Chapter 66: Mental Health Problems

Generalized anxiety disorder, panic attacks, phobias, and obsessive-compulsive disorder are explored with emphasis on appropriate nursing interventions, including desensitization techniques and therapeutic boundary-setting around compulsive behaviors. The chapter then addresses trauma and stressor-related conditions, particularly post-traumatic stress disorder characterized by flashbacks, nightmares, and hypervigilance, alongside the framework of trauma-informed care that reorients clinical thinking toward understanding clients' lived experiences. Moral injury is distinguished as a distinct condition involving guilt and shame from actions conflicting with personal values. Somatic symptom and dissociative disorders are presented as conditions where psychological distress manifests through physical symptoms or fragmented consciousness, including dissociative identity disorder. Mood disorders receive substantial attention, with bipolar disorder explored through manic and depressive phases and associated pharmacological management using lithium carbonate, while depression emphasizes suicide risk assessment and electroconvulsive therapy as an intervention for severe cases. The schizophrenia section details positive and negative symptoms alongside thought disturbances and safety-focused nursing strategies. Personality disorders are categorized into three clusters reflecting odd, dramatic, and anxious presentations, each with characteristic maladaptive patterns. Finally, neurocognitive disorders such as Alzheimer's disease are reviewed with focus on environmental safety, routine establishment, and communication modifications. Throughout, the chapter emphasizes nursing priorities including safety assessment, therapeutic alliance development, symptom management, and evidence-based interventions tailored to each disorder classification.