Mental health terms

29 terms

Alcohol withdrawal syndrome: Symptoms that usually begin 6–24 hours after a heavy, long-term drinker stops or cuts down: tremor, sweating, tachycardia, hypertension, anxiety and insomnia. Seizures and delirium tremens, the most severe form (typically starting 72–96 hours after the last drink), are life-threatening. Severity is tracked with the CIWA-Ar, and benzodiazepines are the main treatment. Thiamine is given with dextrose to prevent Wernicke encephalopathy.
Anxiety: A state of tension, worry and physiological arousal in response to a vague threat. Mild anxiety can sharpen attention and learning; at moderate levels the perceptual field narrows; at severe and panic levels the person cannot follow directions. Assess the level, speak calmly in short sentences, reduce stimuli, and postpone teaching while anxiety is severe.
Bipolar disorder: A mood disorder in which episodes of mania or hypomania alternate with depression. Mania brings elevated or irritable mood, decreased need for sleep, flight of ideas, impulsivity and risky behavior. For a manic client reduce stimulation, speak briefly and clearly and set limits; offer high-calorie finger foods and enough fluids, and monitor lithium levels and signs of toxicity.
Coping: The cognitive and behavioral efforts a person uses to manage stress. Problem-focused coping acts on the stressor itself (seeking information, making a plan); emotion-focused coping eases the feelings it causes (talking, relaxation, prayer). Adaptive strategies solve the problem or reduce distress; maladaptive ones, such as substance use or withdrawal, add to the problems. Ask what has worked for the client before and build on it.
Crisis intervention: Brief, focused help given during an acute crisis, when usual coping fails, to keep the person safe and help them return to their pre-crisis level of functioning. Assess safety and the risk of suicide or violence first; then define the problem, mobilize the person's strengths and supports, and make a concrete, achievable plan.
De-escalation: Using verbal and nonverbal techniques to lower tension with an agitated or angry person before aggression occurs. Keep a safe distance and a clear exit, speak calmly and quietly in short sentences, acknowledge the feeling, offer choices and avoid threatening body language. Restraint or emergency medication is a last resort, used only when these measures fail.
Defense mechanisms: Mostly unconscious psychological strategies people use to protect themselves from anxiety, such as denial, projection, displacement, rationalization, regression, repression and sublimation. Used briefly they can aid adjustment; used rigidly they block coping. For example, a client who refuses to accept a new cancer diagnosis is using denial; do not force it down, but move at the pace the client is ready for.
Delirium: An acute disturbance of attention and awareness that develops over hours to days and fluctuates during the day. It has an underlying cause such as infection, drugs, fluid or electrolyte imbalance, hypoxia or alcohol withdrawal, and is often reversible. It is common in older adults and can be mistaken for dementia. Screen with a tool such as the CAM, report the change, and support orientation, sleep, glasses and hearing aids, and safety.
Delusion: A fixed, false belief held despite clear evidence to the contrary and not explained by cultural or religious beliefs; types include persecutory, grandiose, referential and somatic. Neither argue with nor support the delusion: focus on the underlying feeling, such as fear, build trust and steer the conversation toward reality-based topics.
Dementia: A gradual, progressive decline in memory, language, orientation and executive function that interferes with daily life; Alzheimer disease is the most common cause. Unlike delirium, awareness is clear and the decline develops over months to years. Provide a consistent routine, simple one-step instructions, a safe environment and measures against wandering, and assess and support caregiver burden.
Eating disorders: Serious mental illnesses involving disturbed eating behavior and body image: in anorexia nervosa, markedly low body weight and fear of weight gain; in bulimia nervosa, binge eating followed by compensatory behaviors such as vomiting or laxative use; in binge-eating disorder, bingeing without compensation. Electrolyte imbalances and arrhythmias can be life-threatening. During refeeding, monitor electrolytes, especially phosphate, closely for refeeding syndrome.
Erikson's stages of psychosocial development: Erikson's theory that divides development across the lifespan into eight stages, each with a psychosocial crisis to resolve: trust vs mistrust (infancy), autonomy vs shame and doubt, initiative vs guilt, industry vs inferiority, identity vs role confusion (adolescence), intimacy vs isolation, generativity vs stagnation and integrity vs despair (older age). Fit communication and teaching to the person's stage.
Extrapyramidal symptoms: Movement disorders caused by dopamine blockade, especially with first-generation antipsychotics: acute dystonia (sudden, painful muscle spasms, e.g. of the face, neck or larynx), akathisia (distressing motor restlessness), parkinsonism (rigidity, slowed movement, tremor) and, later, tardive dyskinesia (involuntary lip and tongue movements), which can be permanent. Screen regularly with tools such as the AIMS; acute dystonia affecting the airway is an emergency.
Hallucination: A sensory perception with no real external stimulus, most often auditory. Command hallucinations are asked about specifically because they can lead clients to harm themselves or others. Neither argue with nor validate the hallucination: acknowledge what the client is experiencing and feeling ("I know you hear voices, but I do not hear them"), redirect to reality and keep everyone safe.
Major depressive disorder: A disorder in which depressed mood or loss of interest or pleasure lasts at least two weeks, with changes in sleep, appetite, energy and concentration, feelings of worthlessness or guilt and thoughts of death, impairing function (at least five of nine symptoms in DSM-5-TR). Ask directly about suicide, support self-care, nutrition and sleep, and monitor adherence. Suicide risk can rise as energy returns after antidepressants are started.
Maslow's hierarchy of needs: A humanistic model that ranks human needs from the bottom up: physiological needs (air, water, food, sleep), safety, love and belonging, esteem and self-actualization. Higher needs usually take priority only once lower ones are met. Nurses use it to prioritize: physiological and safety needs, such as airway, breathing, circulation and safety, come before psychosocial needs.
Milieu therapy: Structuring the physical and social environment of a psychiatric unit as a treatment tool. A safe, predictable setting with clear rules, daily activities, community meetings and shared responsibilities builds social skills and coping. Maintain safety on the unit, organize routines and encourage clients to join activities.
Neuroleptic malignant syndrome: A rare but life-threatening reaction to antipsychotic drugs that can occur at any time during treatment. High fever, muscle rigidity, altered mental status, autonomic instability (tachycardia, labile blood pressure, sweating) and a raised creatine kinase are typical. Hold the antipsychotic and notify the prescriber at once; cool the client, support hydration and closely monitor vital signs and electrolytes, as acute kidney failure can occur.
Panic attack: A sudden surge of intense fear that usually peaks within minutes, with palpitations, dyspnea, chest pain, trembling, sweating, dizziness and fear of dying or losing control. Recurrent unexpected attacks with worry about further attacks suggest panic disorder. Because symptoms can feel like a heart attack, physical causes must be ruled out. Stay with the client and guide slow breathing with calm, brief instructions.
Piaget's stages of cognitive development: Piaget's theory of four stages through which children's thinking develops in order: sensorimotor (birth to 2 years; object permanence), preoperational (2–7 years; symbolic, egocentric thinking), concrete operational (7–11 years; logic about concrete things, conservation) and formal operational (11 years and over; abstract reasoning). Explain a procedure to a preschooler with simple words and play, and to a teenager with reasons.
Post-traumatic stress disorder: A disorder lasting more than a month after exposure to a serious traumatic event, with re-experiencing (flashbacks, nightmares), avoidance of reminders, negative changes in thinking and mood, and hyperarousal (startle, insomnia, angry outbursts). Provide a safe, calm and structured environment, use a trauma-informed approach, support relaxation and coping skills, and assess suicide risk.
Schizophrenia: A chronic psychotic disorder that impairs reality testing. It involves positive symptoms (hallucinations, delusions, disorganized speech and behavior), negative symptoms (blunted affect, avolition, social withdrawal, alogia) and cognitive impairment. Antipsychotics are the mainstay of treatment. Monitor adherence and side effects, gently present reality, and support daily living skills and family education.
Stigma: Negative stereotypes, prejudice and discrimination directed at people with mental illness or another health condition; when people turn it on themselves it is called self-stigma. It discourages help-seeking and treatment adherence. Use person-first language ("a person with schizophrenia" rather than "a schizophrenic"), examine your own attitudes and raise awareness in the community.
Stress: The body's and mind's response to a situation seen as taxing or exceeding a person's coping resources. Selye's general adaptation syndrome has three stages: alarm (the fight-or-flight response, with a rise in heart rate, blood pressure and blood glucose), resistance and, if stress persists, exhaustion. Long-lasting stress weakens immunity and slows healing; assess stressors and stress signs and support the client's coping.
Substance use disorder: Uncontrolled, persistent use of a substance despite harm, marked by craving, loss of control, tolerance, withdrawal and impaired social or occupational function. Alcohol, opioids, stimulants, cannabis and sedatives are commonly involved. Take a nonjudgmental use history, watch for intoxication and withdrawal, and give information on harm reduction and treatment options.
Suicide risk assessment: A systematic assessment of suicidal thoughts, plan, access to means, previous attempts and protective factors. Asking directly ("Are you thinking about killing yourself?") does not increase risk; it gives the client a chance to talk. When risk is high, do not leave the client alone, remove items that could be used for harm, maintain close observation and build a safety plan together.
Therapeutic communication: Purposeful, client-centered communication that helps clients express thoughts and feelings, understand their problems and cope. Core techniques are active listening, open-ended questions, reflecting, clarifying, using silence and summarizing. False reassurance ("Do not worry, everything will be fine"), giving advice, judging and asking "why" all block communication.
Therapeutic nurse-client relationship: A purposeful, professional relationship focused on the client's needs, with clear boundaries. Peplau described orientation, working and termination phases; termination is planned from the first meeting. Trust, empathy, respect and consistency are its foundation. Avoid boundary violations such as oversharing personal information or accepting gifts.
Trauma-informed care: An approach that assumes many clients may have experienced trauma and aims to prevent retraumatization. Its principles are safety, trustworthiness and transparency, peer support, collaboration, empowerment and choice, and cultural responsiveness. Explain procedures before doing them, ask permission, give the client control and choices, and avoid coercive practices.