Psychiatric illness tend to fluctuate over time, with their severity increasing and decreasing at different points in time. An episode of an illness (or a relapse) occurs when symptoms are severe and functioning is impaired. Understanding what factors contribute to relapses can help people learn how to manage their illness more effectively, and to prevent relapses or decrease their severity.
Psychiatric illnesses fluctuate over time in their severity
The stress- vulnerability model of psychiatric disorders provides a useful way of understanding how different factors influence the course of mental illness. According to this model, the course of a psychiatrist illness is influenced by several factors: biological vulnerability, stress, medication, drugs and alcohol, coping skills, and social support. Each of these factors is described below, and illustrated in the accompanying diagram.
Each Person has biological vulnerability to different diseases. This vulnerability is determined by a combination of generic and other biological factors. For example, some people have a biological vulnerability to cardiac disease: some people have a vulnerability to specific types of cancer, and some people have a vulnerability to specific psychiatric disorders. Common psychiatric disorders to which people are biologically vulnerable include schizophrenia, schizoaffective disorder, bipolar disorder, major depression, and anxiety disorders.
Once a person has a biological vulnerability to a mental illness, that mental illness may either develop spontaneously or be triggered by stress. Even among people who have a psychiatric illness, vulnerability may differ from one person to another. On average, people who have a greater biological vulnerability to an illness experience more severe symptoms and difficulties.
Stress refers to something in the environment that forces the person to adjust in some way. Stress can take the form of specific life events, such as the death of a loved one, a major move, or being a victim of crime. Stress can also be caused by living in difficult conditions, such as living with people who are hostile and critical, living in unpredictable and dangerous environments, or living in poverty.
People who are biologically vulnerable to a psychiatric disorder and who are exposed to stress are more likely to develop that disorder. Once people have a psychiatric disorder, stress can cause relapses and worsen the course of the illness.
Stress can affect biological vulnerability, leading to symptom relapses.
Factors that affect biological vulnerability and Stress.
Although biological vulnerability and stress influence the course of the psychiatric disorder, they can be affected by several factors. Those factors include medication, drugs and alcohol, coping skills, and social support.
Medications for psychiatric disorders can decrease biological vulnerabiltiy. Medications are effective at both decreasing the severity of symptoms and preventing symptom relapses. People who take medications regularly and do experience relapses tend to have less relapses.
Alcohol and Drugs
Alcohol and Drugs use can increase biological vulnerability. Some substance can directly increase biological vulnerability, while other substances can decrease the beneficial effects of medications on vulnerability. People with psychiatric disorders who use alcohol and drugs regularly are prone to more frequent relapses of their symptoms.
Medications decrease biological vulnerability.
Alcohol and drugs increase biological vulnerability.
Factors That Affect Stress
Stress can be deceased by coping skills, social support, and engaging in meaningful activity.
Coping Skills are strategies that people use to minimize the effects of stress. Examples of coping skills include relaxation, positive self-talk, problem solving, talking out one’s feelings with a friend or support person, exercising, journal writing, and artistic expression. People who have several different coping skills are less susceptible to the negative effects of stress.
Coping skills decrease the negative effects of stress.
Social Support refers to the help and caring that people feel they can count on from other people. Supportive persons can include family members, friends, members of the treatment team, a clergy member, or anyone else with whom a person has a close relationship. Good social support can decrease the effects of stress. Supportive people can sometimes solve problems with a person and decrease stress. For example, if a man feels criticized by his supervisor at work, a supportive person can help him identify strategies for learning more specifically about his supervisor’s concerns. Supportive people can also help a person deal with the negative effects of stress. For example, if a woman has been a victim of crime, she can talk it over with a supportive person, and benefit from that person’s concern and empathy.
Social support and coping skills can interact with one another. People with good coping skills can obtain more social support by reaching out and engaging with other people. Supportive people can also improve others’ coping skills by helping them develop more effective strategies for dealing with stress. People who have more social support tend to experience fewer and less severe relapses.
Social Support decreases the negative effects of stress.
Meaningful Activities are tasks that provide a strong sense of purpose and gratification to a person. Being invovled in meaningful activities helps people to structure their time and gives them somethign to look forward to every day. Examples of meaningful activities include work, going to school, parenting a child, doing volunteer work, caring for someone else, and being a regular participant at a peer support program. Having meaningful activities to engage in reduces suseptibility to stress, because people are actively pursuing their goals and are less focused on stress.
Engaging in meaningful activities decreases the negative effects of stress. V
Treatment Implications of The Stress Vulnerability Model
The stress- vulnerability model points to five ways with psychiatric illness (and their families) can improve the course of their illness and reduce relapses and rehospitalisation:
1. Take psychiatric medications as prescribed.
2. Avoid alcohol and drug use.
3. Increase coping skills.
4. Increase social support.
5. Engage in meaningful activities, such as work, school, and parenting.
Taking these steps can help reduce relapses or lessen the severity of relapses, and therefore can help people make progress toward their personal goals.
Reference: Unknown. Brochure