Yoga Paper 2

Paper-2 mental illness
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1. Delusions in paranoia: Paranoia is a central symptom of psychosis.
Paranoia involves intense anxious or fearful feelings and thoughts often related to
persecution, threat, or conspiracy. Paranoia occurs in many mental disorders, but is
most often present in psychotic disorders. Paranoia can become delusions, when
irrational thoughts and beliefs become so fixed that nothing (including contrary
evidence) can convince a person that what they think or feel is not true. When a
person has paranoia or delusions, but no other symptoms (like hearing or seeing
things that aren't there), they might have what is called a delusional
disorder. Because only thoughts are impacted, a person with delusional disorder
can usually work and function in everyday life, however, their lives may be limited
and isolated.
Signs: Symptoms of paranoia and delusional disorders include intense and
irrational mistrust or suspicion, which can bring on sense of fear, anger, and
betrayal. Some identifiable beliefs and behaviors of individuals with symptoms of
paranoia include mistrust, hypervigilence, difficulty with forgiveness, defensive
attitude in response to imagined criticism, preoccupation with hidden motives, fear
of being deceived or taken advantage of, inability to relax, or are argumentative.
2. Reinforcement
 Reinforcement is used to help increase the probability that a specific

behavior will occur in the future by delivering or removing a stimulus
immediately after a behavior.
a. Positive Reinforcement: Positive reinforcement works by presenting a

motivating/reinforcing stimulus to the person after the desired behavior is
exhibited, making the behavior more likely to happen in the future.
The following are some examples of positive reinforcement:
 A mother gives her son praise (reinforcing stimulus) for doing homework
(behavior).
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 The little boy receives $5.00 (reinforcing stimulus) for every A he earns on
his report card (behavior).
 A father gives his daughter candy (reinforcing stimulus) for cleaning up toys
(behavior).
b. Negative Reinforcement: Negative reinforcement occurs when a certain

stimulus (usually an aversive stimulus) is removed after a particular behavior
is exhibited. The likelihood of the particular behavior occurring again in the
future is increased because of removing/avoiding the negative consequence.
The following are some examples of negative reinforcement:
 Bob does the dishes (behavior) in order to stop his mother’s nagging
(aversive stimulus).
 Joe presses a button (behavior) that turns off a loud alarm (aversive
stimulus)
When thinking about reinforcement, always remember that the end result is to try
to increase the behavior, whereas punishment procedures are used to decrease
behavior. For positive reinforcement, think of it as adding something positive in
order to increase a response. For negative reinforcement, think of it as taking
something negative away in order to increase a response.
3. Wolpe and Systematic desensitization: Systematic desensitization is a

behavioral technique commonly used to treat fear, anxiety disorders and phobias.
Using this method, the person is engaged in some type of relaxation exercise and
gradually exposed to an anxiety-producing stimulus, like an object or place. while
being engaged in some type of relaxation at the same time in order to reduce the
symptoms of anxiety. Steps are:
1. Relaxation
2. Constructing an anxiety hierarchy
3. Pairing relaxation with the situations described in the anxiety hierarchy
For example, a very common phobia is the fear of flying. Some people become
very anxious when travel involves a plane, while others may become extremely
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fearful at the thought of flying and refuse to go anywhere near a plane. Systematic
desensitization has two steps that could be applied to a fear of flying in order to
help reduce the anxiety involved.
4. Mental retardation: Intellectual disability (ID), once called mental retardation,
is characterized by below-average intelligence (IQ score below 70 to 75)
or mental ability and a lack of skills necessary for day-to-day living. People with
intellectual disabilities can and do learn new skills, but they learn them more
slowly i.e. take time to learn.
If your child has an intellectual disability (ID) or mental retardation, their brain
doesn’t develop properly. Their brain may also not function within the normal
range of both intellectual and adaptive functioning.
There are four levels of ID: mild, moderate, severe, and profound. Sometimes ID
may be classified as “other” or “unspecified.” ID involves both a low IQ and
problems adjusting to everyday life. There may also be learning, speech, social,
and physical disabilities.
5. Classification of mental disorders: The classification of mental disorders is

also known as psychiatric nosology or psychiatric taxonomy. It represents a key
aspect of psychiatry and other mental health professions and is an important issue
for people who may be diagnosed. There are currently two widely
established systems for classifying mental disorders or illness:
 International Classification of Diseases (ICD-10) produced by the World

Health Organization (WHO)
 The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) produced
by the American Psychiatric Association (APA).
6. Delusion: A false unshakable belief which are not in keeping with patients or
persons socio-cultural and educational background.
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 Non-bizarre: They involve situations that could occur, such as being

followed, poisoned, infected, loved at a distance, or deceived by one’s
spouse or lover.
 Bizarre: They involve implausible/unrealistic situations such as believing

that someone removed their internal organs without leaving a scar.
 Delusional disorder is characterized by firmly held false beliefs (delusions)

that persist for at least 1 month, without other symptoms of psychosis.
7. Intelligence: Intelligence is “the capacity to acquire and apply knowledge.”

Intelligence includes the ability to benefit from past experience, act purposefully,
solve problems, and adapt to new situations. Intelligence can also be defined as
“the ability that intelligence tests measure. These eight types of intelligence are:
1. Linguistic: spoken and written language skills
2. Logical–Mathematical: number skills
3. Musical: performance or composition skills
4. Spatial: ability to evaluate and analyze the visual world
5. Bodily-Kinesthetic: dance or athletic abilities
6. Interpersonal: skill in understanding and relating to others
7. Intrapersonal: skill in understanding the self
8. Nature: skill in understanding the natural world
8. Postpartum psychosis: A very serious mental illness that can affect a new
mother. The episode of psychosis usually begins within 1 to 3 months of delivery.
A woman with postpartum psychosis may lose touch with reality and have auditory
hallucinations and delusions. Visual hallucinations are less common. Other
symptoms may include insomnia, agitation, anger, and irrational guilt about
somehow having done something wrong. Women who have postpartum psychosis
need prompt treatment and almost always need medication. If they are at risk for
hurting themselves or someone else, women with postpartum psychosis need to be
in a hospital. Many women will experience mild mood changes after having a
baby, known as the "baby blues"
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9. Exhibitionism: Exhibitionism is characterized by achievement of sexual

excitement through genital exposure, usually to an unsuspecting stranger. It may
also refer to a strong desire to be observed by other people during sexual
activity. Exhibitionistic disorder involves acting on these urges with a non-
consenting person or experiencing significant distress or functional impairment
because of such urges and impulses.
Exhibitionists (usually male) may masturbate while exposing themselves to

others. They may be aware of their need to surprise, shock, or impress the
unwilling observer. The victim is almost always a female adult or a child of either
sex. Actual sexual contact is rarely sought, and physical harm to the unsuspecting
witness is unusual.
10. Dyslexia: Dyslexia is a learning disorder that involves difficulty reading due to
problems identifying speech sounds and learning how they relate to letters and
words (decoding). Also called reading disability, dyslexia affects areas of the brain
that process language.
People with dyslexia have normal intelligence and usually have normal vision.
Most children with dyslexia can succeed in school with tutoring or a specialized
education program. Emotional support also plays an important role. Though there's
no cure for dyslexia, early assessment and intervention result in the best outcome.
11. Dyspraxia: A person with dyspraxia has problems with movement,

coordination, judgment, processing, memory, and some other cognitive skills.
Dyspraxia also affects the body's immune and nervous systems. Dyspraxia is also
known as motor learning difficulties; Dyspraxia is a neurological disorder that
impacts an individual's ability to plan and process motor tasks.
12. Seasonal Affective Disorder: Seasonal Affective Disorder (SAD) is a type of

depression that comes and goes with the seasons, typically starting in the late fall
and early winter and going away during the spring and summer. Depressive
episodes linked to the summer can occur, but are much less common than winter
episodes of SAD.
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Symptoms of Major Depression
 Feeling depressed most of the day, nearly every day

 Feeling hopeless or worthless
 Having low energy
 Losing interest in activities you once enjoyed
 Having problems with sleep
 Experiencing changes in your appetite or weight
 Feeling sluggish or agitated
 Having difficulty concentrating
 Having frequent thoughts of death or suicide.
13. Vascular dementia: Vascular dementia is a general term describing problems

with reasoning, planning, judgment, memory and other thought processes caused
by brain damage from impaired blood flow to your brain. You can
develop vascular dementia after a stroke blocks an artery in your brain, but strokes
don't always cause vascular dementia.
Vascular dementia signs and symptoms include:
 Confusion
 Trouble paying attention and concentrating
 Reduced ability to organize thoughts or actions
 Decline in ability to analyze a situation, develop an effective plan and
communicate that plan to others
 Difficulty deciding what to do next
 Problems with memory
 Restlessness and agitation
 Unsteady gait
 Sudden or frequent urge to urinate or inability to control passing urine
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 Depression or apathy
14. PANDAS is short for Pediatric Autoimmune Neuropsychiatric Disorders

Associated with Streptococcal Infections. A child may be diagnosed with
PANDAS when:
 Obsessive compulsive disorder (OCD) and/or tic disorders suddenly appear

following a strep infection (such as strep throat or scarlet fever); or
 The symptoms of OCD or tic symptoms suddenly become worse following a strep
infection.
The symptoms are usually dramatic, happen “overnight and out of the blue,” and
can include motor and/or vocal tics, obsessions, and/or compulsions. In addition to
these symptoms, children may also become moody or irritable, experience anxiety
attacks, or show concerns about separating from parents or loved ones.
15. Neurosis: Neurosis is a class of functional mental disorders involving

chronic distress but neither delusions nor hallucinations. Neurosis refers to
disturbing psychological disorders that still let the sufferer remain in contact with
reality. "neurosis" means "a personality or mental disturbance not due to any
known neurological or organic dysfunction [brain or body problem. There are
many different neuroses: obsessive–compulsive disorder, obsessive–compulsive
personality disorder, impulse control disorder, anxiety disorder, hysteria, and a
great variety of phobias.
Neurosis takes many different forms, including
 anxiety disorders: excessive severe worrying.

 phobias: abnormally intense fears with no objective cause.
 obsessive-compulsive disorders: repetitive acts, such as repeatedly checking
whether doors are locked, oven is turned off, etc.; repetitive handwashing
and intense concern about "germs," etc.
 hysterical disorder
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16. Psychosis is an abnormal condition of the mind that results in difficulties

determining what is real and what is not.[4] Symptoms may include false
beliefs (delusions) and seeing or hearing things that others do not see or
hear (hallucinations).[4] Other symptoms may include incoherent speech and
behavior that is inappropriate for the situation.[4] There may also be sleep
problems, social withdrawal, lack of motivation, and difficulties carrying out daily
activities
17. A hallucination is anything that is sensed—heard, seen, felt, or even smelled—

that is not real. The person experiencing a hallucination may believe that it is real,
and everything about the vision, sound, voice, or other sensation seems very real.
The definition of delusion is a little different, although it also involves the

experience of something that feels real but isn’t. A delusion is a belief that is
obviously false, and yet the individual experiencing it thinks it is absolutely true. A
delusion is not a belief that is false because of a person’s intelligence, education,
culture, religion, or other similar factor; instead, it is false because it of some
abnormality in the individual’s thinking.
Hallucinations and delusions are similar in that they are both false but seem very
real to the person experiencing them. Both are caused by certain mental illnesses
but can also be triggered by medical conditions, injuries, or by no known cause at
all. A hallucination involves the senses and feels real but is not. A delusion is a
false belief that persists in spite of evidence. The differences are that
hallucinations are things that are sensed but not real, while delusions are beliefs
that are not real or correct.
18. Modelling theory of Albert Bandura: Albert Bandura is an eminent person in

the field of developmental psychology and educational psychology. One of his
contributions to the field of psychology and that has relevance to communication is
Modelling theory. In this theory, Albert Bandura stresses on the role of social
learning through observation. He believes that people adopt behavior by observing
others.
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Modelling theory emphasises on the importance of observation and imitation that

takes place from an individual’s view though the characters portrayed through
media, and how it brings a change when it comes to their behavior, knowledge,
attitudes and values. The imitation is more likely to happen if the model holds an
admired status and the activity that they do are of great value. The imitated
behavior is gradually reinforced and the individual identifies with the model and
gradually tries out the behavior.
Stages in Modelling theory

1. Seeing an action portrayed in the media
2. Viewer identifies with the actor
3. The viewer imitates the actor
4. Viewer gets motivated if the activity gets some rewards
19. General adaptation syndrome (GAS) is the predictable way the body
responds to stress as described by Hans Selye. GAS is the three-stage process that
describes the physiological changes the body goes through when under
stress. Selye identified these stages as alarm, resistance, and exhaustion.
Understanding these different responses and how they relate to each other may
help you cope with stress.
GAS can occur with any type of stress. Stressful events can include:
 a job loss
 medical problems
 financial troubles
 family breakdown
 trauma
But while stress is unpleasant, the upside is that GAS improves how your body
responds to stressors, particularly in the alarm stage.
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UNIT-1
1. Mental Health:
Mental health is the normal state of well being. Mental health is a condition which
is characteristic of the average person who meets the demands of life, according to
his capacities and limitations. Mental health is not mere absence of mental illness.
Mental health includes our emotional, psychological, and social well-being. It
affects how we think, feel, and act. It also helps determine how we handle stress,
relate to others, and make choices. Mental health is important at every stage of life,
from childhood and adolescence through adulthood.
Over the course of your life, if you experience mental health problems, your
thinking, mood, and behavior could be affected. Many factors contribute to mental
health problems, including:
 Biological factors, such as genes or brain chemistry

 Life experiences, such as trauma or abuse
 Family history of mental health problems
 Physical factors
 Social factors such as the home, the school and the community.
2. Characteristics of mental health:
Adequate understanding of one’s own self, Adequate feeling of personal worth,

Inadequate feeling of security, Adequate faith in one’s ability, Adequate
understanding of others, Adequate basic harmony, A philosophy of life, Adequate
ability to watch desire with reality, Mentally healthy person expresses emotions,
The Ability to Enjoy Life , Resilience ,
Maintains good relationships:- A mentally healthy individual is never loner and

do not stay isolated. He always seeks company. Relationships he acquire with
others are very strong bonds he forms which last long and satisfies him completely.
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He is always ready to help others and develop a very strong social network. He feel
connected with others and do not consider himself different from rest of the group
and thus never think of hurting others as he understands that hurting someone will
definitely mean hurting himself. He has a strong belief that everyone is connected
and this is a very important characteristic of healthy thinking and emotionally
stable mind.
Mentally healthy person expresses emotions:- A mentally sound and healthy

person exhibits emotions appropriately and is spontaneous in doing so. Hiding
emotions is an unhealthy sign. Emotional awareness is essential to experience and
express this wide spectrum of emotions. When expressing or experiencing, he very
well knows what he is feeling at that time. He knows his feelings are products of
his thoughts and does affect his response which he projects outside. He knows the
difference between emotional expression and emotional self-control and do not try
to cross the line between them. He knows how much to express, what and when to
express i.e., He has a control over his emotions. Emotionally healthy person is
always pleasant and joyful. Does not show rage and anger when meets criticism.
Healthy mind is creative:- Creativity means inventing or discovering something

new and this is a sign of psychological richness. Mind which is functioning
efficiently can be creative. Only sound mind can show the courage and interest in
creating something new and accepts risk. Creativity is given a kick start by
adversity i.e., challenges in life can promote new inventions and discoveries. A
sound mind very well accepts adversity, but mental ill-health may not be able to
face adversity at any cost.
Positivism and hope:- Hope is a key of motivation and in absence of it, desire to
achieve anything would become very dull. Presence of hopes make a person feel
that he is resourceful enough to conquer his desires. A mentally healthy person is
full of hope which keeps his burning desire activated and at the same time is
optimistic. In absence of optimism, hope cannot exist. Only positive attitude lets a
person to accomplish his goals despite thousands of set backs and all those hurdles
which comes in his way. When both optimism and hope are present, a person will
be able to find different ways, especially when one door gets closed as his focus is
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not on making his way past door but to reach his goal. Optimistic approach
towards everything in life will increase life span and keep both mind and body
healthy. Negative approach towards life is very closely related with anger, anxiety,
tension, stress related disorders, depression, mental disorders etc.
Face rejections gracefully:- A mentally healthy person is resilient. He

understands that failures are part of a life and thus failures does not cause set backs
in his life. Whenever he faces hurdles or failures, he just bounce back even
stronger. He knows his weakness and strengths and always finds silver lining in
time of crisis. Being resilient teaches him to adapt to unfavorable circumstances.
Resiliency teaches him flexibility. His ability to face rejections gracefully prevents
disappointments and keeps him stable and helps him to maintain high levels of
functions both physically and psychologically. Rejection faced gracefully teaches a
person to grow strong and provides strength to triumph over difficult times.
Resilience or facing rejection very gracefully is actually considered to be a master
characteristic of emotionally healthy individuals.
Self-confidence is a characteristic of sound mind:- A mentally healthy

individual will have high levels of self-confidence and self-esteem. He is aware of
all his strengths and weaknesses and thus knows how to make best use of them.
Confidence within oneself is s drive that takes him past toughest of the obstacles.
Lack of confidence does not lead to making attempts. Until and unless attempts are
made and chances are taken, success cannot be achieved. Self-confidence
personally prepares a person from inside to take risks unlike in case of lack of
confidence where even a person is scared of taking minimal risks and always plays
safe. Confidence is essential to carry out life in the best possible way and higher
the confidence level, one can make best use of opportunity that approaches him in
his way of life. Along with self-confidence, he also has high self-esteem i.e., he
respects himself as well as admires himself for the person he is. These
characteristics are the signs of a healthy mind. In case of ill-health of mind, self-
confidence and self-esteem does not come to a person very naturally.
Self-aware:- A mentally healthy individual always has insight into himself. He

knows about himself and regularly spends some time in conducting inner
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examination. This kind of self-assessment gives an idea about inner belief systems,
pattern of thoughts which are developing, feelings which are getting generated,
values, motives etc. He thus gets a very clear sense of his personal identity. When
he is clear from inside then outside world appears crystal clear to him. Blurriness
inside which is a sign of mental ill-health will not allow us to understand the
activities which are taking place in the outer world very well leading to dilemma
and insecurities of failures. Throughout our lives we struggle through issues related
with identity because we are really unaware of who we are in real sense. Identity
confusion often develops in individuals who are not self aware and this sort of
problem is often in relation with many social and psychological problems. It leads
to confusion, anxiety and interferes with day to day life as it takes away
contentment from every day life, no matter what choices we make. A person who
is mentally healthy do not face such risks of undergoing identity confusion or
developing a negative identity. Instead, he enjoys a very strong sense of his self-
identity as he develops opinion of his own. In depth of solitude, he spends some
time and develops sense of identity which is quite deep.
Self-disciplined:- Discipline is an important characteristic and necessary factor to

achieve success and self-discipline is an important characteristic of a healthy mind
which leads to healthy living. In absence of discipline, nothing can be
accomplished and when desires are not fulfilled then contentment does not arise
which leads to dissatisfaction. A mentally healthy individual follows a strict
discipline in his life and this is not practiced because of pressure of outer world but
because he loves to live a disciplined life. He creates his goals and then through
strict discipline, carry out all the necessary actions essential to meet them. He
always upholds rules and orders of conduct.
Conclusion:- A mentally healthy person is an individual who is always happy and

joyful in his life. Mental health does not only refer to sound mind but also to
number of characteristics like self-confidence, self-esteem, self-discipline,
resilient, being creative etc. To know about more characteristics determining sound
and healthy mind read here Characteristics of a mentally healthy person: Part-2. In
absence of good mental health, a person cannot display these and many more such
characteristics which are essential to live a successful and happy life. Only good
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mental health will allow a person to be resilient and face rejections very gracefully.
He feels good about his life, events which are taking place in life and can express
and experience his emotions in an appropriate manner. Intimacy or maintaining
good relationships with others is only possible when mind is in sound form.
Mental health is more than just the absence of mental illness. It includes how you
feel about yourself and how you adjust to life events. However, the National
Mental Health Association cites 10 characteristics of people who are mentally
healthy.
1. They feel good about themselves.

2. They do not become overwhelmed by emotions, such as fear, anger, love,
jealousy, guilt, or anxiety.
3. They have lasting and satisfying personal relationships.
4. They feel comfortable with other people.
5. They can laugh at themselves and with others.
6. They have respect for themselves and for others even if there are differences.
7. They are able to accept life’s disappointments.
8. They can meet life’s demands and handle their problems when they arise.
9. They make their own decisions.
10.They shape their environment whenever possible and adjust to it when
necessary.
3. Classification of mental illness:
The classification of mental disorders is also known as psychiatric

nosology or psychiatric taxonomy. It represents a key aspect of psychiatry and
other mental health professions and is an important issue for people who may be
diagnosed. There are currently two widely established systems for
classifying mental disorders:
 Chapter V of the International Classification of Diseases (ICD-10) produced by

the World Health Organization (WHO)
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 The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) produced

by the American Psychiatric Association (APA)
The International Classification of Diseases (ICD) is an international standard
diagnostic classification for a wide variety of health conditions. The ICD-10 states
that mental disorder is "not an exact term", although is generally used "...to imply
the existence of a clinically recognisable set of symptoms or behaviours associated
in most cases with distress and with interference with personal functions." Chapter
V focuses on "mental and behavioural disorders" and consists of 10 main groups:
ICD-10
 F0: Organic, including symptomatic, mental disorders

 F1: Mental and behavioural disorders due to use of psychoactive substances
 F2: Schizophrenia, schizotypal and delusional disorders
 F3: Mood [affective] disorders
 F4: Neurotic, stress-related and somatoform disorders
 F5: Behavioural syndromes associated with physiological disturbances and
physical factors
 F6: Disorders of personality and behaviour in adult persons
 F7: Mental retardation
 F8: Disorders of psychological development
 F9: Behavioural and emotional disorders with onset usually occurring in
childhood and adolescence
 In addition, a group of "unspecified mental disorders".
Within each group there are more specific subcategories. The WHO is revising
their classifications in this section as part of the development of the ICD-11
(revision due by 2018) and an "International Advisory Group" has been established
to guide this.
DSM IV
The DSM-IV was originally published in 1994 and listed more than 250 mental
disorders. It was produced by the American Psychiatric Association and it
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characterizes mental disorder as "a clinically significant behavioral or

psychological syndrome or pattern that occurs in an individual,...is associated with
present distress...or disability...or with a significant increased risk of suffering" but
that "...no definition adequately specifies precise boundaries for the concept of
'mental disorder'...different situations call for different definitions" (APA, 1994 and
2000). The DSM also states that "there is no assumption that each category of
mental disorder is a completely discrete entity with absolute boundaries dividing it
from other mental disorders or from no mental disorders."
The DSM-IV-TR (Text Revision, 2000) consisted of five axes (domains) on which
disorder could be assessed. The five axes were:
Axis I: Clinical Disorders (all mental disorders except Personality Disorders
and Mental Retardation)
Axis II: Personality Disorders and Mental Retardation
Axis III: General Medical Conditions (must be connected to a Mental
Disorder)
Axis IV: Psychosocial and Environmental Problems (for example limited
social support network)
Axis V: Global Assessment of Functioning (Psychological, social and job-
related functions are evaluated on a continuum between mental health and
extreme mental disorder)
UNIT-2
1. Stress and its management?
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Stress is a feeling of emotional or physical tension. Stress is a negative emotional

pressure directed to either alter the situation or accommodate with its after effect.
Stress is your body’s way of responding to any kind of demand or threat. The
stress response is the body’s way of protecting you. When working properly, it
helps you stay focused, energetic, and alert. In emergency situations, stress can
save your life—giving you extra strength to defend yourself, for example, or
spurring you to slam on the brakes to avoid a car accident.
Stress can also help you rise to meet challenges. It’s what keeps you on your toes
during a presentation at work, sharpens your concentration when you’re attempting
the game-winning free throw, or drives you to study for an exam when you’d
rather be watching TV. But beyond a certain point, stress stops being helpful and
starts causing major damage to your health, mood, productivity, relationships, and
your quality of life.
Kind of stress: positive and negative stress
Positive stress: pleasurable stress that accompanies positive events eg: stress
during wedding
Negative stress: unpleasant stress accompanies negative events eg: stress during
funeral
Elements of stress: stressor, stress, stress response, coping strategies
Sources of stress: Sources in the family, Sources within person, Sources in the
job, physical environment, community and society.
Responses to stress:
Cognitive symptoms:
 Memory problems
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 Inability to concentrate
 Poor judgment
 Seeing only the negative
 Anxious or racing thoughts
 Constant worrying
Emotional symptoms:
 Depression or general unhappiness

 Anxiety and agitation
 Moodiness, irritability, or anger
 Feeling overwhelmed
 Loneliness and isolation
 Other mental or emotional health problems
Physical symptoms:
 Aches and pains

 Diarrhea or constipation
 Nausea, dizziness
 Chest pain, rapid heart rate
 Loss of sex drive
 Frequent colds or flu
Behavioral symptoms:
 Eating more or less

 Sleeping too much or too little
 Withdrawing from others
 Procrastinating or neglecting responsibilities
 Using alcohol, cigarettes, or drugs to relax
 Nervous habits (e.g. nail biting, pacing)
Stress related diseases: respiratory disorder, cardio vascular disorder, gastro-

intestinal disorder, Neurological disorder, mental health disorder
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Stress Management
Stress management is a wide spectrum of techniques and psychotherapies aimed

at controlling a person's level of stress, especially chronic stress, usually for the
purpose of and for the motive of improving everyday functioning. Stress
management involves changing the stressful situation when you can, changing
your reaction when you can’t, taking care of yourself and making time for rest and
relaxation.
Yoga — a mind-body practice — is considered one of many types of

complementary and integrative health approaches. Yoga brings together physical
and mental disciplines that may help you achieve peacefulness of body and mind.
This can help you relax and manage stress and anxiety.
Yoga has many styles, forms and intensities. Hatha yoga, in particular, may be a
good choice for stress management. Hatha is one of the most common styles of
yoga, and beginners may like its slower pace and easier movements. But most
people can benefit from any style of yoga — it's all about your personal
preferences.
The core components of hatha yoga and most general yoga classes are:
 Poses. Yoga poses, also called postures, are a series of movements designed to
increase strength and flexibility. Poses range from lying on the floor while
completely relaxed to difficult postures that may have you stretching your
physical limits.
 Breathing. Controlling your breathing is an important part of yoga. Yoga
teaches that controlling your breathing can help you control your body and
quiet your mind.
 Meditation or relaxation. In yoga, you may incorporate meditation or
relaxation. Meditation may help you learn to be more mindful and aware of the
present moment without judgment.
The health benefits of yoga
The potential health benefits of yoga include:
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 Stress reduction. A number of studies have shown that yoga may help reduce
stress and anxiety. It can also enhance your mood and overall sense of well-
being.
 Improved fitness. Practicing yoga may lead to improved balance, flexibility,
range of motion and strength.
 Management of chronic conditions. Yoga can help reduce risk factors for
chronic diseases, such as heart disease and high blood pressure. Yoga might
also help alleviate chronic conditions, such as depression, pain, anxiety and
insomnia.
Effects on the Body
The following is only a partial list of yoga’s benefits:
 Reduced stress
 Sound sleep
 Reduced cortisol levels
 Improvement of many medical conditions
 Allergy and asthma symptom relief
 Lower blood pressure
 Smoking cessation help
 Lower heart rate
 Spiritual growth
 Sense of well-being
 Reduced anxiety and muscle tension
 Increased strength and flexibility
 Slowed aging process
Yoga’s benefits are so numerous, it gives a high payoff for the amount of effort
involved.
Get moving: physical activity, going out, spent in gym etc
Engage socially: social engagement is the quicker, most effective way for stress.
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Make time for fun and relaxation:
Adopt a healthy life style
2. Suicide Prevention
Suicide is when people direct violence at themselves with the intent to end their
lives, and they die because of their actions. A suicide attempt is when people
harm themselves with the intent to end their lives, but they do not die because of
their actions.
Suicide is the act of intentionally causing one's own death.[7] Mental disorders,
including depression, bipolar disorder, schizophrenia, personality
disorders, anxiety disorders, and substance abuse—including alcoholism and the
use of benzodiazepines—are risk factors.[2][4][8] Some suicides are impulsive
acts due to stress, such as from financial difficulties, troubles with relationships,
or bullying.[2][9] Those who have previously attempted suicide are at a higher risk
for future attempts.[2] Effective suicide prevention efforts include limiting access to
methods of suicide—such as firearms, drugs, and poisons; treating mental
disorders and substance misuse; proper media reporting of suicide; and improving
economic conditions.[2][10] Even though crisis hotlines are common, there is little
evidence for their effectiveness
Suicide prevention methods and treatment are based on patient risk factors.
Treatments are prescribed in light of underlying conditions in addition to
prevention of suicidal thoughts and acts. If you are suffering from a mental
disorder, a treatment plan to treat this condition is implemented first. One of the
most common suicide prevention techniques is psychotherapy – also known as talk
therapy – in the form of Cognitive Behavioral Therapy (CBT) or Dialectical
Behavior Therapy (DBT).
Cognitive Behavioral Therapy is a common treatment option for individuals

suffering from a variety of mental disorders. In this method of psychotherapy, you
are taught new ways of dealing with stress and stressful life experiences. In this
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manner, when thoughts of suicide arise, you can redirect those thoughts and cope
with them in a different way than attempting to take your own life.
Dialectical Behavior Therapy is used to help an individual recognize disruptive or

unhealthy feelings or actions. In relation, this therapy method then introduces
techniques on how to deal with difficult or troubling situations. More research is
needed on psychotherapy related to suicide prevention though, as DBT, in
particular, has been shown to decrease the prevalence of attempted suicide but has
shown no effect on completed suicides.
Medications can also be prescribed as a prevention method to suicide; however,

controversy exists in this method, as many medications used in the treatment of
mental disorders include increased risk of suicide as a side effect. Antidepressants
especially carry a risk of potential increase in suicidal thoughts and behavior – but
this risk might be dependent on age. Clinical research has shown that young adults
increase their risk of suicide and suicidal thoughts when taking antidepressants, but
in older individuals, this side effect diminishes.
Increased awareness among doctors is also a prevention technique. Research

indicates that many individuals who have completed suicide or attempted suicide
did seek medical attention in the year prior; however, warning signs may have
been missed. Increased education and awareness among medical professionals
might decrease suicide rates in the future.
Popular “crisis hotlines” have not received solid data indications in the research
that suggest their use is effective or not. Though, one positive side effect of these
hotlines is that they are generally well-known and common – increasing the
general population’s awareness of suicide. In an additional effort to bring
awareness to suicide and risk factors associated with suicide, September 10 has
been observed as World Suicide Prevention Day in partnership with the
International Association for Suicide Prevention and the World Health
Organization.
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3 General adaptation syndrome ?
GAS is the three-stage process that describes the physiological changes the body
goes through when under stress. Hans Selye, a Vienna-born scientist, was the first
person to describe GAS. Selye found that rats displayed a similar set of physical
responses to several different stressors. The latter included cold temperatures,
excessive physical exertions, and injection with toxins. The scientist explained
GAS as the body's way of adapting to a perceived threat to better equip it to
survive.
The three stages of GAS are:
 alarm reaction ▪ resistance ▪ exhaustion

What happens within the body during each of these stages is explored below.
General adaptation syndrome stages
1. Alarm reaction stage: At the alarm reaction stage, a distress signal is sent to a
part of the brain called the hypothalamus. The hypothalamus enables the release of
hormones called glucocorticoids. Glucocorticoids trigger the release of adrenaline
and cortisol, which is a stress hormone. The adrenaline gives a person a boost of
energy. Their heart rate increases and their blood pressure rises. Meanwhile, blood
sugar levels also go up.
These physiological changes are governed by a part of a person's autonomic

nervous system (ANS) called the sympathetic branch. The alarm reaction stage of
the GAS prepares a person to respond to the stressor they are experiencing. This is
often known as a "fight or flight" response.
2. Resistance: During the resistance stage, the body tries to counteract the
physiological changes that happened during the alarm reaction stage. The
resistance stage is governed by a part of the Autonomic Nervous System (ANS)
called the parasympathetic.
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The parasympathetic branch of the Autonomic Nervous System tries to return the
body to normal by reducing the amount of cortisol produced. The heart rate and
blood pressure begin to return to normal. If the stressful situation comes to an end,
during the resistance stage, the body will then return to normal.However, if the
stressor remains, the body will stay in a state of alert, and stress hormones continue
to be produced.
This physical response can lead to a person struggling to concentrate and becoming
irritable. Signs of the resistance stage include:
 irritability ▪ frustration ▪ poor concentration

3. Exhaustion stage
After an extended period of stress, the body goes into the final stage of GAS,
known as the exhaustion stage. At this stage, the body has depleted its energy
resources by continually trying but failing to recover from the initial alarm reaction
stage. Once it reaches the exhaustion stage, a person's body is no longer equipped
to fight stress. They may experience:
 tiredness ▪depression ▪anxiety ▪ feeling unable to cope

If a person does not find ways to manage stress levels at this stage, they are at risk
of developing stress-related health conditions.
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GAS can occur with any type of stress. Stressful events can include: a job loss;
medical problems; financial troubles; family breakdown; trauma
But while stress is unpleasant, the upside is that GAS improves how your body
responds to stressors, particularly in the alarm stage.
Manage GAS: The first step to controlling GAS is to understand what triggers
stress. Different things trigger stress for different people. It is important for a
person to identify what situations and events are particularly stressful for them. It
may then be possible to make lifestyle changes to reduce exposure to these
triggers.
The following activities may also help:
 mindfulness and meditation; deep breathing; yoga and tai chi; relaxing baths;
journaling; seeing friends to talk issues through
3. Anxiety Disorder ?
Anxiety is a feeling of worry or unease or fear, caused by the anticipation of

danger which may be internal or external that can be mild or severe. Anxiety
disorders are a group of mental disorders characterized by significant feelings
of anxiety and fear. Anxiety is a worry about future events, and fear is a reaction to
current events.
Symptoms such as headache, sweating, tightness in the chest, mild stomach

discomfort and restlessness, indicated by an inability to sit or stand. The symptom
may vary among persons. The cause of anxiety may be due to combination
of genetic and environmental factors
Types of anxiety disorders:
1. Generalized Anxiety Disorder (GAD)

2. Obsessive-compulsive Disorder (OCD)
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3. Panic Disorder
4. Phobias: a) specific phobia b) Social phobia c) Agora phobia
5. Post-Traumatic Stress Disorder (PTSD)
i. Generalized Anxiety Disorder (GAD)
An anxiety disorder characterized by excessive, uncontrollable and often irrational

worry about events or activities. This excessive worry often interferes with daily
activities. They worry excessively about money, health, family or work, even when
there are no signs of trouble. They are unable to relax and often suffer from
insomnia.
Physical symptoms, such as feeling tired, headaches, numbness in hand and feet,
breathing difficulties and muscle tension etc. and this symptoms last for at least 6
months
Cause: dysfunction of amygdala, long use of benzodiazepines, tobacco smoking,

excessive use of caffeine
Treatment:
 Medication: Successful treatment may include anti-anxiety medications, such

as buspirone and the benzodiazepines or antidepressants.
 Behavioral therapy: Behavioral therapy focuses on using specific relaxation
techniques to change anxiety-causing behaviors.
 Cognitive-behavioral therapy: Like behavioral therapy, cognitive-
behavioral therapy teaches patients to react differently to the situations and
bodily sensations that trigger anxiety symptoms
 Acceptance and commitment therapy
 Motivational interviewing
 Lifestyle stress management
ii. Obsessive-compulsive Disorder (OCD)
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OCD is a common, chronic and long lasting disorder in which person has
uncontrollable, re-occurring thoughts and behaviors that he/she feels the urge to
repeat over and over.
It is a mental disorder in which people feel the need to check things repeatedly or
have certain thoughts repeatedly. People are unable to control either the thoughts
or the activities for more than short period of time.
Obsessions are repeated thoughts, urges, or mental images that cause anxiety.
Compulsions are repetitive behaviors that a person with OCD feels the urge to do
in response to an obsessive thought
Symptoms:
▪ Excessive cleaning and/or hand washing ▪ Ordering and arranging things in a

particular, precise way ▪ Repeatedly checking on things, such as repeatedly
checking to see if the door is locked or that the oven is off ▪ Compulsive counting▪
Fear of germs or contamination ▪Unwanted forbidden or taboo thoughts involving
sex, religion, and harm ▪Aggressive thoughts towards others or self ▪sexual
obsessions or unwanted sexual thoughts ▪ strange and chronic worry about certain
events such as sleeping, eating, leaving home etc.
Types: ▪ checking ▪ mental contamination/ contamination ▪ ruminations / intrusive

thoughts ▪ hoarding
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Cause:
Genetics: Twin and family studies have shown that people with first-degree
relatives (such as a parent, sibling, or child) who have OCD are at a higher risk for
developing OCD themselves.
Brain Structure and Functioning: Imaging studies have shown differences in the
frontal cortex and sub-cortical structures of the brain in patients with OCD.
Environment: People who have experienced abuse (physical or sexual) in

childhood or other trauma are at an increased risk for developing OCD.
Biology: OCD may be a result of changes in your body's own natural chemistry or
brain functions.
Complications
 Health issues, such as contact dermatitis from frequent hand-washing

 Inability to attend work, school or social activities
 Troubled relationships
 Overall poor quality of life
 Suicidal thoughts and behavior
Treatment
▪ Cognitive behavior therapy ▪ exposure and response prevention (ERP) ▪

Medication ▪Brain lock method such as. Relabel; Reattribute; Refocus; Revalue
iii. Panic Disorder / attack
Panic disorder is characterized by unexpected and repeated episodes of intense fear

followed by physical symptoms that may include chest pain, heart palpitations, and
shortness of breath, dizziness, or abdominal distress. These sensations often mimic
symptoms of a heart attack or other life-threatening medical conditions without any
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warning. An attack typically lasts for 10 to 20 minutes, but in some case it last for
an hours.
Many people with panic disorder develop intense anxiety between episodes,
worrying when and where the next one will strike. Fortunately, effective treatments
have been developed to help people with panic disorder. (See notes)
iv. Phobia
It is a type of anxiety disorder defined by a constant and excessive fear of an object

or situation. It is a rapid onset of fear and is present for more than 6 months. The
affected person goes to great length to avoid the situation or object. If the feared
object or situation cannot be avoided, the affected person experiences
significant distress. People with a phobia:
 May have an irrational or excessive worry about encountering the feared object or
situation
 Take active steps to avoid the feared object or situation
 Experience immediate intense anxiety upon encountering the feared object or
situation
a) Specific or Simple Phobias: people who have a specific phobia have an intense
fear of, or feel intense anxiety about, specific types of objects or situations. The
situation which include fear of dogs, insects, or snakes; driving a car; heights;
tunnels or bridges; thunderstorms; and/or flying.
b) Social anxiety disorder (previously called social phobia): People with social
anxiety disorder have a general intense fear of, or anxiety toward, social or
performance situations. They worry that actions or behaviors associated with their
anxiety will be negatively evaluated by others, leading them to feel embarrassed.
This worry often causes people with social anxiety to avoid social situations.
Social anxiety disorder can shows a range of situations, such as within the
workplace or the school environment.
c) Agoraphobia: People with agoraphobia have an intense fear of two or more of

the following situations:
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 Using public transportation

 Being in open spaces
 Being in enclosed spaces
 Standing in line or being in a crowd
 Being outside of the home alone
People with agoraphobia often avoid these situations, in part, because they think
being able to leave might be difficult or impossible in the event they have panic-
like reactions or other embarrassing symptoms. In the most severe form of
agoraphobia, an individual can become housebound.
d) Separation anxiety disorder: Separation anxiety is often thought of as

something that only children deal with; however, adults can also be diagnosed with
separation anxiety disorder. People who have separation anxiety disorder have
fears about being parted from people to whom they are attached. They often worry
that some sort of harm or something untoward will happen to their attachment
figures while they are separated. This fear leads them to avoid being separated
from their attachment figures and to avoid being alone. People with separation
anxiety may have nightmares about being separated from attachment figures or
experience physical symptoms when separation occurs or is anticipated.
e) Selective mutism: A somewhat rare disorder associated with anxiety is selective

mutism. Selective mutism occurs when people fail to speak in specific social
situations despite having normal language skills. Selective mutism usually occurs
before the age of 5 and is often associated with extreme shyness, fear of social
embarrassment, compulsive traits, withdrawal, clinging behavior, and temper
tantrums. People diagnosed with selective mutism are often also diagnosed with
other anxiety disorders.
v. Post Traumatic stress disorder (see notes)
4. Wolpe and Systematic desensitization
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 Systematic desensitization is a type of behavioral therapy based on the

principle of classical conditioning. It was developed by Wolpe during the
1950s.
 This therapy aims to remove the fear response of a phobia, and substitute a
relaxation response to the conditional stimulus gradually using counter
conditioning. There are three phases to the treatment:
 According to systematic desensitization, a learned response, e.g. fear of
spiders, can be unlearned through classical conditioning and a new response,
e.g. relax when seeing a spider, can be induced. For example, if a person is
afraid of spiders and whenever he sees a spider, he feels anxious. His fear of
spiders can be gradually “unlearned” by using the systematic desensitization
technique. For example, his anxiety could be replaced by relaxation.
Systematic desensitization – Steps: When applying the systematic desensitization

technique to treat phobia, a therapist sometimes follows the following steps:
1. Relaxation
2. Constructing an anxiety hierarchy
3. Pairing relaxation with the situations described in the anxiety hierarchy
Relaxation
The first step of systematic desensitization is learning to relax. If an individual is
afraid of something, e.g. spiders, he needs to learn to relax when he faces the
object of his fear. A common relaxation technique is deep breathing or chest
breathing. Here’s how to do it:
1. Inhale through your nose. When you inhale, your stomach should expand.
2. Hold your breath for 3 seconds
3. Exhale through your mouth
The patient is advised to do the deep breathing exercise for at least 5 minutes.
When someone is exposed to a fearful situation, he might not realize that he is not
doing chest breathing and this will result in tightening of muscles, anxiety, dry
throat, etc. By practising deep breathing regularly, it is easier for an individual to
become more relaxed.
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Another common relaxation exercise is progressive muscle relaxation. In this

exercise, the patient is asked to tighten his muscles and then loosen them gradually.
This exercise can induce deep muscle relaxation in the patient.
Construction of an Anxiety Hierarchy
In this step of systematic desensitization, the patient is asked to list 10-15 triggers
of a specific phobia or situation and rate each trigger from 0-10 where 0 represents
no anxiety at all and 10 represents extreme anxiety. For example, if a patient is
afraid of spiders, his list of triggers may look like this:
1. Thinking about going into the room where there are spiders.
2. Standing near a sofa and moving toward the room.
3. Reaching the door of the room.
4. Thinking about the spider that is in the room.
5. Unlocking the door of the room.
6. Opening the door to the room.
7. Entering the room.
8. Turning on the light of the room.
9. Walking inside the room.
10.Closing the room door.
11.Seeing a spider on the wall.
The patient will then rate each of the above steps from 0-10 according to the level
of his anxiety.
Pairing Relaxation with the Anxiety Hierarchy

In this step of systematic desensitization, the patient is asked to imagine himself
being exposed to his object of fear or a fearful situation. For the patient who is
afraid of spiders, he is advised to close his eyes and imagine himself in a room
alone with a huge spider. When he feels anxious, he is asked to practice the
relaxation exercise.
After each imaginal exposure, the patient is asked to rate his fear of spiders. When
the patient’s rating for the fear drops to a specific value, the therapist moves
toward the next step of the anxiety hierarchy. For example, the patient is asked to
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look at images of spiders or even a dead spider. The therapy continues until the
patient feels no fear when he is exposed to real spiders. The patient is advised to
practice deep breathing and other relaxation exercises whenever he is exposed to
spiders so that his anxiety will gradually be replaced with relaxation.
Systematic desensitization can be self-administered but it is advisable that the

patient consults a therapist.
5. Somatoform disorder?
Somatoform disorder is also known as somatic symptom disorder. It is a mental

disorder which cause as physical symptoms that suggest illness or injury, but
which cannot be explained fully by a general medical condition. And they are not
due to substance, or another mental disorder
In people who have been diagnosed with a somatic symptom disorder, medical
test results are either normal or do not explain the person's symptoms, and history
and physical. People with somatoform disorder are not faking their symptom. The
pain and other problems they experience are real. The symptoms can significantly
affect daily functioning.
A diagnosis of a somatoform disorder can create lot of stress and frustration for
patients. Symptoms are sometimes similar to those of other illness and may last for
years. Other common symptoms include anxiety and depression.
Cause:
 Genetic and biological factors, such as an increased sensitivity to pain

 Family influence, which may be genetic or environmental, or both
 having negative affectivity, a personality trait that involves negative emotions
and poor self-image
 difficulty dealing with stress
 decreased emotional awareness, which can make you focus more on physical
issues than emotional ones
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 learned behaviors, such as getting attention from having an illness or

increasing immobility from pain behaviors
Treatment:
▪ CBT can be given, it can help in some of the following ways which include-
Learn to reduce stress; learn to cope with physical symptom; learn to deal with
depression and other psychological issues; improve quality of life; reduce pre-
occupation with symptom
▪ Antidepressant medication can be given followed by CBT.
Types: a) pain disorder b) somatization disorder c) conversion disorder d)
hypochondriasis / hypochondria / Illness Anxiety Disorder
a) Pain disorder
Pain disorder is chronic pain experienced by a patient in one or more areas, and is
thought to be caused by psychological stress. The pain is often so severe that it
disables the patient from proper functioning. Duration may be as short as a few
days or as long as many years. The disorder may begin at any age, and occurs more
frequently in girls than boys.[1] This disorder often occurs after an accident or
during an illness that has caused pain, which then takes on a 'life' of its own.
Types of Psychogenic Pain: Headaches, muscle pains, back pain, and stomach pains
are some of the most common types of psychogenic pain / pain disorder.
Treatment:
▪psychotherapy such as CBT or operant conditioning
▪medication such as antidepressant, non-narcotic pain killer
▪ sleep therapy, talk therapy, pain management, yoga & music therapy
b) Somatization disorder
Somatic symptom disorder (SSD) occurs when a person feels extreme, anxiety
about physical symptoms. The person has such intense thoughts, feelings, and
behaviors related to the symptoms, that they feel they cannot do some of the
activities of daily life. The symptoms involve combination of several different
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organs and body systems such as pain, neurologic problem, gastrointestinal

complaints and sexual symptoms
A person with SSD is not faking their symptoms. The pain and other problems are
real. They may be caused by a medical problem. Often, no physical cause can be
found. However, it is the extreme reaction and behaviors about the symptoms that
are the main problem.
Causes:
SSD usually begins before age 30. It occurs more often in women than in men. It's
not clear why some people develop this condition. Certain factors may be
involved:
 Having a negative outlook
 Being more physically and emotionally sensitive to pain and other sensations
 Family history or upbringing
 Genetics
People who have a history of physical or sexual abuse may be more likely to have
this disorder. But not everyone with SSD has a history of abuse. Person with SSD
will also have anxiety disorder.
c) Conversion disorder
Conversion disorder is a disorder in which a person
experiences blindness, paralysis, or other symptoms affecting the nervous
system that cannot be explained solely by a physical illness or injury. Symptoms
usually begin suddenly after a period of emotional or physical distress or
psychological conflict
Symptoms of conversion disorder can include a variety of neurological symptoms.
Common symptoms of the disorder include sudden blindness, paralysis, loss of the
voice, trouble coordinating movements (ataxia), loss of the sense of smell
(anosmia), loss of sense of touch, or tingling in the extremities. Some people with
conversion disorder may experience seizures or hallucinations.
Cause:
▪The exact cause of functional neurologic disorders is unknown. Theories
regarding what happens in the brain to result in symptoms are complex and involve
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multiple mechanisms that may differ, depending on the type of functional

neurologic disorder.
▪Basically, parts of the brain that control the functioning of your muscles and
senses may be involved, even though no disease or abnormality exists.
▪Symptoms of functional neurologic disorders may appear suddenly after a
stressful event, or with emotional or physical trauma. Other triggers may include
changes or disruptions in how the brain functions at the structural, cellular or
metabolic level. But the trigger for symptoms can't always be identified.
Treatment:
 Occupational or physical therapy

 Counseling
 Hypnosis
 Antidepressants or antipsychotic drugs
 Treatment of related physical or psychological stressors
d) Hypochondriasis / hypochondria / Illness Anxiety Disorder:

Hypochondriasis or hypochondria is a condition in which a person is excessively
worried about having a serious illness. You may have no physical symptoms. Or
you may believe that normal body sensations or minor symptoms are signs of
severe illness, even though a thorough medical exam doesn't reveal a serious
medical condition. Even though you may visit multiple doctors for treatment
(cause and treatment as somatization disorder)
6. personality disorder?
Personality makes each of us different. Our style of behavior, how we react, our
worldview, thoughts, feelings, and how we interact in relationships are all part of
what makes up our personality. When an individual has a personality disorder, it
becomes harder for them to respond to the changes and demands of life and to
form and maintain relationships with others.
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These experiences can lead to distress and social isolation and increase the risk
of depression and other mental health issues.
Personality is the way of thinking, feeling and behaving that makes a person
different from other people. An individual’s personality is influenced by
experiences, environment (surroundings, life situations) and inherited
characteristics. A person’s personality typically stays the same over time. A
personality disorder is a way of thinking, feeling and behaving that deviates from
the expectations of the culture, causes distress or problems functioning, and lasts
over time.1
There are 10 specific types of personality disorders. Personality disorders are long-
term patterns of behavior and inner experiences that differs significantly from what
is expected. The pattern of experience and behavior begins by late adolescence or
early adulthood and causes distress or problems in functioning. Without treatment,
personality disorders can be long-lasting. Personality disorders affect at least two
of these areas:
o Way of thinking about oneself and others

o Way of responding emotionally
o Way of relating to other people
o Way of controlling one’s behavior
Cluster A personality disorders
These disorders involve behavior that seems unusual and eccentric to others,
according to Mental Health America (MHA). They include:
 paranoid personality disorder

 schizoid personality disorder
 schizotypal personality disorder

Cluster B personality disorders
These disorders feature behavior that is emotional, dramatic, or erratic. Examples

include:
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 antisocial personality disorder

 borderline personality disorder
 histrionic personality disorder
 narcissistic personality disorder
Cluster C personality disorders
Anxiety and fear underlie the behaviors that occur with Cluster C disorders.
Examples of these include:
 avoidant personality disorder

 dependent personality disorder
 obsessive-compulsive personality disorders
Paranoid personality disorder
A person with paranoid personality disorder finds it hard to trust others. They
might think that people are lying to or manipulating them, even when there is no
evidence of this happening. A person may experience:
 mistrust and suspicion

 hypervigilance
 fear
 anxiety about someone taking advantage of them
 anger over perceived abuse
 concern about hidden meanings or motives
The inability to trust others can make it hard for the person to maintain
relationships with those around them.
Around 2–4 percent of the general population may have this disorder.
Schizoid personality disorder
A person with schizoid personality disorder often feels uncomfortable when they
have to relate to others. It affects fewer than 1 percent of the population. Others
may see the person as aloof, detached, cold, or as a "loner." The person will tend
to:
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 avoid close social contact with others

 have difficulty forming personal relationships
 seek out employment that involves limited personal or social interaction
 react to situations in ways that others consider inappropriate
 appear withdrawn and isolated
The person may form attachments with objects or animals, rather than people.
Schizoid personality disorder shares some features with schizophrenia, but they are
not the same. Psychosis and hallucinations are not part of this personality disorder.
Individuals with this personality disorder may have relatives of with schizophrenia
or schizotypal personality disorder.
Schizotypal personality disorder
People with schizotypal personality disorder may have few close relationships
outside their own family. This is because they have difficulty understanding how
relationships develop and also how their behavior affects others. They may also
find it hard to understand or trust others. For a diagnosis, the person will show or
experience five or more of the following behaviors:
 ideas of reference, for example, when a minor event happens, the person believes
it has special significance for them
 odd beliefs or magical thinking which influences their behavior, such as
superstitious thinking, beliefs in telepathy, or bizarre fantasies or preoccupations
 unusual perceptual experiences, including bodily illusions
 odd thinking and speech, for example, metaphorical thinking and overelaboration
 signs of suspiciousness or paranoid thinking
 inappropriate or bizarre facial expressions
 behavior or appearance that seems odd, eccentric, or peculiar
 a lack of close friends and confidants, other than first-degree relatives
 excessive social anxiety
Others may find the person's behavior confusing.
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A person with this condition has a higher risk of developing schizophrenia in the
future.
Antisocial personality disorder
A person with antisocial personality disorder (ASPD) acts without regard to right
or wrong or without thinking about the consequences of their actions on others.
This can result in:
 irresponsible and delinquent behavior

 novelty-seeking behavior
 violent behavior
 a risk of criminal activity
Around 1–3 percent of the general population have ASPD, but around 40–70
percent of people in prisons have it, according to authors who published a study in
2016.
Having conduct disorder before the age of 15 years significantly increases the risk
of having ASPD later in life. It is more likely to affect men than women. The
researchers looked at specific genetic features in 543 participants. They found
similar genetic features in people with the disorder, as well as low levels of grey
matter in the frontal cortex area of the brain. Genetic, biological, and
environmental factors probably all play a role.
Borderline personality disorder
A person with borderline personality disorder will have trouble controlling their
emotions. They may experience:
 mood swings
 shifts in behavior and self-image
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 impulsive behavior
 periods of intense anxiety, anger, and depression, boredom
These intense feeling can last for only a few hours or for much longer periods,
lasting several days. They can lead to relationship difficulties and other challenges
in daily life.
According to the National Institute of Mental Health (NIMH), this can result in:
 rapid changes in how the person relates to others, for example, shifting suddenly
from closeness to anger
 risky behaviors, such as dangerous driving, and spending sprees
 self-harming behavior
 poor anger management
 a sense of emptiness
 difficulty trusting others
 recurrent suicidal behaviors, gestures, threats, or self-mutilation, such as cutting
 feelings of detachment, or dissociation
Histrionic personality disorder
A person with histrionic personality disorder feels a need for others to notice them
and reassure them that they are significant. This can affect the way the person
thinks and acts.
Researchers writing in 2015 called it "one of the ambiguous diagnostic categories"

in mental health. The person may feel a strong need to be loved, and they may also
feel as if they are not strong enough to cope with everyday life alone. It may lead
to behavior that appears:
 self-centered
 provocative and flirtatious
 inappropriate
 excessively emotional or dramatic
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 emotionally shallow
 insincere, as likes and dislikes shift to suit those around the person
 risky, as the person constantly seeks novelty and excitement
The person may function well in social and other environments, but they may also
experience high levels of stress. This can lead to depression and anxiety.
The features of histrionic personality disorder can overlap with and be similar to
those of narcissistic personality disorder.
Narcissistic personality disorder
This disorder features a sense of self-importance and power, but it can also involve
feelings of low self-esteem and weakness. A person with this condition may show
the following personality traits:
 have an inflated sense of their own importance, attractiveness, success, and power
 crave admiration and attention
 lack regard for others' feelings
 overstate their talents or achievements
 expect to have the best of everything
 experience hurt and rejection easily
 expect others to go along with all their plans and ideas
 experience jealousy
 believe they should have special treatment
 believe they should only spend time with other people who are as special as them
 appear arrogant or pretentious
 be prone to impulsive behavior
They may also have a higher risk of:
 mood, substance, and anxiety disorders

 low self-esteem and fear of not being good enough
 feelings of shame, helplessness, anger at themselves
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 impulsive behavior
 using lethal means to attempt suicide
These features can make it hard to maintain healthy relationships and to function in
daily life.
Avoidant personality disorder

Avoidant personality disorder can make it hard to form friendships.
A person with avoidant personality disorderavoids social situations and close

interpersonal relationships, mainly due to a fear of rejection and feeling that they
are not good enough. They may:
 feel inadequate
 have low self-esteem
 find it hard to trust people
They may appear extremely shy and socially inhibited.
A person with avoidant personality disorder may want to develop close

relationships with others, but they lack the confidence and ability to form
relationships. There may also be a higher risk of substance abuse, an eating
disorder, or depression. The person may think about or attempt suicide.
Dependent personality disorder
A person with this condition may have the following characteristics:
 has an excessive need to be taken care of by others

 is overly-dependent on others
 has a deep fear of separation and abandonment
 invests a lot of energy and resources in trying to please others
 goes to great lengths to avoid disagreement and conflict
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 is vulnerable to manipulation by others

 is willing to undergo mistreatment to maintain a relationship
 does not like to be alone
Others may see the person's behavior as:
 submissive
 clingy
 nonassertive
 passive
 docile
The person often lacks confidence in themselves and their abilities. It is difficult
for them to undertake projects independently, or to make decisions without help.
They may find it hard to take responsibility.
A study published in 2011 concluded that people with a dependent personality

disorder are vulnerable to ill-treatment from others, including domestic abuse.
This can lead to further complications, such as depression and anxiety.
Obsessive-compulsive personality disorder

A person with OCPD can find it difficult to accept when something is not perfect.
Obsessive-compulsive personality disorder (OCPD) is not the same as obsessive-
compulsive disorder (OCD). Some people may experience both, however,
and researchers say there appears to be a link between them.
An excessive concern with perfectionism and hard work dominate the life of a
person with OCDP. The individual may prioritize these ideals to the detriment of
close personal relationships. According to the International OCD Foundation, a
person with OCPD may:
 appear inflexible
 feel an overwhelming need to be in control
 find that concerns about rules and efficiency make it hard to relax
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 find it hard to complete a task, for fear that it is not perfect

 be uncomfortable when things are messy
 have difficulty delegating tasks to others
 be extremely frugal when it is not necessary to do so
 hoard items
 may be highly efficient in the workplace
Others may see the individual as sanctimonious, stubborn, uncooperative, and
obstinate.
According to the International OCD Foundation, one difference between OCD and
OCPD is that OCD relates to everyday tasks, while OCPD focuses specifically on
following procedures. In addition, OCD can interfere with the way a person
functions in everyday life, whereas OCPD can enhance a person's professional
performance, while possibly interfering with their life outside of work.
o Antisocial personality disorder: a pattern of disregarding or violating the

rights of others. A person with antisocial personality disorder may not
conform to social norms, may repeatedly lie or deceive others, or may act
impulsively.
o Avoidant personality disorder: a pattern of extreme shyness, feelings of
inadequacy and extreme sensitivity to criticism. People with avoidant
personality disorder may be unwilling to get involved with people unless
they are certain of being liked, be preoccupied with being criticized or
rejected, or may view themselves as not being good enough or socially inept.
o Borderline personality disorder: a pattern of instability in personal
relationships, intense emotions, poor self-image and impulsivity. A person
with borderline personality disorder may go to great lengths to avoid being
abandoned, have repeated suicide attempts, display inappropriate intense
anger or have ongoing feelings of emptiness.
o Dependent personality disorder: a pattern of needing to be taken care of
and submissive and clingy behavior. People with dependent personality
disorder may have difficulty making daily decisions without reassurance
from others or may feel uncomfortable or helpless when alone because of
fear of inability to take care of themselves.
o Histrionic personality disorder: a pattern of excessive emotion and
attention seeking. People with histrionic personality disorder may be
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uncomfortable when they are not the center of attention, may use physical
appearance to draw attention to themselves or have rapidly shifting or
exaggerated emotions.
o Narcissistic personality disorder: a pattern of need for admiration and lack
of empathy for others. A person with narcissistic personality disorder may
have a grandiose sense of self-importance, a sense of entitlement, take
advantage of others or lack empathy.
o Obsessive-compulsive personality disorder: a pattern of preoccupation
with orderliness, perfection and control. A person with obsessive-
compulsive personality disorder may be overly focused on details or
schedules, may work excessively not allowing time for leisure or friends, or
may be inflexible in their morality and values. (This is NOT the same
as obsessive compulsive disorder.)
o Paranoid personality disorder: a pattern of being suspicious of others and
seeing them as mean or spiteful. People with paranoid personality disorder
often assume people will harm or deceive them and don’t confide in others
or become close to them.
o Schizoid personality disorder: being detached from social relationships
and expressing little emotion. A person with schizoid personality disorder
typically does not seek close relationships, chooses to be alone and seems to
not care about praise or criticism from others.
o a pattern of being very uncomfortable in close relationships,
having distorted thinking and eccentric behavior. A person with schizotypal
personality disorder may have odd beliefs or odd or peculiar behavior or
speech or may have excessive social anxiety.
Diagnosis of a personality disorder requires a mental health professional looking at

long-term patterns of functioning and symptoms. Diagnosis is typically made in
individuals 18 or older. People under 18 are typically not diagnosed with
personality disorders because their personalities are still developing. Some people
with personality disorders may not recognize a problem. Also, people may have
more than one personality disorder. An estimated 9 percent of U.S. adults have at
least one personality disorder.2
Treatment
Certain types of psychotherapy are effective for treating personality disorders.

During psychotherapy, an individual can gain insight and knowledge about the
disorder and what is contributing to symptoms, and can talk about thoughts,
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feelings and behaviors. Psychotherapy can help a person understand the effects of
their behavior on others and learn to manage or cope with symptoms and to reduce
behaviors causing problems with functioning and relationships. The type of
treatment will depend on the specific personality disorder, how severe it is, and the
individual’s circumstances.
Commonly used types of psychotherapy include:
o Psychoanalytic/psychodynamic therapy
o Dialectical behavior therapy
o Cognitive behavioral therapy
o Group therapy
o Psychoeducation (teaching the individual and family members about the
illness, treatment and ways of coping)
There are no medications specifically to treat personality disorders. However,

medication, such as antidepressants, anti-anxiety medication or mood stabilizing
medication, may be helpful in treating some symptoms. More severe or long
lasting symptoms may require a team approach involving a primary care doctor, a
psychiatrist, a psychologist, social worker and family members.
6. Substance abuse is when you take drugs that are not legal. It’s also when you
use alcohol, prescription medicine, and other legal substances too much or in the
wrong way.
Substance abuse differs from addiction. Many people with substance abuse
problems are able to quit or can change their unhealthy behavior. Addiction, on the
other hand, is a disease. It means you can’t stop using even when your condition
causes you harm.
Both legal and illegal drugs have chemicals that can change how your body and
mind work. They can give you a pleasurable “high,” ease your stress, or help you
avoid problems in your life.
Drug addiction, also called substance use disorder, is a disease that affects a
person's brain and behavior and leads to an inability to control the use of a legal or
illegal drug or medication. Substances such as alcohol, marijuana and nicotine also
are considered drugs. When you're addicted, you may continue using the drug
despite the harm it causes.
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Drug addiction can start with experimental use of a recreational drug in social
situations, and, for some people, the drug use becomes more frequent. For others,
particularly with opioids, drug addiction begins with exposure to prescribed
medications, or receiving medications from a friend or relative who has been
prescribed the medication.
The risk of addiction and how fast you become addicted varies by drug. Some
drugs, such as opioid painkillers, have a higher risk and cause addiction more
quickly than others.
As time passes, you may need larger doses of the drug to get high. Soon you may
need the drug just to feel good. As your drug use increases, you may find that it's
increasingly difficult to go without the drug. Attempts to stop drug use may cause
intense cravings and make you feel physically ill (withdrawal symptoms).
You may need help from your doctor, family, friends, support groups or an
organized treatment program to overcome your drug addiction and stay drug-free.
Symptoms
Drug addiction symptoms or behaviors include, among others:
 Feeling that you have to use the drug regularly — daily or even several times
a day
 Having intense urges for the drug that block out any other thoughts
 Over time, needing more of the drug to get the same effect
 Taking larger amounts of the drug over a longer period of time than you
intended
 Making certain that you maintain a supply of the drug
 Spending money on the drug, even though you can't afford it
 Not meeting obligations and work responsibilities, or cutting back on social or
recreational activities because of drug use
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 Continuing to use the drug, even though you know it's causing problems in
your life or causing you physical or psychological harm
 Doing things to get the drug that you normally wouldn't do, such as stealing
 Driving or doing other risky activities when you're under the influence of the
drug
 Spending a good deal of time getting the drug, using the drug or recovering
from the effects of the drug
 Failing in your attempts to stop using the drug
 Experiencing withdrawal symptoms when you attempt to stop taking the drug
Recognizing unhealthy drug use in family members
Sometimes it's difficult to distinguish normal teenage moodiness or angst from

signs of drug use. Possible indications that your teenager or other family member
is using drugs include:
 Problems at school or work — frequently missing school or work, a sudden

disinterest in school activities or work, or a drop in grades or work
performance
 Physical health issues — lack of energy and motivation, weight loss or gain,
or red eyes
 Neglected appearance — lack of interest in clothing, grooming or looks
 Changes in behavior — exaggerated efforts to bar family members from
entering his or her room or being secretive about where he or she goes with
friends; or drastic changes in behavior and in relationships with family and
friends
 Money issues — sudden requests for money without a reasonable
explanation; or your discovery that money is missing or has been stolen or
that items have disappeared from your home, indicating maybe they're being
sold to support drug use
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Changes in the brain
Physical addiction appears to occur when repeated use of a drug changes the way your
brain feels pleasure. The addicting drug causes physical changes to some nerve cells
(neurons) in your brain. Neurons use chemicals called neurotransmitters to
communicate. These changes can remain long after you stop using the drug.
Risk factors
People of any age, sex or economic status can become addicted to a drug. Certain
factors can affect the likelihood and speed of developing an addiction:
 Family history of addiction. Drug addiction is more common in some

families and likely involves genetic predisposition. If you have a blood
relative, such as a parent or sibling, with alcohol or drug addiction, you're at
greater risk of developing a drug addiction.
 Mental health disorder. If you have a mental health disorder such as
depression, attention-deficit/hyperactivity disorder (ADHD) or post-traumatic
stress disorder, you're more likely to become addicted to drugs. Using drugs
can become a way of coping with painful feelings, such as anxiety, depression
and loneliness, and can make these problems even worse.
 Peer pressure. Peer pressure is a strong factor in starting to use and misuse
drugs, particularly for young people.
 Lack of family involvement. Difficult family situations or lack of a bond
with your parents or siblings may increase the risk of addiction, as can a lack
of parental supervision.
 Early use. Using drugs at an early age can cause changes in the developing
brain and increase the likelihood of progressing to drug addiction.
 Taking a highly addictive drug. Some drugs, such as stimulants, cocaine or
opioid painkillers, may result in faster development of addiction than other
drugs. Smoking or injecting drugs can increase the potential for addiction.
Taking drugs considered less addicting — so-called "light drugs" — can start
you on a pathway of drug use and addiction.
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Complications
Drug use can have significant and damaging short-term and long-term effects.
Taking some drugs can be particularly risky, especially if you take high doses or
combine them with other drugs or alcohol. Here are some examples.
 Methamphetamine, opiates and cocaine are highly addictive and cause

multiple short-term and long-term health consequences, including psychotic
behavior, seizures or death due to overdose.
 GHB and flunitrazepam may cause sedation, confusion and memory loss.
These so-called "date rape drugs" are known to impair the ability to resist
unwanted contact and recollection of the event. At high doses, they can cause
seizures, coma and death. The danger increases when these drugs are taken
with alcohol.
 Ecstasy or molly (MDMA) can cause dehydration, electrolyte imbalance and
complications that can include seizures. Long-term, MDMA can damage the
brain.
 One particular danger of club drugs is that the liquid, pill or powder forms of
these drugs available on the street often contain unknown substances that can
be harmful, including other illegally manufactured or pharmaceutical drugs.
 Due to the toxic nature of inhalants, users may develop brain damage of
different levels of severity.
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Paper-2 mental illness

1. Delusions in paranoia: Paranoia is a central symptom of psychosis.

 Reinforcement is used to help increase the probability that a specific

a. Positive Reinforcement: Positive reinforcement works by presenting a

The following are some examples of positive reinforcement:

b. Negative Reinforcement: Negative reinforcement occurs when a certain

The following are some examples of negative reinforcement:

3. Wolpe and Systematic desensitization: Systematic desensitization is a

5. Classification of mental disorders: The classification of mental disorders is

 International Classification of Diseases (ICD-10) produced by the World

 Non-bizarre: They involve situations that could occur, such as being

 Bizarre: They involve implausible/unrealistic situations such as believing

 Delusional disorder is characterized by firmly held false beliefs (delusions)

7. Intelligence: Intelligence is “the capacity to acquire and apply knowledge.”

9. Exhibitionism: Exhibitionism is characterized by achievement of sexual

Exhibitionists (usually male) may masturbate while exposing themselves to

11. Dyspraxia: A person with dyspraxia has problems with movement,

12. Seasonal Affective Disorder: Seasonal Affective Disorder (SAD) is a type of

Symptoms of Major Depression

 Feeling depressed most of the day, nearly every day

13. Vascular dementia: Vascular dementia is a general term describing problems

Vascular dementia signs and symptoms include:

14. PANDAS is short for Pediatric Autoimmune Neuropsychiatric Disorders

 Obsessive compulsive disorder (OCD) and/or tic disorders suddenly appear

15. Neurosis: Neurosis is a class of functional mental disorders involving

Neurosis takes many different forms, including

 anxiety disorders: excessive severe worrying.

16. Psychosis is an abnormal condition of the mind that results in difficulties

17. A hallucination is anything that is sensed—heard, seen, felt, or even smelled—

The definition of delusion is a little different, although it also involves the

18. Modelling theory of Albert Bandura: Albert Bandura is an eminent person in

Modelling theory emphasises on the importance of observation and imitation that

Stages in Modelling theory

 Biological factors, such as genes or brain chemistry

Adequate understanding of one’s own self, Adequate feeling of personal worth,

Maintains good relationships:- A mentally healthy individual is never loner and

Mentally healthy person expresses emotions:- A mentally sound and healthy

Healthy mind is creative:- Creativity means inventing or discovering something

Face rejections gracefully:- A mentally healthy person is resilient. He

Self-confidence is a characteristic of sound mind:- A mentally healthy

Self-aware:- A mentally healthy individual always has insight into himself. He

Self-disciplined:- Discipline is an important characteristic and necessary factor to

Conclusion:- A mentally healthy person is an individual who is always happy and

1. They feel good about themselves.

3. Classification of mental illness:

The classification of mental disorders is also known as psychiatric

 Chapter V of the International Classification of Diseases (ICD-10) produced by

 The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) produced

 F0: Organic, including symptomatic, mental disorders

characterizes mental disorder as "a clinically significant behavioral or

1. Stress and its management?

Stress is a feeling of emotional or physical tension. Stress is a negative emotional

Kind of stress: positive and negative stress

Elements of stress: stressor, stress, stress response, coping strategies

 Depression or general unhappiness

 Aches and pains

 Eating more or less

Stress related diseases: respiratory disorder, cardio vascular disorder, gastro-

Stress management is a wide spectrum of techniques and psychotherapies aimed

Yoga — a mind-body practice — is considered one of many types of

Effects on the Body

The following is only a partial list of yoga’s benefits: