Module 10: Mental Disorders & Treatment

Mental Disorders:

• Somatogenic Hypothesis: mental disorders have physiological causes

• Psychogenic Hypothesis: symptoms are caused by psychological processes

• Biopsychosocial Model: holistic perspective taking into account psychological processes like stress, trauma, and memories—biological factors like genetics and brain chemistry, but also sociocultural influences like poor living conditions, race, or culture

• Diathesis-Stress Model: the diathesis creates a predisposition towards the disorder—the stress provides a trigger that sparks the disorder

• Mental Disorders: dysfunctional patterns of thoughts, feelings, or behaviors that interfere with daily life

• DSM: diagnostic and statistical manual for mental disorders

• DSM-5: includes disorders like anxiety disorders, obsessive-compulsive disorders, trauma/stress related disorders, bipolar disorders, depressive disorders, psychotic disorders, dissociative disorders, eating disorders, substance abuse disorders, neurodevelopment disorders, personality disorders, and more

• Anxiety Disorders: among the most common, affecting 15 to 20% of the US population—includes panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder, and phobias—other types of disorders that also include extreme anxiety are obsessive-compulsive disorder and trauma/stress-related disorders

• Panic Disorder: characterized by having unexpected panic attacks

• Agoraphobia: fear of being in situations in which help might not be available or escape might be difficult or embarrassing

• Social Anxiety Disorder: intensely afraid of being watched and judged by others

• Generalized Anxiety Disorder: characterized by continuous and pervasive feelings of anxiety—worry all the time, frequently agitated, can’t identify what’s causing the anxiousness

• Phobias: include experiences of excessive distressing and persistent fear or anxiety about a specific object or situation

• Obsessive-Compulsive Disorder: characterized by unwanted repetitive thoughts which become obsessions which are sometimes accompanied by actions which compulsions—debilitating condition where ritualistic behaviors are performed to relieve intense and unbearable anxiety

• Post Traumatic Stress Disorder: type of trauma and stressor related disorder that also includes extreme anxiety—its symptoms are classified into four major clusters in the DSM-5

• Major Depressive Disorder: when an individual has experienced at least five signs of depression for more than two weeks, includes depressed mood, significant appetite loss or gain, too much or too little sleep, decreased interest in activities, feeling worthless, fatigued, or lethargic, and difficulty concentrating or making decisions—for a diagnosis, symptoms need to cause the person or others around them prolonged distress

• Bipolar Disorder: includes dark lows of depression but also bouts of mania

• Schizophrenia: one of the most impairing forms of mental illness, schizophrenia spectrum disorders are characterized by disorganized thinking, emotions and behaviors that are often incongruent with their situations, and disturbed perceptions including delusions and hallucinations

• Psychotic Symptoms: hallucinations, delusions, and disorganized thinking are categorized as positive symptoms—blunted affect, reduced speech, and social withdrawal are negative symptoms

• DID (Dissociative Identity Disorder): rare disorder where a person exhibits two or more distinct and alternating identities

• Eating Disorders: the most deadly, most common are anorexia nervosa, bulimia nervosa, and binge-eating disorder

• Anorexia Nervosa: typically starts during puberty and is most prevalent among adolescent females—involves maintaining a starving diet that leads to abnormally low body weight, efforts to maintain a very low body weight are motivated by intense fear of becoming fat

• Bulimia Nervosa: includes body image disturbance and may occur at any body weight, key behavioral symptoms includes binge-eating followed by fasting or purging

• Binge-Eating Disorder: significant binge-eating, followed by emotional distress, feelings of lack of control, disgust, or guilt, but without purging or fasting

Treatment:

• Psychotherapy: general term for treatment that includes talking with a mental health provider—most common type of treatment since the early 1900s

• Psychoanalysis: developed by Sigmund Freud, uses free association or dream analysis to help uncover unconscious thoughts and promote insight

• Psychodynamic Therapies: therapies stemming from Sigmund Freud’s original psychoanalysis

• Psychodynamic Therapy: focuses on helping people gain insight on the impact of unconscious internal forces, early relationships, and critical childhood experiences

• Existential & Humanistic Traditions: focuses on people’s capacity for making rational choices, achieving self-acceptance, and attaining their maximum potential

• Client-Centered Therapy: encourages therapists to provide an empathetic, genuine, and accepting environment, and to use active listening where the therapist echos and clarifies what their clients are saying and feeling

• Behavior Therapists: view negative behaviors as the problem to be solved and that all behavior is the result of learning, and the remedy involves new learning

• Exposure Therapy: used to treat anxiety by having a person face their fears through gradual exposure to situations that they typically avoid

• Behavior Therapy: can reduce symptoms associated with specific phobias, panic disorder, traumatic experiences, major depression, and some other anxiety disorders

• Cognitive Therapy: focuses on what people think rather than what they do

• CBT (Cognitive-Behavioral Therapy): combination of cognitive and behavioral therapy—focuses on present issues rather than the past, and includes highly structured sessions and even homework aimed at helping people practice new skills and new ways of thinking

• Mindfulness Approach: comes from Buddhist and yoga practices—a process that tries to cultivate a non-judgmental yet attentive mental state, and focuses on awareness of bodily sensations, thoughts, and the outside environment

• Treatment Manual: tells the therapist exactly how to proceed during the study

• Proponents: treatment should be based on a therapist’s judgement

• Opponents: it is critical that evidence-based treatment is delivered with integrity

• Confirmation Bias: the tendency to favor information that confirms our beliefs

• Illusory Correlation: the tendency to perceive causal relationships when there are none

• Bias Blind Spot: the inclinations to perceive biases in others but not ourselves

• Monoamine Oxidase (MAO) Inhibitors & Tricyclic Antidepressants: the two major classes of antidepressants, both increase the amount of norepinephrine and serotonin available for synaptic transmission

• Selective Serotonin Reuptake Inhibitors (SSRI’s): acts minimally on norepinephrine and dopamine and mainly act on serotonin

• Atypical Antidepressants: for patients who are bothered by the side effects of SSRI’s and can’t take the tricyclics or MAO inhibitors—work in various ways on serotonin, norepinephrine, and dopamine systems

• Mood Stabilizers: medications to treat bipolar disorder

• Tranquilizers (Anxyiolytics): for patients suffering from disabling anxiety—work by increasing neurotransmission and synapses containing the neurotransmitter gaba

• Beta-blocker: used for anxiety disorders, a medication intended to control autonomic arousal

• Electroconvulsive Therapy (ECT): involves using electrical current to induce seizures to help alleviate the effects of severe depression

• Repetitive Transcranial Magnetic Stimulation (rTMS): involves the painless application of repeated electromagnetic pulses

• Deep Brain Stimulation (DBS): includes surgically implanting a kind of brain pacemaker that sends out electrical impulses to specific parts of the brain to help normalize brain activity

• Vagal Nerve Stimulation: involves implanting a battery-powered stimulator in the chest just underneath the skin, the stimulator delivers carefully calibrated electrical pulses to the vagus nerve