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Topics Discussed in this Video:

  • Mood Disorders
  • Anxiety Disorders
  • Psychosis
  • Substance Use Disorders
  • Trauma-related Disorders
  • Eating Disorders (anorexia, bulimia)
  • Personality Disorders (OCPD, NPD, BPD, etc.)
  • Mental Health
  • Suicide

 

In Part 1 and 2 of this video, Dr. Matt Brosi gives an overview of the state of mental health in Oklahoma and especially in rural areas of the state. Dr. Brosi will also describe some of the ways to provide support to individuals who struggle with mental health disorders as well as communities who experience increased risk for mental health challenges.

 

 

 

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Why This Conversation Is Important Now

Mental health challenges are commonly overlooked or dismissed, and on a number of indicators Oklahoma faces particular challenges with mental health. The COVID-19 pandemic has also disrupted life for thousands of individuals in Oklahoma, exemplifying how major disruptions, lack of resources, and isolation can impact mental health. These are among the reasons that it is important to talk and learn about mental health issues. There is also a general lack of understanding of what mental health disorders look like, what can increase their disruptive impact, and what can be done to help the situations for those with mental health challenges. One of the common hardships for people struggling with mental health challenges is the misunderstandings and negative judgments that they come across in society. Having the conversation about mental health now can begin changing the stigma surrounding mental health for people in your communities.

 

Oklahoma is Not “Ok”

Nationally, about 1 in 5 people meet the criteria for a mental illness in a given year while about 1 in 25 experience a serious mental illness in a given year. Possibly because of the stigma surrounding mental health challenges, two in three people with a mental illness do not seek treatment. In Oklahoma specifically, we experience some of the highest rates on mental illness in the US. To put this in perspective, Oklahoma ranks 3rd in the nation for rates of any mental illness, 2nd in the nation for substance-abuse disorders, 2nd in the nation for serious mental illness. Taken together, the challenges with mental health in Oklahoma put the state ranked among the highest in the nation for rates of mental health issues with, nearly a million Oklahomans with a mental health or substance-abuse challenges. Some of the factors that may contribute to these grim rankings could be significant treatment gaps, lack of funding at the state level, large service gaps, and the lack of treatment for the incarcerated population. Among the major mental health disorders it is helpful to understand are mood disorders and anxiety disorders.

 

Mood Disorders

Mood disorders are a group of disorders that share the main feature of a mood disturbance characterizing the disorder. The following four disorders are among the most common of mood disorders:

  • Major depression: This is largely characterized by people who experience a depressed mood, changes in their sleeping or eating habits, become more isolated, or have suicidal thoughts.
  • Bipolar depression: Characterized by mood swings wherein a person swings dramatically from a depressed mood to a manic episode, characterized by high energy or risk taking behaviors.
  • Post-partum depression: This type of depression is related to changes in new mothers’ hormone levels that are experienced shortly after giving birth to infants.
  • Seasonal depression: This mood disorder is related to seasonal weather changes that leads individuals to receive less sunlight and greater isolation.

The source of mood disorders is complex and often involves genetic, hormonal, and stress overload factors in the development of symptoms. Nearly 70% of individuals can correctly identify depression, but many also don’t know what to do about it.

 

Handling Depression

Depression thrives on isolation, a lack of a trusted system of support, and negative self-beliefs. Because of this, genuinely connecting with others is often critical for individuals suffering from depression, as is changing routines that keep isolation active and keep a person from getting outside and from being physically active. Mental health professionals can also help individuals identify and separate from negative beliefs about themselves.

 

Anxiety Disorders

Anxiety disorders are the most common mental health issue. Anxiety itself, however, can be beneficial in some situations when it helps promote caution or a careful approach in appropriate situations. It becomes problematic when anxiety, either because of its frequency or intensity, begins to get in the way of living day to day life. Some of the common anxiety disorders individuals experience include.

Generalized Anxiety Disorder: Characterized by individuals who has persistent worries about a wide range of situations.

  • Specific Phobias: Disruptive worry about specific activities, situations, or objects.
  • Social Anxiety Disorder: Characterized by individuals who avoid situations where they will be around other individuals.
  • Acute Stress Disorder: Within one month of experiencing a traumatic instance, an individual shows signs of elevated anxiety or avoidance that are associated with the traumatic incident.
  • Post-Traumatic Stress Disorder: Long term avoidance, elevated anxiety, or panic attacks when around situations or people that remind an individual of a traumatic experience.
  • Panic Disorder: Intense fear and shortness of breath without the presence of a real threat.
  • Obsessive-Compulsive Disorder: Characterized by individuals who have a drive to repeat rituals (such as repeatedly touching or checking an object or repeatedly washing hands) involving situations or objects that they feel elevated anxiety about.

 

Anxiety Iceberg:

When we consider individuals who experience anxiety, we often focus on behaviors or emotions that we see on the surface such as avoidance of situations or people, anger, or lack of focus. What we don’t see as easily are feelings like being out-of-control, deep fear, or other motivations that are hidden below the surface for individuals who experience anxiety disorders. For these people, naming and validating those “beneath the surface” can be an important first step in soothing anxiety and moving towards acting in ways that is less disruptive to daily life.

 

Psychosis

In essence, psychosis is a feature of some mental illness which involves a loss of contact with reality. This loss of contact often results in distressing disruptions in thinking, emotion, and behavior and in some cases may need a higher level of support and care for individuals and families. Schizophrenia is an example of a mental disorder which includes psychosis as a major feature and which may include hallucinations along with other disorders in thinking. Psychosis can also be a feature that accompanies other mental health challenges in mood disorders. The precursors of psychosis are complex and may include stress, genetics, and sometimes drug use.

 

Substance Use Disorders

Substance use disorders are a classification of disorders that include the common central feature of a person experiencing significant distress and disruptions in their family, work, social, or other areas of life stemming from substance use. Often individuals with a substance use disorder are addicted to a substance, meaning that they often feel an intense desire for the substance, need to take increasing amounts of a substance to experience the same effects, and experience withdrawal when going for extended periods without the substance. Substances that individuals may take that can create the conditions for a substance use disorder include tobacco, alcohol, marijuana, prescription drugs (used in a way or by a person other that as prescribed), and a variety of illicit drugs. Substance use disorders can become dangerous when levels of use increase to dangerous levels or when different substances are used simultaneously and their compound effect becomes dangerous or deadly.

 

Mental Health for Vulnerable Populations

 

Adolescents

As a group, adolescents are at particular risk for developing some of the mental health challenges described above. Approximately 20% of adolescents have mental health disorder and, along with challenges with anxiety and depression, they have some of the highest rates of prescription opioid abuse and high suicide rates. Some of what may contribute to adolescents experiencing this increased risk include isolation, high pressure to succeed, significant concern over acceptance by peers, sleep disturbances, and a feeling of uncertainty about their future. Some of these factors may also be exacerbated by the way that many adolescents utilize media.

 

Veterans and Military Members

Military veterans are also at risk for relatively high rates of Post TSD, substance abuse disorders, and suicide. In addition to the exposure to violence and death, both commonly part of the makeup of trauma associated with Posttraumatic Stress Disorder (PTSD), military veterans also experience major transitions regularly including as relocating, separation from family, and reintegration into family life. Each of these adds pressure to military veterans and their families and increases their risk for mental health challenges.

 

Providing Help

While mental health challenges are complex and have a wide variety of impacts for individuals, families, and communities, there are some small things that can be done to make a meaningful difference to aid individuals experiencing mental health challenges. The acronym ALGEE can be used to outline some of these steps:

  • Assess for risk suicide or harm
  • Listen unjudgementally
  • Give reassurance and information
  • Encourage appropriate professional help
  • Encourage self-help and other support strategies

 

Many times, helping at an earlier stage can make a difference in recovery or reduction in symptoms from mental health challenges. There are many individuals who struggle with a mental health challenge, and likewise there are resources available professionally and in our communities where people can get the support and help they need.

 

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.dsm05
  • Curtin, S. C., Warner, M., & Hedegaard, H. (2016). Increase in Suicide in the United States, 1999-2014. NCHS data brief, (241), 1–8.
  • Galea, S., Merchant, R. M., & Lurie, N. (2020). The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention. JAMA internal medicine, 180(6), 817-818. doi:10.1001/jamainternmed.2020.1562
  • Mental Health First Aid USA (2020). How to Help Someone with Depression. Retrieved from https://www.mentalhealthfirstaid.org/external/2018/09/how-to-help-someone-with-depression/
  • National Alliance on Mental Illness (2019). Mental Health by the Numbers. Retrieved from https://www.nami.org/mhstats.
  • Nguyen, T. (2015). Parity or Disparity: The State of Mental Health America. Mental Health America.
  • Oklahoma Department of Mental Health and Substance Abuse Services (2020). Prevalence Rates for Behavioral Health Issues in Oklahoma. Retrieved from https://www.ok.gov/odmhsas/Additional_Information/Statistics_and_Data/
  • Reisman M. (2016). PTSD Treatment for Veterans: What's Working, What's New, and What's Next. P & T : a peer-reviewed journal for formulary management, 41(10), 623–634.
  • Seal, K. H., Bertenthal, D., Miner, C. R., Sen, S., & Marmar, C. (2007). Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Archives of Internal Medicine, 167(5), 476-82.
  • Seal, K. H., Cohen, G., Waldrop, A., Cohen, B. E., Maguen, S., & Ren, L. (2011). Substance use disorders in Iraq and Afghanistan veterans in VA healthcare, 2001-2010: Implications for screening, diagnosis and treatment. Drug and alcohol dependence, 116(1-3), 93–101. https://doi.org/10.1016/j.drugalcdep.2010.11.027
  • Substance Abuse and Mental Health Services Administration, Community Conversations About Mental Health: Information Brief. HHS Publication No. SMA-13-4763. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.
  • Substance Abuse and Mental Health Services Administration. (2012). Treatment Episode Data Set, Substance Abuse and Mental Health Services Administration: http://www.samhsa.gov/data/DASIS.aspx#teds
  • Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
  • Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
  • Twenge, J., Joiner, T., Rogers, M., & Martin, G. (2017). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science, 6(1), 1-15. https://doi.org/10.1177/2167702617723376

 

Where to Find Help

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