• Generalized anxiety disorder = anxiety and worry that tis excessive and difficult to control and occurs for more days of at least 6 months

  • Symptoms = physical, cognitive, psychological symptoms

    • Fight-or-flight response

• Phobic disorder = irrational fear of an object that interferes with normal functioning

• PTSD = someone goes through a traumatic event -> causes person to re-experience that stress associated with the event -> pain attack

  • Symptoms = nightmares/unwanted memories, avoidance of situations that bring back memories, heightened reactions

  • Triggers = exposure to actual/threatened death and serious injury or sexual violation

• Panic disorder = someone has uncontrollable panic attacks for an extended period of time (> 2 weeks)

  • Symptoms = shortness of breath, racing heart, unfocused feeling of out of control -> can come on rapidly

• Obsessive-Compulsive Disorder (OCD) = Having obsessive stress over a particular event or issue and performing ritualistic or compulsive behaviour to ameliorate (to make better) the stress

  • Obsessions lead to compulsons (obsessive behaviors)

  • Seen in =Tourette’s, chronic tic disorder, eating disorders, ADHD

• Major depressive disorder = Profound sadness, slowed thought processes, loss of interest in previous sources of pleasures

  • Symptoms = depressed mood or marked loss of interest

    • changes in sleep, appetite, energy level, concentration, daily behaviour, self-esteem, thoughts of suicide, unable to engage in basic behaviours

  • Time = Last for > 2 weeks

  • Who is more vulnerable? = Abnormalities at norepinephrine + serotonin synapses, reduced hippocampal volume + suppressed neurogenesis (forming new neurons), hormonal changes resulting overactivity along HPA axis (hypothalamic-pituitary-adrenal), learned helplessness

• Bipolar Disorder = manic episodes and periods of depression

  • Manic episodes = inflated self-esteem, high energy, racing thoughts

• Somatoform disorders = Suffers from some form of physical ailment, when there is no real cause for that ailment to occur

  • Conversion Disorder =  convert stress into some physical ailment

  • Hypochondria = believes that he has major medical malady, but doctors find nothing physically wrong

    • Patient seeks treatment for an ailment that he believes exists

• Eating Disorders

  • Anorexia nervosa = refusing to eat

  • Bulimia nervosa = cannot stop eating + self-induced compensations

  • Binge-eating disorder = eats a lot in ONE episode

• Dissociative Identity Disorder (DID) = presence of 2 or more distinct personality states

  • Cause = reaction to trauma as a way to help a person avoid bad memories

  • Psychogenic or dissociative fugue state = forgetting past and creates new history

  • Psychogenic amnesia = forgets past but realizes it is forgotten

• Schizophrenia = affects person’s ability to think, feel, behave clearly

  • Overall symptoms = touch with reality, disorganized speech, decreased daily participation, difficulty with concentration and memory

  • Positive symptoms = presence of problematic behaviours

    • Hallucinations

    • Delusions

    • Wild flights of ideas

  • Negative symptoms = absence of healthy behaviours

    • Flattened emotions

    • Social withdrawal

    • Apathy

• Personality disorders

  • Cluster A = odd behaviour

    • Paranoid = mistrust of others

    • Schizoid = lack interest in social relationships

    • Schizotypal = odd beahviour or thinking

    • Schizophrenia

      • Discomfort in close relationships

      • cognitive/perceptual distortions

      • Eccentric behaviour

  • Cluster B = dramatic

    • Antisocial = disregard for the law and rights of others

    • Borderline = instability in relationship

    • Histrionic = pervasive attention-seeking

    • Narcissistic = need for admiration

  • Cluster C = anxious

    • Avoidant = social inhibition

    • Dependent = pervasive on others

    • OCD

• Distress

  • Ego-dystonic = they know they have a problem and is distressed

  • Ego-syntonic = do not believe they have any issues

Treatments

• 2 major approaches

  • Psychotherapy - insight therapies

    • Psychoanalysis = help patient uncover unconscious conflicts that give rise to anxiety

      • Time = 1 hr/day several days a week for several years

      • Key terms = free association, transference

    • Humanism

      • Carl Rogers

      • Unconditional positive regard

      • Provide a sounding board for people to voice their thoughts

      • Active listening and parroting

    • Behaviorism

      • Create environmental context in conflict with behaviours demonstrated

      • Good for phobias

      • Aversion therapy

    • Cognitive 

      • SSRI = reduce depression -> blocking reuptake of serotonin in synapse

        • prozac

      • antipsychotic drugs = reduce psychotic symptoms -> cut dopamine in brain

        • thorazine

  • Biomedical therapies

    • Antipsychotic drugs

      • First gen antipsychotic drugs (Thorazine) - dampens responsiveness to irrelevant stimuli

        • Provide most help to patients experiencing “positive” symptoms of schizophrenia

      • Have powerful side effects (tremors, twitches)

    • Antianxiety drugs

      • Xanax/Ativan

      • Depress CNS activity

      • Can be addictive

    • Antidepressant drugs

      • Treat anxiety, OCD, and PTSD

      • Increasing availability of neurotransmitters to elevate arousal/mood

      • Prozac, Soloft, Paxil

      • SSRIs - selective serotonin reuptake inhibitors

      • Take 4 weeks to have full effect

    • Mood-stabilizing medications

      • Depakote - controls manic episodes associated with bipolar disorder

      • Lithium - levels emotional highs and lows of bipolar

        • Lower risk of suicide

    • Electroconvulsive therapy

      • Shocks brain

      • Effectively treats severe depression who do not respond to drug therapy

      • 3 sessions per week for 2-4 weeks - 70% improved

      • Reduces suicidal thoughts

    • Alternative neurostimulation therapies

      • Magnetic stimulation

        • Repetitive transcranial magnetic stimulation (rTMS)

          • Performed wide-awake

          • Magnetic coil close to skull stimulate/suppress areas of cortex

          • No memory loss

        • Works for depression

      • Deep-brain stimulation

        • Treat Parkinson’s tremors

      • Transcranial electrical stimulation/Mild cranial electrical stimulation

        • Produces 1-2 miliamp current to scalp

    • Psychosurgery

      • Surgery that removes/destroys brain tissue

      • Least-used biomedical intervention

      • Lobotomy

• 3 categories of therapy

  • Insight (talk) 

  • Behaviour

  • Biomedical

• Notes

  • Humanistic vs psychoanalytic

• Cognitive and cognitive-behavioral therapies -> anxiety, PTSD, insomnia, depression

• Behavioral conditioning therapies -> specific behavior problems (phobias, marital problems, sexual dysfunctions)

• Psychodynamic therapy -> depression and anxiety

• Nondirective counseling/ client-centered therapy -> mild/moderate depression