HLTHAGE 1CC3 Lecture 4: Lecture 4
27 Jun 2018
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May 10, 2017
Mental Health Lecture 4
Think: what makes these disorders distinct from one another? What is the overlap? What are the
connections between these and the other disorders previously discussed?
Fear: response to real and present danger; the danger is something you are facing at that time, it’s a
genuine threat. E.g. wandering around woods, bear jumps out at you. Fight or flight.
Anxiety: Involves anticipation of a future event, the threat is not there in front of you. Something that
could happen, but necessarily wont.
Physiological changes. You suspect that this threat will materialize, as a consequence your body
kicks into action. E.g. pulse, heart rate increase, sweating.
Difficult to keep control of your thoughts. Things move quickly; you might not want to think
about a subject, but it’s hard to get it out.
Halo effect: It encircles you; it’s like a prism that colours everything else that you look at. Your
beliefs about the future, past, etc. can be tinted in someway by that anxiety.
Whether you are facing fear or anxiety, despite the fact that the target of those feelings, there is
similarities on how we experience them.
Some positive uses; up to a point. Without exceptionality, becomes problematic. Anxiety can be helpful
as it helps you take action, organize how to respond to upcoming threat. The problem: Somewhere the
anxiety gets too much, here we get clinical significance.
Classification of anxiety disorders got their own chapter in 1980, DSM III. Whether something is its own
chapter or a subset is important. In the past, anxiety disorders were grouped with depression and OCD
(the neuroses; emotional disturbances where the person was aware there was a problem)- this implied
there was a connection between these things. DSM III broke up all the neuroses.
In DSM 5 awareness was redesigned. Anxiety disorders now look really different than they did in 1970s,
significant because if we look at these as disease states, you wouldn’t think there would be such a
sweeping change.
Now, the client does not have to necessarily know that their feelings are neurotic, the clinician is the
one who will decide if their fear and worry is disproportionate to the situation.
Controversy: Everyone feels different. What’s disproportionate for one person, could be
different for another.
E.g. if most of our HCP come from a specific socioeconomic status, they may not have insight
into what a working class individual’s potential threat might be.
Splitting movement: We have now 5+ really bid anxiety disorders that are all their own categories,
diagnosis, causes and ideal treatments; all disconnected. Before, the neuroses split into depression,
OCD, anxiety, and a few others. Anxiety is now further split; panic, social, agoraphobia, etc.
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May 10, 2017
What all these things share in common: Intense worry that is disproportionate to actual
environmental danger.
How useful, significant, and natural are these splits?
Anxiety is one of the most common mental disorders. This was not the case in our very recent past. The
interest in anxiety, some would argue, is about the 21 century mainly. Historically, mental health
problems are aimed around mania, deep melancholia, or some sort of psychosis.
What changes is the introduction of Freud’s theories on psychoanalysis (a form of talk therapy, a theory
of what causes someone to be mentally ill too-based on psychological model; we bury conflicts beneath
the surface and they then cause problems for us).
Panic disorder: Characterized by panic attacks that happen repeatedly; they are unexpected, and not
always happening in relation to something that you are actually panicking about.
Panic attack is not just feeling nervous, more often described closely with a heart attack. Feel
warm, racing pulse, sweating hands, breaths are shallow, etc. – feels like you are dying.
When you look at the list of symptoms, there is an overwhelming preponderance of physical feelings! So
yes, this is mental illness but it is quite physical in its character.
Derealisation (unreality; when you feel like you are in an unreal situation, things seem like a movie), or
depersonalization (detached from body and can see yourself from a different angle)- *not in a psychotic
sense.
Person may obsessively worry about another attack in the future.
May lead to avoidance strategies; because avoidance works. E.g. if you were at a certain grocery store at
the time of first attack, don’t go back to that store.
In avoiding the thing we worry about, it solidifies the thought that that is something that we
should worry about.
Specific (Simple) Phobia: involves having a really intense and specific anxiety/worry/fear of a particular
object, sometimes a situation.
**Irrational: the degree of fear you have, doesn’t line up with the actual threat itself. E.g. living in a war
zone and nervous people were going to break into your house and kill your family; that is not irrational.
Phobias are not selective; you encounter it every time you meet that object.
Your fear of this object/situation takes over your life. It becomes a daily reality.
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Document Summary
Fear: response to real and present danger; the danger is something you are facing at that time, it"s a genuine threat. E. g. wandering around woods, bear jumps out at you. Anxiety: involves anticipation of a future event, the threat is not there in front of you. You suspect that this threat will materialize, as a consequence your body kicks into action. Things move quickly; you might not want to think about a subject, but it"s hard to get it out. Halo effect: it encircles you; it"s like a prism that colours everything else that you look at. Your beliefs about the future, past, etc. can be tinted in someway by that anxiety. Whether you are facing fear or anxiety, despite the fact that the target of those feelings, there is similarities on how we experience them. Anxiety can be helpful as it helps you take action, organize how to respond to upcoming threat.
