Mental Health Reflective Assessment

     "1 in 10 children and young people aged 5 - 16 suffer from a diagnosable mental health disorder - that is around three children in every class" (youngminds.org). The second unit in NEW School was mental health. Throughout this unit, Neto and Tucker taught us a lot about mental health in all three classes that are incorporated into this core, English, science and technology. There were a lot of things that I took away from this unit and there were so many assignments I completed and learned from. 

      In English, there was a writing assessment where we had to select one of the characters from the play, Romeo and Juliet by William Shakespeare. The assignment was to study the character's behaviors in the book and decide what kind of mental illness they had. This assignment was called a psychoanalysis of a character. While reading Romeo and Juliet, Tucker decided that while reading a play it had to be performed so that the students can really immerse themselves into the text and have fun. 

Leeann and Kelly Acting as Romeo and Juliet

Riley acting as Juliet

All the students had an option to be an actor, summarizer, vocabulary finder, emotional labeler or a poetic device finder. The summarizers would summarize the selected scenes, vocabulary group would find vocabulary in the scenes that is hard to understand and they would present to the class the definition with examples, the emotional labelers made signs that the actors would wear that would tell the audience how the character is feeling and the poetic device finders found poetic devices in the text. With all these roles available, the whole class can work together to understand the text and also understand the mental health situations that each character seemed to be dealing with. 

      In science this unit we learned a lot about the neurons in the brain, neurotransmitters and what is happening inside the human brain when someone is struggling with a mental illness. We also conducted a lab experiment based on forensics where we extracted DNA and used an electrophoresis gel chamber to find out who murdered Romeo and Juliet. Neto started off the unit with teaching us about the brain and everything there is to know about neurons and neurotransmitters.

Neto helped us to understand that these are one of the factors that go into mental health disorders like anxiety and depression. After we were done reading Romeo and Juliet, Neto and Tucker assigned a new project, there was a murder we had to solve. One of the characters in the book murdered Romeo and Juliet and we had to perform a lab that involved using DNA to find out who the killer was. My group originally thought it was Capulet but at the end of the experiment, we discovered it was Friar Lawrence.

Starting our gel electrophoresis chambers

Extracting the DNA

Preparing the DNA for the gel chamber

This lab really helped me understand DNA more than I did before and understand how to extract it and figure out who killed Romeo and Juliet, even though the lab had inconclusive evidence. 

      In social media and technology, I learned a lot about filming and creating videos and I also learned a lot about depression from a webinar. After we finished reading Romeo and Juliet, Neto and Tucker put us in big groups and gave us a topic and and Act from Romeo and Juliet. We recreated the scene based on our given topic to help show our understanding of both the Act and the topic assigned. For my group, we were given Act 2 and the topic of Keeping Up With the Kardashians. This assignment helped me gain new experience with script writing, costuming and filming. Along with gaining hands on experience with technology, this unit we also got to listen in on something that we may have to experience someday in the future. One day in NEW, we tuned in to a webinar on depression by Dr. Stringaris. 

Depression In Teens Webinar

This was an interesting experience because although webinars aren't the most entertaining thing in the world, it is still something that many people have to experience whether it be listening to one or creating one. Webinars have become a big part in many people's professions. 

      Overall, the mental health unit was a very interesting unit that let my classmates and I experience many different opportunities to help us understand mental health in many different subjects. English, science and technology taught us mental health using writing assignments, plays, videos, labs, filming and webinars. This unit incorporated Romeo and Juliet very well into understanding how to diagnose a mental illness and know the behaviors of someone who may be dealing with a mental illness. Science videos and labs helped to understand neurons in the brain and DNA. Technology helped me to use new knowledge on filming to show how much I know about mental health. 

Sebastian Junger's Ted Talk

The first thing we did in class today was watch a Ted Talk about PTSD from Sebastian Junger. Junger himself served a little in the military before 9/11 and experienced some PTSD himself. PTSD stands for post traumatic stress disorder and it is very common in veterans. Junger pointed out that a lot of the people that live in modern society today are more predisposed to be depressed and have a higher rate of killing themselves than someone who lives in a poor society. He also explained that after 9/11 occurred, crime rates lowered in New York, there was less violence, lower rates of suicide and veterans claimed that their PTSD symptoms lowered. Junger explained that the reason for this is that when something traumatizes a whole nation, they can heal together as a group of people that experienced the same kind of trauma. Junger concluded the Ted Talk with explaining that the reason that most veterans come home from war with PTSD is because it is easier to cope in groups and since America is such a broken society, veterans come home from the war to find that the country that the have been protecting and fighting for, isn't united. 10% of the military experience violent experiences in shooting, watching their friends get shot or getting seriously injured, but 50% of the military people experience PTSD.  It is hard for vets to come home and have to see what is happening in America, Junger believes this to be one of the main reasons for PTSD rates to be so high.

Eating Disorders

Anorexia Nervosa:

Anorexia Nervosa, or Anorexia, is an eating disorder where someone who is already thin or at a normal body weight, restricts themselves of food and has an obsessive fear of gaining weight. 1 in every 200 Americans suffer from this eating disorder. Anorexia is a very dangerous eating disorder that can result in many serious medical conditions such as slow heart rate, low blood pressure, muscle loss or weakness, reduction of bone density, dehydration, fatigue, dry hair or dry skin.

Warning Signs:

Some of the warning signs of anorexia nervosa are,

• Dramatic weight loss.
• Preoccupation with weight, food, calories, fat grams, and dieting.
• Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.).
• Frequent comments about feeling “fat” or overweight despite weight loss.
• Anxiety about gaining weight or being “fat.”
• Denial of hunger.
• Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate).
• Consistent excuses to avoid mealtimes or situations involving food.
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the need to “burn off” calories taken in.
• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Treatment Options:

• If the patient's life is in immediate danger than hospitalization might be the best option. Hospitalization can be in a medical or psychiatric ward.
• Because of all the complications that come with anorexia, the patient may need frequent monitoring of vital signs to make sure that they are healing.
• The first goal in treatment is going back to a healthy weight a psychiatrist or doctor can help a patient to find the best way to do this
• There are two different kinds of therapy, family-based therapy and individual therapy. Family based therapy is best for teens because the family can help the child or teen see how much they should be eating. Individual therapy is best for adults and helps to normalize eating patterns
• Medicine is not an option for anorexia

Bulimia Nervosa:

Bulimia Nervosa is a potential life threatening eating disorder where there is a cycle of binging and then self induced vomiting to help loose weight. Bulimia can lead to many health consequences such as imbalance in electrolytes, inflammation or possible rupture in esophagus, tooth decay, chronic or irregular bowel movements and gastric rupture.

Symptoms:

• Frequent episodes of consuming large amounts of food and then vomiting
• A feeling of being out of control during the binging episodes
• self esteem overly related to body image

Warning Sings:

• Evidence of binging
• Evidence of purging
• Excessive, Rigid exercise habits
• Unusual swelling in the cheeks or jaw area
• Calluses on the back of the hands and knuckles
• Discoloration or staining on teeth
• Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions.

• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.
• Continued exercise despite injury; overuse injuries.

Treatment Options

• Therapies like support groups, Cognitive behavior therapy, Counseling and other forms of therapy
• Medications
• Self Care like physical exercise
• Specialists like doctors and psychologists can help

Binge Eating Disorder:

Binge eating disorder is a eating disorder of episodes of binging until the point of discomfort where the person feels out of control. Binge eating can cause

Symptoms:

• Lack of control once one begins to eat.
• Depression.
• Grief.
• Anxiety.
• Shame.
• Disgust or self-hatred about eating behaviors

Warning Signs:

• Eating large amounts of food
• Eating even when full
• Eating rapidly during binge episodes
• Frequent dieting without weight loss
• Frequently eating alone
• Hoarding food
• Hiding empty food containers

Treatment Options:

• Psychotherapy like individual counseling that focuses on changing the behavior and thinking of the patient
• Medication
• Nutrition Counseling with a specialist can help get the eating habits back on track
• Group and family therapy is very important because it helps the family members understand what is going on

Symptoms:

• Lack of control once one begins to eat.
• Depression.
• Grief.
• Anxiety.
• Shame.
• Disgust or self-hatred about eating behaviors

Depression Webinar

In class today we listened in on a Webinar about depression by Dr. Stringaris. A webinar is exactly what it sounds like, a seminar on the web. Webinars are a very common thing for people to tune into, especially when their profession involves constant new discoveries of new information like scientists and nurses. 

Stringaris starts the webinar discussing some evolutionary theories of depression:
Protection from negative outcomes, Psychic Pain, A way to change one's own environment and protection from infections.

To find out if someone has depression are if if five or more of the following symptoms have been present during the same time:

• Depressed mood
• Diminished interest in pleasure
• Significant weight loss
• Insomnia or oversleeping
• Agitation or retardation
• Fatigue or loss of energy nearly every day
• Feelings of worthlessness of excessive or inappropriate guilt (may be delusional) nearly every day
• Recurrent thoughts of death (not fear of dying) but suicidal thoughts

Adolescents and Depression:

Suicide is one of the main causes of death in adolescents, adolescents with major depression are 30 times more likely to die of suicide.

Aetiology of Depression

Genes: 30-50% of the liability to depression is due to genetic factors. 

Gene-environmental correlation: Increased genetic liability for lifetime traumas

Gene-environmental interaction: different genotypes respond to environmental variability in different ways

Development and Depression:

Girls are more likely to develop depression during puberty possibly due to the changes in the body and also hormonal changes. 

Girls who experience puberty earlier are more likely to develop depression possibly to hormones,  being so young, being subjected to stress and being exposed to girls who are order and are experiencing adult things. 

Continuities, homotypic:

Childhood depression does not predict adult depression

Anxiety: early on anxiety precedes depression though the links are bidirectional by mid-late adolescence

Alcohol: probably and internalizing pathway to depression

ODD/CD: the strongest predictors of later depression

Behavior Problems and depression:

40% of depressed young adults have had serious disruptive problems during development

Early onset and persistence show the highest depression risk in girls 

Neurology of Depression

Depression is probably a heterogeneous syndrome,

It is useful to think of two core abnormalities

Negative Bias and missing the positive: 

More common to spot the negative or misinterpret a neutral face as sad or angry

People who suffer from depression are more likely to pick up the negative and show an increase of negativity in the amygdala in the brain. Missing the positive, a depressed person may be more likely to miss something positive in their environment like a smile, antidepressants seem to help with this. 

Disrupted Hedonic Processing:

Anticipatory anhedonia: Someone with depression may not think they deserve anything like an award, depression is being unable to see why something might be rewarding

In the brain, processing an award in an area of the brain, it is important in the path of genesis in depression, they are much more likely to become depressed.

Diagnosis

Parents focus on the irritability/oppositionality

Teachers focus on the academics

Person cannot bring themselves to talk about is, patients can be perplexed 

Awareness is key in diagnosis, knowing that adolescence is a peak period 

Screening is only appropriate in samples that are relatively high risk

Diagnosis should also address:

Presence of manic symptoms

Underlying medical causes (e.g. anemia, thyroid disease) 

Risk assessment! (have they cut before, have they tried to kill themselves, etc.)

Treatment

the downstream effect of genes and environment

Medical treatment and psychological targets behavior feelings and thoughts

The first line treatment of depression is simple:

Pharmacology

serotonin reputake inhibitors (SRI's)

fluovetine, serttaline, citalopram

Psychological therapy:

cognitive behavior therapy (CBT)

inter person therapy (IPT)

In mild cases, start with CBT/IPT if you have access to trained therapists

About 60% of young people respond to antidepressant but 50% also respond to the placebo possibly because related to the severity of the depression, the higher the severity of the depression, the lower the response to the treatment.

Antidepressants offer a good risk benefit ratio:

Numbers needed to treat: 10

Numbers needed to harm: 112

 This is important in the context of the suicidality debate and the black box warning.

Project Success

What is a mental disorder?

A mental disorder can be something that affects a person's thinking, emotional state and behavior
It can disrupt the person's ability to work or attend school, carry out daily activities or engage in satisfying relationships

How do you diagnose?

Books can be useful, they are used by professionals, social workers, forensic and legal specialists



What is Anxiety?

There's good anxiety and problematic anxiety it's a normal response to certain situations
Good: Keeps you on your toes and makes you read like before a test or performance
Problematic: A persistent and severe or worry that becomes difficult to control or manage, it is often far more extreme. To be diagnosed you should have it for at least six months

What are some anxiety symptoms? 

Emotional symptoms: apprehension, difficulty concentrating, tense, nervous, being on edge, expecting the worst, restless, lack of sleep, watching for danger
Physical: upset stomach, nausea, hyperventilation, pounding heart, sweating





When is anxiety bad?

Normal: keeps you aware and focused to help you complete tasks
Problematic: After getting through the test or performance, the anxiety continues or when it interferes with everyday tasks

What are the different types of anxiety?

General, Social, Specific Phobias, Panic Disorder and others like OCD and PTSD

What are some causes of anxiety?

Biological Reasons: Genetics, Substance abuse, Medical conditions/medications, Brain chemistry
Environmental Reasons: abuse, truama, high stress, violence
Life Circumstances: Significant losses, Divorce in family, Stressful situations, Unresolved family conflict

What is depression?

Either characterized by a depressed mood, lack of interest in activities that they once were really interested in

What are the symptoms?

Depressed mood, irritability, decreased interest or pleasure, change in sleep patterns, loss of weight or gain in weight, apathetic, guilt, worthlessness, feeling unworthy, difficulty in concentrating




What is the difference between sadness and depression?

Sadness: normal human response to events  Depression: No cause or reason

What causes depression?

Hereditary, Brain chemistry, Environment, Stress, Medication, Alcohol/Drugs

What are some treatment options?

Psychotherapy or medication, an accommodation of the two is the best option. To receive medication it requires a doctor visit

Why is it necessary to receive treatment?

Symptoms can worsen if there is no treatment which can cause problems at school, running away, social addiction, drug and alcohol abuse, reckless behavior, violence, low self esteem, self harm behaviors and suicide

What are the warning signs of suicide?

Giving away possessions, self harm, claiming that they will see dead relatives soon, someone with depression is suddenly really happy,  threats to hurt or kill themselves, saying they want to kill themselves, previous attempts, looking for guns or pills, writing goodbye letters,



QPR

Question... A person about suicide
Persuade... The person to get help
Refer... The person to the appropriate resources

Romeo and Juliet Films - Self Reflection

There were 10 Nutrition groups during the first semester of the school year. Two teams grouped up together to make 5 big groups and each of them tackled a Romeo and Juliet act to reenact but with a new theme. For example, my group had to reenact Act II of Romeo and Juliet but do it Keeping Up With the Kardashians style. Juliet was Kim Kardashian, Romeo was Kanye West and so on. Other groups had themes like The Hunger Games, Western and The Real Housewives of Wherever. Watching all these movies was very entertaining and also humorous.
My role in this project was to help write the script and film the movie along with wardrobe and makeup. I did not want to participate in the acting so instead I took up those roles in this project. After watching the final product of our video I sadly regret not taking more of a lead role in the script writing because the video didn't turn out the exact way I wanted it to be.
I was not a part of the editing process but I wish I was because the scenes in our video were out of order as well.

Keeping Up With Romeo and Juliet

Although the video didn't turn out the way I wanted, I don't regret being a part of it because it was a fun experience where everyone could be creative and have fun together.

Brain Anatomy Narrative

Isabella Lacefield

NEW School

Neto

December 8, 2016

The Worst Days of My Life

I’ll never forget that night. I knew he was sick, but I didn’t know he was that sick. My husband and I thought it was the flu. Dylan’s had always been a very healthy boy, so we figured he had caught something at school, and we made him stay home until it passed. We thought the vomiting would eventually go away until we heard him a few days later.. It was three in the morning and I had never been more scared in my life. John and I woke up to the sound of our seven year old son violently vomiting. We ran to his bedroom to find him leaning over his bed, puking on the ground. My husband and I rushed over to him to console and calm him down, I noticed one of his eyes was almost looking up in his skull. He couldn’t stop retching. My husband’s eyes met mine. I knew it was time “We have to get him to a doctor, now!”

I had never been so scared in my life, until now. Now we wait, wait to hear what is wrong with our son. John and I hold hands silently, entrapped in our own grim thoughts, wondering what’s happening to our son. I stare at the white tile. I don’t even dare to look up because I am afraid. I don’t know what I’m afraid of, but  I know  I’ll have a good reason soon.

“Mr. and Mrs. Pierce?”

I looked up and saw the deliverer of my fears, the doctor. I didn’t speak because I didn’t want to know. I wanted a few more moments of everything being alright. No, I wanted to go back to a few weeks ago when Dylan was a happy and healthy boy.

“We’ve scanned him with an MRI and discovered that there is a medulloblastoma tumor on Dylan’s cerebellum.”

I felt my heart stop. I couldn’t speak, and I didn’t want to. I looked back down at the white tile and just stared at it. This couldn’t be happening, not to my little Dylan, he’s only 7. He doesn’t deserve this.

“Our son… has cancer?” my husband asked, keeping his face in his hands.

“I understand that this must be shocking to you. It is common for this kind of tumor to be found in children Dylan’s age. We can surgically remove it and he will have a good chance of surviving.”

No one responded, neither my husband or I could bear to look up.

“Has your son been experiencing problems with basic coordination skills, headaches, vomiting, drowsiness, changes in appetite, or unusual eye movements?” the doctor asked, keeping a sincere voice that really didn’t help.

My husband looked at him, “We thought he had the flu,” his voice cracked, his eyes teared up and he put his face back in his hands, shaking his head in dismay.

“That is completely understandable, a lot of parents do. This must be very difficult for you to take in, I’m going to leave you two alone. Take all the time you need.” The doctor quietly walked away, leaving us in the waiting room  wondering if our son would live to be eight years old.

I started to cry. It was the only thing I could do, my son has cancer. “Am… am,” My voice shook “ am I a...a bad mom?” I looked away from the white tile for the first time in what felt like an eternity, and saw John, his eyes glistening from tears. He was twisting his wedding ring on his finger anxiously.

“No, no, no, no, no,” He reached his arm over and pulled me in, “any mother would have done the same thing”. He held me tight as I sobbed into his chest.

“I should… should have k-known something w-was wrong.” I couldn’t stop the tears, John held me tighter and rubbed my back.

“You couldn’t have known.” He continued to rub big circles on my back as I slowly calmed down, “We need to be brave, for Dylan”.

I looked up at him and nodded. I had to think about our son, he needs John and I if he’s going to survive.

“The doctor said he has a good chance of surviving the surgery. Dylan’s a strong, brave boy, he can handle this.”

“Okay.”

Weeks had passed and Dylan had been through multiple radiation and chemo treatments. The doctor was planning on surgically removing the tumor tonight. I was scared. Dylan stayed strong through it all, he’s somehow managed to stay happy through all this. As I stand outside Dylan’s room and watch the doctors prep him for surgery through the window, I’m scared. There was always that chance of my son never waking up again, that one chance of my son dying. I can’t imagine life without him, he always brightens up my day and grounds me.

“Mrs. Pierce?” The doctor interrupted my thoughts and was standing next to me.

I cleared my throat and look over, obviously on the verge of crying. “Yes?”

“We’re about to take him up for surgery, do you want to walk with us to the operating room?”

I wiped my eyes “Yes, that sounds great.”

John and I walked on either side of the gurney memorizing every feature of Dylan’s face before they took him away.

“Why are you so sad, Mommy?” Dylan looked up at me, he was so cute, even with his little hair net on and the bags under his eyes.

I wiped my eyes again and plastered a smile on my face “I’m not sad, I’m just really going to miss you while you’re in surgery, that’s all.”

Dylan looked up at me with his big eyes “You’ll see me after, it’ll be over before you know it.”

I doubted that. “Alright honey” I said as I smiled down on him.

“I’m sorry Mr. and Mrs. Pierce, but this is as far as you can go.” The doctor interrupted as the gurney stopped at a big door.

Both John and I hugged Dylan as long and as tight as we could, I inhaled his scent and held onto it for as long as possible before I would say goodbye. “I love you.” we said to Dylan.

“I love you too.” Dylan said as the doctors began to roll him away to the operating room. “See you soon” he shouted before the doors closed behind him.

I felt the world stop. That might have been the last time I will ever see my son. A nurse came and escorted John and I to the waiting room where we waited. It was the longest I had ever waited for anything in my life. We sit there in silence waiting for either joyous news or devastating, earth shattering news. John every so often would go get us coffee and walk around but I never moved. When I was on the verge of sleep, John shook me awake.

“The doctor’s coming.”

Works Cited

“Medulloblastoma” American Brain Tumor Association, http://www.abta.org/brain-tumor-information/types-of-tumors/medulloblastoma.html?referrer=https://www.google.com/

Vapiwala,Neha & Plastaras, John P. “All About Medulloblastoma” OncoLink, June 5, 2016.

https://www.oncolink.org/cancers/pediatric/information/brain-tumors/all-about-medulloblastoma