talking about mental health and mental illness
fundamentals part one so there's obviously two parts to this and this is based on the
surgeon general's report on mental health in this presentation we're going to explore the
neuroscience of mental health how mental illness manifests itself we'll learn about the prevalence
and epidemiology and the costs of mental illness a little bit we're not going to go into that a lot
because it's you know not all that interesting we'll explore the biological psychosocial and
individual risk factors for mental illness and review the differences between correlation
and causation in order to determine consequences so let's start with the neuroscience of
mental health and one of the things that you know it's really important to remember is that
a lot of our feelings our emotions our ability to think and perceive things occurs in the brain
you know so if your brain is not healthy and happy then it's going to be hard to feel healthy
and happy and concentrate and do all that stuff so you know we want to focus on this
and i'm not going to get deep into the details with the diagrams of the
axons and the dendrites and all that because you know that's really technical and
we're just going to hit the highlights today the working of the brain depends on the nerve
cells being able to communicate with each other well that makes sense now there are two different
things that impact that structural and nutritional is kind of how i categorized it structural means
you know if a neuron gets damaged in some way if it gets burned up if it gets injured in
a traumatic brain injury something like that it could cause a problem with the neurons
communicating with one another nutritional is when the neurons um don't have the nutritional
components necessary to make the neurotransmitters and to secrete them into the synaptic space
each neuron makes over a thousand connections so one neuron is really important and we have like
billions of neurons in our brain so it's important to recognize that each one has over a thousand
connections one of the cool things to recognize though is also the fact that well it has 1 000
connections since there are billions of neurons if one goes a little wonky then there is a
workaround which is why a lot of people with traumatic brain injury are able to or after
stroke can can redevelop a lot of the skills and things that they had if not all of them
before that brain injury now the frontal lobe is involved with our motor behavior it's involved
with how we physically react to situations the prefrontal cortex which you know you
can kind of think of as your forehead is responsible for planning and integrating
cognitive and emotional streams of information which is a really fancy way of saying it takes how
we're thinking about something and helps us figure out how we feel about it so if we're thinking
about something as scary then we're going to have an emotional reaction which is fear and it's
going to synthesize those two things together if we're thinking of something as exhilarating
then it's going to synthesize that too so you know the example i usually give is roller
coasters i'm terrified of roller coasters some people love them we can look
at the same exact roller coaster and have two very different emotional reactions
based on our cognitions our thoughts about the roller coasters the other thing that's important
to remember in neuroscience is the brain continues to develop until you're about 25 that impulse
control area is still developing until about 25. so we want to make sure that in this development
process the brain has all of the abilities through good sleep and adequate care and good nutrition
and all that stuff to develop as fully as possible they found that a lot of the brain
injury that occurs as a result of chronic stress trauma and substance
use is actually significantly worse in people who experience those things before the
age of 25 because the brains still developing so that just throws a monkey and monkey wrench
into the works so you know we do want to look at the timing of some of these stressors in
addition to just the stressors themselves so electrical signals from the neuron are
converted into chemicals called neurotransmitters so neuron the the ascending neuron basically
secretes neurotransmitters into the space between neuron number one and neuron number
two the neurotransmitters are released from the sending neuron into the space and they attach
like a key into a lock called a receptor on the receiving neuron so the receiving neuron passes on
that that signal and it's kind of like that game you used to play when you were a kid telephone
you know everybody would pass along the message well if there's a breakdown in the system
if there's not enough neurotransmitter the wrong neurotransmitter goes through then you know
there's going to be a breakdown in the system and how people feel think or react the more receptors
that are stimulated the more intense the reaction so if a little bit of neurotransmitter is secreted
and only two or three receptors are stimulated that's going to be a pretty low reaction if 50 or
16 receptors are stimulated that's going to be a more intense reaction so for example when somebody
takes cocaine you know that is an excitatory drug that we take it secretes the excitatory
neurotransmitters like glutamate into that synaptic cleft so then the receptors it's just
flooded and that just floods into the receiving neuron and it finds every single lock that's
available so the person gets this like supercharge of excitement the excitatory neurotransmitters
include norepinephrine and glutamate and this is really pretty overly simplistic
because most neurotransmitters are involved in a lot of things and we have other videos on
the all ce used education channel at all ceus.com youtube about um neurotransmitters and
neurobiology so you can get into the depths of that a little bit more if you want
to inhibitory or calming neurotransmitters include gaba which is our main common
neurotransmitter and to some extent serotonin and we hear a lot about serotonin in terms of it
being an antidepressant it is also an anti-anxiety neurotransmitter serotonin also is responsible
for a lot of other things including libido and appetite and pain perception and heart rate it has
14 at least different functions in the body other neurotransmitters that we hear about a lot include
dopamine and dopamine has at least five functions it is our pleasure chemical so if we secrete a
lot of dopamine that it's going to tell us do that again it helps us concentrate and learn and
it motivates us so dopamine is really important acetylcholine you know that's another one of
those neurotransmitters it's more involved in schizophrenia um endorphins are our natural
opiates so we have those going in there and endorphins help us not feel pain as much and feel
a little bit happier and substance p is one that we're learning about now and you know we've just
started to learn about over the past 20 years but it is responsible in part for pain regulation
anxiety regulation and stress management neurotransmitter availability is impacted by the
presence of other neurotransmitters and hormones and i'm going to show you a couple diagrams in a
couple of minutes but neurotransmitters if there is cortisol in the system which is a hormone that
is our stress chemical and our stress chemical is telling our body fightfully protect yourself so
it is going to basically shut down or reduce the availability of things like gaba and serotonin
because the body is trying to fight or flee the presence of certain hormones if you
have um not enough estrogen or not enough testosterone it impacts the availability of
serotonin so everything is interconnected we can't just say you know we want to
increase serotonin we need to look at what's causing serotonin to be low or
what's causing gaba or dopamine to be low the other thing that impacts the strength
of the neurotransmitter is the quality and quantity of it so if you're not eating a good
diet and i'm not talking about being a super nutrition freak i'm just talking about getting
some basic proteins in there and some vitamins if you're not eating a quality diet your body
can't make the neurotransmitters if it can't make the neurotransmitters it can't secrete
the neurotransmitters so you're not going to feel as much you're going to feel flat blah
or you're only going to feel or really feel intensely the neurotransmitters that your body
does have the building blocks to make vitamins and minerals help break down amino acids which are
proteins to make neurotransmitters and again i'm going to show you a diagram in a second so it's
important to understand that you can't just have crap you know crap in produces crap out so we
want to make sure that you're getting something relatively healthy but without proper nutrition
and adequate stress management remember we want to keep that cortisol from disrupting the whole
system the neurons will not be able to function effectively so we need to make sure that the
neurons are not disrupted by too much stress and too much cortisol and that they have the building
blocks to make the new neurotransmitters that'll help us feel happy and calm so here's the first
diagram and this is how serotonin and melatonin are made tryptophan is a protein that we eat
and it's available in you know most any food so it's not like it's hard to get tryptophan but
tryptophan requires iron magnesium calcium vitamin b6 and folic acid to be converted or broken down
into something called 5-htp which is a precursor of serotonin okay so we have 5-htp
that's kind of like you know raw fuel it still has to be distilled down to make the
stuff that we put in our car so 5 htp has to have vitamin c vitamin b6 zinc and magnesium
in order to be broken down to make serotonin okay so now we have serotonin and serotonin
is responsible for like i said a lot of things libido appetite sleep um pain perception as well
as depression and anxiety and other things so if you don't have enough serotonin you may have gut
and heart problems you may have sleep problems cravings for carbohydrates alcohol and
other certain drugs and fibromyalgia and other pain conditions when your serotonin
level is low your pain tolerance is lower the other thing with serotonin is it is broken
down to make melatonin and melatonin is our sleep hormone so if you don't have enough serotonin
you're probably not going to be sleeping well which puts you in a state of stress your body says
you're exhausted you don't have the energy to go you're kind of the the weak lion and the pride
and you're going to be the one that's going to be killed first so you need to be alert um and and
our body operates on a very primitive survival mechanism or thought process like that so when
you're stressed your hpa axis your hypothalamic pituitary adrenal axis or your threat response
system because that's a lot easier to say gets activated so when you're under stress because
you're in pain you're injured you're sick or you're just stressed out the brain tells the body
to release cortisol which is your stress hormone and adrenaline which is your get up and go hormone
all right sounds like a good plan if you're under stress you need to get stuff done so these things
cause the release of glucose which is blood sugar that's great gives you the energy to get the stuff
done it suppresses sex hormones because right now you're under stress it is not the time to be
procreating it's the time to be protecting your own self and it also suppresses serotonin it
suppresses serotonin because you are under stress right now your body perceives a threat of some
sort so it doesn't want you relaxing it doesn't want you chilling out it wants you activated so
it suppresses serotonin which is can be a calming neurochemical so what does all that do well
that means that you have very little libido and when your serotonin is
suppressed your anxiety can go up and your depression can go up your you don't have
as much melatonin so you're not getting as much sleep so you're going to start to feel fatigued
and you may feel start feeling more irritable well when you're fatigued and feeling irritable
then that generally leads back and intensifies the body's threat response so you get in this
negative cycle here and you have to figure out how to break it so all of these things play
together that it's really important to recognize you can't just pluck out one thing and go oh let's
just increase this and everything will be fine that may not be it in a lot of my other classes
i talk about making a good marinara sauce when you're making a good marinara sauce you have
basil parsley oregano garlic onion um fennel you have lots of different spices and if you taste
it and it tastes a little bit off it doesn't just mean let's just add some more oregano because
oregano may enhance the flavor of a couple other spices in there so then those spices are
too strong and you've got to play them down so it's a gentle balancing act between
all of the spices in the marinara sauce just like it's a balancing act between
all the neurotransmitters in the brain so when people's brains are
not functioning optimally when they don't have adequate neurotransmitters
they may start to feel depressed anxious angry or they may start experiencing something
more severe such as psychosis or dementia so let's talk about how does mental
illness manifest because this is really important a lot of times people think of mental illness at
its late stages and if we pick up on the signs of mental illness and i really hate the term
mental illness because it's so pathologizing but if we pick up on the signs of depression
and anxiety and that kind of stuff early then we can prevent it from causing ripples of
problems so what does it look like think about when you're anxious you know you may have rapid
heart rate you may have muscle tension you may feel light-headed those are all stress reactions
those are all cortisol and and adrenaline reactions that result when your body perceives
stress of some sort and it can lead to anger it can lead to anxiety just kind of depends on
whether you choose to fight or flee the situation but these are signs that you know you're not happy
fatigue is common it can be common in anxiety when you're anxious for so long at a certain
point your body goes i can't win this fight so it stops devoting as much energy to that when
you're anxious for too long remember on that last slide when you're anxious your body is not
letting you get good quality sleep it's kind of like a soldier sleeping in a foxhole you may doze
off but it's not going to be good quality sleep because you got all that cortisol running through
your system so eventually you're going to get fatigued if nothing else just from lack of quality
sleep you may have appetite changes some people have no appetite at all you know food just makes
them sick other people start craving carbohydrates and things like that remember when on that last
slide if you don't have enough serotonin you may start having cravings for carbohydrates alcohol
and certain drugs well when you're under stress your body is suppressing serotonin so guess what
you may start craving carbohydrates especially you may have dysregulation of mood and i've
never really liked that term but it means you have excessive anxiety or fear or excessive
irritability or anger or depression and what's excessive is what starts being
problematic for you or what lasts for more than you know a couple of days we
all experience these emotions when something happens we can feel anxious
or angry or when we lose something important we can feel depressed and those are normal
emotions i don't want you to get the idea that we don't want to feel those things because we do
we want to feel the full range of emotions though so when it becomes too much when it starts
interfering with your relationships and your motivation and your work and all that other
stuff then we need to start taking a look at it cognitive dysfunction is another thing that can
be an example of mental illness if you start having difficulty with memory or concentration
now norepinephrine and dopamine are two of your neurotransmitters that are involved with memory
and concentration and when people get anxious when they get depressed or when they start
having other problems mental health problems memory and concentration are some of the first
things to go so you do want to pay attention after a baby for example you know i had what i
called mommy brain for the first year you know i wasn't sleeping as much as i would have liked to
um and and i would walk into a room and couldn't remember what i walked in there for you know i
was 28 it wasn't like i was you know 68 or 78 and but the difficulty with memory
and concentration was more because of my fatigue and that system not working as
efficiently as it could other things like deficiency of thiamine can
cause alcohol-related dementia which can make it difficulty for people to
remember or concentrate or function in daily life and finally disturbances of thought and perception
such as hallucinations thinking you see hear taste or feel something that's really not
there and delusions and those are like um delusions of grandeur you think you are you know
god or you think you're the president or whatever or you can have delusions of persecution where
you think spies are chasing you so there are a lot of disturbances of thought and perception
but to most people that hear those they're going yeah i'm not thinking so um but to the person
who is experiencing those disturbances of thought and perception they make perfect sense so you
can't rationalize with somebody who's having hallucinations or delusions you just need to
accept that they're in a different space right now these are all things we want to be on the lookout
for in ourselves too think about when you start getting burned out at work or you start getting
to a point where you might be depressed that's the time you want to intervene what symptoms do
you have you know i know i tend to get a lot of muscle tension my neck hurts a lot i'm fatigued i
crave carbohydrates you know i know i'm going down a bad road um if i continue doing what i'm doing
and i don't step back and say what needs to change so anxiety is one of those mood disorders
that we talk about and a lot of people have when you experience something that triggers
the fight or flight response you can either feel anxiety which is the flight response it says
get me the heck out of here or the fight response which is saying either i can't get out
of here so i need to protect myself or i am going to conquer this threat
either one is in response to a threat obsessive compulsive disorder panic disorder
and phobias all kind of fall under this anxiety umbrella one thing that's interesting
about obsessive-compulsive disorder is it has components of anxious emotions so it has an
emotional component obsessional thinking so it has a cognitive component and behavioral compulsions
when people have ocd they start getting very very worried and very very anxious that something bad
is going to happen if they don't do something and in order to make those thoughts go away they have
to do that like check the door or check the stove and and that helps them feel a little
bit calmer for a short period of time so let's talk a little bit about how common
are mental illnesses or mood disorders according to the cdc and the surgeon general about
20 of the us struggles with a mental illness in any given year and this is true for adults and
children that think twenty percent doesn't sound too bad but when you think of it in terms of
numbers that means one in five people so look around your office look around your church look
around your own household if you've got more than five people in the household there's a chance that
one of those people may experience mental illness in this 12-month period that's a lot and that
doesn't mean 20 percent of the population over here will ever experience it that means in
one year so those 20 may experience it in 2017 and then you know five percent of them get better
and then another five percent experience it in 2018.
So a lot of people are going to be touched
by mental illness at some point in their life in 1996 over a hundred billion dollars was spent
as a direct cost of mental illness in the u.s now direct cost relates to hospitalizations uh
medical treatment those sorts of things indirect costs are costs such as you know employers who
lost productivity from employees it's estimated that greater than 45 percent of people will
experience an addiction in their lifetime now i'm not necessarily talking to drugs or alcohol
you know it can be sex addiction it can be smoking it can be food issues or it can be alcohol
or drugs there are a lot of different addiction or addictive behaviors out there but it's estimated
that nearly half of people will experience one in their lifetime so we need to be aware of
that because it doesn't matter what kind it is it negatively impacts the person's life that
by definition for it to be an addiction it has to negatively impact the person
in two or more areas of their life so well that sounds kind of all depressing what
do we know well we know that there are risk and protective factors and those factors can be in
the individual they can be in the person's biology or they can be in the psychosocial realm
which kind of encompasses their environment their friends and all that other stuff well that's
great so there's all these risk and protective factors so why don't we know what causes it well
because we've never been able to find a one-to-one causation where we can say if this happens
then this person is definitely going to develop an addiction or become depressed
we have a lot of information out there and we're going to talk about these risk
and protective factors in a few minutes but it's important to recognize that correlation
means you know it's more likely if the person has you know certain genetic characteristics like a
family history of depression and they're exposed to trauma when they're a child then they have a
stronger chance of developing depression or ptsd it doesn't mean it can it will happen
there is you know a lot of variation there so causation we don't know
correlation we're quite sure of causes of health and disease are
generally viewed as a product of the interplay or interaction between biological
psychological and socio-cultural factors according to the biopsychosocial model one factor
by itself may not weigh in very heavily but the combination of factors are exponentially additive
which means you may have a genetic predisposition but if you've got a great environment when you're
growing up and you've got good self-esteem and you take care of yourself that genetic predisposition
may not ever show itself but if you have a genetic predisposition an unhealthy environment and
you know you have low self-esteem for example all of those things together may add up to
finally cause that problem to express itself mental disorders arise in part from defects
not in single genes but multiple genes so they found a lot of physical problems that have
occurred as a result in defects in a single gene so they can look on the on the dna and they
can go that one you know that's a problem mental disorders we haven't found a causation
we haven't found a gene that we can say if the person has this gene they're going to get
develop depression we've also haven't found a correlation a strong correlation where we can
say if they have that one gene then there's a strong chance they'll develop depression there
are multiple genes that have to be interacting mental illness appears to result from the
interaction of those multiple genes that confer risk so a person may have genes to have a
more irritable or fussy temperament as a child in addition to a genetic predisposition or a genetic
inheritance of certain genes related to depression so there's a lot of stuff that goes in there
one thing that's good to know is that no gene is equivalent to fate for mental illness so
we're not going to look at the dna and go you're definitely going to develop schizophrenia
or you're definitely going to develop depression we can't say that there are modifiable
environmental risk factors which can become targets for prevention efforts and we're
going to talk about those in a couple slides even with a high level of heritability such as
schizophrenia it's essential to point out that environmental factors such as environment
nutrition and health care access play a significant role in the severity and course of
the disorder again not everybody who inherits a gene for a mental health disorder like
schizophrenia that does tend to have high heritability will necessarily develop
it if they have a really good environment infectious agents can penetrate into the brain
where they can cause mental disorders so this is one of those risk factors that is generally
modifiable we do want to protect ourselves from as many viruses and infection infectious agents
as possible some examples include hiv-associated dementia which happens because the immune cells
in hiv get you know messed up and they're called macrophages and they indirectly call cause the
death of nearby neurons because they release toxins as they're trying to destroy you know
the virus and other things so you know it's kind of the the byproduct kind of like the gas
or not the gas but the um what am i thinking of the exhaust that comes out of our car the
byproduct is what's killing these nearby neurons herpes simplex encephalitis sometimes when
people get herpes it can migrate to their brain and cause their brain to swell measles and
encephalitis can cause the brain to swell rabies encephalitis you know all of these obviously
are penetrating into the brain and causing physic physiological disruption
in the neurons in the brain and there's also a new classification of obsessive
compulsive disorder called pandas or pediatric autoimmune neuropsychiatric disorders associated
with streptococcal infection which basically means the kid got strep and the strep went to the brain
the strep infection somehow manages to attack a part of the brain called the basal ganglia which
results in ocd or obsessive-compulsive disorder symptoms so what can we do and i said we're going
to talk about risk factors but i changed my mind and we're going to talk about protective factors
adequate prenatal care let's make sure when the fetus is in there it's getting everything
it needs and it's not exposed to things like alcohol drugs or viruses including
toxoplasmosis that can potentially cause brain injury adequate medical medical care once
the child is out of the womb we need to make sure that they are not exposed to those viruses and
if they have a head injury they get treatment etc and this is true for adults too you know any of a
lot of these things can happen when you're adults herpes simplex encephalitis or hiv-associated
dementia you know we can get herpes we can get hiv or if you're not vaccinated even measles
when you are older and it can cause brain damage and poor hygiene and health practices you know
wash your hands so you're not getting those potential harmful agents in your body get enough
sleep and eat enough good good nutritious foods so your brain can do its job we
need to keep the brain healthy and those are the ways to protect
yourself biologically psychosocial protective factors now i'm going to start out
with young children because they're unique young children need attachments to responsive
caregivers so it's really important that they have a caregiver or several caregivers that are
responsive and comforting and all that kind of stuff that goes a long way to the development
of trust and self-esteem and self-efficacy you can learn more about that in
our videos on child development and they need to have consistency in rules and
parental supervision so they need to understand the environment and under feel like they've got
some control in what's going on now for all people from infants through elderly we need a safe
nurturing somewhat stimulating environment safe from physical harm say from emotional harm
it needs to be nurturing so we have friends we have family we have people that care about us
and stimulating enough to kind of keep our brain working because if you don't use it you lose
it and they've done a lot of studies that have found in the elderly population those people who
stay more cognitively engaged and more physically engaged tend to have fewer signs of dementia and
cognitive decline we want to protect everybody from abuse and neglect not only does that hurt
self-esteem and mood and produce a lot of anxiety and stress but it can cause physical damage to the
brain we want to protect people from abandonment and life stress now life stress happens but we do
want to try to mitigate that as much as possible and and protect them from feelings of abandonment
so they always have hopefully somebody they can rely on we want to protect people from being
in a household with a member that has a mental illness or substance use disorder when you're
in a household with somebody with depression it can be exhausting it can be depressing
it can be frustrating it can be a lot of unhappy type emotions so we do want to make sure
that if you're living with somebody with mental illness or substance use disorder you have support
outside of the home and household conflict and family dysfunction increases everybody's stress so
we do want to make sure that we're addressing that we want to make sure people have consistent
support positive peer relationships school and work success and some sort of
a sense of control over their environment for individuals we want to look at you know
what things may contribute well you can't really contribute control whether you were a full term
or a premature birth that that just happened but that is one of those individual characteristics
if a child is born premature you know all of the stuff didn't finish linking up before they were
born and the more premature they are the more likely they are to have difficulties which can
lead to developmental delays so it's important that this person receives early intervention
for developmental delays which may be genetic um because of down syndrome or something else
or illness related children who have lots of ear infections often have developmental
delays which can cause them to struggle in school and in peer relationships and it's been
linked to increases in depression and anxiety and prematurity is also in there it's not really
an illness or genetic but we do want to make sure that early intervention is available physical
disabilities people need early intervention and you know children can be born with them but
they can also be acquired at any stage in your life and when people lose the ability
to function in some way if they lose their sight or lose the use of an arm or whatever
it is it has a significant impact on their sense of of self it also results in a period of
grieving and some anger and and some other stuff that we need to help people work through or people
need to work through it but it's important that people recognize if i develop a disability or if
my child is born with a disability you know we're gonna have to figure out how that person can
learn to accept and embrace that disability as you know being differently abled comorbid mental
health issues we want to look for them sometimes a child may be born with you know mental health
issues and start showing signs of depression or anxiety or ocd or adhd at a very young age it's
not super common but the earlier we catch it the earlier we can provide intervention and prevent it
from having a ripple effect on their development temperament you know everybody has different
preferences for the types of environment they like to be in if people are aware of their
temperament then they can put themselves in environments that are in line with what they
prefer for example you know extroverts tend to be like like to be around a lot of people they draw
energy from other people whereas introverts don't and my daughter is an introvert and we'll go to
martial arts or she'll go to a picnic or something and she'll come home and she's like okay two hours
of extroverting was plenty for me today and she will just want to go to a room and draw or you
know sit on the couch and veg for a little while because it's draining for her but she recognizes
that so if she has to go into a situation that adds a little bit of stress she recognizes it
and then takes care of herself before and after so knowing your temperament doesn't mean you
can always be in your preferred environment but it means you know what's going to be stressful
so you can save up energy leading into it and you can take care of yourself afterwards which
helps prevent exhaustion frustration depression anxiety a high self-esteem is great because it
means you feel good you're not relying on somebody else to tell you you're okay so developing a
high self-esteem in children is awesome but if it didn't happen when you were a kid no harm no fat
well a little bit of harm but it's not irreparable people can develop their self-esteem as adults
and getting adequate nutrition and sleep again so the body can do what it needs to do those are all
things the individual can do to protect themselves so mental health is largely impacted
by the functioning of the brain and the learning experiences of the person
so remember i referred to the roller coaster you know i look at a roller coaster and i'm
terrified somebody else looks at a roller coaster they think wow that's really awesome i'd love to
do that i look at a dog running towards me barking and i'm like oh sweet puppy somebody else may
look at a dog running towards them barking and carrying on and be like that dog's going to eat me
so it's all based on our learning experiences that we process and then our brain figures out
how we're supposed to respond either with a calm response or a stress response damage to
the brain itself or problems in neurotransmitter functioning can lead to mental illness
if certain parts of the brain get damaged irreparably especially large
parts not just a single neuron people can experience more apathy
depression anxiety or impulse control issues biological protection includes proper prenatal
care and avoidance of viruses and substances which can harm the fetus or your own brain
harm your brain such as hiv or hepatitis or um herpes psychosocial protection includes ensuring a
safe supportive environment and the development of healthy coping skills this can happen at any
age we all need a safe supportive environment and you know most of us could use a little
help with our coping skills once in a while because life will sometimes throw us more than
we can handle and that's when we grow individual protection includes good health behaviors
development of self-esteem and this is an ongoing process we should even as adults
we should be working on ensuring that we're developing our self-esteem and we feel good
about ourselves understanding one's temperament and needs and receiving early intervention for
any traumas developmental delays or disabilities so again early intervention doesn't necessarily
just mean childhood it can be you know if there was a trauma you were in a car accident
and you know it was a traumatic experience getting early intervention for that can be
vital to preventing the development of ptsd does it mean that everybody who experiences
a trauma has to go to counseling no it's important for that person to check in and say
what resources do i have what do i need and can i manage this on my on my own but they provide early
intervention for themselves and if they realize they need more help than they've got available
personally then they can reach out for counseling other videos that relate to this are on
youtube remember i said you go to all ceus.com youtube and i have three different
playlists one's on self-esteem development one's on child development and
one's on infant toddler development and all of those can be useful we also have
videos on depression and ptsd and other things if you're interested all right well thank you for
joining me today and i will see you on thursday
