Lecture 1 & 2 Learning Objectives

Confucius

balance the 5 elements (fire, earth, metal, water, and wood) that control your mood -> each element corresponds to a different emotion 

Hippocrates

imbalance of too much phlegm, black bile, yellow bile, and too little blood -> these components work together to form your personality 

Pythagoras

3 layer cake -> balance your biological humors - reason, intelligence, and impulse

Socrates and Plato

• your poor mental health is a reflection of your lack of contentment and non-optimal soul. You have a personal responsibility for your mental health

• Focus: One’s higher rational intelligence constantly fought against one’s lower irrational animal instincts

• Plato: believed that there was a perfect model of human and we should develop ourselves to achieve that perfection

Aristotle

• Soul belongs in the living body and life is not about obtaining perfection; rather, we should study what’s in front of us

• Heart was the seat of thought and emotions

• Disagreed with Plato as Plato believed humans could be perfect and we should work to become that level of perfection

Jean Paul Sartre

Humans are born into a universe lacking any meaning. Humans are condemned to be free so we should focus on making our life meaningful using this freedom.

Descartes

The body is a complex machine but the actions of your mind are conscious and voluntary. Mind is distinct from the body. Your mind is ill so work on your mind to fix it.

• Reflexology - acting to reflexes

  Ex. a dog hears a bell and knows its time to eat

Prehistoric beliefs about mood disorders

• Neolithic - little distinction between the universe and the individual. Uncontrollable external factors (such as evil spirits) affected people and their behavior

  • ex. Wearing an amulet to protect against evil spirits

  • ex. Trepanning - creating holes into people skulls to free them of evil spirits

Ancient beliefs about mood disorders

• China - divination bones

  • a priest would etch a person’s problems into a bone and throw it into a fire. reading the cracks would lead to a solution

• Greece - pharmacon (priests) who would drug sacrifices called pharmakoi

• Egypt - heart was the center of the mind

  • a light heart after death would mean the person could pass onto the afterlife

Roman beliefs about mood disorders

• mood disorders were a result of clogged pores and could be cured by bloodletting

  • Notable figure: Galen

    • linked anatomical studies to the description of mood and behavior

    • 3 states associated w/ behavior (yielding, strict rules, and confused)

• Avicenna - front of the head was associated with higher order thinking

How was the understanding of mood disorders affected by the breakdown of feudalism, the Inquisition, and the plague?

Led to superstitious fear and ignorance of mood disorders

Renaissance

• Practicality overcame the popular obsession with the supernatural.

• Had careful observation and classification of mood disorders

What was the first institution for the mentally ill called?

St. Mary of Bethlehem

Why was the Gutenberg printing press important to the study and understaning of mood disorders?

Allowed for books to be reprinted and people became more literate

Robert Burton

• Published the Anatomy of Melancholy, which distinguished mood disorders from insanity and obsessive compulsive behavior

Luigi Galvani

• demonstrated that there was static electricity in the brain → led to electroconvulsive shock therapy

Describe 3 historical events that influenced our understanding of mood disorders.

• Walter Freeman & the lobotomy - part of lesion studies, use of an ice pick to damage the frontal love and make children more docile

• Pharmacological revolution - discovery of isoniazid and iproniazid, and chlorpromazine

  • Isoniazid & iproniazid - first developed as a tuberculosis medicine but the effect of the medicine was that patients were happier and moving, tuberculosis bacteria unaffected

  • Chlorpromazine - initially intended to be an allergy medicine but happened to act on the dopamine receptors that are involved in psychosis

• The other philosophers I mentioned

Evaluate ways that historical misconceptions still influence our beliefs about mental illness.

• Some still think mood disorders are the work of the devil/evil spirts

• Individuals have full control of their mental health

• Pythagoras - 3 layer cake

• Heart isn’t the center of the brain as Aristotle believed

DSM criteria for diagnosing depression

Patients have to present w/ 5 or more symptoms across a 2+ week period

1) Depressed mood most of the day

2) Anhedonia - lack of interest, enjoyment, or pleasure

3) Significant weight gain or loss

4) Slowing down of thought and reduced physical activity

5) Fatigue

6) Feelings of worthlessness or inappropriate guilt

7) Diminished ability to think or concentrate

8) Recurrent thoughts of suicide

Explain why Serotonin, Dopamine and Norepinephrine are strong neurotransmitter modulators of mood.

• Released into the areas of the brain that are responsible for emotion

  • AMY, ACG, PFC

Describe the process of electrochemical neural signaling.

1) Electrical signals as an action potential tend to push a neuron to be excited or not

2) When the neuron is excited, the neuron will fire and release a vesicle (full of neurotransmitters)

3) Calcium helps dock vesicles at the end of the membrane

4) Neurotransmitters releases into the synapse and heads to a downstream neuron to stimulate postsynaptic receptors

5) The process of transporter reuptake recycles neurotransmitters to stop the signal or inactivation where enzymes break down the neurotransmitter or transporters take the neurotransmitter back to the terminal