5 Stages of grief
1-Denial (shock and disbelief), 2-Anger ("Why me"?), 3-Bargaining (If God will help me through this, I will...), 4-Depression (full impact of situ), 5-Acceptance (peace regarding situ)
Loss of ego boundaries or gross impairment in reality testing. Has delusions/hallucinations and has a lack of relationships with others and the world.
Psychiatric disturbance characterized by increased anxiety and expressed directly or altered through defense mechanisms. Appears as obsession, compulsion, phobia or sexual dysfunction.
Anxiety or avoidance. Examples: phobia, OCD, panic disorder, GAD or PTSD.
Disruption in usual consciousness, memory, identity or perception of environment. Ex: dissociative amnesia, dissociative fugue, dissociative identity or depersonalization.
Adaptive coping mechanisms
Ways to deal with stress or anxiety. Ex: sleeping, exercise, smoking, fidgeting, yawning, drinking, talking, eating, laughing, crying, cursing, pacing, day dreaming. Mourning is also adaptive.
Type of dissociative disorder, has feeling of self are temporarily lost. Alteration in perception/experience in self.
Syndrome that imminent harm/danger is to occur. Increased glucose, bp, hr and rr. Decreased uo and vasoconstriction. Psychosis pts use Flight response.
Reliving a past experience.
Constantly scanning surroundings.
La bell indifference
Symptom of conversion in which there is a relative lack of concern that is out of keeping with severity of the impairment.
Maladaptive coping responses
Comes from good (adaptive) coping responses that are used to such a degree that there is interference with ability to deal with reality, interpersonal relationships or occupational relationships.
By having a disorder (anxiety) actually lowers the anxiety level.
"Sick role" benefits from being sick and dependent.
Bodily complaints. Unknown cause, meds dont help and is chronic.
Physical s/s with no organic pathology. Ex: hypochondriasis, conversion, somatization or pain disorder.
Something an outsider can not see or detect without the pt telling so. (headache)
Usually post-war. "Why didn't I die too?" Guilt for friends/acquaintances dying in battle.
Librium (chlordiazepoxide), Valium (diazepam), Serax (oxazepam), Tranxene (chlorazepate), Ativan (lorazepam), Klonopin (clonazepam), Xanax (alprazolam). LV STAKX abbreviation.
Non-addictive anxiety medication
medications for insomnia
Lunesta (eszopiclone) or Ambien (zolpidem).
(slightly) HR^, RR^, BP^, muscles slightly tense but comfortable, mood-alert, ambitious, ready. Perception-alert, sees details well. Learning-broad, enhanced and optimal. This is the healthy level to be in to learn.
(noticeably) HR^, RR^, BP^. Muscle tone-increased tension, h/a, repetitive manner (pacing). Mood-nervous, upset. Perception-focuses narrowly. Learning-slow/limited.
HR rapd/irregular, RR rapid/irregular, BP high. Muscle tone-extreme tension, unable to move almost, increased speed and intensity. Mood-out of control, panicky. Perception-distorted. Learning-no learning possible.
3 Types: Agoraphobia: fear of going out. Socialphobia: fear of introducing self. Simplephobia: every other phobia; spider, etc.
EEG, PET/MRI, CT/X-ray, EKG, CBC, UA and drug screen.
Based upon: stage of development, family, culture, health beliefs, spiritual beliefs, available resources and Human needs.
increased or decreased sleep, fatigue, irritability, restlessness, decreased concentration and difficulty controlling worry.
Increased HR, palpitations, chest pain, n/v, sweating, tremors, dizziness or fear of dying. (sudden and lasts for only minutes, no real trigger)
Hostile, rituals (3 "C"s-clean, checking and counting), excessive behaviors to decrease anxiety, obsessions, recognizes OC are unreasonable, interferes with ADLs.
controls fear by avoiding, fears are specific to things or places and recognizes fears are irrational.
increased or decreased sleep, restricted affect, outbursts of anger, startles easily, hypervigilant, may have survivor guilt, flashbacks (zone out) or decreased interest in activities.
Somatoform pain disorder s/s
complaints of pain that does not change, anxious about s/s, frequently goes to different drs, excessive analgesic with no pain relief.
Negative results on medical tests are not reassuring, fearful of disease, frequently goes to different drs, constantly seeks reassurance about illness.
Conversion disorder s/s
Unconscious alteration in motor/sensory functioning, will have anxiety prior to effect takes place, La belle indifference, anxiety precede development of disorder and uses conversion.
Brain structure of schizophrenics
enlarged cerebral ventricles, dilated cortical sulci and fissures. Temporal lobe may be decreased.
Neurotransmitter hypothesis for schizo
Schizo or Schizo s/s may be due to excess of dopamine dependent neuronal brain activity. Excess activity may be due to increased production at nerve terminals, increased receptor sensitivity or reduced activity for dopamine antagonists. NE, serotonin, Ach, GABA, prostaglandins and endorphins have been suggested as culprits as well.
Prolactin levels are effected by dopamine levels. In schizo, there is too much dopamine. With antipsychotics, they reduce dopamine, which increases prolactin and could be a reason for s/s of schizo.
helps deal with stressful situations. Falls low in depression, usually following together with dopamine.
seems to be due to increased melatonin due to the lack of sunlight. (Lack of sun increases melatonin)
Brain center effected by anxiety
Limbic system. OCD has been pointed to the cingulate gyrus in the limbic system. Panic disorder is correlated with the locus coeruleus in the limbic system.
Neurotransmitters involved with anxiety
NE: causes hyperarousal (^esp with panic), serotonin: OCD s/s (this is the reason SSRIs work with OCD) and GABA: postsynaptic excitation, thus interupting the progression of electrical impulse at synaptic junction (use benzos to treat this).
Thought to be a hypothalamic dysfunction. Ct scans reveal enlarged CSF spaces, but reverses with weight gain. Neurotransmitters: low serotonin, NE and dopamine.
Instrument that shows a person the unnoticed body processes to become voluntary as to achieve stress relief. Such conditions are: muscle tension, skin surface temp, BP and HR. Often used with another relaxation therapy like deep breathing, meditation, progressive relaxation or imagery.
To use wrongfully, or in a harmful way. Improper treatment or conduct that may result in injury.
Substance abuse def
Maladaptive pattern of use with a substance.
4 Criteria for dx substance abuse
one or more within 12 months period for positive dx 1-recurrent substance use resulting in failure to fulfill role: work, school or home. 2-recurrent substance use in situations where it is physically harmful: driving or operating machinery. 3-recurrent substance related legal problems: arrests. 4-Continued use despite having persistent or recurrent social or interpersonal problems caused by substance effects: arguments, fights.
Compulsive or chronic requirement. The need/desire is so strong that the person will experience distress if not fulfilled.
7 criteria for substance dependence
3 or more for positive dx. 1-Tolerance (marked increase need for same effect) 2-withdraw symptoms. 3-Often taken in larger amounts or taken for longer than intended. 4-Persistent desire/unsuccessful effort to cut down substance. 5-Great deal of time used to acquire substance, use the subs or to recover from effects. 6-Important social, occupation or recreational activities shortened due to use. 7-Sub continued despite knowledge of problem: ulcer from drinking, depression from cocaine.
Showing no facial expression.
Showing little to no expression,
Expressions are not congruent with topic.
Ability to conceptualize and hypothesize.
Lowered or saddened mood that leads to dysfunction of ADLs.
Quick and unpredictable mood swings.
Euphoria, extreme excitement or hyperactivity.
Flight of Ideas
Quickly going from topic to topic.
Indifference to or disinterest in the environment.
Mood disorder where person has mood swings from depression to mania with periods of normality as well. Swings can be day to day, month to month or even year to year.
High levels of cortisol have been found in depressed patients. There is a hyper secretion because the hormonal inhibition fails.
Chronic mood disorder involving numerous episodes of hypomania and depressed mood, but not enough to be dx with bipolar.
A state of uneasiness or dislike for life.
Similar to MDD, but no psychosis present or detectible. Described as "down in the dumps".
Depressed state due to events in the persons life.
Severe form of depressive episode. Symptoms are exaggerated and interest or pleasure in virtually all activities is lost.
Mixed feelings or emotions.
Condition like schizophrenia, but focuses inward on a fantasy world, while distorting or excluding the external environment.
Al-anon family groups
adult children of alcoholics.
Consume thousands of calories.
Psychotic condition from withdraw of chronic alcoholics. s/s are delusions, hallucinations, anxiety and disorientation.
One who enables another to persist in a self-destructive behavior (drinking) by providing excuses to avoid possible consequences.
Fine, downy hair like on an infant.
Vomiting after a binge.
Thiamine deficiency, usually seen in severe alcoholics due to the lack of nutrients.
Characterized by causing CNS depression with a range from tranquilizing anxiety all the way to coma or death. 3 categories: 1-Barbiturates, 2-Nonbariturate hypnotics, 3-Antianxiety agents.
Why CNS depressants are addictive
Due to the lengthy time of CNS depression, the body gets used to the slowed processes, and when a person is taken off of them, a hyperexcitability can occur and can cause convulsions or even death.