The Reverend Dr.Kelly Murphy Mason,

Psy.D., M.Div., M.S., LCSW-QCSW:Clinical Pastoral Psychotherapist in Private Practice in NYC;

Community Minister in Metropolitan New York

Stressors/ = PsychologicalSupports Distress

Psychological Distress + X = Mental Disorder

(Clinical condition-Psychopathology)

Psychospiritual*

Sociocultural

Biophysical

Cognitive/Behavioral

Assessment accounts for multiple factors and is therefore “multiaxial”

Diagnosis is a medical term Diagnosis is both organized & coded in

the DSM, published by APA Psychiatrists provide medical

management for mental disorders, using prescription psychotropics in their pharmacotherapy

Developmental Disorders

Dementia Substance Abuse/

Dependence Schizophrenia &

Psychotic Disorders, inc. Paranoia

Dissociative Disorders Somataform Disorders

Eating Disorders Sleep Disorders Sexual/ Gender

Identity Disorders Personality Disorders Factitious Disorder Impulse Control

Disorders Adjustment Disorders Anxiety Disorders Mood Disorders

Anxiety Disorders include: Panic; Phobia, including Social; OCD; PTSD; and Generalized Anxiety Disorder

Mood Disorders include: Dysthymia, Major Depressive Disorder, Single Episode or Recurrent; Bipolar Disorder; Mood Disorder due to…

Some disorders are self-limiting Episodic depression tends to worsen Self-esteem is often damaged Social isolation becomes problematic Neurovegetative symptoms are real Depression can be “masked”, esp. in

males, who are at higher risk for suicide Mania and psychosis sometimes figure in

the disorder

Depression & Anxiety-Spectrum Disorders frequently are comorbid, sometimes difficult to distinguish

Depression can be secondary to a general medical condition

Substance-induced mood disorders require dual diagnosis and specialized treatment

Alcohol Use Amphetamine Use Cocaine Use Hallucinogen Use Opioid Use Inhalant Use Cannabis Use

Sedative/Anxiolytic Use – the “iatrogenic effect”

Polysubstance Dependence

Substance Intoxication

Substance Withdrawal

Antidepressant SSRIs: Prozac, Zoloft, Lexapro, etc.

Atypicals: Wellburtin & Effexor

Anxiolytics, inc. benzodiazapenes: Xanax, Ativan

Mood stablizers, eg. Lithium

Antipsychotics: Abilify, Zyprexa

Psychostimulants: Ritalin, Adderall

Sleep aids: Remeron

People often attempt to self-medicate with substances or self-soothe through the so-called “soft addictions” as a coping strategy

Some people may be higher functioning, others lower functioning

Some internalize, others externalize Some people are in an acute phase,

others in the management stage Many mental disorders go undiagnosed

Problems with primary support group, i.e., the family or marriage

Problems in the social environment Educational/Occupational problems Housing problems Economic problems Problems with health care

People may need to strengthen their relational skills and coping strategies, as well as adjust their mental schema

Good “hygiene” includes self-care honoring the mind-body-soul connection

Strong spiritual community & solid pastoral care can provide protective benefits

Preventative mental health care is optimal

People feel dignified by a holistic approach to themselves & their situations

A healthy congregation can be a therapeutic milieu

Preach compassion The faith community can work as a collective to

both destigmatize and normalize mental disorders

Psychoeducation can be a very important part of church programming & congregant learning

Social justice groups can advocate for mental health parity

Peer support and group work fill significant needs, especially if they are offered in a safe environment

Relational problems Possible abuse, history of abuse Spiritual or religious problems Bereavement or complicated grief Acculturation Phase of life problem

Interpersonal supports need to be enlisted

Psychotherapy is quite effective, both short- or long-term, and in combination with pharmacotherapy

Education and empowerment are linked in such treatments as bibliotherapy

Mental disorders tend to leave marks that last for a time…

Tend to your own mental health! Take good care of yourself…

Acquaint yourself with the spectrum of mental disorders

Know and respect your limits

Ministers and religious educators are not generally qualified as providers of mental health care and so must have an understanding of when professional mental health care is needed

Ideally, some sort of referral network is established before it is needed in a time of crisis

Certain conditions are chronic and not necessarily ever “cured”

Obsessive-Compulsive Personalities

Histrionic Personalities

Paranoid Personalities

Schizotypal Personalities

Dependent Personalities

Borderline Personalities

Avoidant Personalities

Narcissistic Personalities

Grossly disorganized behavior Delusions or hallucinations Indications of decompensation Suicidal statements, threats, or gestures Menacing actions Serious expressions of concern

Remember that mental disorders tend to have involved etiologies

Those struggling with mental disorders are much more than a coded diagnosis and may retain their signature strengths

Treatment outcomes for mental disorders continue to steadily improve, even in cases of recurrence

Eliminate us-and-them thinking, since lifetime prevalence is high

The Caring Congregations Program Online sources such as

www.mentalhealth.com Advocacy groups such as NAMI Public organizations such as NIMH Phone services like 1-800-LIFENET Local counseling centers and hospitals

Q: ?

A: “It depends…”