story of her sister, who committed suicide while Lidia was in college. www.youtube.com/watch?v=rKZCeYo9gyM&feature=channel

National Survivors of Suicide Day, 8 minutes A video of the American Foundation for Suicide Prevention. Eight people share how their lives have been affected by suicide. www.youtube.com/watch?v=MD7Odg3RnAg&feature=related

Understanding Schizophrenia, 4 minutes A video of the Health Science Channel. Health care providers and people living with schizo-phrenia discuss the illness. www.youtube.com/watch?v=ZLhmD2UYEdc

WHO: Mental Health, 5 minutes A video produced by the World Health Organization that discusses the prevalence of mental health issues, with an emphasis on an international perspective. www.youtube.com/watch?v=L8iRjEOH41c



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