Caregiver Self-Study: Mental Illness
June – 2016
Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. As Caregivers, it is important to have an understanding of the client’s type of mental illness and how best to respond to their symptoms.
in this self study the reader will learn:
Basic information about the most common mental illnesses
Difference between mental health concern and a mental illness diagnosis
Helpful approaches when working with a client with mental illness
*If you are reading this self-study on line, you may click on the blue hyperlinks to read more information.
By Mayo Clinic Staff
Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.
A mental illness can make you miserable and can cause problems in your daily life, such as at school or work or in relationships. In most cases, symptoms can be managed with a combination of medications and talk therapy (psychotherapy).
Signs and symptoms of mental illness can vary, depending on the disorder, circumstances and other factors. Mental illness symptoms can affect emotions, thoughts and behaviors.
Basic Information about the Classes of Mental Illness
Mental illnesses, in general, are thought to be caused by a variety of genetic and environmental factors:
Inherited traits. Mental illness is more common in people whose blood relatives also have a mental illness. Certain genes may increase your risk of developing a mental illness, and your life situation may trigger it.
Environmental exposures before birth. Exposure to environmental stressors, inflammatory conditions, toxins, alcohol or drugs while in the womb can sometimes be linked to mental illness.
Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When the neural networks involving these chemicals are impaired, the function of nerve receptors and nerve systems change, leading to depression.
Common types of mental illnesses
Schizophrenia spectrum and other psychotic disorders
Psychotic disorders cause detachment from reality — such as delusions, hallucinations, and disorganized thinking and speech. The most notable example is schizophrenia, although other classes of disorders can be associated with detachment from reality at times.
This class includes disorders with alternating episodes of mania — periods of excessive activity, energy and excitement — and depression. The person’s moods may also fluctuate and may not seem appropriate to the situation at hand.
These include disorders that affect how you feel emotionally, such as the level of sadness and happiness, and they can disrupt your ability to function. Examples include major depressive disorder and premenstrual dysphoric disorder.
Anxiety is an emotion characterized by the anticipation of future danger or misfortune, along with excessive worrying. It can include behavior aimed at avoiding situations that cause anxiety. This class includes generalized anxiety disorder, panic disorder and phobias.
Obsessive-compulsive and related disorders
These disorders involve preoccupations or obsessions and repetitive thoughts and actions. Examples include obsessive-compulsive disorder, hoarding disorder and hair-pulling disorder (trichotillomania).
Neurocognitive disorders affect your ability to think and reason. These acquired (rather than developmental) cognitive problems include delirium (rapid onset, usually due to an infection or medications and is reversible), as well as conditions or diseases such as traumatic brain injury or Dementias such as Alzheimer's disease.
A personality disorder involves a lasting pattern of emotional instability and unhealthy behavior that causes problems in your life and relationships. Examples include borderline , antisocial and narcissistic personality disorders.
Working With the Client with Mental Illness
Mental illness is common. About 1 in 5 adults has a mental illness in any given year. Mental illness can begin at any age, from childhood through later adult years, but most begin earlier in life. There are such a wide variety of mental illnesses and each person will experience them differently. That being said, there are some general concepts that will help the Caregiver better support and care for their client with a mental illness diagnosis.
People with mental illness deserve respect, just as persons with other medical illnesses. Caregivers can act as the client’s advocate, relating to the client as an individual and not as their diagnosis or symptoms.
Listen. This always leads to a better understanding of what the client is experiencing.
The client with mental illness most often will know on some level that “something is not right.” This may make them feel anxious. Reassure the client that you are there to make sure they are safe and help them feel better.
Work on one issue at a time. Symptoms of mental illness can be overwhelming. Work with the client (and Care Manager) to identify one thing that is achievable, like washing up that day.
Strange behaviors can be part of the symptoms of the client’s mental illness. Don’t take them personally – even when your client’s negative thoughts or statements seem to be directed at you, the Caregiver.
Communicate frequently with the Care Manager and follow the care plan. This helps to maintain a consistent team approach and to provide the Caregiver with good ideas to care for the client.
Pay attention to things that bother your client (like crowds) and things that have helped them manage better (like planning a trip out of the house when less people are around).
Give sincere encouragement and praise when you notice the client taking positive steps. Often, people with mental illnesses have a low opinion of themselves. Connect with them on the positives and build their trust.
Be sensitive to the client’s family’s emotions. They may have mixed feelings – frustration, sadness, anger or shame. These are normal and should not be judged. It is important to remind the family that one of the reasons Caregivers are with the client so that they can take care of themselves.
Be sensitive to your own emotions. You may have mixed feelings – frustration, sadness, anger or shame. These are normal and should not be judged. It is important to remember that you need to take care of yourself, too.
Your client may be experiencing symptoms that distract them like hearing voices or experiencing scary or confusing thoughts. Caregivers should take a calm non-threatening approach, speaking in short, simple sentences. Directions should be broken down into single steps.
Remember that the Caregiver is part of a team. Always contact the Care Manager immediately it you are worried about the safety of the client, others, or yourself.
DSM-5 diagnostic classification. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Aug. 31, 2015.
Use of the manual. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Aug. 31, 2015.
Overview of mental health care. Merck Manual Consumer Version. http://www.merckmanuals.com/home/mental-health-disorders/overview-of-mental-health-care/introduction-to-mental-health-and-mental-health-care. Accessed Aug. 31, 2015.
Understanding psychotherapy and how it works. American Psychological Association. http://www.apa.org/helpcenter/understanding-psychotherapy.aspx. Accessed Aug. 31, 2015.
For friends and family members. MentalHealth.gov. http://www.mentalhealth.gov/talk/friends-family-members/. Accessed Aug. 31, 2015.
Mental Illness: Mayo Clinic
In the Know Inservice Module “Working with the Mentally Ill,. 1998-2002
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