Treatment and Understanding of Psychiatric Disorders

Treatment Modalities for Psychiatric Illnesses

• Common Disorders:

  • Depression, Anxiety, and Psychosis are major psychiatric illnesses.
  • Schizophrenia incidence is about 1% in the U.S.
  • Chronic nature of these illnesses complicates treatment.

• Characteristics of Psychiatric Disorders:

  • Affective and emotional instability, behavioral problems, cognitive dysfunction.
  • Mental illness can be biological or physiological due to trauma, impacting daily functioning in society and relationships.

Treatment Approaches

• Main Types of Treatment:

  • Psychotherapy/Talk Therapy:
  • Aims to help patients express themselves and address their issues.
  • Brain Stimulation:
  • Includes Transcranial Magnetic Stimulation (TMS) and implant devices.
  • Drug Therapy:
  • Used in treating various mental disorders.

• Patient Assessment Before Medication:

  • Gather complete medication history, including OTC and herbal preparations.
  • Monitor vital signs, weight, and fall risk.
  • Assess mental status and ask about suicidal thoughts.
  • Notify prescriber if suicidal plans are present.

• Post-Medication Monitoring:

  • Reassess vital signs and mental status after administration; medications can cause dizziness and drowsiness.

Depression Overview

• Definition:

  • Characterized by persistent sadness, loss of energy, difficulty in daily functioning.

• Causes:

  • Imbalance of neurotransmitters: serotonin, norepinephrine, dopamine.
  • Contributing factors include stress, trauma, environment, genetics, and physical illnesses.

• Types of Depression:

  • Major Depression: disabling; symptoms persist for 2 weeks.
  • Bipolar Disorder: marked by erratic mood swings, from mania to depression.

• Treatment:

  • Includes counseling, psychotherapy, and antidepressant medications (e.g., SSRIs, TCAs).

Antidepressants Information

• Mechanisms:

  • SSRIs (Selective Serotonin Reuptake Inhibitors) and TCAs (Tricyclic Antidepressants) help correct neurotransmitter imbalances.
  • Response time for medications can be up to 8 weeks.

• Common Side Effects:

  • Dizziness, hypotension, drowsiness, nausea, and sexual dysfunction (impotence).

• Teaching Priorities for Patients:

  • If a dose is missed, take it as soon as possible unless close to the next dose.
  • Warn about the risks of alcohol and heavy machinery while on medication.
  • Notify all healthcare providers if undergoing surgical procedures.

Anxiety Disorders Overview

• Definition:

  • Anxiety is characterized by worry, nervousness, or unease about future events.

• Types of Anxiety Disorders:

  • Panic Disorder: intense physical panic attacks.
  • Generalized Anxiety Disorder: persistent, excessive worry.
  • Phobic Disorder: intense fear of specific objects/situations.
  • Obsessive-Compulsive Disorder (OCD): repetitive behaviors or thoughts.

Antianxiety Medications

• Classes of Medication:

  • Benzodiazepines (e.g., Xanax, Ativan) act quickly (30 min to effect).
  • Common Side Effects:
  • Dizziness, drowsiness, potential for dependence.

• Teaching Priorities for Patients:

  • Avoid alcohol, antacids, and grapefruit juice while on these medications.
  • Do not abruptly stop taking benzodiazepines to avoid withdrawal symptoms.

Psychosis Overview

• Definition:

  • Psychosis is characterized by a severe disorder in which thoughts and emotions are so impaired that contact with reality is lost.

• Symptoms Include:

  • Confusion, disorganized thoughts, extreme emotions, delusions, hallucinations.

• Antipsychotic Drugs (e.g., Seroquel):

  • Used to manage symptoms of psychosis; may be prescribed for sleep issues.
  • Common Side Effects:
  • Drowsiness, dizziness, gastrointestinal upset, tardive dyskinesia (involuntary movements).

• Important Considerations:

  • Patients should avoid alcohol and maintain hydration, especially when on psychotropic medications.
  • Ensure any abnormal symptoms such as tardive dyskinesia are reported to the prescriber.