OUTLINE Modules 46 47 48 PSYCHOLOGICAL DISORDERS 1 History 2 Diagnosis 3 Mood Disorders 4 Anxiety Disorders 5 Psychotic Disorders PSYCHOLOGICAL DISORDERS Historical overview of views on mental illness The Middle Ages Not thought of as an illness but rather o Seen as witches o Seen as prophets 1700 1900s Europe Recognized mental illness as a problem Placed in hospitals o Nothing like current facilities o Chains tours 1790 s France Treatment more civilized Fresh air 1800 1900 s USA Fresh air concept lives on Encouraged rest relaxation o Spa like facilities Current world view Research Diagnostic criteria to classify disorders PSYCHOLOGICAL DISORDERS Classification of Disorders DSM V Handbook w basic organization of disorders 2 major clusters of disorders Categories Anxiety Dissociative Mood Schizophrenia Personality Diagnosis of Disorders Descriptions of symptoms and behaviors Must have certain number of these symptoms diagnosis checklist of criteria Problems Descriptions are lacking changing Patients aren t sure of many symptoms MOOD DISORDERS 1 Major Depression Must have many symptoms for at least 2 weeks Must affect your ability to conduct your life Symptoms helplessness Depressed mood lack of hope feelings of Suicidal thoughts Tearfulness Change in appetite more or less Change in weight more or less Lack of interest in normal activities Change in sleep pattern more or less Low energy level This combination of symptoms is very unpleasant o Purposeless underwater jet lagged Other Points Suicide o Women 3 times more likely to try pills o Men 2 times more successful suicides guns MOOD DISORDERS cont More depressive disorders 2 Dysthymia mildest form of depression still able to conduct life Diagnosis must have mild symptoms for at least 2 years 3 Seasonal Affective Disorder SAD Experience depression only during times of decreased light o Wintertime in NE o Prevalent in Alaska long winter little light o Prevalent in Seattle lots of cloudy days Treatment o Sit in front of UV lights for several hrs day o Melatonin sleep hormone MOOD DISORDERS cont 4 Bipolar Disorder Manic Depressive Combines Depressive episodes manic episodes and repeat What is a Manic Episode Symptoms Racing thoughts Pressured speech Lack inhibitions Promiscuity Feelings of omnipotence Needs significantly less sleep High energy can NOT sit still Spending sprees gambling Up side to mania Can get lots of work done very creative time Down side to mania Hard to manage can lead to trouble with the law MOOD DISORDERS Causes of mood disorders Depressive disorders 1 Biological Basis Brain o Lack of serotonin o Treat with SSRI s Prozac Zoloft Paxil Genetic component o If a relative has it it increases your odds 2 Environmental triggers Stress at work loss of loved one fail a course can trigger a depressive episode Bipolar Disorders Biological Basis Genetic component large o Very heritable Brain o Responds well to medication but we don t know why Lithium depacote neurotonin ANXIETY DISORDERS General symptoms Anxiety in some form that is Persistent long lasting Intense severe Maladaptive behaviors to reduce it Types of Anxiety Disorders 1 Phobias Def fear which interferes with one s life Specific phobias Fear is focused on some object situation or behavior Develops from 1 a past event or 2 irrational no cause EX snakes blood dogs heights elevators flying Fear of humiliation or embarrassment in front of Social Phobia others o Won t attend social events o Won t speak out in class etc Agoraphobia Fear of being in a situation you can t escape o Never leaves home ANXIETY DISORDERS 2 Panic Disorder Has extreme attacks of anxiety coming from out of the blue Anxiety attacks Severe sympathetic NS arousal o Racing heart sweaty palms feel like you can t breathe Last few moments feels like forever 3 Generalized Anxiety Disorder GAD A continual overanxious state o Worried tense concerned above and beyond what is appropriate o Arousal of sympathetic nervous system at lower levels break out in a sweat etc ANXIETY DISORDERS 4 Obsessive Compulsive Disorder OCD Repetitive disturbing thoughts or images that you can NOT control Repetitive behaviors you do to try to alleviate the Obsessions Compulsions thoughts Common ones Concern with germs disease cleanliness EX normal to wash hands once before eating NOT 40 times a day until they bleed Concern that something bad will happen if you don t do repetitive rituals EX Normal to check if you locked your door once NOT check it 10 times after you go to bed Concern with exactness EX must chew each bite of food 17 times ANXIETY DISORDERS Causes of Anxiety Disorders Debate Psychological basis Most people think that these disorders reflect some event that occurred which is internalized Learn from classical conditioning EX your plane hits bad turbulence now seeing a plane elicits fear Learn from observation EX you see a movie about a plane crash now you fear flying because you think you could die Biological basis Frontal lobes are active when in an anxious state Anxiety disordered people are VERY responsive to same drugs that treat depression SSRI serotonin PSYCHOTIC DISORDERS Generally Disorders where sense of reality is impaired Schizophrenia the big one Onset Symptoms NO CURE Drugs have lots of side effects PSYCHOTIC DISORDERS Causes of Schizophrenia Point No one really knows what the cause is Some guesses 1 Genetics 2 Dopamine 3 Brain abnormalities 4 Viral infection in prenatal development 5 Environmental factors DISSOCIATIVE DISORDERS Def disorders involving disruptions in a person s memory consciousness or identity Very rare Very controversial 1 Dissociative FUGUE 2 Dissociative Identity Disorder aka Multiple Personality Disorder EATING DISORDERS 1 Anorexia Nervosa Symptoms Facts Causes 2 Bulimia Nervosa Symptoms Facts 3 Binge Eating Disorder EATING DISORDERS Medical complications of eating disorders Anorexia Nervosa Bulimia Nervosa AXIS II PERSONALITY DISORDERS General points Notes Organization Cluster A Cluster B Cluster C PERSONALITY DISORDERS CLUSTER A Paranoid Schizoid Schizotypal CLUSTER B Antisocial Borderline Narcissistic Histrionic PERSONALITY DISORDERS CLUSTER C Avoidant Dependent Obsessive Compulsive
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