Electroconvulsive Therapy ECT causing a seizure through electric shock o Treatment for severe depression o We don t know why it works o Memory side effects can be significant o Can be cognitive impairment as well o But we try to avoid long term brain damage Phototherapy used for Seasonal Affective Disorder light exposure Exercise is helpful for depression as well Treatment for bipolar disorder o 70 heritability o Difficult to treat w o medication o Lithium is the most common medication o 80 effective o Mood stabilizer o Don t know exactly why it works o It may alter norepinephrine receptors o Hard for some people to tolerate though become blunted o Therapy is helpful too when combined with medication o Therapy Help keep people off medication Heal family relationships reality testing supportive person who tells them that they are becoming unstable E g if you have schizophrenia you can ask someone if they are hearing voices as well or If you are hallucinating o Low relapse 20 for those who continue medication o Many stop taking medication b c they like the manic episodes Most effective treatments o Anxiety behavior and cognition o Depression multiple treatments o Bipolar lithium o Schizophrenia pharmacological What therapy approaches work o Caring therapists Schizophrenia with reality can t tell what s rational not Schizophrenia is a psychotic disorder o 1 of population has it o Confessing what patients are thinking catharsis Personality interacts with different stressors and experiences and filters them Psychotic disorders significantly alters experience of reality that can be impairing lose touch o Delusion irrational and bizarre beliefs e g the CIA is following me my neighbors are moving my furniture around etc thought process o Hallucination perceptual experience hearing seeing smelling things not actually there e g think they see a shadow seeing someone s face warping o Disorganized speech and incoherent thought processes can look manic o Grossly disorganized behavior irrational and erratic behavior o Catatonic behavior rare literally freeze or repeat movements o Negative symptoms lack of normal behavior e g apathy Video on schizophrenia o Man says a picture has a headache o Then starts talking about a sperm and an egg o disorganized thoughts o Twirling hair around disorganized behavior People with schizophrenia generally are normal as children but in high school show symptoms that are precursors to schizophrenia e g stop being motivated by college there are signs of hallucinations delusions etc o 25 have one episode and become normal again o 25 have to be hospitalized o 50 are in between o 75 significant impairment in life Positive and negative symptoms o Positive an excess of symptoms E g delusions Hallucinations Loosening of associations e g the picture has a headache Disorganized behavior More likely to respond to medication o Negative deficits in functioning E g isolation Withdrawal Apathy Blunted emotions neither happy nor sad nor angry etc Classic delusions o Persecution think someone is trying to hurt them o Reference believe that someone is trying to communicate with them e g the newscaster is trying to send them a message o Grandeur identity think they are special e g Jesus the president etc o Guilt think they have done something terrible e g responsible for tornado o Control think someone is taking control of your mind inserting or stealing thoughts Disordered thought o Formal thought disorder word salad scrambled sentences don t make sense but they think it does o Disorder of thought content delusions Generally coherent Formal thought generally involves disorder of thought content Disordered mood family member o Flat mood few emotions or inappropriate responses e g laughing at the death of a Schizoaffective disorder schizophrenia w mood disorder mania if you treat the mood disorder you are still left with schizophrenia o Different from psychotic mood disorder mood disorder w a psychotic episode o if the mood is congruent e g you are depressed and you hear voices telling you to kill yourself it is a mood disorder it is often a mood disorder Types of schizophrenia o Paranoid type Delusions of persecution auditory hallucinations Think people are out to harm them No disorganized speech behavior or flat inappropriate affect Seem completely normal until they say something that shows you they are paranoid o Disorganized type Disorganized speech and behavior Emotionally blunted Not paranoid o Catatonic type Will end up in the hospital Rare o Undifferentiated type Don t meet other diagnostic categories Organized thoughts not paranoid not catatonic May have delusions or hallucinations Freezing in motion scared that if they moved something terrible would happen OR echolalia repeating a phrase or word over and over E g Man thought people were becoming different people thought as he walked down the street the lights changed depending on his movements o 3 classic examples of schizophrenia paranoid type videos David Thinks people steal his glasses if he gets new glasses they will embed a transmitter in the frame Thinks he s being investigated by the government Organized set of delusions no auditory hallucinations for example Thinks he has a lot of evidence Normal emotions Looks normal besides his glasses and teeth Fairly intelligent Ms Leonard Hears voices says they are getting louder and are threatening her will take over her body Flat Looks frightened but blunted Isn t moving much but not catatonic because she s just frightened Looking off to the side at where the voices are coming from Not processing what the interviewer is saying Different from David emotional expressiveness and hears voices Ms Wilcox Woman stabbed herself Thinks her family and friends were being harassed o Her sister lost everything in a tornado o Her mother died Thinks they are trying to get to her Thinks her phone is bugged Looks normal organized thoughts Was doing ok until her mother died major stressor Acknowledged that medication might help whereas David wouldn t have gone on medication because didn t think he needed it
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