PSYCHOTIC SYMPTOMS by mikeholy

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									PSYCHOTIC SYMPTOMS
HALLUCINATIONS
  False sensory impressions without any
  external basis. (ie hearing voices when
  there is no one around).
  Any sensory modality can be involved:
  Hearing, vision, taste, smell, touch:
HALLUCINATIONS

 AUDITORY:
  Can be either elementary noises (ie-- a
  buzzing sound) or complete voices (ie-- a
  man talking).
   • Both forms are commonly found in psychotic
     disorders, organic disorders, and substance
     abuse disorders. The individual may describe
     these voices as inside or outside of their head,
     and you may note evidence that they are
     responding to internal stimulation (ie-- looking
     around for the source of the voice, answering
     questions to self, etc.)
HALLUCINATIONS

  VISUAL:
   • Can be elementary (ie-- seeking shadows
     move, colors change) or complex (seeing
     people, animals, snakes, etc.)
   • Usually associated with substance abuse or
     organic disorders, and in PTSD reactions.
   • If they are bizarre in nature (ie-- pink elephants
     floating thru wall) it may be Delirium Tremors
     (acute alcohol withdraw) and is a medical
     emergency.
HALLUCINATIONS

  TACTILE:
   • Usually described as insects crawling on skin or moving
     inside of body.
   • Usually associated with substance abuse (cocaine
     intoxication or amphetamine/hallucinogen psychosis).
  OTHER:
   • Olfactory, gustatory(taste) and tactile hallucinations are
     often more indicative of a physical condition such as
     alcohol withdrawal and seizure disorders.
   • Also associated with PTSD
DELUSIONS

False beliefs about reality that are
maintained despite strong evidence to
the contrary.
Usually related to a psychotic disorder.
Cannot talk the person out using logic
or reason.
DELUSIONS (cont.)
  PARANOIA: Ideation involving a
  suspicion that one is being followed,
  harassed, watched, or unfairly treated. The
  most common form of delusion in
  psychiatric clients.
  GRANDIOSE: Delusions of inflated power,
  wealth, knowledge, identity.
  PERSECUTORY: Delusion in which the
  central theme is being attacked, chased, or
  conspired against.
DELUSOINS (cont.)
  REFERENCE: A delusion that objects
  have a particular significance (ie wearing
  the color red means that a person is the
  devil)
  OTHER:
   • Thought broadcasting (receiving special
     messages from TV or radio)
   • Somatic (missing body parts),
   • Jealousy– Loving someone from a distance (ex
     John Hinkley)
DEPRESSION
16% of Americans will have it during their
lifetime.
In any given 1-year period, 9.5 % of the
population, or about 18.8 million American
adults, suffer from a depressive illness
Unfortunately, many people do not
recognize that depression is a treatable
illness.
Who gets depression?
   Women-- Almost twice as likely to become depressed as
   men.
   Men-- Risk for depression is lower, but men are more likely
   to go undiagnosed and less likely to seek help.
    • often masked by alcohol or drugs, or by the socially
      acceptable habit of working excessively long hours.
   Elderly-- Loved ones may attribute the signs of depression
   to the normal results of aging, and many older people are
   reluctant to talk about their symptoms. As a result, older
   people may not receive treatment for their depression.
   Children-- Symptoms of Depression are often masked–
   More anger and withdrawal.
What is Depression?
 Major depression
   A combination of symptoms that interfere
   with the ability to work, study, sleep, eat,
   and enjoy once pleasurable activities.
   May occur only once but often person will
   have several episodes in a lifetime.
   Duration of over two weeks of consistent
   symptoms
Depression
 Symptoms of Depression include:
   constant feelings of sadness, irritability, or
   tension
   decreased interest or pleasure in usual
   activities or hobbies
   loss of energy, feeling tired despite lack of
   activity
   a change in appetite, with significant
   weight loss or weight gain
Depression
  a change in sleeping patterns, such as
  difficulty sleeping, early morning
  awakening, or sleeping too much
  restlessness or feeling slowed down
  decreased ability to make decisions or
  concentrate
  feelings of worthlessness, hopelessness,
  or guilt
  thoughts of suicide or death
Other Types of Depression:
   Dysthymia mildly depressed on most days over a
   period of at least two years. Symptoms resembling
   major depression, but with less severity.
   Seasonal Affective Disorder The recurrence of
   the symptoms during certain seasons that is the
   hallmark of this type of depression.
   Bipolar disorder (AKA- Manic Depression)
   Mood is cyclical in nature. Mood may swing from
   Depression to Mania.
Other Types of Depression:
   Postpartum Depression
    • It typically occurs in the first few months after delivery,
      but can happen within the first year after giving birth.
    • Often, postpartum depression interferes with the
      mother's ability to bond with her newborn.
    • Postpartum depression is different from the "Baby
      Blues", which tend to occur the first few days after
      delivery and resolve spontaneously.
    • Can become postpartum psychosis
    • Medical intervention is ESSENTIAL
Treatment of Depression:
    Medication
   •   Can be initiated by any physician or APN
   •   Selective Serotonin Reuptake Inhibitor (SSRI)
          reuptake of Serotonin in brain. Neurotransmitter linked
           with depression
          Examples- prozac, paxil, lexapro
   •   Mood Stabilizers
          Used for bi-polar type depressions
          Ex– Lithium, depakote,
   •   Anti-psychotics
          For more sever depressions, and post partum psychosis
Treatment of Depression:
    Psychotherapy
   •   Multiple approaches to psychotherapy –
          Cognitive-behavioral
          interpersonal
          psychodynamic
   •   Identify the factors that contribute to
       depression and to deal effectively with the
       psychological, behavioral, interpersonal
       and situational causes.
   •   Best Practice: Medication for symptom
       control with concurrent psychotherapy.
SUICIDE: Facts
 11th leading cause of death in the United
 States.
   8th leading cause of death for males
   19th leading cause of death for females
   3rd leading cause of death for ages 15-24
 In 2001, the rate was 10.7/100,000
   white men over 85, 54/100,000.
 Men complete more suicides-- 4:1
 Women attempt more suicides– 3:1
SUICIDE: Facts
 Methods:
  #1 Firearms 60 % of all completed
   • 80% of these are white males
  #2 Men– hanging, Women- self poisoning
Suicide: Myths
 MYTH:Young people who talk about suicide never attempt or
 complete suicide.
 FACT: Talking about suicide is usually a cry for help
 MYTH: Attempted or completed suicides happen without
 warning.
 FACT: Most (about 95%) are preceded by warning signs that
 are often not recognized
 MYTH: Suicidal people are fully intent on dying.
 FACT : Most suicidal people desperately want to live; they are
 just unable to see alternatives to their problems.
 MYTH: Once someone is suicidal, they are suicidal forever.
 FACT: Most suicidal people are suicidal for only limited periods
 of time.
Suicide: Warning Signs
 Talking about suicide, death, and/or no reason to live.
 Preoccupied with death and dying.
 Withdraw from friends and/or social activities.
 Have a recent, severe loss (especially a relationship), or threat
 of a significant loss.
 Experience drastic changes in behavior.
 Lose interest in hobbies, work, school, etc.
 Prepare for death by making out a will (unexpectedly) and final
 arrangements.
 Give away prized possessions.
Suicide: Warning Signs
 Have attempted suicide before.
 Take unnecessary risks; be reckless and/or impulsive.
 Lose interest in their personal appearance.
 Increase their use of alcohol or drugs.
 Express a sense of hopelessness.
 Be faced with a situation of humiliation or failure.
 Have a history of violence or hostility.
 Have been unwilling to "connect" with potential helpers.
SUICIDE: Intervention
 What You Can Do If Think Someone May
 Be Suicidal:
   Be direct. Talk openly and matter-of-factly about suicide. Ask
   the person, "Are you thinking of killing yourself?"
   Listen. Allow expressions of feelings, including feelings about
   wanting to die.
   Don't say things like "It's not so bad" or "Things will get better
   soon." That invalidates the overwhelming feelings that the suicidal
   person is having and can cause them to feel very alone.
    Don't be judgmental. Be objective vs. subjective. A crisis to them
   is not the same as a crisis to you.
SUICIDE: Intervention
 What You Can Do If Think Someone May
 Be Suicidal:
   Try to find out how the person plans to kill
   himself or herself.
    • Do they have a specific plan, with the time, day and/or method
      picked out? The more specific the plan, the greater the risk.
   Remove the method.
   Call law enforcement if there is immediate
   danger
   Get help from experts
   Do not leave the suicidal person alone!!!
SUICIDE: Intervention
 Call 911 if there has been any attempt for
 there is imminent danger
 Contact your screening center:
   Gloucester County: 845-9100
   Salem County: 299-3001
   Cumberland County 455-5555

								
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