Treatments for Psychological Disorders PDF

# Treatments for psychological disorders ## Overview of Treatments - **Biomedical** - Drug therapy - Electric and magnetic therapies - **Psychological** - Psychoanalytic/psychodynamic - Humanistic/positive - Behavioral - Cognitive-behavioral - Group - **Technology-b...

# Treatments for psychological disorders ## Overview of Treatments - **Biomedical** - Drug therapy - Electric and magnetic therapies - **Psychological** - Psychoanalytic/psychodynamic - Humanistic/positive - Behavioral - Cognitive-behavioral - Group - **Technology-based** - Virtual reality - Online therapies - **Combined** - Drugs & psychotherapy - Integrative - Mindfulness + psychotherapy - **Emerging** - Psychedelic - Genetic/optogenetic ## Drug Therapy ### Traditional Antipsychotics - Side effects: fatigue, visual impairment, tardive dyskinesia - Tardive Dyskinesia: involuntary movements of jaw, tongue, face, mouth and body tremors #### **Penothiazines** - Helps treat schizophrenia - Diminish hallucinations, confusion, agitation and paranoia - Found by Henri Laborit - Block dopamine receptors ##### **Types of Penothiazines** - Chlorpromazine/Thorazine - Haloperidol (Haldol) ### Atypical Antipsychotics - Newer drugs/second generation - Less likely to give Tardive Dyskinesia - Block different types of dopamine receptors - Does not work better than traditional - Side effects: major weight gain, risk of diabetes, reduction of white blood cells, Problems with balance, liver disease, cardiovascular problems, cancer. #### **Types of Atypical Antipsychotics** - Clozapine(Clozaril) - Olanzapine (Zyprexa) - Risperidone (Risperdal) ## Depression ### Monoamine oxidase (MAO) inhibitors - For depression - Breaks down monoamine neurotransmitters (norepinephrine, epinephrine, dopamine, serotonin) - Inhibits actions of enzymes-> neurotransmitters stay active in synapses for longer duration-> improves moods - Rarely prescribed because of life-threatening increase in blood pressure #### **Types of MAO** - Marplan, Nardin, Parnate ### Tricyclic Antidepressants - Also used for ADHD - Blocking reuptake of serotonin and norepinephrine almost equally. - Side effects include; dry mouth, weight gain, irritability, confusion, constipation - Mostly side effects come from norepinephrine #### **Types of Tricyclic Antidepressants** - Imipramine and amitriptyline/Elavil, Anafranil ### Bubropion - Side effects; Weightloss, dry mouth, headaches #### **Types of Bubropion** - Wellbutrin ## Selective Serotonin Reuptake Inhibitors (SSRIs) - Make more Serotonin available in the synapse - Presynaptic neuron->Serotonin releases->synapse - Binds with Serotonin specific sites on the post synaptic neuron - Simulates firing of neurons #### **Types of SSRIs** - Prozac(fluoxitine) - Zoloft(Sertraline) - Paxil(Paroxetine) - Celexa (Citalopram) ## Anxiety ### Benzodiazepines - Calming - Addictive #### **Types of Benzodiazepines** - Valium - Librium - Xanax ## Barbiturates - Addictive, higher chance of overdose - Slows breathing and heart rate #### **Types of Barbiturates** - Pentobarbital ## Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) - Used for both depression and anxiety and even OCD, disorders of impulse control; compulsive gambling, skin picking - Enhances both serotonin and norepinephrine - Blocks reuptake/reabsorbtion= more Serotonin and norepinephrine - More effective than SSRIS - Side effects; agitation, insomnia, nausea, difficulty in orgasm and increased likelihood of suicide #### **Types of SNRI** - Pristiq and Effexor ## Bipolar ### Lithium - Stabilize mania - Inhibits excitatory cellular, enzymatic and neurochemical activity from glutamate and enzyme that produces glycogen - Glycogen is form of energy used by the body - Side effect; increased thirst diarrhea, nausea, tremors, cognitive problems, kidney failure, brain damage, cardiac effects - Difficult to determine effective dosage #### **Types of Lithium** - Lithobid ## Electric and Magnetic Therapies ### Electroconvulsive - Passing electrical current through a person's brain - For major depression - Electrodes to the patient's head with voltage 60 to 140 - Standard ECT 12 sessions - Increase the volume of amygdala and hippocampus - Increase Grey matter - Side effects: Memory loss because of destroyed brain tissue ### Repetitive Transcranial Magnetic Stimulation - For major depression and negative side effects of schizophrenia - Stimulate the outer layer of the cortex - Expose brain in high-intensity magnetic fields instead of electricity. ### Transcranial Direct Current Stimulation - Stimulate subcortical brain structures - Shows great promise in preventing relapse - May help prevent substance abuse ## Deep brain stimulation - Planting Electrodes to the brain for electric stimulation in specific regions and cluster of neurons - Stimulates the brain for people with depression causing better mood - Shows promise for dementia, anorexia, OCD ## Psychotherapy - Use of psychological techniques based on theories to modify maldaptive behaviors and thought patterns #### **Types of Psychotherapy** * **Psychoanalytic-Psychodynamic Therapy** - Original form of talk therapy - From Freud's theory - Meeting 3-5 times a week - Uncovering unconscious motives more so through dream interpretation ##### **Techniques of Psychodynamic** - Free association- recounts dream and takes idea of whatever comes to mind - Association with all the recalled dreams image - Symbols in dreams interpretations ## Transference - Unconscious reaction to the therapist as if it's someone from their past - Could be anyone in the current situation or life of the client - Brings out unconscious reactions, thoughts and emotions to a situation. ## Catharsis - Process of releasing intense unconscious emotions in a therapeutic setting ## Humanistic/positive therapy - Help client reach their greatest potential - From humanistic psychology of Rogers ### **Techniques** * **Client centered therapy** - Idea that humans have mental health problems because their ideal self is far from who they are - Create a safe environment where client can be who they are without judgment - Unconditional positive regards with genuine acceptance and empathy ## Behavior Therapy - Apply classical and operant conditioning - Focus on changing behavior rather than thoughts, feeling or emotions - Eliminates undesirable behaviors and increase desirable ones ### **Techniques** * **Token economies** - Treat maldaptive behaviors through operant conditioning - Desirable behavior= chip/coin= privileges - May help with substance abuse for people with schizophrenia - May help with life skills of children with autism * **Systematic desensitization** - Mostly used for simple phobias and anxiety disorders - Relaxation + gradual exposure to a phobic object - Increasing contact with feared object from mild to extreme - Relys on the fact that people cannot be both anxious and relaxed at the same time * **Levels** - Imagine, virtual, real * **Implosion Therapy or Flooding** - Vivo exposures or extreme exposures to phobic objects - Heavy exposure not gradually ## Cognitive - Identify Irrational thoughts and patterns then challenges these thoughts - Restructure Irrational thought patterns - Socrates method; giving client questions that help recognize erroneous thoughts. - Time limited and collaborative ### **Cognitive behavioral** - Cognitive + behavioral techniques to shape desirable and rational thoughts and behaviors - Short term treatment applied to PTSD, depression, OCD, Phobia, Eating disorders, substance abuse. - Change the way client evaluates potential emotional threats - Encourages reappraisal; reexamination of events that was viewed stressful ### **Group Therapy** - People with the same problems meet in therapy - Therapist as facilitator - Follows a structured process - Helps remove feeling of isolation ### **Support groups** - Less structured therapeutic context - People with common situation share experience without pragmatic treatment goals. - Facilitator, meeting time, open format. - Offer sense of community ## Evidence based therapies - Treatment choices based on empirical evidence of their efficacy ## Technology based therapies - A more accessible therapy with the use of technology ### **Types** * **Virtual reality therapies** - Virtual/digital simulations of environment that are hard to create otherwise - For Phobias or PTSD - Can use VR * **Second life** - Virtual environment where others interact real time * **olive online therapy** - Mostly for those in areas where therapy is not accessible ## Combined Approaches ### **Types** * **Drugs and Psychotherapy** - combining medications with psychological approaches to deal with both biological and psychological factors * **Integrative therapy** - Eclectic approach where one uses numerous techniques on clients - Adjust techniques to situation without bias to any technique ## Prolonged exposure therapy - For people with PTSD - combines CBT and desensitization and relaxation - Sometimes combined with drugs for Anxiety disorders ## Mindfulness training and Psychotherapy - Makes use of mindfulness meditation; Mediator is trained to calm both body and mind to notice thoughts and feelings without linging to those thoughts and feeling - Help people keep thoughts and emotions in perspective - CBT+ mindfulness therapy - Standard cognitive patterns help recognize depressogenic thought patterns + mindfulness meditation helps approach thoughts non-judgmentaly ## Dialectical Behavior Therapy - For borderline personality disorder - CBT+mindfulness without medications - Individual as well as group therapy helps client develop non-judgmental attitudes towards their own emotions and accept their current behavior ## Emerging Therapies - Existing new therapies that are not fully developed and tested ### **Types** * **Genetic Therapies** - Attempt to influence genes ### **Types of genetic approach** * **Optogenetics** - Applying light to neurons to control their activity by altering expression of certain genes - More precise brain stimulation * **Psychedelic Medicine** - Controlled usage of psychedelic drugs to treat physical and mental disorders ## MDMA Assisted psychotherapy - for PTSD - Makes client more comfortable with their emotions - Psychotherapeutic helps client verbalize - Client sits with two therapist or a sitter and a therapist, explains the possible effect of the drug - Possible placement of placebo instead of the drug - Follow up sessions but only 1 or 2 times - Drug is only for the initial session - May be tried as last resort for people with depression