- Electroconvulsive Therapy (ECT)- causing a seizure through electric shocko Treatment for severe depressiono We don’t know why it workso Memory side effects can be significanto Can be cognitive impairment as wello 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 disordero (70% heritability)o Difficult to treat w/o medicationo Lithium is the most common medicationo 80% effectiveo Mood stabilizero Don’t know exactly why it workso It may alter norepinephrine receptorso Hard for some people to tolerate though- become “blunted”o Therapy is helpful too when combined with medicationo 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 hallucinatingo Low relapse: 20% for those who continue medicationo Many stop taking medication b/c they like the manic episodes- Most effective treatmentso Anxiety: behavior and cognitiono Depression: multiple treatmentso Bipolar: lithiumo Schizophrenia: pharmacological - What therapy approaches work?o Caring therapistso Confessing what patients are thinking/catharsis- *Personality interacts with different stressors and experiences and filters themSchizophrenia- Psychotic disorders: significantly alters experience of reality that can be impairing; lose touch with reality; can’t tell what’s rational/not- Schizophrenia is a psychotic disordero 1% of population has ito Delusion: irrational and bizarre beliefs (e.g. the CIA is following me, my neighbors are moving my furniture around, etc.)  thought processo 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 manico Grossly disorganized behavior: irrational and erratic behavioro Catatonic behavior: (rare), literally freeze or repeat movementso Negative symptoms: lack of normal behavior (e.g. apathy)- Video on schizophreniao Man says a picture has a headacheo Then starts talking about a sperm and an eggo  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 againo ~25% have to be hospitalizedo ~50% are in betweeno  75% significant impairment in life- Positive and negative symptomso 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 medicationo Negative: deficits in functioning E.g. isolation Withdrawal Apathy Blunted emotions (neither happy nor sad nor angry, etc.)- Classic delusionso Persecution: think someone is trying to hurt themo Reference: believe that someone is trying to communicate with them- e.g. the newscaster is trying to send them a messageo 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 thoughto 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 moodo Flat mood (few emotions) or inappropriate responses (e.g. laughing at the death of a family member)- Schizoaffective disorder (schizophrenia w/mood disorder/mania)- if you treat the mood disorderyou are still left with schizophreniao Different from psychotic mood disorder: mood disorder w/a psychotic episodeo *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 schizophreniao 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 paranoido Disorganized type Disorganized speech and behavior Emotionally blunted  Not paranoido Catatonic type Freezing in motion (scared that if they moved something terrible would happen) OR echolalia (repeating a phrase or word over and over) Will end up in the hospital Rareo Undifferentiated type Don’t meet other diagnostic categories Organized thoughts, not paranoid, not catatonic May have delusions or hallucinations E.g. Man thought people were becoming different people, thought as he walkeddown the street the lights changed depending on his movementso 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 harassedo Her sister lost everything in a tornadoo 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