CVMA-ACMV

Mental Health Illness Checklist

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Mental Health Illness Checklist

 

The Public Health Agency of Canada defines mental illnesses as alterations in thinking, mood or behaviour associated with significant distress and impaired functioning. They result from complex interactions of biological, psychosocial, economic and genetic factors.1 Mental illnesses can affect individuals of any age; however, they often appear by adolescence or early adulthood. There are many different types of mental illnesses, and they can range from single, short-lived episodes to chronic disorders. It would be impossible to cover all types in this checklist document. As such, the checklists will focus on anxiety disorders, mood disorders including major depression and bipolar disorder, substance related disorders, and psychotic disorders with the intent to help recognition of self and others. Each person is different and will have unique signs and symptoms, but these are some of the more common signs and symptoms for each mental health problem.

Anxiety

Anxiety disorders are characterized by excessive and persistent feelings of nervousness, anxiety, and even fear which interfere with an individual's everyday life for an extended period of time.

Signs and symptoms of anxiety2,3

Psychological include:

  • Excessive worry
  • Feeling keyed up, on edge
  • Irritability, impatience
  • Fear, sense of doom or imminent danger
  • Difficulty relaxing 
  • Feeling detached from oneself
  • Mind racing or mind going blank. Difficulty concentrating or paying attention
  • Seeping poorly. Difficulty falling asleep. Vivid dreams

Physical include:

  • Heart palpitations, chest pain, rapid heart rate, flushing
  • Hyperventilation, shortness of breath
  • Dizziness, headache, vertigo, tingling or numbness of the skin
  • Dry mouth, choking, stomach pains, nausea, vomiting, diarrhea
  • Muscle ache and tension, restlessness

Behavioural include:

  • Obsessive or compulsive behavior
  • Distress in social situations
  • Avoidance of situations

If you’re wondering how to learn more about signs and symptoms of anxiety and how to help someone with anxiety, check out: mentalhealthfirstaid.org/2018/12/how-to-help-someone-with-anxiety


Mood disorders

Mood disorders are characterized by the lowering or elevation of a person's mood and interfere with an individual's everyday life for an extended period of time. There are two main forms of mood disorders – depressive and bipolar.

Signs and symptoms of depression2

Physical include:

  • Looking sad, dejected, or anxious
  • Loss of interest or pleasure in usually enjoyed activities
  • Looking unkept.
  • Change in weight or appetite
  • Speaking slowly in monotones
  • Slowed thinking and body movements or agitation, unable to sit still, pacing or hand-wringing
  • Poor concentration and difficulty making decisions
  • Decreased energy, tiredness and fatigue
  • Sleep disturbances

Attitudes and words include:

  • Feelings of guilt, worthlessness, helplessness or hopelessness
  • Sense of worthlessness, guilt, blame
  • Using words like “I’m a failure”, “I am so alone”, “There is nothing good out there”, “I have let everyone down”
  • Thoughts of death

The Goldberg Depression Scale4 screens for depression. It is not intended to diagnose depression. If a person rates high on this scale, a professional assessment can accurately diagnose whether the person has clinical depression. It also includes a scale for anxiety. 

Signs of bipolar disorder

People with bipolar disorder have extreme mood swings and experience periods of depression and mania, often with extended periods of “normal” mood in between. 2

Signs and symptoms of depression in bipolar disorder2

During episodes of depression the person has some or all the signs and symptoms listed above in depression. There may be days, weeks, or years between the manic and depressive episodes, or they may occur one right after the other. 

Signs and symptoms of mania in bipolar disorder1,2,5

  • Increased energy, talking or moving. Inappropriate excitement
  • Elevated or elated mood. Feeling on top of the world, feelings of invincibility
  • Less need for sleep
  • Irritability or excessive anger
  • Increased sexual thoughts and activity, sometimes resulting in promiscuity and inappropriate or unsafe behavior. Loss of self-control and impulsive or reckless behaviour
  • Racing and disconnected thoughts
  • Hallucinations and delusions. The person is convinced their manic beliefs are real. They do not realize they are ill and have poor judgment

If you are wondering how to learn more about manic disorder, check out the Public Health Agency of Canada, which includes links to additional resources: canada.ca/en/public-health/services/chronic-diseases/mental-illness/what-should-know-about-bipolar-disorder-manic-depression.html


Substance Related Disorders

Using a substance does not mean that a person has a substance-related problem or disorder. Substance use is a problem when use continues despite physical, mental, social, legal and/or financial consequences and failure to meet duties at work, school or home.2

Signs and symptoms

A simple way of understanding and describing substance abuse is to use the 4C’s approach:

  • Craving
  • Loss of control of amount or frequency of use
  • Compulsion to use
  • Continued substance use despite consequences such as use when it is physically hazardous

The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item screening tool developed by the World Health Organization (WHO) to assess alcohol consumption, drinking behaviors, and alcohol-related problems. Both a clinician-administered version (page 1) and a self-report version of the AUDIT (page 2) are provided. Find it here: drugabuse.gov/sites/default/files/files/AUDIT.pdf

If you are be wondering how to learn more about substance abuse, addiction, and dependency including harm reduction, check out ontario.cmha.ca/addiction-and-substance-use-and-addiction.


Psychotic disorders

These are mental health problems that cause the person to lose touch with reality. 

Signs and symptoms that a psychotic disorder is developing2,7:

  • Depression
  • Increased anxiety
  • Suspiciousness, a constant feeling of being watched or followed (delusions which are a strong belief in something that isn’t true)
  • Blunted or flat, inappropriate emotion
  • Irrational, angry or fearful responses to friends and family. Suddenly laughing when someone tells a sad story
  • Feeling “different” or feeling like your thoughts have sped up or slowed down
  • Hallucinations, sensing things that aren’t really there. Hallucinations can occur with any of the five senses (hearing, sight, taste, touch, smell). The most common hallucination is hearing another voice talking that others can’t hear.
  • Jumbled and illogical speech
  • Slow, awkward, rigid or very fast movements

Are you interested in learning more about mental health and how to help someone who is developing a mental health problem or is in a mental health crisis?

Mental Health First Aid (MHFA) is a two-day course that teaches people how to recognize the symptoms of mental health problems:

  • Provide initial help and guide a person towards appropriate professional help.
  • Reach out to your local MHFA chapter to register for an open enrollment course or gather together a minimum of 15 people and invite a MHFA trainer to teach the course
  • mentalhealthfirstaid.ca

References and Resources

  1. Public Health Agency of Canada Mental Disorders https://www.canada.ca/en/public-health/services/chronic-diseases/mental-illness.html
  2. Mental Health First Aid Canada Participant Workbook, 2011, http://www.mentalhealthfirstaid.ca
  3. Mental Health First Aid USA Signs and symptoms of anxiety and how to help someone with anxiety https://www.mentalhealthfirstaid.org/2018/12/how-to-help-someone-with-anxiety/   
  4. Goldberg, D., et al. "Detecting anxiety and depression in general medical settings." Bmj 297.6653 (1988): 897-899.
  5. Government of Canada. The Human Face of Mental Health and Mental Illness in Canada. Ottawa (Ontario); Minister of Public Works and Government Services Canada; 2006. 188 p. Cat. No. HP5-19/2006E. ISBN: 0-662-43887-6.  https://www.bmj.com/content/bmj/297/6653/897.full.pdf
  6. Ontario Mental Health Association signs and symptoms of substance abuse and addiction ontario.cmha.ca/addiction-and-substance-use-and-addiction  
  7. B.C. Mental Health Association signs and symptoms of psychosis https://cmha.bc.ca/documents/psychosis-2/
  8. Canadian Mental Health Agency has resources for mental health https://cmha.ca/

This checklist was written by Dr. Kathy Keil. Dr. Keil studied cognitive and neuropsychology in her undergraduate and graduate psychology degrees prior to attending veterinary school. She is not a licensed psychologist. She has training in Mental Health First Aid, safeTALK suicide awareness, ASIST suicide intervention, and is licensed to teach safeTALK. She regularly teaches suicide awareness and basic intervention skills to veterinary professionals and ways for them to take care of their own mental well-being. She is a member of the ABVMA Member Wellness Committee and a technical services veterinarian with Merck Animal Health. She is the leading force behind the Merck-CVMA “It’s Time to Talk about Mental Health in Vet Med” Awareness Campaign.