Differentiating mental health urgencies and emergencies from the ordinary pain of existence - PowerPoint Presentation

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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

Life 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.

People 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.

Getting 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)

When 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”

When 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

In 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

Suicide 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)

A few kids of psychiatric problems

Depression

Bipolar disorder (mania)

Substance abuse problem

Psychosis (schizophrenia)

Personality Disorder (Borderline Personality Disorder)

Depression

Poor sleep

Lack of interest in activities

Excessive Guilt

Low Energy

Poor Concentration

Appetite changes

Psychomotor retardation

Suicidal ideation

Bipolar 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

Psychosis (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

Substance 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

Personality 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

.