BURN OUT and THE WAY TO HANDLE IT AND OVERCOMING IT

BURNT OUT

1. BURN OUT,STRESS AND DEPRESSION

2. WHAT IS STRESS? Physiological or Biological Stress is an organism's response to a stressor such as an environmental condition or a stimulus. Stress is a body's method of reacting to a challenge. According to the stressful event, the body's way to respond to stress is by sympathetic nervous system activation which results in the fight-or-flight response. In humans, stress typically describes a negative condition or a positive condition that can have an impact on a person's mental and physical well-being.

3. YERKES DODSON LAW

4. REACTION TO STRESS REACTION TO STRESS CAN BE -SHORT TERM -LONG TERM -EXTREME AND LIFE THREATENING REACTION TO STRESS CAN AFFECT A PERSON’S - PHYSICAL HEALTH -EMOTIONAL HEALTH -THINKING -SOCIAL ACTIVITY

5. What Triggers Stress? • How you view things • Work / Family • Unpredictable events • Poor health habits • Negative attitudes • Unrealistic expectations • Perfectionism

6. The diathesis-stress model is a modern development of a longstanding debate about the causes of mental illness DIATHESIS STRESS MODEL

7. S Y M P T O M S O F S T R E S S

8. Burnout is a psychological term that refers to long-term exhaustion and diminished interest in work. It is extreme fatigue, manifested physically, emotionally and spiritually. BURNOUT

9. DIFFICULTY SLEEPING EASILY DISTRACTED FEELING AT THE END OF TETHER EASILY IRRATABLE TRYING TO AVOID SITUATION THAT CAUSE DISTRESS NEVER TAKING A BREAK FEELING OUT OF CONTROL FEELING LIKE NOT REALLY GETTING ANYWHERE FEELING TRAPPED PUTTING ON BRAVE FACE 10 SIGNS & SYMPTOM OF BURNOUT

10. STRESS MANAGEMENT

11. DEPRESSION “Sustained or chronic stress, in particular, leads to elevated hormones such as cortisol, the "stress hormone," and reduced serotonin and other neurotransmitters in the brain, including dopamine, which has been linked to depression”. When the stress response fails to shut off and reset after a difficult situation has passed, it can lead to depression in susceptible people. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. It affects how one feels, thinks and behaves and can lead to a variety of emotional and physical problems. One may have trouble doing normal day-to-day activities, and may feel as if life isn’t worth living

12. Depression & Suicide Depression is present in at least 50 percent of all suicides.  The lifetime risk of suicide among patients with untreated depression ranges from 2.2% to 15%.  Those suffering from depression are at 25 times greater risk for suicide than the general population.  Instances of suicide in men is almost four times greater than in women. However, women have higher rates of suicide ideation and attempts. The difference is attributed to men choosing more effective methods resulting in the higher rate of success

13. There are several forms of depressive disorders. 1. Major depressive disorder, or major depression 2. Dysthymic disorder, or dysthymia 3. Minor depression Psychotic depression Postpartum depression Seasonal affective disorder (SAD) 4. Bipolar disorder What are the different forms of depression?

14. Signs And Symptoms Of Depression Persistent sad, anxious, or "empty" feelings Feelings of hopelessness or pessimism Feelings of guilt, worthlessness, or helplessness Irritability, restlessness Loss of interest in activities or hobbies once pleasurable, including sex Fatigue and decreased energy Difficulty concentrating, remembering details, and making decisions Insomnia, early-morning wakefulness, or excessive sleeping Overeating, or appetite loss Thoughts of suicide, suicide attempts Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment .

15. ILLNESS OFTEN CO EXIST WITH DEPRESSION Post-traumatic stress disorder (PTSD) Obsessive-compulsive disorder Panic disorder Social phobia Generalized anxiety disorder Depression also may occur with other serious medical illnesses such as heart disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinson's disease

16. CAUSES OF DEPRESSION 1. Genetic or Hereditary 2. Biological/Biochemical/Medication 3. Dietary 4. Environmental 5. Socio Cultural Factors /Situations/ Relationships /Personality

17. PATHOPHYSIOLOGY • The Biogenic Amine Hypothesis - caused by a deficiency of monoamines, particularly noradrenaline and serotonin. • The Receptor Sensitivity Hypothesis - depression is the result of a pathological alteration (supersensitivity and up-regulation) in receptor sites - TCAs or MAOIs causes desensitization (the uncoupling of receptor sites) and possibly down_x0002_regulation (a decrease in the number of receptor sites). • The Serotonin-only Hypothesis - emphasizes the role of serotonin in depression and downplays noradrenaline. • The Permissive Hypothesis • The Electrolyte Membrane Hypothesis • The Neuroendocrine Hypothesis

18. DIAGNOSIS •History Collection •Mental Status Examination •ICD – 10 Criteria

19. PERSISTENT DEPRESSIVE DISORDER Depression that lasts for 2 years or longer is called Persistent Depressive Disorder.  It used to be known as “dysthymia”. May treated with psychotherapy,medication , or a combination of the two.

20. Seasonal Affective Disorder Seasonal Affective Disorder (SAD) is a period of Major Depression that most often occurs during the winter months, when the days grow short and you get less sunlight.  Antidepressants and “light therapy” can help. You'll need to sit in front of a special bright light box for about 15-30 minutes each day

21. Psychotic Depression People with Psychotic Depression have the symptoms of Major Depression, along with "psychotic" symptoms, such as: − hallucinations (seeing or hearing things that aren't there), − delusions (false beliefs), or − paranoia (wrongly believing that others are trying to harm you). A combination of antidepressant and antipsychotic drugs can treat psychotic depression. ECT may also be an option.

22. Premenstrual Dysphoric Disorder (PMDD) − Women with PMDD have depression and other symptoms at the start of their period. − Antidepressant medication or sometimes oral contraceptives can treat PMDD.  Postpartum Depression − Women who have Major Depression in the weeks and months after childbirth may have PMDD. − Antidepressant drugs can help. Female Variants

23. The treatment of depression is effective only 60- 80% of the time. As a rule of thumb, only 1/3 of patients respond to each course of antidepressants. In developed countries with well-organized health care systems, between 44%-70% of patients with depression do not receive treatment in any given year. If left untreated, depression can lead to co_x0002_morbid mental disorders, recurrent depressive episodes, and higher rates of suicide.

24. Most commonly prescribed antidepressants: − Selective Serotonin Reuptake Inhibitors (SSRIs) - Zoloft, Celexa, Prozac, Lexapro, Paxil; − (Serotonin Antagonists and Reuptake Inhibitors) (SARIs) – Desyrel; − Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – Effexor, Cymbalta; − Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs) – Wellbutrin.  Estrogen has shown limited efficacy of treating premenstrual- related depression; in post-menopausal women estrogen has some effect in treating depression and may enhance the effectiveness of antidepressants. Major non-drug treatments include psychotherapy, shock therapy (ECT), and exercise. Common Treatments

25. General: insomnia, fatigue, dizziness, drowsiness.  Gastrointestinal: dry mouth (includes dryness of the mucous membranes in the mouth, throat, and nostrils), increased appetite and weight gain, nausea, constipation.  Neuropsychiatric: anxiety, agitation, irritability, blurred vision.  Sexual: loss of sexual desire and other sexual problems, such as Erectile Dysfunction (ED) and decreased orgasm.  Long-term side effects include Tachyphylaxis (tolerance) (“Prozac Poop-Out”); possibly an increased risk of Type II Diabetes. Common Side Effects of Antidepressants

26. Cognitive-Behavioral Therapy (CBT) helps patients restructure negative thought patterns  Interpersonal Therapy (IPT) helps patients understand and work through troubled relationships Psychotherapy