Mental health illness and emotional wellbeing

Discussing mental health

This assignment will discuss mental health, mental illness and how it relates to our emotional wellbeing. The relevance of working with patients with mental health will be discussed along with the type of care and assistance a nurse can offer. Additionally it will discuss the differences between the terms mental health and Mental illness. Furthermore it will discuss the different phases of mental health and mental illness during the course of an individual’s life span. It will focus on the mental health issue/problem/illness that an individual may experience.

Mental health is a term that encompasses a range of experiences and situations that an individual can feel both mentally and physically. It is an umbrella term which encompasses a continuum from the most severe disorders to a variety and common mental health problems and mild symptoms of different intensity and duration (Barry M. Jenkins R. 2006)

A definition of mental health is personal and based upon ones individual life experiences and life context. “Mental health can be influenced by our gender, social class race, religious beliefs, and experience of family life”. “Mental health has been described as multifaceted with six dimensions behavioural, affective, spiritual, cognitive, psychological, and socio-political”. The Health Education Authority defined mental health in 1997 as “the emotional and spiritual resilience which enables us to survive pain, disappointment and sadness”. “It is a fundamental belief in our own and others’ dignity and worth”. (Creek J. Lougher L. 2006)

The Mental Health Foundation has defined a mentally healthy individual as one who can “Be confident and assertive; Develop emotionally, creatively, intellectually and spiritually; Initiate, develop and sustain mutually satisfying personal relationships; Be aware of others and empathise with them; Face problems, resolve them and learn from them; Use and enjoy solitude; Play and have fun; Laugh, both at themselves and at the world”.

The absence of mental illness and emotional health refers to the presence of a positive mind, giving you the ability to laugh and “they are able to carry on with their normal lives” (Jackson-Triche M., Wells K.B., Minnium K., 2002)

People who have good health can still have underlying emotional problems and mental problems. This can be caused by a physical imbalance in the brain, stress, family problems and stressful work/education can make it worse.

These mental and physical feelings can cause the individual to become divided and live a separate life from others in society. The negativity of a mental health problem will hinder the individuals natural potentialities in life such an early education, work, marital and become unsociable (Guntrip H. 1964) Lots of people who are emotionally healthy have learned to cope with their stresses and problems by seeking help from the doctor. Being mentally or emotionally healthy is much better for each individual than being a sufferer of depression, anxiety, dementia, Alzheimer and other psychological issues. One way to deal with stress is the ability to be able to learn and change ones life style, in a positive manner and being able to maintain a fulfilling happy relationship thus giving you self confidence (Beck A.T.1987) To improve and maintain a balanced mental health you need to take care of yourself everyday and try to follow a regime of rest, good nutrition, and exercise, limit alcohol and try not to use cigarettes or drugs. Key points that can exacerbate someone with a metal health problem can be on receiving bad news such as redundancy, divorce, bereavement or financial situations can contribute negatively to a person developing a mental health problem (Holmes and Rahe 1967)

Mental health is not a debilitating condition and with the right help and support an individual can lead a full happy and meaningful life style (Eaton 1951: 88)

Mental illness may be experienced by people who have a mental health problem so severe that they may get a diagnosis as having a mental illness, which will involve the services and support of a specialist mental health care team. It should be remembered that mental illness is prone to misinterpretation as frequently people who experience a mental health problem display erratic or unusual behaviour, have an inaccurate perception of reality or express views which differ from the majority of the rest of society, hence they can be confused with people who are eccentric, or whose lifestyle and views differ from those of other people (Hart 2004) It can be an on going experience from mental wellbeing through to a severe and enduring mental illness affecting a person’s overall emotional and psychological condition. Consequently, some people with mental illness will need no support, others may need only occasional support, and still others may require more substantial, ongoing support to maintain their quality of life. “To understand the difference between mental health and mental illness specifically relates to both the length of time and severity of the changes to a person’s behaviour thought patterns and display of emotions. The more severe and lengthy the impact of these changes, the more a person may struggle to manage their everyday life and the greater the chances of them developing a mental illness. Generally speaking, people with a lower stress threshold are more susceptible to developing a mental illness”. (Wong 2006)

Dementia is the most serious form of memory problems. There are several causes of dementia with the most common being Alzheimer’s disease, this causes a progressive intellectual deterioration from mental deficiency (Boehm A.E. and Seymour B. 1947) The symptoms of the disease as a distinct entity were first identified by Emil Kraepelin (1856-1926), and the characteristic neuropathology was first observed by Alois Alzheimer in (1864-1915) 1906. It mainly affects people over the age of 65 years and one in five people over the age of 80 years. The common symptoms of Alzheimer disease begin with the letter A and are known as the 4As of Alzheimer disease. Each of the symptoms causes difficulty in daily life. The 4As refer to Amnesia (Memory loss); Aphasia (Language); Apraxia (Doing things); Agnosia (Reconizing the world) (Rabins P.V., Lyketsos C.G. and Steele C.D. 2006)

Other symptoms associated with Alzheimer’s sufferers are numerous but some of the most common would be. Difficulty with speech in that all their words both written and verbal are incomprehensible. People who suffered with Alzheimer’s disease have difficulty in understanding daily life such as washing and dressing in the morning (Gauthier S. 2006) Most of the time they are confused about simple things that normal people could take for granted, such as, the changing of the seasons, months of the years and their own birthday, they can completely fail to remember how to look after themselves. People with Alzheimer’s are often not able to recognize themselves in the mirror (Warner M.L. 2000) Also people with Alzheimer’s react differently to normal people and you can find some sufferers who will just walk up and down the corridor each morning for hours. Also Alzheimer’s sufferers can find themselves walking aimlessly into other sufferers private rooms and taking belongings not meant for them. One of the more common delusions suffered by someone with Alzheimer’s is that someone is hiding or stealing objects (Eisenberg M.G. Richter E.F. Zaretsky H.H. 2005). This petty stealing and hiding of goods can not be blamed on the Alzheimer’s sufferer because the illness is making them not to remember the difference between good and bad deeds. An Alzheimer’s sufferer will not be stealing for personal gain but will have no reason at all about why he is committing this act of theft. Due to his mental state the Alzheimer’s sufferer will have no recollection about any acts he may have committed. It is the duty of the nurse to advocate on his behalf by speaking to the victim that due to his/her mental state that no crime had deliberately been committed by the defendant as he is suffering with Alzheimer’s and would not have realized what he/she had done was wrong. Trying to convince people with Alzheimer’s that they aren’t who they think they are, or that you are who they think aren’t, is properly futile (Mooney S.F. 2008) As the condition gets worst, the families of the Alzheimer’s sufferers will become even more worried about the situation their loved one is getting into. The family needs to get as much advice about the situation as they can from their doctor or health care worker, and seek professional consultation from a consultant or a doctor. Some Alzheimer’s sufferers refuse to believe that they have something wrong with them and that they do not need help from anyone. Denial of there condition now becomes an active defence mechanism for some Alzheimer’s sufferers (Friedman J. 1987) They may be completely reticent that their state of mind is in good working order and that they have been wrongly diagnosed.

For this part of the assignment, the chosen topic will be depression and how it relates to a certain gentleman. The individual was cared for at a rehabilitation ward. In order to protect the individual’s true identity; the Nursing and Midwifery Council (NMC) (2009) code of conduct will be enforced, and therefore the individual’s name will be changed. The patient was admitted onto the ward after suffering a fractured femur when he fell to the ground coming down his stairs in his house. He was calling out for help and was discovered one hour later by a neighbour who was passing by his house. On admission the patient’s medical notes indicated that he had a history of depression and is on a daily medication. The patient is a gentlemen aged 68 years old and has now been separated from his wife for the last 8 years. He has three grown up sons but does not now have any contact or get any support from them. The patient dwells alone in a council run flat and his occupation was a bus driver. His depression over the years had made him isolated and a reclusive person. The mental health state of this patient was characterised by certain idiosyncrasies such as, he was unwilling to make eye contact whenever he was spoken too, he would invariable also keep his back facing towards the person speaking to him. Other traits which characterised this individual has having a mental health condition were the way he would cover this face with his hands while he would be seating in a group at the table having his meal, this showed a complete lack of social interaction with people around him. This behaviour of the patient showed that the patient had a mental health state that he had been suffering with for some time. On further investigation the patient revealed that he has a problem with leaving his house and mixing with people, invariably he would always remain house bound with his curtains always drawn closed. He expressed a desire to only go for walks during the evenings when it was completely dark and this made him feel more secure and comfortable within himself. In my opinion he may be suffering from a form of social phobia where he is afraid or unable to meet strangers who he has no knowledge of. He stated that he had been a depressive person on and off for his whole life and that his depressive state had only now in old age become a hindrance to his normal lifestyle, thus accumulating in recent bouts of dizziness, fainting and the subsequent breaking of bones after falls. The patient was quite lucky this time around in that his fall from the stairs was quite a short fall of some 4 steps, if he had fallen from the top flight of stairs he could be in hospital with far greater injuries than what he actually sustained and his fall could have been fatal.

One mental health problem leading to depression that an individual may experience could be through the loss of a loved one. They are as likely as anyone else to have suffered the loss of a parent in early childhood, making them especially vulnerable to depression (Cappeliez P. & Flynn R.J. 1993)

People who are already suffering with a mental health issue are going to find that the trauma of discovering that someone who they loved has passed away will be an even greater burden on their already mental fragility. Such feelings that one will experience after being told about the death of a close relation can range from depression, suicidal thoughts, feelings of hopelessness, loneliness, lack of sleep, emotional distress and unable to cope with daily life (Melnick, Vijaya L., Dubler, Nancy N 1985) The mental health state of this individual patient would give me a lot of concerns after such a shock as a bereavement of a close relative. His mental health state before this news was given to him; had already become a worry for the staff as he was already showing signs of suicidal tendencies. This gentlemen’s demure was one of a frail individual lacking any self esteem and of a nervous disposition. Other symptoms noticed were a sense of instability, inability to communicate verbally in a precise and understandable manner (Phillips E.L. 1977).

As a nurse the care and assistance I can assist the patient with would be to speak to the patient in a quieter non judgmental manner and listen attentively to what the patient has to say and let the patient know that he or she is safe (Finkleman A.W. 1997) Dependant on the severity of the mental illness the patient is suffering and his behaviour would really be an indication as to what help I could be most useful to assisting him/her in. If the patients mental illness is very severe and of a violent nature, the nurse would have to understand her limitation and abilities before confronting the patient. Otherwise one could do more harm than good and put your self in danger. If you as a nurse feel comfortable, confident and trust in your own judgment with the placement you can then start to talk and listen to what the patient has to say (Zander K.S 1980) It is important to talk to the patient in a simple spoken manner, using non technical words and short phrases, also encourage family members or friends to touch and talk to the patient so that the patient feels comfortable and confident in your approach to them ( Brunner S. and Suddarth D.S. 2000).

In conclusion the main points raised are that mental health is more wide spread an ailment and that it is shown that it can manifest itself in a wide variety of different situations both mental and physical. Mental health in some form can happen to anyone both in its simple or its more complex form. Statistically learning from the research I have obtained, mental health is on the increase in the community and at an alarming rate. This is due in part to the way world/lifestyle is progressing at an ever faster pace. With financial institutions and climate control in the daily news and seemingly out of control it is no wonder people are suffering from more mental health problems than they used to do. In this technological super fast world that we inhabit peoples lives are put in a lot of stress and anxiety thus leading to a state of depression and other physical issues.

On reflection on writing about the subject of mental health I was extremely surprised to learn how widespread the mental health issue is and how difficult it can be to diagnose. The multiplicity and variance of the different stages of mental health was also quite alarming in its complexity in its minor and serious stages.

The knowledge gained from my research and writings about mental health will enable me to take these issues into consideration when caring for a patient with a mental health problem. The objective is to produce a nurse who is a competent consumer of research information (Dimmitt C. Carey J.C. Hatch P.A. 2007)

As far as the grammar and spelling of the essay is concerned I would admit that this is not one of my strongest areas, but due to the wonders of a word processor with its spell and grammar checker my mistakes were soon rectified.

Structure wise, I think the essay is as good as I was able to achieve considering it has been some years before I had attempted such a demanding piece of work. One of my greatest assets which I found while attempting this essay was to do with time management. I found myself to be a very strict time keeper even during my long day length placements where I would arrive home much tied, after such a long day on my feet. I was always able to find 3-4 hours each evening to evaluating my research articles and this amount of time gave me a lot more enjoyment in my research as I was not constantly rushing to meet my deadline to finish the essay. It has been argued by (Williams L. & Wilkins 2005) that evaluating research articles is a skill as important as clinical assessment, planning, intervention, and evaluation. Without the most current up to date knowledge in one’s field (nursing), care may be outdated, resulting in less effective patient care and treatment. By comprehending up to date best practices from the research I had learned in the construction of this essay and incorporating it into the care of the patient is essential for quality nursing to occur.