PHYSIOBIO UNIT 6 - PSYCHOLOGICAL DISORDERS.pdf

UNIT 6 – PSYCHOLOGICAL DISORDERS The risk of depression in women is nearly twice as high as it is for men. Once a person in the family has this Lesson 16. Mood Disorders diagn...

UNIT 6 – PSYCHOLOGICAL DISORDERS The risk of depression in women is nearly twice as high as it is for men. Once a person in the family has this Lesson 16. Mood Disorders diagnosis, their brothers, sisters, or children have a - A mood disorder is a mental health class that higher chance of the same diagnosis. In addition, health professionals use to broadly describe relatives of people with depression are also at increased all types of depression and bipolar risk for bipolar disorder. disorders. Once a person in the family has a diagnosis of bipolar Types of Mood Disorders disorder, the chance for their brothers, sisters, or Major depression. Having less interest in usual children to have the same diagnosis is increased. activities, feeling sad or hopeless, and other symptoms Relatives of people with bipolar are also at increased for at least 2 weeks may indicate depression. risk for depression. Dysthymia. This is a chronic, low-grade, depressed, What are the symptoms of mood disorders? or irritable mood that lasts for at least 2 years. Depending on age and the type of mood disorder, a person may have different symptoms of depression. The Bipolar disorder. This is a condition in which a following are the most common symptoms of a mood person has periods of depression disorder: alternating with periods of mania or elevated mood. Mood disorder related to another health condition. – Ongoing sad, anxious, or “empty” mood Many medical illnesses (including cancer, injuries, – Feeling hopeless or helpless infections, and chronic illnesses) can trigger symptoms of depression. – Having low self-esteem Substance-induced mood disorder. Symptoms of – Feeling inadequate or worthless depression that are due to the effects of medicine, drug abuse, alcoholism, exposure to toxins, or other forms of – Excessive guilt treatment. – Repeating thoughts of death or suicide, wishing to die, or attempting suicide (Note: People with this symptom What causes mood disorders? should get treatment right away!) Many factors contribute to mood disorders. – Loss of interest in usual activities or activities that were They are likely caused by an imbalance of brain once enjoyed, including sex chemicals. – Relationship problems Life events (such as stressful life changes) may also contribute to a depressed mood. – Trouble sleeping or sleeping too much – Changes in appetite and/or weight Mood disorders also tend to run in families. – Decreased energy Who is at risk for mood disorders? Anyone can feel sad or depressed at times. However, – Trouble concentrating mood disorders are more intense and harder to manage than normal feelings of sadness. Children, teens, or – A decrease in the ability to make decisions adults who have a parent with a mood disorder have a – Frequent physical complaints (for example, headache, greater chance of also having a mood disorder. stomachache, or tiredness) that don’t get better with However, life events and stress can expose or worsen treatment feelings of sadness or depression. This makes the feelings harder to manage. – Running away or threats of running away from home Sometimes, life’s problems can trigger depression. – Very sensitive to failure or rejection Being fired from a job, getting divorced, losing a loved one, death in the family, and financial trouble, to name a – Irritability, hostility, or aggression few, all can be difficult and coping with the pressure may be troublesome. These life events and stress can bring How are mood disorders diagnosed? on feelings of sadness or depression or make a mood Mood disorders are a real medical disorder. disorder harder to manage.  A psychiatrist or other mental health professional The patient's brain is stimulated with a brief controlled usually diagnoses mood disorders through a complete series of electrical pulses. This causes a medical history and psychiatric evaluation. seizure within the brain that lasts for approximately a minute. How are mood disorders treated? Mood disorders can often be treated with success. The patient is asleep for the procedure and awakens Treatment may include: after 5-10 minutes, much as from minor surgery. – Antidepressant and mood stabilizing Risks: medicines—especially when combined with ECT treatment has been associated with temporary psychotherapy have shown to work very well in the memory loss and temporary difficulty learning. treatment of depression risks of general anesthesia – Psychotherapy—most often cognitive-behavioral - Transcranial Stimulation (magnetic pulses) and/or interpersonal therapy. This therapy is focused on TMS targets the activity of nerve cells in your brain, changing the person’s distorted views of himself or which may help with depression. It could also help for herself and the environment around him or her. It also OCD, anxiety, and PTSD. helps to improve interpersonal relationship skills, and identifying stressors The procedure may also improve motor dysfunction, in the environment and how to avoid them. benefiting those with Parkinson’s disease, multiple sclerosis, or stroke rehabilitation. – Family therapy- The aim of family therapy is to find ways for family members to help each other. In family TMS is mainly used to treat depression. It’s had therapy, a therapist works with families and those in success helping people who don’t respond to close relationships who experience problems. The antidepressant medication and psychotherapy. therapist explores their views and relationships to understand the problems they are The therapy is done by a TMS technician or TMS having. physician. – Other therapies, such as electroconvulsive therapy Transcranial Stimulation benefits: and transcranial stimulation TMS is primarily used to treat major depressive - Electroconvulsive Therapy disorder (MDD), sometimes simply called depression. -medical treatment most commonly used in patients with severe major depression or bipolar disorder that has not It’s generally recommended for those who haven’t responded to other treatments. found relief from medication and psychotherapy. > ECT involves a brief electrical stimulation of the good treatment for OCD, PSTD, anxiety, stroke, brain while the patient is under anesthesia. schizophrenia, among others > It is typically administered by a team of trained medical > ECT uses electric currents to induce a professionals that includes a psychiatrist, an seizure, while TMS uses magnetic pulses to anesthesiologist, and a nurse or physician assistant. stimulate the brain in a non-invasive way. > Note: It does not prevent a return of the illness in the How are mood disorders treated? future. Families play a vital supportive role in any treatment process. > Usually, there is a need to continue with some type of maintenance treatment. When correctly diagnosed and treated, people with medication mood disorders can live, stable, productive, healthy psychotherapy lives. Patients typically receives ECY 2 or 3 times a week or 6 to 12 treatments Can mood disorders be prevented? At this time, there are no ways to prevent or reduce patient is given first anesthesia and a muscle relaxant the incidence of mood disorders. and electrodes are attached to the scalp at precise However, early diagnosis and treatment can reduce locations. the severity of symptoms, enhance the person’s normal growth and development, and improve the quality of life of people with mood disorders.  - Issues with communication, child doesn't Lesson 17. Other Psychological Disorders respond to his/her name - Hysterics A List of Psychological Disorders - Preferred to play alone The term psychological disorder is sometimes used to - Sensitive to loud noises refer to what is more frequently known as mental - Tiptoeing disorders or psychiatric disorders. Mental disorders are - Avoiding eye contact patterns of behavioral or psychological symptoms that - Ignoring the danger impact multiple areas of life. These disorders create - Delayed speech improvement distress for the person experiencing these symptoms. - Aversion to touching While not a comprehensive list of every mental > These disorders are characterized by qualitative disorder, the following list includes some of the major deficits in the development of reciprocal social categories of disorders described in the Diagnostic and interaction, verbal and nonverbal communication skills, Statistical Manual of Mental Disorders (DSM). The latest and imaginative play; restricted repetitive and edition of the diagnostic manual is the DSM-5 and was patterns of behavior, interests, and activities; and released in May of 2013. The DSM is one of the most stagnation of development or loss of skills. widely used systems for classifying mental disorders and provides standardized diagnostic criteria. > Symptoms and signs may include, but are not limited to, abnormalities and unevenness in the development of cognitive skills; unusual responses to Attention Deficit Hyperactive Disorder sensory stimuli; and behavioral difficulties, including (ADHD) hyperactivity, short attention span, being impulsive, is characterized by a pattern of behavior, aggressive, or actions of self-injury. present in multiple settings (e.g., school and home), that can result in performance issues in Conduct Disorders social, educational, or work settings. is characterized by behavior that violates either the rights of others or major societal norms. divided into two categories of inattention and hyperactivity and impulsivity that include behaviors These symptoms must be present for at least three like failure to pay close attention to details, difficulty months with one symptom having been present in the organizing tasks and activities, excessive talking, past six months. fidgeting, or an inability to remain seated in appropriate situations. To be diagnosed with conduct disorder, the symptoms must cause significant impairment in social, academic or ADHD Signs and Symptoms in Children: - Forgetfulness occupational functioning. The disorder is typically - Carelessness diagnosed prior to adulthood. - Risky behavior - Trouble getting along Disruptive Mood Dysregulation Disorder (DMDD) - Disorganization > its symptoms go beyond describing temperamental - Excessive talking children to those with a severe impairment that requires - Daydreaming clinical attention. - Difficulties staying still Autism Spectrum Disorder (ASD) is characterized by severe and recurrent temper People with ASD tend to have communication deficits, outbursts that are grossly out of proportion in intensity or such as responding inappropriately in conversations, duration to the situation. misreading nonverbal interactions, or having difficulty building friendships appropriate to their age. These occur, on average, three or more times each > In addition, people with ASD may be overly dependent week for one year or more. on routines, highly sensitive to changes in their environment, or intensely focused on inappropriate items > Between outbursts, children with DMDD display a persistently irritable or angry mood, most of the day and > The symptoms of people with ASD will fall on a nearly every day, that is observable by parents, continuum, with some individuals showing mild symptoms and others having much more severe teachers, or peers. symptoms. This spectrum will allow clinicians to account for the variations in symptoms and behaviors from > A diagnosis requires the above symptoms to be person to person. present in at least two settings (at home, at school, or with peers) for 12 or more months, and symptoms must Autism Early Signs be severe in at least one of these settings  During this period, the child must not have gone three > DSM-5 criteria reduce the frequency of binge eating or more consecutive months without symptoms. and compensatory behaviors that people with bulimia nervosa must exhibit, to once a week from twice weekly The onset of symptoms must be before age 10, and a as specified in DSM-IV. DMDD diagnosis should not be made for the first time before age 6 or after age 18. Common Symptoms of Bulimia: - Eating a significant amount of food in a limited Feeding and Eating Disorders time (binging) Binge Eating is defined as recurring episodes of eating significantly - Experiencing feelings of guilt, shame, or anxiety more food in a short period of time than most people after eating would eat under similar circumstances, with episodes marked by feelings of lack of control. Someone with - Preoccupation with body weight or shape binge eating disorder may eat too quickly, even when he or she is not hungry. - Purging food from the body after eating > The person may have feelings of guilt, - Use of diet pills or diuretics to control weight embarrassment, or disgust and may binge eat alone to hide the behavior. - Excessive exercise to prevent weight gain > This disorder is associated with marked distress and Intellectual Disability occurs, on average, at least once a week over three > Intellectual disability involves impairments of general months. mental abilities that impact adaptive functioning in three domains, or areas. These domains determine This change is intended to increase awareness of the how well an individual copes with everyday tasks: substantial differences between binge eating disorder and the common phenomenon of overeating. The conceptual domain includes skills in language, reading, writing, math, reasoning, knowledge, and Anorexia Nervosa memory. which primarily affects adolescent girls and young women, is characterized by distorted body image and The social domain refers to empathy, social excessive dieting that leads to severe weight loss with a judgment, interpersonal communication skills, the pathological fear of becoming fat. ability to make and retain friendships, and similar Capacities. - Criterion A focuses on behaviors, like restricting calorie intake, and no longer includes the word The practical domain centers on self-management in “refusal” in terms of weight maintenance since areas such as personal care, job responsibilities, money that implies intention on the part of the patient management, recreation, and organizing school and and can be difficult to assess. work tasks. - The DSM-IV Criterion D requiring amenorrhea, > While intellectual disability does not have a specific or the absence of at least three menstrual age requirement, an individual’s symptoms must begin cycles, will be deleted. during the developmental period and are diagnosed based on the severity of deficits in - This criterion cannot be applied to males, adaptive functioning. pre-menarchal females, females taking oral contraceptives and post- menopausal females. > The disorder is considered chronic and often In some cases, individuals exhibit all other co-occurs with other mental conditions like depression, symptoms and signs of anorexia nervosa but attention-deficit/hyperactivity disorder, and autism still report some menstrual activity. spectrum disorder Internet Gaming Disorder > The Internet is now an integral, even inescapable part Bulimia Nervosa of many people’s daily lives; they turn to it to send is characterized by frequent episodes of binge eating messages, read news, conduct business and much followed by inappropriate behaviors such as self-induced more. But recent scientific reports have begun to focus vomiting to on the preoccupation some people develop with certain avoid weight gain. aspects of the Internet, particularly online games.  strategies and accommodations to help maintain > The “gamers” play compulsively, to the exclusion of independence and perform activities of daily living other interests, and their persistent and recurrent online activity results in clinically significant impairment or To be diagnosed with this disorder, there must be distress. changes that impact cognitive functioning. These symptoms are usually observed by the individual, a > People with this condition endanger their academic or close relative, or other knowledgeable informant, such job functioning because of the amount of time they as a friend, colleague, or clinician, or they are detected spend playing. They experience symptoms of withdrawal through objective testing. when kept from gaming. Obsessive Compulsive and Related Disorders > Much of this literature stems from evidence from Asian Hoarding Disorders countries and centers on young males. The studies > is characterized by the persistent difficulty discarding suggest that when these individuals are engrossed in or parting with possessions, regardless of the value Internet games, certain pathways in their brains are others may attribute to these possessions. triggered in the same direct and intense way that a drug addict’s brain is affected by a particular > The behavior usually has harmful effects—emotional, substance. physical, social, financial, and even legal—for the person suffering from the disorder and family members. > The gaming prompts a neurological response that For individuals who hoard, the quantity of their collected influences feelings of pleasure and reward, and the items sets them apart from people with normal collecting result, in the extreme, is manifested as addictive behaviors. behavior. > They accumulate a large number of possessions that Major depressive Disorder and the “Bereavement often fill up or clutter active living areas of the home or Exclusion” workplace to the extent that their intended use is no > is a medical illness that affects how you feel, think and longer possible. behave causing persistent feelings of sadness and loss of interest in previously enjoyed activities. Excoriation (Skin-Picking) Disorder > is characterized by recurrent skin-picking resulting in > Depression can lead to a variety of emotional and skin lesions. physical problems. It is a chronic illness that usually requires long-term treatment. > Individuals with excoriation disorder must have made repeated attempts to decrease or stop the skin picking, - While the grieving process is natural and unique to which must cause clinically significant distress or each individual and shares some of the same features of impairment in social, occupational or other important depression like intense sadness and withdrawal from areas of functioning. The symptoms must not be better customary activities, grief and depression are also explained by symptoms of another mental disorder. different in important aspects: Personality Disorders In grief, painful feelings come in waves, often > are associated with ways of thinking and feeling about intermixed with positive memories of the oneself and others that significantly and adversely affect deceased; in depression, mood and ideation are how an individual functions in many aspects of life. almost constantly negative. > They fall within 10 distinct types: paranoid personality In grief, self-esteem is usually preserved; in disorder, schizoid personality disorder, schizotypal MDD, corrosive feelings of worthlessness and personality disorder, antisocial personality disorder, self-loathing are common. borderline personality disorder, histrionic personality, narcissistic personality disorder, avoidant personality While many believe that some form of disorder, dependent personality disorder and depression is a normal consequence of obsessive-compulsive personality disorder. bereavement, MDD should not be diagnosed in the context of bereavement since diagnosis The hybrid methodology retains six personality would incorrectly label a normal process as a disorder types: disorder. 1. Borderline Personality Disorder - Intense emotions Mild Neurocognitive Disorder - Fears of abandonment goes beyond normal issues of aging. It describes a - Unstable relationsgips level of cognitive decline that requires compensatory - Identity issues  - Aggressiveness 2. Obsessive Compulsive Personality Disorder 6. Nacissistic Personality Disorder (OCPD) - Feeling superior or special - Preoccupation with orderliness, perfectionism in - Lack of empathy areas such as cleanliness and order - Need for admiration - Exploiting others - Inflexible, rigid rules irrespective of - Sensitive to rejection consequences Other psychological disorders: - Intense attention to detail, lists and procedures often leading the point of the task being 1. Gender Dysphoria redundant 2. Paraphilic Disorder 3. Posttraumatic Stress Disorder - Individuals can lack insight into their behavior 4. Schizophrenia and impact and often have no desire to change 5. Sleep-Wake Disorders 6. Specific Learning Disorder - Individuals can have both OCD and OCPD 7. Social Communication Disorder (OCD is a mental health disorder 8. Somatic Symptom Disorder characterized by excessive thoughts and 9. Substance-Related and Addictive Disorders repetitive behaviors. OCPD, on the other hand, is a personality disorder. Unlike a mental Lesson 18. Prevention and Treatment of health disorder that may be short-term and Psychological Disorders treatable, a personality disorder is a lifelong disorder that disrupts thoughts, behavior, and Mental Health Promotion mood.) It refers to positive mental health, considering mental - Often inflexible on areas such as values, morals health as a resource, as a value on its own and as a and ethics, can be forceful of others to follow the basic human right essential to social and economic same principles development. - 2%-8% of the general population are thought to “Mental health promotion activities imply the creation have OCPD of individual, social and environmental conditions that enable optimal psychological and psychophysiological - Lack of awareness of others and their development. frustration, often believing they are at fault for not operating in the same way Such initiatives involve individuals in the process of achieving positive mental health, enhancing quality of 3. Avoidant Personality Disorder life and narrowing the gap in health expectancy between - Choosing isolation over social situations countries and groups. - Hypersensitive to criticism - Fear of being embarrassed It is an enabling process, done by, with and for the - Poor self-image people. Prevention of mental disorders can be 4. Schizoid Personality Disorder considered one of the aims and outcomes of a broader - Does not want or enjoy close relationships mental health promotion strategy. - Has an apparent indifference to praise or criticism by others Macro-strategies to reduce risk and improve quality of life: - Rarely experiences or expresses strong Improving nutrition emotions Improving housing - Has little or no desire for sexual activity Improving access to education Reducing economic insecurity - Chooses hobbies, activities and jobs that are solitary in nature, like playing an instrument, Strengthening community networks gaming, or working on cars Reducing the harm from addictive substances 5. Antisocial Personality Disorder - Disregard for rules Reducing stressors and enhancing resilience: - Disregard for the rights of others Promoting a healthy start in life - Deceitfulness Reducing child abuse and neglect - Manipulation Coping with parental mental illness  Enhancing resilience and reducing risk behaviour in What can be done to improve psychological schools disorders? In addition to seeking and receiving treatment, a Dealing with family disruption person may be able to improve his symptoms and Intervening at the workplace decrease his risk of recurrence by: Supporting refugees – Avoiding alcohol or illicit drug use Ageing mentally healthy –Avoiding caffeine or other stimulants How are psychological disorders treated? – Eating on a regular schedule The first step in the treatment of psychological – Exercising regularly disorders is recognizing that a problem exists. Often, – Getting enough sleep people who have psychological disorders deny their problem and do not seek medical care for their –Keeping appointments and taking medications symptoms. Regular medical care can be helpful because as directed it allows a health care professional to provide early screening tests. Regular medical care also provides an opportunity for your health care professional to promptly evaluate symptoms and your risks for developing psychological disorders. Treatment frequently involves psychotherapy to work on behaviors, skill development, and thought process. Initial hospitalization may be necessary for coexisting medical problems, serious complications, severe disorders, or substance abuse. Medications can be quite helpful for some personality disorders. Significant improvement can occur with proper treatment. Common Treatments for Psychological Disorders Antianxiety medications Antidepressant medications to improve moods Antipsychotic medications to treat disordered thought patterns and altered perceptions Cognitive Behavioral Therapy to work on thought patterns and behavior Family therapy to help develop support and understanding Group therapy Hospitalization for coexisting medical problems, serious complications, severe disorders, or substance abuse Identification and treatment of coexisting conditions Individual therapy Mood-stabilizing medications Psychodynamic therapy to work on discovering and understanding past issues and their relationship to current thoughts and behaviors Support groups Talk therapy