C180 Mental Health Packet: Therapeutic Communication & Disorders Overview

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Western Governors University

C180 Introduction to Psychology

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Anxiety Disorders

Anxiety disorders are a group of mental health conditions characterized by excessive and persistent feelings of fear, worry, or tension. When these feelings last for at least six months and significantly interfere with daily functioning, they can be considered an anxiety disorder. While mild anxiety is a normal response to stress, chronic or extreme anxiety may require therapeutic or pharmacological intervention.

Common Types of Anxiety Disorders

Type	Description
Monophobia	The intense fear of being alone, leading to distress or panic when separated from others.
Zoophobia	Persistent fear of animals, often specific (e.g., dogs, snakes) or generalized.
Acrophobia	The extreme fear of heights that can cause panic attacks or avoidance behavior.
Separation Anxiety Disorder	Extreme fear or anxiety experienced when separated from individuals with whom one has a strong emotional attachment. While this behavior is normal in early childhood, it is atypical and maladaptive in adults.

Anxiety disorders can manifest in both physical and psychological symptoms, such as increased heart rate, muscle tension, sleep disturbances, and difficulty concentrating.

Obsessive-Compulsive and Related Disorders

Obsessive-Compulsive and Related Disorders (OCRDs) involve repetitive thoughts, impulses, or behaviors that individuals feel driven to perform. These actions are typically aimed at reducing distress or preventing perceived harm, even though they are often recognized as irrational.

Examples of OCRDs

Disorder	Description
Obsessive-Compulsive Disorder (OCD)	Characterized by persistent, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions). These actions temporarily relieve anxiety but often interfere with daily life.
Hoarding Disorder	The compulsive urge to collect and retain items regardless of their value, potentially creating unsafe or unsanitary living conditions.
Body Dysmorphic Disorder (BDD)	An excessive preoccupation with imagined or minor flaws in physical appearance, leading to distress and functional impairment.

Definitions

Obsession: Recurrent, intrusive thoughts, urges, or images that cause anxiety or distress.
Compulsion: Repetitive behaviors or mental acts performed to reduce anxiety or prevent a feared event or situation.

Somatic Symptom and Related Disorders (Somatoform Disorders)

Somatic Symptom Disorders occur when psychological distress manifests as physical symptoms that cannot be explained by any underlying medical condition. Patients often experience significant impairment in functioning and may frequently seek medical attention.

Types of Somatoform Disorders

Disorder	Description
Somatic Symptom Disorder	Involves excessive thoughts, feelings, or behaviors related to physical symptoms that cause distress or disruption in daily life.
Conversion Disorder (Functional Neurological Symptom Disorder)	Sudden appearance of neurological symptoms such as paralysis, blindness, or seizures without a known neurological cause. Often linked to psychological conflicts.
Post-Traumatic Stress Disorder (PTSD)	Develops after exposure to traumatic events, resulting in symptoms such as flashbacks, nightmares, anxiety, and emotional detachment lasting more than one month.

Common Manifestations

Somatic Symptom Disorder	Conversion Disorder	PTSD
Excessive concern with physical symptoms, multiple doctor visits, overuse of medication, and fluctuation of symptoms with stress levels.	Motor or sensory dysfunctions such as paralysis, pseudoseizures, blindness, or loss of speech.	Persistent anxiety, intrusive memories, nightmares, emotional numbing, and avoidance of trauma-related stimuli.

Assessment and Management

Assessment Tool: PHQ-15 (Patient Health Questionnaire-15) to screen for common somatic symptoms.
Nursing Considerations:
- Prioritize safety and establish trust with the client.
- Validate that the client’s symptoms are real to them.
- Encourage expression of emotions while limiting excessive focus on physical complaints.
- Teach relaxation and stress management techniques.
- Encourage participation in individual, group, or support group therapies.

Medications

Antidepressants (such as SSRIs) and anxiolytics may be prescribed to manage anxiety and depressive symptoms associated with these disorders.

Neurocognitive Disorders

Neurocognitive disorders involve a decline in cognitive functioning, affecting memory, attention, reasoning, and communication abilities. These disorders may be reversible or irreversible depending on the underlying cause.

Delirium

Delirium is a sudden and acute change in mental status characterized by disorientation, confusion, and impaired attention. It typically develops over hours to days and requires immediate medical evaluation.

Features	Description
Onset	Rapid (hours to days)
Causation	Often secondary to medical conditions such as infection, substance withdrawal, surgery, or electrolyte imbalances.
Symptoms	Disorganized thinking, confusion, memory loss, anxiety, agitation, and hallucinations. Symptoms often worsen at night.
Treatment	Identify and treat the underlying cause. Maintain safety, ensure hydration and nutrition, and avoid physical restraints when possible.

Delirium is reversible with prompt intervention, but delays in treatment can result in serious complications.

Alzheimer’s Disease

Alzheimer’s disease is a progressive and irreversible neurodegenerative disorder that primarily affects memory, cognitive skills, and behavior. It is the most common form of dementia, typically developing gradually over months to years.

Risk Factors

Category	Examples
Genetic	Family history of Alzheimer’s disease, especially in first-degree relatives.
Neurological	Traumatic brain injuries or head trauma.
Age	Risk increases significantly after 65 years.
Cardiovascular and Lifestyle	Sedentary lifestyle, high cholesterol, obesity, diabetes, and poor diet.

Stages of Alzheimer’s Disease

Stage	Description
Mild (Early Stage)	Subtle memory lapses, misplaced objects, difficulty focusing, but independence in daily activities remains.
Moderate (Middle Stage)	Noticeable cognitive decline, confusion about personal history, personality changes, and inability to perform some ADLs. Wandering and frustration are common.
Severe (Late Stage)	Requires total care. Loss of communication skills, mobility, and ability to swallow. May result in coma or death.

Nursing Interventions

Maintain a calm and structured environment to reduce agitation.
Provide simple, direct communication and give one instruction at a time.
Support caregivers and families in long-term care planning.
Monitor nutrition, hydration, and sleep.
Medications such as cholinesterase inhibitors (Donepezil, Rivastigmine, Galantamine) may improve quality of life but do not cure the disease.

Generic Name	Trade Name	Use
Donepezil	Aricept	Early and moderate Alzheimer’s disease
Galantamine	Razadyne	Alzheimer’s and Parkinson’s-related dementia
Rivastigmine	Exelon	Alzheimer’s and dementia associated with Parkinson’s

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). APA Publishing.

Mayo Clinic. (2024). Anxiety disorders: Symptoms and causes. Retrieved from https://www.mayoclinic.org

National Institute of Mental Health. (2023). Obsessive-compulsive and related disorders. Retrieved from https://www.nimh.nih.gov