Common mental health conditions
Mental health nurses care for people with a wide range of conditions. Understanding their features guides assessment and support. This lesson is for learning, not for diagnosing anyone. For study only, not clinical guidance: always follow your programme, current local protocols, and supervising clinicians.
Depression
Major depressive disorder involves persistent low mood or loss of interest for at least two weeks, with symptoms such as changes in sleep and appetite, fatigue, poor concentration, feelings of worthlessness, and thoughts of death. Treatment includes psychotherapy, antidepressant medication, and support. Suicide risk must always be assessed.
Anxiety disorders
Anxiety disorders include generalised anxiety disorder (persistent, excessive worry), panic disorder (sudden intense episodes of fear with physical symptoms), and phobias. Nursing care includes a calm presence, simple clear communication, teaching breathing and grounding techniques, and supporting therapy such as cognitive behavioural therapy (CBT).
Bipolar disorder
Bipolar disorder involves episodes of depression and of mania (elevated or irritable mood, reduced need for sleep, racing thoughts, impulsive behaviour). During mania, nurses provide a calm, low-stimulation environment, ensure nutrition and rest, set consistent limits, and monitor mood stabilisers such as lithium.
Schizophrenia
Schizophrenia involves positive symptoms (hallucinations, delusions, disorganised thinking) and negative symptoms (reduced emotional expression, motivation, and social engagement). For hallucinations, nurses acknowledge the patient's experience without arguing ('I don't hear the voices, but I understand they are real to you'), focus on reality, and assess for commands to self-harm.
Substance use disorders
Substance use disorders involve continued use despite harm. Withdrawal from alcohol can be dangerous, including seizures and delirium tremens, often appearing within 6-72 hours after the last drink; scales such as CIWA guide monitoring and treatment. Opioid use disorder is treated effectively with medications such as buprenorphine and methadone, and naloxone reverses overdose.
Eating disorders
Anorexia nervosa involves restriction of food intake, low body weight, and intense fear of weight gain; it has one of the highest mortality rates of any mental illness. Bulimia involves binge eating and compensatory behaviours such as vomiting. Refeeding in severe malnutrition must be gradual and monitored because of refeeding syndrome, a dangerous electrolyte shift.
Dementia and delirium
Dementia is a gradual, progressive decline in memory and thinking, such as Alzheimer's disease. Delirium is an acute, fluctuating disturbance of attention and awareness, often caused by infection, medications, dehydration, or surgery; it is a medical emergency that is often reversible. A sudden change in an older patient's mental state should be treated as possible delirium.
Worked example
An 82-year-old patient, alert and chatting yesterday, is now confused, restless at night, and unable to focus on conversation. Her temperature is 38.2 C. This acute, fluctuating change suggests delirium, possibly from infection, rather than dementia. The nurse reports promptly, anticipates tests for causes such as urinary or chest infection, keeps her safe, and reorients her gently.
Key takeaways
Depression involves at least two weeks of low mood or lost interest; always assess suicide risk. Anxiety care emphasises calm presence and coping skills. Mania needs low stimulation and limits. In schizophrenia, acknowledge hallucinations without arguing. Alcohol withdrawal can be dangerous; opioid use disorder responds to medication. Anorexia carries high mortality and refeeding risks. Delirium is acute and often reversible; dementia is gradual.
Flashcard
Two weeks or more of low mood or lost interest
Check your understanding
An older patient becomes suddenly confused over a day, with fluctuating attention and a fever. This most likely suggests: