You are required to explore and critically analyse the information provided in the case study materials and address the following discussion points, linking them specifically to Georgia’ anxiety.
The essay deals with the case study of Georgia. She is a 22 year old university student suffering from mental stress and anxiety. She is not able to cope up with her studies. She has got few supports. She takes alcohol occasionally; her sleep is deprived and feels fatigued. In response to the case study the assignment aims to reflect on the information provided. Based on the analysis the assignment demonstrates the understanding of the mental health and illness, the relationship between the mental and physical health, understanding of the personal recovery and why it is needed or Georgia. The assignment recognises and responds to the mental health needs of Georgia. Based on literature review the best treatment for Georgia based on her symptoms is highlighted with rationale for the choices.
According to World Health Organisation, “There is no health without mental health” (Pilgrim 2017). It means that everyone has health and similarly everyone also has mental health. Every human in their course of life face challenges to mental health i.e. well being. It may or may not be termed as mental illness. These challenges are similar to the challenges to physical health. Mental health in short indicates the well being with regards to the emotions, feelings, thoughts, problem solving ability, social connections, critical thinking skills, ability to overcome difficulties, and understanding of world around us (Townsend and Morgan 2017).
Not every person experiences the mental illness. Mental illness is the state of mind that effects the way people behave, think, act, speak, feel, or interact with others. These aspects may in turn hamper the other aspects of life. Every person who is sick may not be diagnosed with chronic illness. Similarly, a person may have poor mental health without serious mental disorder or illness. Mere absence of symptoms does not define good mental health. Instead it is more than that. Good mental health is represented by the ability to manage life competently, make rationale choices, deal the challenges robustly and fee satisfied with life. Mental illnesses arise from stresses in life and genetic vulnerability (Hankin et al. 2015).
According to Besser and Zeigler-Hill (2014) looming deadlines, increasing workload, financial hardships, relationship issues, are the common cause of stress when students make transition from high school to tertiary education. University students are in transitory period, as they jump from adolescents to adulthood and is known to be the stressful period. In the given case study, Georgia is a university student. She is pursuing her career in psychology. She is mentally stressed due to workload. It is affecting her concentration in studies and is missing deadlines. Her anxiety is evident from panic and worries during exams. Georgia has few supports as she lives distant from her parents. Her brother too works in London. She has minimal contact with her high school friends. Moreover, she is also not in relationship from more than two years. It must have pushed her to extreme level of anxiety that she can no longer cope up with her life. As per Song and Lindquist (2015) students staying away from home have greater responsibility both domestically and financially. It may add to stress owing to the change in environment and external factors. Students are highly vulnerable to stressors in university life. Further, social isolation pushes people towards reduce communication and increased marginalisation.
As per Khan et al. (2016) when a person experience shocking, dangerous or scary event he/she suffers from post traumatic stress disorder (PTSD). It can be interpreted that Georgia’s stress is due to past experience from driving where she almost had an accident during driving test. In this disorder the memories of trauma remain flashes back and keep the adrenaline high in level. High adrenaline hampers the sleep pattern and increases anxiety by disturbing the normal function of hippocampus region of brain. As Georgia avoids driving it indicates PTSD. The common symptoms of PTSD that bare also observed in Georgia are irregular heartbeats, feeling of panic and intake of alcohol. As per case study, Georgia occasionally drinks alcohol when she goes out with her friends.
The mental health condition of Georgia can be related with the study of Besser and Zeigler-Hill (2014). According to this study, the severity of mental health issues is increasing among college and university students. A substantial proportion of medical, nursing and psychology students are suffering from anxiety, stress, and depression. Increasing age, overweight, female sex, and obesity are some of the factors significantly associated with the stress among students in higher studies. In case of Georgia her BMI and BP is normal but have high respiratory rate of 22. It can be related with the shortness of breath experienced by Georgia.
Georgia complains that she may be unable to cope up like her mother. It can be interpreted that her mother was too anxious and stressed in life. As argued by modern genetics, studying on generalised anxiety disorder, there is high potential of genetics vulnerability to develop anxiety. Georgia might have inherited vulnerability genes from her mother as suggested by molecular genetic studies (Hankin et al. 2015).
The relationship between mental and physical health is explained by various studies. According to Townsend and Morgan (2017) poor mental health increases the risk of chronic physical conditions. People with serious mental disorders have been found to experience chronic physical health disorders. On the contrary, people with chronic physical conditions were found at risk of developing poor mental health. For instance, a nutritious diet improves mental health functioning. In addition it also improves the sleep pattern and concentration. It increases energy levels. A healthy diet assists in faster recovery from physical illness.
Hypertension, musculoskeletal diseases, obesity and cardiovascular disease were all found to be associated in group of people with traumatic experiences. In case of Georgia, it is due to anxiety and stress that she is experiencing shortness of breath, heart pounding and feeling of doom. After the experiences of trauma, brain responds more sensitively to triggers and stress. It affects the autonomic nervous system that results in wear and tear in body. Consequently, there is physical effect in the body. Both the physical and mental health is influenced by the social determinants of health (World Health Organization 2014). Hence, taking steps to improve mental health can in turn improve the physical health.
In the given case study, Georgia needs to recover from her mental stress and anxiety. It will help her deal with life more positively. Recovery from mental illness helps an individual to enjoy meaningful activity in life. It will avoid the barriers such as breaks in career, adjusting to changes and feeling unsure. Personal recovery is important to fulfil the unmet needs. According to Maslow’s original hypothesis, an individual must fulfil the lower needs and progress linearly to achieve higher level needs (Henwood et al. 2015). Georgia must be able to recover from her psychological condition (mood alteration, anxiety and stress), safety, love and belongings, low self-esteem to reach the stage of self actualisation as per Maslow’s model.
In case of Georgia, only if she recovers from stress and anxiety that she will be able to focus on her studies and fulfil her ambition. She must recover from her traumatic experiences so that it does not hamper her sleep pattern, concentration, studies, and feeling of fatigue. Georgia must recover from parental and social isolation. She must overcome her increasing consumption of alcohol. In doing so, Georgia will have meaningful life and can deal with daily challenges both academic and personal. Recovery does not mean just managing the symptoms but to increase mental resilience (Slade et al. 2014).
The mental health needs of Georgia as per the case study are: 1. Overcome past stress and trauma- to find meaning and purpose to life, feel fulfilled and have full control over their lives. Georgia needs to overcome emotional responses and fear of imminent threat. 2. Avoid alcohol use- Alcohol consumption increases stress, depression and anxiety. 3. Good relationships- is needed for personal empowerment and improve quality of life. 4. Social inclusion- Staying away from loved ones increases stress. Social inclusion is needed for mental support. 5. Satisfying work- to overcome stress and anxiety is needed. It will assist people in achieving goals of life and reduce stress. 6. Development of resilience- to deal with possible adversity and stress in life (Townsend and Morgan 2017).
There are effective treatments for mental illnesses if received optimally. The common therapies for the anxiety and stress appropriate for university students are Social support, psychotherapy, cognitive and behavioural therapy- Recovery is enhanced by strong social connectedness. Taking part in educational, training, volunteering, social and employment opportunities supports recovery in Georgia. Psychotherapy and cognitive behavioural therapy assists clients in developing awareness of verbal and non-verbal behaviours. It will help Georgia clarify meaning of actions and feelings. It will lead to client acknowledging anxiety and fear. CBT was also found effective in addiction treatment and sleep disorder like insomnia (Olthuis et al. 2015)
Pharmacotherapy- Patients are administered with benzodiazepines, Busiprone, for stress and imipramine and clomipramine is administered for panic disorder. These drugs also work as antidepressant agents. Both paroxetine and sertraline are FDA approved drugs for anxiety disorder. Patient must strictly adhere to the guidelines given by practioner as well as therapy schedule (Both et al. 2014).
Supportive counselling- is needed to promote positive coping strategies in patients. Wellness can be promoted by assisting clients in identifying new methods of coping. The professionals helps clients review happenings, thoughts, feelings prior to anxiety attack. It will help create awareness of negative thoughts in Georgia to substitute with positive thoughts (Pybis et al. 2017). Relaxation techniques- Recent studies on mindfulness based strategise for anxiety and stress emphasise on music therapy, deep breathing, imagery and others. It will help reduce stress and cope up with triggers. Exercise, and diet have also been found to play role in relaxation and reduction in stress level (Song and Lindquist 2015).
The implications for practice for the professionals working with mental illness include implementing person centered approach during diagnosis, assessment and treatment of the patients (Dixon-Gordon et al. 2015). It will help build therapeutic relationship with clients so that it gives safety, comfort, to the patients. The mental health practioners and nursing professionals must accept patients non-judgmentally. Effective communication and interpersonal communication skills are required to promote psychological well being, physical health and emotional well being. The professional must implement evidence based practice for best health outcomes (Townsend and Morgan 2017).
In conclusion, mental health is the complicated field of science. Poor mental illness is caused by multiple factors. If neglected, mental illness can manifest into wide variety of physical illnesses. Stress and anxiety is very common among university students. Literature review has helped understand and explore the mental illness, recovery, mental health needs and treatment related aspects using in case study of Georgia. Mental and physical health is interrelated and personal recovery is essential. Metal illness can be treated by combination of pharmacological and non-pharmacological interventions. As per literature evidence professionals should implement evidence based care and person centered approach.
References
Besser, A. and Zeigler-Hill, V., 2014. Positive personality features and stress among first-year university students: Implications for psychological distress, functional impairment, and self-esteem. Self and Identity, 13(1), pp.24-44.
Both, C., Kojda, G. and Lange-Asschenfeldt, C., 2014. Pharmacotherapy of generalized anxiety disorder: focus and update on pregabalin. Expert review of neurotherapeutics, 14(1), pp.29-38.
Dixon-Gordon, K.L., Aldao, A. and De Los Reyes, A., 2015. Repertoires of emotion regulation: A person-centered approach to assessing emotion regulation strategies and links to psychopathology. Cognition and Emotion, 29(7), pp.1314-1325.
Hankin, B.L., Young, J.F., Abela, J.R., Smolen, A., Jenness, J.L., Gulley, L.D., Technow, J.R., Gottlieb, A.B., Cohen, J.R. and Oppenheimer, C.W., 2015. Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress. Journal of abnormal psychology, 124(4), p.803.
Henwood, B.F., Derejko, K.S., Couture, J. and Padgett, D.K., 2015. Maslow and mental health recovery: A comparative study of homeless programs for adults with serious mental illness. Administration and Policy in Mental Health and Mental Health Services Research, 42(2), pp.220-228.
Khan, A.A., Haider, G., Sheikh, M.R., Ali, A.F., Khalid, Z., Tahir, M.M., Malik, T.M., Salick, M.M., Lakhani, L.S., Yousuf, F.S. and Khan, M.B., 2016. Prevalence of post-traumatic stress disorder due to community violence among university students in the world’s most dangerous megacity: A cross-sectional study from Pakistan. Journal of interpersonal violence, 31(13), pp.2302-2315.
Olthuis, J.V., Watt, M.C., Bailey, K., Hayden, J.A. and Stewart, S.H., 2015. Therapist-supported internet cognitive–behavioural therapy for anxiety disorders in adults. BJPsych Advances, 21(5), pp.290-290.
Pilgrim, D., 2017. Key concepts in mental health. Sage. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=PhgjDgAAQBAJ&oi=fnd&pg=PP1&dq=mental+health+WHO+defination&ots=fcpabMUKTV&sig=9s9N4yfA4ux3YXLhw7WA-U1_cdU#v=onepage&q&f=false
Pybis, J., Saxon, D., Hill, A. and Barkham, M., 2017. The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2 nd UK National Audit of psychological therapies. BMC psychiatry, 17(1), p.215.
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S. and Whitley, R., 2014. Uses and abuses of recovery: implementing recovery?oriented practices in mental health systems. World Psychiatry, 13(1), pp.12-20.
Song, Y. and Lindquist, R., 2015. Effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students. Nurse Education Today, 35(1), pp.86-90.
Townsend, M.C. and Morgan, K.I., 2017. Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
World Health Organization, 2014. Social determinants of mental health. World Health Organization.
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