PsycHe Finer PoinTs

What is a Nervous Breakdown?
A nervous breakdown can be described as an acute emotional or psychological collapse. The term nervous breakdown is not a medical term, but rather a colloquial term used by the general public to refer to and characterize a wide range of mental illnesses.
It generally occurs when a person is unable to function in social roles anymore, experiencing severe depression or feelings of being out of touch with reality. This often occurs after a long period of stress which has not been adequately dealt with.
This inability to function can occur in both work and personal arenas, resulting in difficulty in fulfilling obligations. It also causes the individual to develop physical, mental and emotional symptoms. A person experiencing symptoms of a nervous breakdown may feel extreme tiredness, weakness, and episodes of uncontrollable crying, confusion, disorientation and feelings of worthlessness.
There may also be a loss of self-esteem and confidence, extreme weight loss or weight gain, disrupted sleep patterns and feelings of guilt and despair. In severe cases, an inability to move, called catatonic posturing, may result. This is a serious psychiatric condition and should not be taken lightly.
source:www.medhi-healing.com/http://toolsforlife-dvd.com.au/help/nervous_breakdowns.html

Disorders Associated with a Nervous Breakdown
• Depression
• Panic disorder
• Anxiety
• Generalized anxiety
• Acute stress disorder
• Post-traumatic stress disorder
• Trauma disorders
• Schizophrenia
• Psychotic disorders
• Mood disorders
• Biopolar disorder

Learning to manage stress and identify the early symptoms of a nervous breakdown such as anxiety, depression and panic disorders can help to prevent its onset. Many people have experienced being on the verge of a nervous breakdown, and it is this feeling of overwhelming helplessness that has forced them to revamp their lifestyles and has offered them the opportunity for growth and enlightenment.
Diagnosing a Nervous Breakdown
Your doctor will perform a physical examination to rule out any other medical conditions, and also ask you what symptoms you are experiencing. A course of medication may be prescribed as well as a referral to a psychologist or psychotherapist.
Warning Signs Indicating a Nervous Breakdown
There are physical, emotional and behavioral warning signs and symptoms of a nervous breakdown. They include:

Physical symptoms
• Insomnia
• Loss of appetite or an increase in appetite with ‘comfort eating’
• Diarrhea
• Constipation
• Irritable Bowel Syndrome (IBS)
• Breathing problems
• Migraine headaches
• Low libido
• Disrupted menstrual cycle

Emotional symptoms
• Anxiety
• Depression
• Agitation and restlessness
• Indecision
• Loss of confidence and self–esteem
• Inability to stop crying
• Feelings of guilt, poor judgment

Behavioral symptoms
• Mood swings
• Strange behavior such as odd body movements or undressing in public

In more extreme cases, psychosis can occur where the person will experience complete loss of contact with reality. The symptoms may include hallucinations or visions, feelings of victimization or persecution, strange speech patterns and behaviors as well as extreme guilt or grandiosity.
What Causes a Nervous Breakdown?
There is always a trigger or catalyst that sparks a nervous breakdown. Breakdowns usually stem from a change in a major life event such as a broken relationship, death of a loved one, a demanding job or financial difficulties. Factors that contribute to a breakdown include:

• Stress
• Depression
• Drug and alcohol use
• Genetics (family history)
• Coexisting medical conditions such as vitamin deficiencies or thyroid disorders

Help for Nervous Breakdowns

There are many treatment methods and approaches for dealing with nervous breakdowns. Choosing the right one depends on the diagnosis of the individual case, as there is no standard cure.

source:www.medhi-healing.com/http://toolsforlife-dvd.com.au/help/nervous_breakdowns.html

Preventative
Obviously the best approach is to prevent the breakdown from occurring in the first place. Recognizing the warning signs of a nervous breakdown and reducing and managing stress levels can often produce excellent results and prevent the total collapse usually associated with a nervous breakdown.

Conventional Medicine

Conventional treatments once signs of a nervous breakdown are observed usually consist of anti-depressants or other psychiatric medications. These can have serious side effects as they are high schedule drugs. Prescription drugs alone do not offer a comprehensive treatment for any psychiatric or stress related condition. It is important to seek help in managing the conditions that led up to the breakdown. This is best done by consulting a psychologist.

Natural Remedies

Herbal and homeopathic remedies have the potential to address many of the symptoms of nervous distress and have the advantage of being safe and effective, without many of the side effects and potential for addiction commonly associated with the psychiatric drugs. By incorporating these remedies into your lifestyle, you are not only being proactive but also improving your physical, mental and emotional health.
Herbal and homeopathic remedies commonly recommended include ingredients such as St. John's wort (Hypericum perforatum), Passiflora incarnata, Lavender, Valerian and Melissa officinalis. Homeopathic remedies may also be very beneficial in addressing the underlying causes of the psychological distress and are very useful along with psychotherapy.

Nutritional Supplements

Signs of a nervous breakdown include stress which often means that the individual becomes deficient in certain vitamins and minerals – especially if appetite is also affected. A good multivitamin can be very beneficial and special attention should be paid to taking extra vitamins in the B complex, particularly Vitamin B6 and B12.
Other therapies
Aromatherapy, yoga, reflexology, Reiki and massage therapy can all be useful adjuncts to treatment and can greatly assist in aiding relaxation and stress management.

Prevention Tips for Nervous Breakdowns

Taking care of ourselves physically, mentally, spiritually and emotionally is very important, especially with the hectic demands placed on our daily lives. These useful tips include:
• Eating a healthy diet and improving food choices
• Exercising regularly
• Actively seeking professional help for better coping mechanisms or help with emotional issues
• Taking a break from work and going on vacation
• Practicing deep breathing exercises and meditation
• Incorporating fun and laughter into your life
• Allowing more time for a good night’s rest
• Limiting alcohol and tobacco intake
• Avoiding drugs
• Learning to relax by taking time for yourself
• Maintaining contact with family and friends
• Treating yourself regularly by playing a round of golf, or spending the day at the spa.

source:www.medhi-healing.com/http://toolsforlife-dvd.com.au/help/nervous_breakdowns.html

What is a Nervous Breakdown?
A nervous breakdown can be described as an acute emotional or psychological collapse. The term nervous breakdown is not a medical term, but rather a colloquial term used by the general public to refer to and characterize a wide range of mental illnesses.
It generally occurs when a person is unable to function in social roles anymore, experiencing severe depression or feelings of being out of touch with reality. This often occurs after a long period of stress which has not been adequately dealt with.
This inability to function can occur in both work and personal arenas, resulting in difficulty in fulfilling obligations. It also causes the individual to develop physical, mental and emotional symptoms. A person experiencing symptoms of a nervous breakdown may feel extreme tiredness, weakness, episodes of uncontrollable crying, confusion, disorientation and feelings of worthlessness.
There may also be a loss of self-esteem and confidence, extreme weight loss or weight gain, disrupted sleep patterns and feelings of guilt and despair. In severe cases, an inability to move, called catatonic posturing, may result. This is a serious psychiatric condition and should not be taken lightly.

Disorders Associated with a Nervous Breakdown
• Depression
• Panic disorder
• Anxiety
• Generalized anxiety
• Acute stress disorder
• Post-traumatic stress disorder
• Trauma disorders
• Schizophrenia
• Psychotic disorders
• Mood disorders
• Biopolar disorder

Learning to manage stress and identify the early symptoms of a nervous breakdown such as anxiety, depression and panic disorders can help to prevent its onset. Many people have experienced being on the verge of a nervous breakdown, and it is this feeling of overwhelming helplessness that has forced them to revamp their lifestyles and has offered them the opportunity for growth and enlightenment.
Diagnosing a Nervous Breakdown
Your doctor will perform a physical examination to rule out any other medical conditions, and also ask you what symptoms you are experiencing. A course of medication may be prescribed as well as a referral to a psychologist or psychotherapist.
Warning Signs Indicating a Nervous Breakdown
There are physical, emotional and behavioral warning signs and symptoms of a nervous breakdown. They include:

Physical symptoms
• Insomnia
• Loss of appetite or an increase in appetite with ‘comfort eating’
• Diarrhea
• Constipation
• Irritable Bowel Syndrome (IBS)
• Breathing problems
• Migraine headaches
• Low libido
• Disrupted menstrual cycle

Emotional symptoms
• Anxiety
• Depression
• Agitation and restlessness
• Indecision
• Loss of confidence and self–esteem
• Inability to stop crying
• Feelings of guilt, poor judgment

Behavioral symptoms
• Mood swings
• Strange behavior such as odd body movements or undressing in public

In more extreme cases, psychosis can occur where the person will experience complete loss of contact with reality. The symptoms may include hallucinations or visions, feelings of victimization or persecution, strange speech patterns and behaviors as well as extreme guilt or grandiosity.
What Causes a Nervous Breakdown?
There is always a trigger or catalyst that sparks a nervous breakdown. Breakdowns usually stem from a change in a major life event such as a broken relationship, death of a loved one, a demanding job or financial difficulties. Factors that contribute to a breakdown include:

• Stress
• Depression
• Drug and alcohol use
• Genetics (family history)
• Coexisting medical conditions such as vitamin deficiencies or thyroid disorders

Help for Nervous Breakdowns

There are many treatment methods and approaches for dealing with nervous breakdowns. Choosing the right one depends on the diagnosis of the individual case, as there is no standard cure.

Prevention Tips for Nervous Breakdowns

Preventative
Obviously the best approach is to prevent the breakdown from occurring in the first place. Recognizing the warning signs of a nervous breakdown and reducing and managing stress levels can often produce excellent results and prevent the total collapse usually associated with a nervous breakdown.

Conventional Medicine

Conventional treatments once signs of a nervous breakdown are observed usually consist of anti-depressants or other psychiatric medications. These can have serious side effects as they are high schedule drugs. Prescription drugs alone do not offer a comprehensive treatment for any psychiatric or stress related condition. It is important to seek help in managing the conditions that led up to the breakdown. This is best done by consulting a psychologist.

Natural Remedies

Herbal and homeopathic remedies have the potential to address many of the symptoms of nervous distress and have the advantage of being safe and effective, without many of the side effects and potential for addiction commonly associated with the psychiatric drugs. By incorporating these remedies into your lifestyle, you are not only being proactive but also improving your physical, mental and emotional health.
Herbal and homeopathic remedies commonly recommended include ingredients such as St. John's wort (Hypericum perforatum), Passiflora incarnata, Lavender, Valerian and Melissa officinalis. Homeopathic remedies may also be very beneficial in addressing the underlying causes of the psychological distress and are very useful along with psychotherapy.

Nutritional Supplements

Signs of a nervous breakdown include stress which often means that the individual becomes deficient in certain vitamins and minerals – especially if appetite is also affected. A good multivitamin can be very beneficial and special attention should be paid to taking extra vitamins in the B complex, particularly Vitamin B6 and B12.
Other therapies
Aromatherapy, yoga, reflexology, Reiki and massage therapy can all be useful adjuncts to treatment and can greatly assist in aiding relaxation and stress management.

Prevention Tips for Nervous Breakdowns

Taking care of ourselves physically, mentally, spiritually and emotionally is very important, especially with the hectic demands placed on our daily lives. These useful tips include:
• Eating a healthy diet and improving food choices
• Exercising regularly
• Actively seeking professional help for better coping mechanisms or help with emotional issues
• Taking a break from work and going on vacation
• Practicing deep breathing exercises and meditation
• Incorporating fun and laughter into your life
• Allowing more time for a good night’s rest
• Limiting alcohol and tobacco intake
• Avoiding drugs
• Learning to relax by taking time for yourself
• Maintaining contact with family and friends
• Treating yourself regularly by playing a round of golf, or spending the day at the spa.

source:www.medhi-healing.com/http://toolsforlife-dvd.com.au/help/nervous_breakdowns.html

Can progress to conduct disorder to anti-social behaviour
• short attention span
• impulsive ; shifts from one activity to the other
• Destructive and hyperactive: unable to sit still, keeps on running and climbing
• May occur at age 3 and lasts for at least 6 months but often diagnosed upon entrance to school
• Id dominant: mother or the nurse will act as superego

Manifestations:
• talkative
• appearance – dirty
• behaviour – clumsy, impatient, easily distracted

Nursing Interventions:
• safety
• provide place to study, eat play, bath
• schedule time for all activities
• set limits

- Echolalia, poor eye contact, can’t express verbally

Manifestations:
• communication – difficulty communicating
• appearance – neat, obsessive compulsive, wants constancy
• behaviour – ritualistic behaviour, flat affect, repetitive

Nursing Interventions
• Promote safety
• Constancy
• Expressive therapy – uses art, poetry, decreasing risk for injury, improve social interaction, be able to express feelings.

• Diet, underweight <85% of expected fat, 3 months amenorrhea, failure to recognize problem.
• Most common in women (90-95%), usually teenagers.
Starvation - an attention-getting device; a psychotic disorder, early manifestation of schizophrenia.

Contributing Factors:
1. Disturbed self-image
2. Parent-child conflicts
3. Past and present experiences resulting to feeling
of dependency & helplessness

Warning Signs of Possibility of Anorexia Nervosa:
1. Drastic weight loss in the presence of unusual eating habits
2. Obsession with neatness including frequency in mirror-gazing
3. Hostility and desire to control others
4. Calorie counting, dieting, excessive exercise
5. Depressed mood
6. Amenorrhea or irregular menses
7. Wearing loose-fitting to mask physical appearance as it changes
8. Denying hunger

Symptoms:
1. Dry, flaky or cracked skin
2. Skeletal-like appearance
3. Hypothermia
4. Brittle hair and nails, hair beginning to fall out
5. Amenorrhea or menstrual irregularity
6. see self as fat
7. DHN, malnutrition, electrolyte imbalance
8. Constipation
9. Loss of appetite
10. Intense fear of becoming obese
11. Decreased BP, PR, basal metabolic rate
12. Total lack of concern about symptoms

Nursing interventions:
1. Establish nutrition pattern
2. Setting limits
3. State that three meals a day is necessary to maintain a healthy body
4. Allow some control in decision making
5. Teach stress management, journal keeping
6. Monitor eating pattern and weight
7. Anti-depressant

-Binge eating and purging, normal weight, irregular menstruation, dental carries, diarrhea, knows the problem but ashamed and embarrassed.
Priority:
• fluid volume balance
• weight gain – monitor weight, eating pattern, stay 1 hour after eating, accompany in toilet

Complications:
1. Chronic inflammation of the lining of the esophagus
2. Rupture of the esophagus
3. Dilatation of the esophagus
4. Rupture of the stomach
5. Electrolyte imbalance or abnormalities, leading to arrhythmias of the heart and metabolic alkalosis
6. Heart problems, irreversible Cong. Heart failure
7. Chronic enlargement of the parotid gland
8. Dehydration
9. Irritable bowel syndrome or abnormal dilatation of the colon
10. Rectal prolapsed or abscess
11. Rupture of the diaphragm
12. Dental erosion
13. Chronic edema
14. Fungal infections of the vagina or rectum

Nursing interventions:
8. Establish nutrition pattern
9. Setting limits
10. State that three meals a day is necessary to maintain a healthy body
11. Allow some control in decision making
12. Teach stress management, journal keeping
13. Monitor eating pattern and weight
14. Anti-depressant

1. Agoraphobia – fear of open spaces
2. Claustrophobia – fear of closed spaces
3. Hematophobia – fear of blood
4. Manophobia – fear of being alone
5. Astrophobia – fear of electrical storms
6. Acrophobia – fear of heights
7. Nyctophobia – fear of darkness
8. Pyrophobia – fear of fires
9. Social phobia – fear of situations in which one might be embarrassed or
criticized, fear of exposure
10. Zoophobia – fear of animals
11. Xenophobia – fear of strangers
12. Mysophobia – fear of dirt or germs
13. Hydrophobia – fear of water
14. Ceraunophobia –fear of thunder
15. Androphobia – fear of men
16. Iatrophobia- fear of doctors
17. Ochlophobia – fear of crowds
18. Simple Phobia – fear of object or situation

• An irrational fear of an object or situation that persists, although the person may recognize it as unreasonable.
• Associated with panic level anxiety if the object, situation, or activity cannot be avoided.
• Defense mechanisms commonly used include repression and displacement.

Interventions:

1. Stay with client when anxiety is high to promote safety and security.
2. Identify the basis of the anxiety.
3. Allow the client to verbalize feelings about the anxiety-producing object or situation; frequently talking about the feared object is the first step in the desensitization process.
4. Teach relaxation techniques such as breathing exercises, muscle relaxation exercises and visualization of pleasant situations.
5. Promote desensitization by gradually introducing to the feared object or situation in small doses.
6. Do not force the client to have contract with the phobic object or situation.

Source: Saunders Comprehensive Review’ Linda Anne Silvestri, MSN, RN

After experiencing a psychologically traumatic event, the individual is prone to reexperience the event and have recurrent and intrusive dreams or flashbacks.
Stressor:
1. Natural disaster
2. Terrorist attack
3. Accidents
4. Combat experiences
5. Victim rape
6. Victim of crime or violence
7. Victim of sexual, physical, and emotional abuse
8. Reexperiencing the events as flashbacks
Assessment:
1. Emotional numbness
2. Detachment
3. Depression
4. Anxiety
5. Sleep disturbances and nightmares
6. Flashbacks of the event
7. Hyper vigilance
8. Guilt about surviving the event
9. Poor concentration and avoidance of activities that trigger the memory of the event
Interventions:
1. Be non judgemental and supportive.
2. Assure the client that his or her feelings and behaviours are normal reactions.
3. Assist the client to recognize the association between his or her feelings and behaviours and the trauma.
4. Therapy Encourage the client to express his or her feelings; provide individual that addresses loss of control or anger issues.
5. Assist the client to develop adaptive coping mechanisms and to use relaxation techniques.
6. Encourage the use of support groups
7. Facilitate a progressive review of the trauma experience.
8. Encourage the client to establish and re-establish relationships.
9. Inform the client that hypnotherapy or systematic desensitization may be used as a form of treatment.

Source: Saunders Comprehensive Review’ Linda Anne Silvestri, MSN, RN

1. False reassurance
2. Changing the subject
3. Value judgement
4. Under loading
5. Over loading
6. Invalidation
7. Incongruence
8. Internal validation
9. Giving advice

1. Broad Opening
2. Exploring
3. Identifying Themes
4. Silence
5. Restating
6. Reflecting
7. Stating the observed
8. Voicing doubt
9. Encouraging description of perception
10. Presenting reality or confronting
11. Placing event in time or sequence
12. General leads
13. Empathy
14. Interpreting
15. Focusing
16. Verbalizing the Implied
17. Asking Questioning
18. Encouraging Evaluation
19. Encouraging goal
20. Encouraging decision
21. Giving Information
22. Limit setting
23. Encouraging consideration of options
24. Feedback
25. Encouraging evaluation