Emotional Health and Emotional Distress
The concept of emotional health encompasses a person’s ability to function as comfortably and productively as possible. Typi-cally, people who are mentally healthy are satisfied with them-selves and their life situations. In the usual course of living, emotionally healthy people focus on activities geared to meet their needs and attempt to accomplish personal goals while con-currently managing everyday challenges and problems. Often, people must work hard to balance their feelings, thoughts, and behaviors to alleviate emotional distress, and much energy is used to change, adapt, or manage the obstacles inherent in daily living. A mentally healthy person accepts reality and has a positive sense of self. Emotional health is also manifested by having moral and humanistic values and beliefs, having satisfying interpersonal re-lationships, doing productive work, and maintaining a realistic sense of hope (Chart 7-3).
When people have unmet emotional needs or distress, they ex-perience an overall feeling of unhappiness. As tension escalates, security and survival are threatened. How different people re-spond to these troublesome situations reflects their level of cop-ing and maturity. Emotionally healthy people endeavor to meet the demands of distressing situations while still facing the typical issues that emerge in their lives. The ways in which people re-spond to uncomfortable stimuli reflect their exposure to various biologic, emotional, and sociocultural experiences.
When stress interferes with a person’s ability to function com-fortably and inhibits the effective management of personal needs, that person is at risk for emotional problems. The use of ineffective and unhealthy methods of coping is manifested by dysfunctional behaviors, thoughts, and feelings. These behaviors are aimed at relieving the overwhelming stress, even though they may cause further problems.
Coping ability is strongly influenced by biologic or genetic fac-tors, physical and emotional growth and development, family and childhood experiences, and learning. Typically, a person reverts to the strategies observed early in life that were used by family members, caregivers, and others to solve conflict. If these strate-gies were not adaptive, the person exhibits a range of painful and nonproductive behaviors. Dysfunctional behavior in one person not only seriously affects that person’s emotional health but can also put others at risk for injury or death.
As these destructive be-haviors are repeated, a cyclic pattern becomes evident: impaired thinking, negative feelings, and more dysfunctional actions that prevent the person from meeting the demands of daily living (Chart 7-4).
No universally accepted definition of what constitutes an emotional disorder exists. But many views and theories share in common the idea that a number of variables can interfere with emotional growth and development and impede successful adap-tation to the environment. Most clinicians have adopted the state-ment from the American Psychiatric Association’s Diagnostic andStatistical Manual of Mental Disorders (DSM-IV TR), which de-fines the term mental disorder as a group of behavioral or psycho-logical symptoms or a pattern that manifests itself in significant distress, impaired functioning, or accentuated risk of enduring se-vere suffering or possible death. Risk factors for mental health problems are listed in Chart 7-5
Patients seen in medical-surgical settings often struggle with psychosocial issues of anxiety, depression, loss, and grief. Abuse, addiction, chemical dependency, body image disturbances, and eating disorders are a few examples of health situations that require extensive physical and emotional care to restore optimal func-tioning. The dual challenge for the health team is to understand how the patient’s emotions influence current physiologic condi-tions and to identify the best care for the patient experiencing un-derlying emotional and spiritual distress.
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