Wilbur R Dattilo MD Assistant Clinical Professor Department of Psychiatry University of Utah Life is suffering Everyone sometimes feels depressed sad lonely anxious stressed out bored hopeless or any other negative emotion you can imagine ID: 935743
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Slide1
Differentiating mental health urgencies and emergencies from the ordinary pain of existence
Wilbur R.
Dattilo
MD
Assistant Clinical Professor
Department of Psychiatry
University of Utah
Slide2Life is suffering
Everyone sometimes feels depressed, sad, lonely, anxious, stressed out, bored, hopeless or any other negative emotion you can imagine.
Knowing that suffering IS normal can be helpful in preventing us from “feeling bad about feeling bad”
A mentally “healthy” thing to do is to allow ourselves to feel the way we are feeling and “lean in” to hard emotions without trying to “get rid” of them.
Slide3People are all different
We all have a lot of different traits: Some of us seem perfectly adapt to live in the world like it is now, while others seems more adapt to a different set of experiences.
Some of us are “wired” to be more depressed, anxious, neurotic, fat, thin, or like-alcohol more than most.
We could image a set of circumstances in which a “negative” trait could actually help us survive.
Nature
doesn
’
t care if we are happy, only that (some of us)
survive and reproduce.
Slide4Getting Help
Almost anyone could benefit from HELP manage the stresses of life/ stop avoiding/ live up to our potentials.
All of us NEED help at some point in time.
There are a lot of ways that people can get help (family, community, church, service, exercise, friends,
and mental health professionals)
Slide5When does someone need URGENT help from a mental health professional?
Inability to work/love/ function in a relationship/ manage responsibilities:
Cant get out of bed
Cant take care of kids
Cant go to work
Cant maintain a job
Cant maintain a relationship
Frequent crying spells.
Cant leave the house.
Cant (do something else)
Cant stop drinking
All Psychiatric Diagnoses require “Dysfunction”
Slide6When does someone need EMERGENCY help?
WHEN SOMEONE IS GOING TO GET (badly) HURT.
Someone intends to or is planning to kill him or herself.
Someone intends to or is planning to kill someone else
Someone is acting so recklessly that he or she or someone else is going to get hurt.
Someone so completely lacks the ability to care for him or herself that he/she cannot act in a safe way
Slide7In a psychiatric emergency
Act as if it is any other medical emergency:
Take the person to any Emergency Room or to a psychiatric hospital.
Call the police or ambulance (911)
Even if they don
’
t want help.
About Suicide
Suicidal “ideation” can be passive or active.
Passive = “I wish I was dead”
Active = “I think I am going to kill myself”
Everyone sometimes thinks about suicide
Asking about suicide does not increase the chance that it will happen
When talking about suicide consider:
Risk factors
Plan
Intent
Means
Slide9Suicide Risk Factors
Some are static (there is nothing we can do about them)
Previous suicide attempt
Family history of suicide
Chronic pain, chronic medical condition, or recent
loss
Older white men are demographically at the highest risk of completing suicide
Some can be modified
Intoxication/ active substance abuse
Access to a weapons (especially guns)
Slide10A few kids of psychiatric problems
Depression
Bipolar disorder (mania)
Substance abuse problem
Psychosis (schizophrenia)
Personality Disorder (Borderline Personality Disorder)
Slide11Depression
Poor sleep
Lack of interest in activities
Excessive Guilt
Low Energy
Poor Concentration
Appetite changes
Psychomotor retardation
Suicidal ideation
Slide12Bipolar Mania
High
energy and excessive activity
Overly
good mood
Irritability
or impatience
Fast
, erratic talking
Racing
thoughts
Inability
to concentrate
Little need for sleep
Feelings of power
Poor judgment
Reckless spending
High sex drive
Alcohol or drug
abuse
Aggression
Refusal to admit that there is a problem
Slide13Psychosis (schizophrenia)
Delusions
–
Hallucinations
–
Grossly
disorganized or catatonic behavior
Negative symptoms
lack
of emotion - the inability to enjoy
acitivities
as much as before
Low energy - the person sits around and sleeps much more than normal
lack of interest in life, low motivation
Affective flattening - a blank, blunted facial
experession
or less lively facial movements or physical movements.
Alogia
(difficulty or inability to speak)
Inappropriate social skills or lack of interest or ability to socialize with other people
Inability
to make friends or keep friends, or not caring to have friends
Social isolation - person spends most of the day alone or only with close family
Slide14Substance Use Disorder
Taking the
drug
in larger amounts and for longer than intended
Wanting to cut down or quit but not being able to do it
Spending a lot of time obtaining the
drug
Craving or a strong desire to use
the drug
Repeatedly unable to carry out major obligations at work, school, or home due to
drug use
Continued use despite persistent or recurring social or interpersonal problems caused or made worse by
drug
use
Stopping or reducing important social, occupational, or recreational activities due to
drug
use
Recurrent use of
drug
in physically hazardous situations
Consistent use of
drug
despite acknowledgment of persistent or recurrent physical or psychological difficulties from using opioids
Tolerance. Withdrawal
Slide15Personality Disorder (Borderline Personality Disorder)
Frantic efforts to avoid being abandoned by friends and family.
Unstable personal relationships that alternate between idealization—“I’m so in love!”—and devaluation—“I hate her.”
Distorted
and unstable self-image, which affects moods, values, opinions, goals and relationships.
Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, substance abuse or reckless driving.
Suicidal and self-harming behavior.
Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.
Chronic feelings of boredom or emptiness.
Inappropriate, intense or uncontrollable anger—often followed by shame and guilt.
Dissociative
feelings
Severe
cases of stress can also lead to brief psychotic episodes
.