{"id":178,"date":"2017-11-09T21:05:24","date_gmt":"2017-11-09T21:05:24","guid":{"rendered":"https:\/\/pressbooks.hccfl.edu\/blueprint\/chapter\/54-mental-health\/"},"modified":"2024-03-31T22:13:03","modified_gmt":"2024-03-31T22:13:03","slug":"54-mental-health","status":"publish","type":"chapter","link":"https:\/\/pressbooks.hccfl.edu\/blueprint\/chapter\/54-mental-health\/","title":{"raw":"Chapter 17: Mental Health","rendered":"Chapter 17: Mental Health"},"content":{"raw":"<div class=\"textbox shaded\">\r\n<div class=\"wp-nocaption wp-image-636 aligncenter\" style=\"text-align: center;\">\r\n\r\n<em>\"It is only in sorrow bad weather masters us; in joy we face the storm and defy it.\"<\/em>\r\n\r\n<\/div>\r\n<div style=\"text-align: center;\"><\/div>\r\n<div class=\"wp-nocaption wp-image-636 aligncenter\" style=\"text-align: center;\">- Amelia Barr<\/div>\r\n<\/div>\r\n<h3>Mental<strong> Health Basics<\/strong><\/h3>\r\nKnowing how to take care of your mental health when you\u2019re in college is just as important as maintaining your physical health. In fact, there\u2019s a strong link between the two: doctors are finding that positive mental health can actually improve your physical health.\r\n\r\nSo, what is \u201cmental health?\" Mental health can be defined as \u201ca state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.\u201d[footnote]\u201cMental Health Basics,\u201d Centers for Disease Control and Prevention<em>,<\/em> 2013, April 22, 2016.[\/footnote] Having good mental health doesn\u2019t necessarily mean being\u00a0happy or successful all the time. Most people feel depressed, lonely, or anxious now and then, but those with good mental health can take these feelings in stride and overcome them. When such feelings or moods persist and interfere with a person\u2019s ability to function normally, though, it may be a sign of a more serious mental health problem and time to seek help.\r\n\r\nThe term <em>mental illness<\/em> refers to mental disorders or health conditions characterized by \u201calterations in thinking, mood, or behavior (or some combination thereof) associated with distress and\/or impaired functioning.\u201d[footnote]\u201cMental \u00a0Health Basics.\u201d[\/footnote] Depression is the most common type of mental illness, and it affects more than 26 percent of the U.S. adult population.\u00a0It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease.\r\n\r\nEvidence has shown that mental disorders, especially depressive disorders, are strongly linked\u00a0to the occurrence and course of many chronic diseases\u2014including diabetes, cancer, cardiovascular disease, asthma, and obesity\u00a0and many risk behaviors for chronic disease, such as physical inactivity, smoking, excessive drinking, and insufficient sleep. In other words, if your mental health is poor, you may be at greater risk for disease and poor physical health.\r\n<h3>Mental<strong> Health Indicators<\/strong><\/h3>\r\nIn the public health arena, more emphasis and resources have been devoted to screening, diagnosis, and treatment of mental illness than mental health. Little has been done to protect the mental health of those who are free\u00a0from mental illness. There are some known indicators of mental health, including the following:\r\n<ul>\r\n \t<li>Emotional well-being: life satisfaction, happiness, cheerfulness, peacefulness.<\/li>\r\n \t<li>Psychological well-being: self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one\u2019s environment, spirituality, self-direction, and positive relationships.<\/li>\r\n \t<li>Social well-being:\u00a0social acceptance, belief in the potential of people and society as a whole, personal self-worth and usefulness to society, and a sense of community.<\/li>\r\n<\/ul>\r\nFormer surgeon general David Satcher suggests\u00a0that there are social determinants of mental health\u2014just as there are social determinants of general health\u2014that need to be in place to support mental health[footnote]Rahn Bailey, \u201c<a href=\"https:\/\/ajp.psychiatryonline.org\/doi\/full\/10.1176\/appi.ajp.2015.15040450\">The Social Determinants of Mental Health<\/a>,\u201d <em>American Journal of Psychiatry<\/em> 172, no. 9 (September 1, 2015): 913-914.[\/footnote]. These include adequate housing, safe neighborhoods, equitable jobs and wages, quality education, and equity in access to quality health care.\r\n\r\nThere are also some common-sense strategies that you can adopt to support and improve your emotional,\u00a0psychological, and social\u00a0health. Not surprisingly, they are very similar to the strategies one uses to cope with stress:\r\n<ul>\r\n \t<li>Eat a balanced diet<\/li>\r\n \t<li>Get enough sleep<\/li>\r\n \t<li>Get regular physical activity<\/li>\r\n \t<li>Stay socially connected with friends and family<\/li>\r\n \t<li>Make smart choices about alcohol and drugs<\/li>\r\n \t<li>Get help if you are anxious\u00a0or depressed<\/li>\r\n<\/ul>\r\n<h3>Depression<\/h3>\r\nDepression is a common but serious mood disorder that\u2019s more than just a feeling of \u201cbeing down in the dumps\u201d or \u201cblue\u201d for a few days. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.\r\n\r\nIf you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:\r\n<ul>\r\n \t<li>Persistent sad, anxious, or \u201cempty\u201d mood<\/li>\r\n \t<li>Feelings of hopelessness, or pessimism<\/li>\r\n \t<li>Irritability<\/li>\r\n \t<li>Feelings of guilt, worthlessness, or helplessness<\/li>\r\n \t<li>Loss of interest or pleasure in hobbies and activities<\/li>\r\n \t<li>Decreased energy or fatigue<\/li>\r\n \t<li>Moving or talking more slowly<\/li>\r\n \t<li>Feeling restless or having trouble sitting still<\/li>\r\n \t<li>Difficulty concentrating, remembering, or making decisions<\/li>\r\n \t<li>Difficulty sleeping, early-morning awakening, or oversleeping<\/li>\r\n \t<li>Appetite and\/or weight changes<\/li>\r\n \t<li>Thoughts of death or suicide, or suicide attempts<\/li>\r\n \t<li>Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and\/or that do not ease even with treatment<\/li>\r\n<\/ul>\r\nDepression is one of the most common mental disorders in the United States. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. It usually starts between the ages of fifteen and thirty, and is much more common in women. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter, when there is less natural sunlight. Depression is one part of bipolar disorder.\r\n\r\nDepression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two.\r\n\r\nThere are days that you will feel down, especially when the demands of college get to you. These feelings are normal and will go away. If you are feeling low, try to take a break from the pressures of college and do something you enjoy. Spend time with friends, exercise, read a good book, listen to music, watch a movie, call a friend, talk to your family, or anything else that makes you feel good. If you feel depressed for two weeks, or the feeling keeps coming back, you should talk to a counselor in the health services\/center. They see lots of students who are anxious, stressed, or depressed at college.\r\n<h3>Loneliness<\/h3>\r\nMost people experience occasional loneliness, and it\u2019s an especially common experience among first-time college students, who find themselves in an unfamiliar environment with a completely new social scene. Loneliness isn\u2019t necessarily about being alone\u2014you can be surrounded by people and still feel alone. It\u2019s the <em>feeling<\/em> of being alone that counts, along with feeling empty, unwanted, or isolated. In the following Ted Talk, Sherrie Turkle describes how, in this age of near-constant digital\u00a0\u201cconnection,\u201d loneliness is a challenge that faces us all:\r\n<h3>Video: <em>Connected, but alone?<\/em> Sherry Turkle, TED 2012<\/h3>\r\nhttps:\/\/youtu.be\/t7Xr3AsBEK4\r\n\r\nIf you\u2019re feeling lonely, try taking Turkle\u2019s advice and start a conversation with someone. College is a great place to meet new people and develop new and interesting relationships. Others in college are new, just like you, and will welcome the chance to connect with and get to know another classmate. Try joining a campus interest group or club, play a team sport, or just ask another student if they\u2019d like to meet for coffee or to study.\r\n\r\nIf feelings of loneliness persist, and especially if you also feel depressed, you should get help from a counselor or health services.\r\n<h3>Eating<strong> Disorders<\/strong><\/h3>\r\nEating disorders are mental health illnesses that involve emotional and behavioral disturbance surrounding weight and food issues. The most common are anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating disorders can have life-threatening consequences.\r\n<h4><strong>Anorexia nervosa<\/strong><\/h4>\r\nCharacterized by self-starvation and extreme weight loss either through restriction or through binge-purging. This may frequently be a result of body dysmorphic disorder (a condition in which someone feels that their body looks differently than it actually does) or a result of other psychiatric complications such as OCD or depression. Starvation can cause harm to vital organs such as the heart and brain, can cause nails, hair, and bones to become brittle, and can make the skin dry and sometimes yellow or covered with soft hair. Menstrual periods can become irregular or stop completely.\r\n\r\nPeople with <strong>bulimia nervosa<\/strong> eat large amounts of food (also called bingeing) at least two times a week and then vomit (also called purging) or exercise compulsively. Because many people who \u201cbinge and purge\u201d maintain their body weight, they may keep their problem a secret for years. Vomiting can cause loss of important minerals, life-threatening heart arrhythmia (irregular heartbeat), damage to the teeth, and swelling of the throat. Bulimia can also cause irregular menstrual periods.\r\n\r\nPeople who binge without purging also have a disorder called <strong>binge eating disorder<\/strong>. This is frequently associated with feelings of loss of control and shame surrounding eating. People who are diagnosed with this disorder tend to gain weight, and many will have all of the consequences of being overweight, including high blood pressure and other cardiac symptoms, diabetes, and musculoskeletal complaints.\r\n\r\nIf you think you might have an\u00a0eating disorder, you should go to the student health center or counseling center and get help. Talk with your family and close friends. Going for help and talking to others about your feelings and illness can be very difficult, but it\u2019s the only way that you\u2019re going to get better. Many colleges have treatment programs for these conditions and trained counselors who can relate to people with an eating disorder.\r\n<h3>Anxiety<strong> Disorders<\/strong><\/h3>\r\nPeople with anxiety disorders respond to certain objects or situations with fear and dread. They have physical reactions to those objects, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if a person:\r\n<ul>\r\n \t<li>Has an inappropriate response to a situation<\/li>\r\n \t<li>Cannot control the response<\/li>\r\n \t<li>Has an altered way of life due to the anxiety<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_176\" align=\"alignnone\" width=\"1024\"]<img class=\"wp-image-2657 size-large\" title=\"Brenda Thach\" src=\"https:\/\/pressbooks.hccfl.edu\/wp-content\/uploads\/sites\/88\/2017\/11\/Brenda-Thach-mental-health-scaled-1.jpg\" alt=\"A line drawing of a bath tub, plants, and candles in a calm and private environment including a sign reading don't forget to breathe \" width=\"1024\" height=\"794\" \/> Self care[\/caption]\r\n<h3>Anxiety disorders include the following:<\/h3>\r\n<h4><strong>Obsessive-compulsive disorder (O<\/strong><strong>CD)<\/strong><\/h4>\r\nA type of anxiety disorder. If you have OCD, you have repeated, upsetting thoughts called obsessions. You do the same thing over and over again to try to make the thoughts go away. Those repeated actions are called compulsions. Examples of obsessions are a fear of germs or a fear of being hurt. Compulsions include washing your hands, counting, checking on things or cleaning. Untreated, OCD can take over your life. Researchers think brain circuits may not work properly in people who have OCD. It tends to run in families. The symptoms often begin in children or teens. Treatments that combine medicines and therapy are often effective.\r\n<h4><strong>Panic disorder<\/strong><\/h4>\r\na kind of anxiety disorder that causes panic attacks. Panic attacks are sudden feelings of terror for no reason. You may also feel physical symptoms, such as\r\n<ul>\r\n \t<li>Fast heartbeat<\/li>\r\n \t<li>Chest pain<\/li>\r\n \t<li>Breathing difficulty<\/li>\r\n \t<li>Dizziness<\/li>\r\n<\/ul>\r\nPanic attacks can happen anytime, anywhere and without warning. You may live in fear of another attack and may avoid places where you have had an attack. For some people, fear takes over their lives and they cannot leave their homes.\r\n\r\n<img class=\"size-large wp-image-2677\" src=\"https:\/\/pressbooks.hccfl.edu\/wp-content\/uploads\/sites\/88\/2024\/03\/Avery-Swain-Anxiety-scaled-1.jpg\" alt=\"Eyes, eyebrows, a nose, and a mouth surrounded by colorful swirls filling the canvas\" width=\"760\" height=\"1024\" \/>\r\n\r\nPanic disorder is more common in women than men. It usually starts when people are young adults. Sometimes it starts when a person is under a lot of stress. Most people get better with treatment. Therapy can show you how to recognize and change your thinking patterns before they lead to panic. Medicines can also help.\r\n\r\nA<strong> phobia<\/strong>\u00a0is a strong, irrational fear of something that poses little or no actual danger. There are many specific phobias. Acrophobia is a fear of heights. You may be able to ski the world\u2019s tallest mountains but be unable to go above the fifth floor of an office building. Agoraphobia is a fear of public places, and claustrophobia is a fear of closed-in places. If you become anxious and extremely self-conscious in everyday social situations, you could have a social phobia. Other common phobias involve tunnels, highway driving, water, flying, animals, and blood. People with phobias try to avoid what they are afraid of. If they cannot, they may experience:\r\n<ul>\r\n \t<li>Panic and fear<\/li>\r\n \t<li>Rapid heartbeat<\/li>\r\n \t<li>Shortness of breath<\/li>\r\n \t<li>Trembling<\/li>\r\n \t<li>A strong desire to get away<\/li>\r\n<\/ul>\r\nTreatment helps most people with phobias. Options include medicines, therapy or both.\r\n<h3><strong>Post-traumatic stress disorder (PTSD)<\/strong><\/h3>\r\nYou can get PTSD after living through or witnessing a traumatic event, such as war, a hurricane, rape, physical abuse, or a bad accident. PTSD makes you feel stressed and afraid after the danger is over. It affects your life and the people around you. PTSD can cause problems like\r\n<ul>\r\n \t<li>Flashbacks, or feeling like the event is happening again<\/li>\r\n \t<li>Trouble sleeping or nightmares<\/li>\r\n \t<li>Feeling alone<\/li>\r\n \t<li>Angry outbursts<\/li>\r\n \t<li>Feeling worried, guilty, or sad<\/li>\r\n<\/ul>\r\nPTSD starts at different times for different people. Signs of PTSD may start soon after a frightening event and then continue. Other people develop new or more severe signs months or even years later. PTSD can happen to anyone, even children.\r\n\r\nMedicines can help you feel less afraid and tense. It might take a few weeks for them to work. Talking to a specially trained doctor or counselor also helps many people with PTSD. This is called talk therapy.\r\n\r\n<img class=\"size-large wp-image-176\" src=\"https:\/\/pressbooks.hccfl.edu\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-741x1024.jpg\" alt=\"Line drawing of a figure with a downward gaze expression, a maze at the top of an open head, surrounded by eyes and two sets of text. One book floats overhead with words of positivity while negative words surround the torso of the figure.\" width=\"741\" height=\"1024\" \/>\r\n\r\nStress can severely affect ones state of mental health, causing fear, anxiety, and grief\r\n<h3>Suicidal<strong> Behavior<\/strong><\/h3>\r\nSuicide causes immeasurable pain, suffering, and loss to individuals, families, and communities nationwide. On average, 112 Americans die by suicide each day. Suicide is the second leading cause of death among 15\u201324-year-olds, and more than 9.4 million adults in the United States had serious thoughts of suicide within the past twelve months. But suicide is preventable, so it\u2019s important to know what to do.\r\n\r\n<img class=\"size-large wp-image-2685\" src=\"https:\/\/pressbooks.hccfl.edu\/wp-content\/uploads\/sites\/88\/2024\/03\/Lillium-Nobbs-Piling-Up-scaled-1.jpg\" alt=\"Girl sitting with arms wrapped around knees in distress.\" width=\"768\" height=\"1024\" \/>\r\n\r\nPiling up\r\n<h4><strong>Warning Signs of Suicide<\/strong><\/h4>\r\nIf someone you know is showing one or more of the following behaviors, he or she may be thinking about suicide. Don\u2019t ignore these warning signs. Get help immediately.\r\n<ul>\r\n \t<li>Talking about wanting to die or to kill oneself<\/li>\r\n \t<li>Looking for a way to kill oneself<\/li>\r\n \t<li>Talking about feeling hopeless or having no reason to live<\/li>\r\n \t<li>Talking about feeling trapped or in unbearable pain<\/li>\r\n \t<li>Talking about being a burden to others<\/li>\r\n \t<li>Increasing the use of alcohol or drugs<\/li>\r\n \t<li>Acting anxious or agitated; behaving recklessly<\/li>\r\n \t<li>Sleeping too little or too much<\/li>\r\n \t<li>Withdrawing or feeling isolated<\/li>\r\n \t<li>Showing rage or talking about seeking revenge<\/li>\r\n \t<li>Displaying extreme mood swings<\/li>\r\n<\/ul>\r\n<h4><strong>Get Help<\/strong><\/h4>\r\nIf you or someone you know needs help, call the National Suicide Prevention Lifeline at 1.800.273.TALK (8255). Trained crisis workers are available to talk 24 hours a day, 7 days a week.\r\n\r\nIf you think someone is in immediate danger, do not leave him or her alone\u2014stay there and call 911.\r\n<h3>Resources<\/h3>\r\n<a href=\"http:\/\/ok2talk.org\/\">OK2TALK<\/a>\u00a0is a community for young adults struggling with mental health problems. It offers a safe place to talk.\r\n<div class=\"textbox exercises\">\r\n<h3>Activity<\/h3>\r\n<h4>Objectives<\/h4>\r\n<ul>\r\n \t<li>Identify the difference between occasional negative emotions and more serious mental health issues, such as anxiety disorder or depression<\/li>\r\n \t<li>Explore practices for ensuring mental health and emotional balance in your life<\/li>\r\n \t<li>Identify resources for further information and guidance about mental health issues<\/li>\r\n<\/ul>\r\n<h4>Directions<\/h4>\r\n<ul>\r\n \t<li>Watch the following Tedx Talk, featuring college student Jack Park.\u00a0In this talk, Jack\u00a0shares his story of living with a mental disorder and revisits some of the ways he found help and hope. He makes the case for seeing\u00a0mental illness in a new light, so that people can begin to address some of the issues associated with suicide, depression, and other preventable mental disorders.<\/li>\r\n<\/ul>\r\n<h4 style=\"text-align: left;\">\u00a0\u00a0\u00a0\u00a0 Video: <em>Shedding Light on Student Depression<\/em>, Jack Park TEDx Penn<\/h4>\r\nhttps:\/\/youtu.be\/ur8TZf6HWSs\r\n\r\n[h5p id=\"18\"]\r\n\r\nWrite a short (1\u20132 pages) response paper in which you address the following questions: What do you think of Jack\u2019s practice\u00a0of changing his \u201cto-do\u201d lists into \u201cwant-to-do\u201d lists? What does he hope to gain from this\u00a0shift? Which coping mechanisms does Jack observe his fellow students using to deal with stress and mental health challenges? What does Jack think is the deeper problem? Why, in Jack\u2019s view, is it hard for people to get help for mental health problems in the same way they might seek help for dental problems? Add your own thoughts\u00a0about the obstacles you think students may\u00a0face in getting help for mental health issues.\r\n\r\n<\/div>\r\n<div class=\"textbox\">\r\n<h3>Licenses and Attributions:<\/h3>\r\n<h3>CC Licensed Content:<\/h3>\r\n<ul>\r\n \t<li><a href=\"https:\/\/courses.lumenlearning.com\/suny-collegesuccess-lumen1\/chapter\/mental-health\/\" target=\"_new\" rel=\"noopener\"><strong>Mental Health<\/strong><\/a>: Provided by Lumen Learning, this chapter offers comprehensive insights into mental health, under a Creative Commons Attribution (CC BY) license.<\/li>\r\n \t<li><strong>A Bath for the Soul<\/strong> by Brenda Thach: This work is licensed under Creative Commons Attribution (CC BY), offering a reflective exploration on self-care and mental wellness.<\/li>\r\n \t<li><strong>Emptiness<\/strong> by Avery C. Swain: Licensed under Creative Commons Attribution No Derivatives (CC BY-ND), this piece delves into the feelings of void and isolation.<\/li>\r\n \t<li><a target=\"_new\" rel=\"noopener\"><strong>Stress and Mental Health<\/strong><\/a> by Sergio Delgado: A detailed examination of the relationship between stress and mental health, available under a CC BY license.<\/li>\r\n \t<li><strong>Piling Up<\/strong> by Lillium Nobbs: This work is licensed under Creative Commons Attribution (CC BY), discussing the cumulative effects of stress and strategies for coping.<\/li>\r\n<\/ul>\r\n<h3>All Rights Reserved Content:<\/h3>\r\n<ul>\r\n \t<li><a href=\"https:\/\/youtu.be\/t7Xr3AsBEK4?list=PLQdWctT0t4veKqW8rTIQ0XlcS_DoCLrGE\" target=\"_new\" rel=\"noopener\"><strong>Sherry Turkle: Connected, but Alone?<\/strong><\/a>: A TED talk provided by Sherry Turkle, exploring how technology impacts our real-life connections and mental health, under the standard YouTube license.<\/li>\r\n \t<li><a href=\"https:\/\/youtu.be\/ur8TZf6HWSs\" target=\"_new\" rel=\"noopener\"><strong>Shedding Light on Student Depression | Jack Park | TEDxPenn<\/strong><\/a>: Jack Park's TEDx talk on the realities of student depression, offered under the standard YouTube license.<\/li>\r\n<\/ul>\r\n<h3>Public Domain Content:<\/h3>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.cdc.gov\/mentalhealth\/basics.htm\" target=\"_new\" rel=\"noopener\"><strong>Mental Health Basics<\/strong><\/a>: An educational resource provided by the CDC, covering fundamental aspects of mental health, available in the public domain.<\/li>\r\n \t<li><a href=\"https:\/\/www.nlm.nih.gov\/medlineplus\/collegehealth.html\" target=\"_new\" rel=\"noopener\"><strong>College Health<\/strong><\/a>: Provided by the National Institutes of Health, this resource offers guidance on maintaining health and wellness during college, in the public domain.<\/li>\r\n<\/ul>\r\nAdaptations to the original materials include the removal of images and relocation of learning objectives.\r\n\r\n<\/div>","rendered":"<div class=\"textbox shaded\">\n<div class=\"wp-nocaption wp-image-636 aligncenter\" style=\"text-align: center;\">\n<p><em>&#8220;It is only in sorrow bad weather masters us; in joy we face the storm and defy it.&#8221;<\/em><\/p>\n<\/div>\n<div style=\"text-align: center;\"><\/div>\n<div class=\"wp-nocaption wp-image-636 aligncenter\" style=\"text-align: center;\">&#8211; Amelia Barr<\/div>\n<\/div>\n<h3>Mental<strong> Health Basics<\/strong><\/h3>\n<p>Knowing how to take care of your mental health when you\u2019re in college is just as important as maintaining your physical health. In fact, there\u2019s a strong link between the two: doctors are finding that positive mental health can actually improve your physical health.<\/p>\n<p>So, what is \u201cmental health?&#8221; Mental health can be defined as \u201ca state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.\u201d<a class=\"footnote\" title=\"\u201cMental Health Basics,\u201d Centers for Disease Control and Prevention, 2013, April 22, 2016.\" id=\"return-footnote-178-1\" href=\"#footnote-178-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a> Having good mental health doesn\u2019t necessarily mean being\u00a0happy or successful all the time. Most people feel depressed, lonely, or anxious now and then, but those with good mental health can take these feelings in stride and overcome them. When such feelings or moods persist and interfere with a person\u2019s ability to function normally, though, it may be a sign of a more serious mental health problem and time to seek help.<\/p>\n<p>The term <em>mental illness<\/em> refers to mental disorders or health conditions characterized by \u201calterations in thinking, mood, or behavior (or some combination thereof) associated with distress and\/or impaired functioning.\u201d<a class=\"footnote\" title=\"\u201cMental \u00a0Health Basics.\u201d\" id=\"return-footnote-178-2\" href=\"#footnote-178-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a> Depression is the most common type of mental illness, and it affects more than 26 percent of the U.S. adult population.\u00a0It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease.<\/p>\n<p>Evidence has shown that mental disorders, especially depressive disorders, are strongly linked\u00a0to the occurrence and course of many chronic diseases\u2014including diabetes, cancer, cardiovascular disease, asthma, and obesity\u00a0and many risk behaviors for chronic disease, such as physical inactivity, smoking, excessive drinking, and insufficient sleep. In other words, if your mental health is poor, you may be at greater risk for disease and poor physical health.<\/p>\n<h3>Mental<strong> Health Indicators<\/strong><\/h3>\n<p>In the public health arena, more emphasis and resources have been devoted to screening, diagnosis, and treatment of mental illness than mental health. Little has been done to protect the mental health of those who are free\u00a0from mental illness. There are some known indicators of mental health, including the following:<\/p>\n<ul>\n<li>Emotional well-being: life satisfaction, happiness, cheerfulness, peacefulness.<\/li>\n<li>Psychological well-being: self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one\u2019s environment, spirituality, self-direction, and positive relationships.<\/li>\n<li>Social well-being:\u00a0social acceptance, belief in the potential of people and society as a whole, personal self-worth and usefulness to society, and a sense of community.<\/li>\n<\/ul>\n<p>Former surgeon general David Satcher suggests\u00a0that there are social determinants of mental health\u2014just as there are social determinants of general health\u2014that need to be in place to support mental health<a class=\"footnote\" title=\"Rahn Bailey, \u201cThe Social Determinants of Mental Health,\u201d American Journal of Psychiatry 172, no. 9 (September 1, 2015): 913-914.\" id=\"return-footnote-178-3\" href=\"#footnote-178-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a>. These include adequate housing, safe neighborhoods, equitable jobs and wages, quality education, and equity in access to quality health care.<\/p>\n<p>There are also some common-sense strategies that you can adopt to support and improve your emotional,\u00a0psychological, and social\u00a0health. Not surprisingly, they are very similar to the strategies one uses to cope with stress:<\/p>\n<ul>\n<li>Eat a balanced diet<\/li>\n<li>Get enough sleep<\/li>\n<li>Get regular physical activity<\/li>\n<li>Stay socially connected with friends and family<\/li>\n<li>Make smart choices about alcohol and drugs<\/li>\n<li>Get help if you are anxious\u00a0or depressed<\/li>\n<\/ul>\n<h3>Depression<\/h3>\n<p>Depression is a common but serious mood disorder that\u2019s more than just a feeling of \u201cbeing down in the dumps\u201d or \u201cblue\u201d for a few days. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.<\/p>\n<p>If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:<\/p>\n<ul>\n<li>Persistent sad, anxious, or \u201cempty\u201d mood<\/li>\n<li>Feelings of hopelessness, or pessimism<\/li>\n<li>Irritability<\/li>\n<li>Feelings of guilt, worthlessness, or helplessness<\/li>\n<li>Loss of interest or pleasure in hobbies and activities<\/li>\n<li>Decreased energy or fatigue<\/li>\n<li>Moving or talking more slowly<\/li>\n<li>Feeling restless or having trouble sitting still<\/li>\n<li>Difficulty concentrating, remembering, or making decisions<\/li>\n<li>Difficulty sleeping, early-morning awakening, or oversleeping<\/li>\n<li>Appetite and\/or weight changes<\/li>\n<li>Thoughts of death or suicide, or suicide attempts<\/li>\n<li>Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and\/or that do not ease even with treatment<\/li>\n<\/ul>\n<p>Depression is one of the most common mental disorders in the United States. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. It usually starts between the ages of fifteen and thirty, and is much more common in women. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter, when there is less natural sunlight. Depression is one part of bipolar disorder.<\/p>\n<p>Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two.<\/p>\n<p>There are days that you will feel down, especially when the demands of college get to you. These feelings are normal and will go away. If you are feeling low, try to take a break from the pressures of college and do something you enjoy. Spend time with friends, exercise, read a good book, listen to music, watch a movie, call a friend, talk to your family, or anything else that makes you feel good. If you feel depressed for two weeks, or the feeling keeps coming back, you should talk to a counselor in the health services\/center. They see lots of students who are anxious, stressed, or depressed at college.<\/p>\n<h3>Loneliness<\/h3>\n<p>Most people experience occasional loneliness, and it\u2019s an especially common experience among first-time college students, who find themselves in an unfamiliar environment with a completely new social scene. Loneliness isn\u2019t necessarily about being alone\u2014you can be surrounded by people and still feel alone. It\u2019s the <em>feeling<\/em> of being alone that counts, along with feeling empty, unwanted, or isolated. In the following Ted Talk, Sherrie Turkle describes how, in this age of near-constant digital\u00a0\u201cconnection,\u201d loneliness is a challenge that faces us all:<\/p>\n<h3>Video: <em>Connected, but alone?<\/em> Sherry Turkle, TED 2012<\/h3>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Connected, but alone? | Sherry Turkle\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/t7Xr3AsBEK4?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>If you\u2019re feeling lonely, try taking Turkle\u2019s advice and start a conversation with someone. College is a great place to meet new people and develop new and interesting relationships. Others in college are new, just like you, and will welcome the chance to connect with and get to know another classmate. Try joining a campus interest group or club, play a team sport, or just ask another student if they\u2019d like to meet for coffee or to study.<\/p>\n<p>If feelings of loneliness persist, and especially if you also feel depressed, you should get help from a counselor or health services.<\/p>\n<h3>Eating<strong> Disorders<\/strong><\/h3>\n<p>Eating disorders are mental health illnesses that involve emotional and behavioral disturbance surrounding weight and food issues. The most common are anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating disorders can have life-threatening consequences.<\/p>\n<h4><strong>Anorexia nervosa<\/strong><\/h4>\n<p>Characterized by self-starvation and extreme weight loss either through restriction or through binge-purging. This may frequently be a result of body dysmorphic disorder (a condition in which someone feels that their body looks differently than it actually does) or a result of other psychiatric complications such as OCD or depression. Starvation can cause harm to vital organs such as the heart and brain, can cause nails, hair, and bones to become brittle, and can make the skin dry and sometimes yellow or covered with soft hair. Menstrual periods can become irregular or stop completely.<\/p>\n<p>People with <strong>bulimia nervosa<\/strong> eat large amounts of food (also called bingeing) at least two times a week and then vomit (also called purging) or exercise compulsively. Because many people who \u201cbinge and purge\u201d maintain their body weight, they may keep their problem a secret for years. Vomiting can cause loss of important minerals, life-threatening heart arrhythmia (irregular heartbeat), damage to the teeth, and swelling of the throat. Bulimia can also cause irregular menstrual periods.<\/p>\n<p>People who binge without purging also have a disorder called <strong>binge eating disorder<\/strong>. This is frequently associated with feelings of loss of control and shame surrounding eating. People who are diagnosed with this disorder tend to gain weight, and many will have all of the consequences of being overweight, including high blood pressure and other cardiac symptoms, diabetes, and musculoskeletal complaints.<\/p>\n<p>If you think you might have an\u00a0eating disorder, you should go to the student health center or counseling center and get help. Talk with your family and close friends. Going for help and talking to others about your feelings and illness can be very difficult, but it\u2019s the only way that you\u2019re going to get better. Many colleges have treatment programs for these conditions and trained counselors who can relate to people with an eating disorder.<\/p>\n<h3>Anxiety<strong> Disorders<\/strong><\/h3>\n<p>People with anxiety disorders respond to certain objects or situations with fear and dread. They have physical reactions to those objects, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if a person:<\/p>\n<ul>\n<li>Has an inappropriate response to a situation<\/li>\n<li>Cannot control the response<\/li>\n<li>Has an altered way of life due to the anxiety<\/li>\n<\/ul>\n<figure id=\"attachment_176\" aria-describedby=\"caption-attachment-176\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2657 size-large\" title=\"Brenda Thach\" src=\"https:\/\/pressbooks.hccfl.edu\/wp-content\/uploads\/sites\/88\/2017\/11\/Brenda-Thach-mental-health-scaled-1.jpg\" alt=\"A line drawing of a bath tub, plants, and candles in a calm and private environment including a sign reading don't forget to breathe\" width=\"1024\" height=\"794\" \/><figcaption id=\"caption-attachment-176\" class=\"wp-caption-text\">Self care<\/figcaption><\/figure>\n<h3>Anxiety disorders include the following:<\/h3>\n<h4><strong>Obsessive-compulsive disorder (O<\/strong><strong>CD)<\/strong><\/h4>\n<p>A type of anxiety disorder. If you have OCD, you have repeated, upsetting thoughts called obsessions. You do the same thing over and over again to try to make the thoughts go away. Those repeated actions are called compulsions. Examples of obsessions are a fear of germs or a fear of being hurt. Compulsions include washing your hands, counting, checking on things or cleaning. Untreated, OCD can take over your life. Researchers think brain circuits may not work properly in people who have OCD. It tends to run in families. The symptoms often begin in children or teens. Treatments that combine medicines and therapy are often effective.<\/p>\n<h4><strong>Panic disorder<\/strong><\/h4>\n<p>a kind of anxiety disorder that causes panic attacks. Panic attacks are sudden feelings of terror for no reason. You may also feel physical symptoms, such as<\/p>\n<ul>\n<li>Fast heartbeat<\/li>\n<li>Chest pain<\/li>\n<li>Breathing difficulty<\/li>\n<li>Dizziness<\/li>\n<\/ul>\n<p>Panic attacks can happen anytime, anywhere and without warning. You may live in fear of another attack and may avoid places where you have had an attack. For some people, fear takes over their lives and they cannot leave their homes.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-2677\" src=\"https:\/\/pressbooks.hccfl.edu\/wp-content\/uploads\/sites\/88\/2024\/03\/Avery-Swain-Anxiety-scaled-1.jpg\" alt=\"Eyes, eyebrows, a nose, and a mouth surrounded by colorful swirls filling the canvas\" width=\"760\" height=\"1024\" \/><\/p>\n<p>Panic disorder is more common in women than men. It usually starts when people are young adults. Sometimes it starts when a person is under a lot of stress. Most people get better with treatment. Therapy can show you how to recognize and change your thinking patterns before they lead to panic. Medicines can also help.<\/p>\n<p>A<strong> phobia<\/strong>\u00a0is a strong, irrational fear of something that poses little or no actual danger. There are many specific phobias. Acrophobia is a fear of heights. You may be able to ski the world\u2019s tallest mountains but be unable to go above the fifth floor of an office building. Agoraphobia is a fear of public places, and claustrophobia is a fear of closed-in places. If you become anxious and extremely self-conscious in everyday social situations, you could have a social phobia. Other common phobias involve tunnels, highway driving, water, flying, animals, and blood. People with phobias try to avoid what they are afraid of. If they cannot, they may experience:<\/p>\n<ul>\n<li>Panic and fear<\/li>\n<li>Rapid heartbeat<\/li>\n<li>Shortness of breath<\/li>\n<li>Trembling<\/li>\n<li>A strong desire to get away<\/li>\n<\/ul>\n<p>Treatment helps most people with phobias. Options include medicines, therapy or both.<\/p>\n<h3><strong>Post-traumatic stress disorder (PTSD)<\/strong><\/h3>\n<p>You can get PTSD after living through or witnessing a traumatic event, such as war, a hurricane, rape, physical abuse, or a bad accident. PTSD makes you feel stressed and afraid after the danger is over. It affects your life and the people around you. PTSD can cause problems like<\/p>\n<ul>\n<li>Flashbacks, or feeling like the event is happening again<\/li>\n<li>Trouble sleeping or nightmares<\/li>\n<li>Feeling alone<\/li>\n<li>Angry outbursts<\/li>\n<li>Feeling worried, guilty, or sad<\/li>\n<\/ul>\n<p>PTSD starts at different times for different people. Signs of PTSD may start soon after a frightening event and then continue. Other people develop new or more severe signs months or even years later. PTSD can happen to anyone, even children.<\/p>\n<p>Medicines can help you feel less afraid and tense. It might take a few weeks for them to work. Talking to a specially trained doctor or counselor also helps many people with PTSD. This is called talk therapy.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-176\" src=\"https:\/\/pressbooks.hccfl.edu\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-741x1024.jpg\" alt=\"Line drawing of a figure with a downward gaze expression, a maze at the top of an open head, surrounded by eyes and two sets of text. One book floats overhead with words of positivity while negative words surround the torso of the figure.\" width=\"741\" height=\"1024\" srcset=\"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-741x1024.jpg 741w, https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-217x300.jpg 217w, https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-768x1061.jpg 768w, https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-1112x1536.jpg 1112w, https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-65x90.jpg 65w, https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-225x311.jpg 225w, https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health-350x484.jpg 350w, https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-content\/uploads\/sites\/88\/2024\/03\/X-Sergio-Delgado-Vallejo-stress-mental-health.jpg 1240w\" sizes=\"auto, (max-width: 741px) 100vw, 741px\" \/><\/p>\n<p>Stress can severely affect ones state of mental health, causing fear, anxiety, and grief<\/p>\n<h3>Suicidal<strong> Behavior<\/strong><\/h3>\n<p>Suicide causes immeasurable pain, suffering, and loss to individuals, families, and communities nationwide. On average, 112 Americans die by suicide each day. Suicide is the second leading cause of death among 15\u201324-year-olds, and more than 9.4 million adults in the United States had serious thoughts of suicide within the past twelve months. But suicide is preventable, so it\u2019s important to know what to do.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-2685\" src=\"https:\/\/pressbooks.hccfl.edu\/wp-content\/uploads\/sites\/88\/2024\/03\/Lillium-Nobbs-Piling-Up-scaled-1.jpg\" alt=\"Girl sitting with arms wrapped around knees in distress.\" width=\"768\" height=\"1024\" \/><\/p>\n<p>Piling up<\/p>\n<h4><strong>Warning Signs of Suicide<\/strong><\/h4>\n<p>If someone you know is showing one or more of the following behaviors, he or she may be thinking about suicide. Don\u2019t ignore these warning signs. Get help immediately.<\/p>\n<ul>\n<li>Talking about wanting to die or to kill oneself<\/li>\n<li>Looking for a way to kill oneself<\/li>\n<li>Talking about feeling hopeless or having no reason to live<\/li>\n<li>Talking about feeling trapped or in unbearable pain<\/li>\n<li>Talking about being a burden to others<\/li>\n<li>Increasing the use of alcohol or drugs<\/li>\n<li>Acting anxious or agitated; behaving recklessly<\/li>\n<li>Sleeping too little or too much<\/li>\n<li>Withdrawing or feeling isolated<\/li>\n<li>Showing rage or talking about seeking revenge<\/li>\n<li>Displaying extreme mood swings<\/li>\n<\/ul>\n<h4><strong>Get Help<\/strong><\/h4>\n<p>If you or someone you know needs help, call the National Suicide Prevention Lifeline at 1.800.273.TALK (8255). Trained crisis workers are available to talk 24 hours a day, 7 days a week.<\/p>\n<p>If you think someone is in immediate danger, do not leave him or her alone\u2014stay there and call 911.<\/p>\n<h3>Resources<\/h3>\n<p><a href=\"http:\/\/ok2talk.org\/\">OK2TALK<\/a>\u00a0is a community for young adults struggling with mental health problems. It offers a safe place to talk.<\/p>\n<div class=\"textbox exercises\">\n<h3>Activity<\/h3>\n<h4>Objectives<\/h4>\n<ul>\n<li>Identify the difference between occasional negative emotions and more serious mental health issues, such as anxiety disorder or depression<\/li>\n<li>Explore practices for ensuring mental health and emotional balance in your life<\/li>\n<li>Identify resources for further information and guidance about mental health issues<\/li>\n<\/ul>\n<h4>Directions<\/h4>\n<ul>\n<li>Watch the following Tedx Talk, featuring college student Jack Park.\u00a0In this talk, Jack\u00a0shares his story of living with a mental disorder and revisits some of the ways he found help and hope. He makes the case for seeing\u00a0mental illness in a new light, so that people can begin to address some of the issues associated with suicide, depression, and other preventable mental disorders.<\/li>\n<\/ul>\n<h4 style=\"text-align: left;\">\u00a0\u00a0\u00a0\u00a0 Video: <em>Shedding Light on Student Depression<\/em>, Jack Park TEDx Penn<\/h4>\n<p><iframe loading=\"lazy\" id=\"oembed-2\" title=\"Shedding Light on Student Depression | Jack Park | TEDxPenn\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/ur8TZf6HWSs?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<div id=\"h5p-18\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-18\" class=\"h5p-iframe\" data-content-id=\"18\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Shedding Light on Student Depression, Jack Park TEDx Penn: Transcript\"><\/iframe><\/div>\n<\/div>\n<p>Write a short (1\u20132 pages) response paper in which you address the following questions: What do you think of Jack\u2019s practice\u00a0of changing his \u201cto-do\u201d lists into \u201cwant-to-do\u201d lists? What does he hope to gain from this\u00a0shift? Which coping mechanisms does Jack observe his fellow students using to deal with stress and mental health challenges? What does Jack think is the deeper problem? Why, in Jack\u2019s view, is it hard for people to get help for mental health problems in the same way they might seek help for dental problems? Add your own thoughts\u00a0about the obstacles you think students may\u00a0face in getting help for mental health issues.<\/p>\n<\/div>\n<div class=\"textbox\">\n<h3>Licenses and Attributions:<\/h3>\n<h3>CC Licensed Content:<\/h3>\n<ul>\n<li><a href=\"https:\/\/courses.lumenlearning.com\/suny-collegesuccess-lumen1\/chapter\/mental-health\/\" target=\"_new\" rel=\"noopener\"><strong>Mental Health<\/strong><\/a>: Provided by Lumen Learning, this chapter offers comprehensive insights into mental health, under a Creative Commons Attribution (CC BY) license.<\/li>\n<li><strong>A Bath for the Soul<\/strong> by Brenda Thach: This work is licensed under Creative Commons Attribution (CC BY), offering a reflective exploration on self-care and mental wellness.<\/li>\n<li><strong>Emptiness<\/strong> by Avery C. Swain: Licensed under Creative Commons Attribution No Derivatives (CC BY-ND), this piece delves into the feelings of void and isolation.<\/li>\n<li><a target=\"_new\" rel=\"noopener\"><strong>Stress and Mental Health<\/strong><\/a> by Sergio Delgado: A detailed examination of the relationship between stress and mental health, available under a CC BY license.<\/li>\n<li><strong>Piling Up<\/strong> by Lillium Nobbs: This work is licensed under Creative Commons Attribution (CC BY), discussing the cumulative effects of stress and strategies for coping.<\/li>\n<\/ul>\n<h3>All Rights Reserved Content:<\/h3>\n<ul>\n<li><a href=\"https:\/\/youtu.be\/t7Xr3AsBEK4?list=PLQdWctT0t4veKqW8rTIQ0XlcS_DoCLrGE\" target=\"_new\" rel=\"noopener\"><strong>Sherry Turkle: Connected, but Alone?<\/strong><\/a>: A TED talk provided by Sherry Turkle, exploring how technology impacts our real-life connections and mental health, under the standard YouTube license.<\/li>\n<li><a href=\"https:\/\/youtu.be\/ur8TZf6HWSs\" target=\"_new\" rel=\"noopener\"><strong>Shedding Light on Student Depression | Jack Park | TEDxPenn<\/strong><\/a>: Jack Park&#8217;s TEDx talk on the realities of student depression, offered under the standard YouTube license.<\/li>\n<\/ul>\n<h3>Public Domain Content:<\/h3>\n<ul>\n<li><a href=\"http:\/\/www.cdc.gov\/mentalhealth\/basics.htm\" target=\"_new\" rel=\"noopener\"><strong>Mental Health Basics<\/strong><\/a>: An educational resource provided by the CDC, covering fundamental aspects of mental health, available in the public domain.<\/li>\n<li><a href=\"https:\/\/www.nlm.nih.gov\/medlineplus\/collegehealth.html\" target=\"_new\" rel=\"noopener\"><strong>College Health<\/strong><\/a>: Provided by the National Institutes of Health, this resource offers guidance on maintaining health and wellness during college, in the public domain.<\/li>\n<\/ul>\n<p>Adaptations to the original materials include the removal of images and relocation of learning objectives.<\/p>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-178-1\">\u201cMental Health Basics,\u201d Centers for Disease Control and Prevention<em>,<\/em> 2013, April 22, 2016. <a href=\"#return-footnote-178-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-178-2\">\u201cMental \u00a0Health Basics.\u201d <a href=\"#return-footnote-178-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-178-3\">Rahn Bailey, \u201c<a href=\"https:\/\/ajp.psychiatryonline.org\/doi\/full\/10.1176\/appi.ajp.2015.15040450\">The Social Determinants of Mental Health<\/a>,\u201d <em>American Journal of Psychiatry<\/em> 172, no. 9 (September 1, 2015): 913-914. <a href=\"#return-footnote-178-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":2,"menu_order":17,"comment_status":"open","ping_status":"closed","template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["lumen-learning"],"pb_section_license":""},"chapter-type":[],"contributor":[91],"license":[],"class_list":["post-178","chapter","type-chapter","status-publish","hentry","contributor-lumen-learning"],"part":29,"_links":{"self":[{"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/pressbooks\/v2\/chapters\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/wp\/v2\/comments?post=178"}],"version-history":[{"count":12,"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/pressbooks\/v2\/chapters\/178\/revisions"}],"predecessor-version":[{"id":467,"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/pressbooks\/v2\/chapters\/178\/revisions\/467"}],"part":[{"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/pressbooks\/v2\/parts\/29"}],"metadata":[{"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/pressbooks\/v2\/chapters\/178\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/wp\/v2\/media?parent=178"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/pressbooks\/v2\/chapter-type?post=178"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/wp\/v2\/contributor?post=178"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.hccfl.edu\/blueprint\/wp-json\/wp\/v2\/license?post=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}