Non psychotic disorders aka neurotic disorders o Obsessive Compulsive Disorder OCD Repetitive intrusive thoughts obsessions ritualistic behaviors compulsions that interfere significantly with an individual s functioning Debilitating actually impairs functioning E g obsession did I run someone over with my car repeats over in your head compulsion drive around the block to check if you ran someone over E g did I turn the stove off leave the house did I turn the stove off check multiple times to see if you turn it off over and over Checking behavior is reinforced 1 3 of population Moderately heritable Problem suppressing thoughts Video Woman Stephanie with child Jake fears that someone might kidnap her child Sets up traps so that if someone does kidnap her child she can tell When she goes on walks Jake has to be in front of him the whole time Also is afraid of contamination avoids litter when out for a walk Washes her hands every time before she interacts with Jake 22 times in Lathers hand completely scrapes under nails washes hands again then a half hour rinses again She knows her anxiety is irrational but can t stop control it To treat stop them from doing the ritual e g have them touch something dirty and not wash their hands Causes Learning theory Link to panic disorder and agoraphobia learning component Caudate nucleus region of brain dysfunctional Caudate nucleus is part of the basal ganglia Basal ganglia help impulse suppression can t turn off their thoughts Theory is that the prefrontal cortex is overactive Strep infection may cause OCD by affecting the caudate nucleus region o Anxiety disorder Interpretation of normal behavior fear that is amplified washing hands washing hands all the time in really hot water Biological factors Inhibited temperaments Increased CNS activation panic disorder E g a normal person would read the sentence the doctor examined Emma s growth as a checkup whereas those with anxiety disorder may interpret it as Emma having cancer People with a biological risk of having a panic disorder with a family history of anxiety have a higher chance of having a panic attack after hyperventilating and after inhaling carbon dioxide o Treating anxiety disorder Specific phobias hierarchies of fear teaching people to relax and gradually exposing them to things they are more afraid of Cognitive behavioral methods Virtual treatments for fears E g someone with social phobia first talking to a stranger later hosting a party etc E g phobia of germs touch the table touch the doorknob touch the escalator railing dig through the trash etc o Cognitive behavioral treatment Look at thinking and restructuring the thinking May change beliefs May use mindfulness meditation awareness of the present thoughts and feelings identifying symptoms when they come up or stress reduction Cognitive therapy help people understand their thinking Cognitive restructuring stops people from making assumptions and automatic thoughts realistic thinking behavior Cognitive Behavioral Therapy CBT treatment using combo of thinking and We may have irrational thoughts rethinking those beliefs o Cognitive behavioral are the most effective for anxiety disorders but for others medication can be helpful SSRIs social phobia Lower chance of relapse with mediation CBT is very effective for panic disorder imipramine is too a placebo helps too b c you don t know that it s a placebo CBT imipramine most effective o OCD exposure and response prevention Expose to something afraid of prevent them from their normal behavior E g touching a doorknob and not letting them wash their hands phobia of germs Some reduction in OCD with medication Little with placebo Exposure ritual prevention is most effective Mood disorders o Overlap between depression and anxiety some medications are helpful for both o Over 70 depressed also have generalized anxiety disorder anxious fatigued muscle tension etc o Significant relationship with social phobia as well o Small relationship with panic or agoraphobia specific phobia OCD o The Real World Suicide Risk Prevention Cause of death for a lot of people Half of people who commit suicide are depressed Many motives Can be biological Others can influence you Hard to predict but there are warning signs Young black males and many white males are at risk old white males are highly at risk females are at lower risk than males o Major depressive episode Not just a slump unmotivated Significant difficulty simply functioning Might be trying to act like they are okay but aren t Less interested in activities low pleasure Things that used to be fun aren t fun Significant weight loss or gain Sleep disturbances insomnia and hypersomnia Psychomotor agitation psychomotor retardation movement or lack of movement for no specific reason such as pacing Fatigue loss of energy Feel worthless guilty Can t think concentrate Thoughts of death relief from life Sometimes have no feelings at all feel empty Often lose social support system because no one wants to be around them o Psychotic features Hallucination can be auditory E g hearing voices of someone they know or don t saying you re worthless Delusions e g someone is telling the neighbors I m worthless over the news May first think they have schizophrenia if hearing voices but if the voices are saying what a depressed person would be thinking it could just be depression o Another type of depression less severe dysthymia disorder neurotic depression Chronic 2 years long term Not so debilitating that they can t function Under or over eating Under or over sleeping Low energy Fatigue Low self esteem Can t concentrate Feel hopeless Describe it as depression but not one that makes them dysfunctional o Bipolar disorder Used to be called manic depression Manic and depressive episodes 2 poles extreme euphoria and extreme depression If you ever have a manic episode you qualify for manic depression Cyclothymia no episodes of severe depression or severe manic episodes but History of depressive episodes usually don t need to diagnose as go into states of depression and almost mania Bipolar I History of manic episodes bipolar I Bipolar II History of hypomania History of major depressive episodes Still able to function Manic episode Distinct period of an elevated mood often euphoric Inflated self esteem or grandiosity Periods of time when you don t need to sleep not insomnia where want to sleep but can t because don t WANT to sleep Very talkative and pressure to keep talking