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195 Cards in this Set
- Front
- Back
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What is the science of psychopathology?
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The scientific study of psychological disorders.
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Define psychological disorder
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-Psychological dysfunction associated with distress
-impairment in functioning that is not a typical or culturally expected response. |
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Who was John Grey (briefly)?
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Champion of the biological tradition in the US
Most influential psychiatrist at the time Believed insanity was always due to physical causes, therefore the mentally ill should be treated as physically ill. Rest, diet, and proper room temperature and ventilation |
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When were the first effective medications for severe psychotic disorders created?
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1927-insulin shock therapy
During the 1950’s |
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Who was Carl Rogers and what concepts were tied to his humanistic theories?
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(1902-1987)
Originated client-centered therapy (person-centered therapy) Therapist takes a passive role making as few interpretations as possible Unconditional Positive Regard Complete and almost unqualified regard and acceptance of a clients feelings and actions Empathy Sympathetic understanding of an individual’s particular views |
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Who is considered the founder of behaviorism?
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John B. Watson
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B.F. Skinner (1904-1990)
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Operant Conditioning: behavior changes as a result of what happens after the behavior
Reinforcement, shaping |
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Joseph Wolpe (1915-1997)
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Pioneering psychiatrist from South Africa
Founder of systematic desensitization to help his clients with phobias Used Behavioral Therapy |
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What is the multidimensional integrative approach to psychopathology? What plays an influence?
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Approach to the study of psychopathology which holds that psychological disorders are always the products of multiple interacting causal factors.
Biological Dimensions: causal factors from the fields of genetics and neuroscience Psychological dimensions: causal factors from behavioral and cognitive processes Emotional Influences Social influences Interpersonal Influences Developmental Influences |
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What is the diathesis-stress model and how does it work?
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INHERITED TENDENCY+STRESS=DISSORDER
Hypothesis that both an inherited tendency (a vulnerability) and specific stressful conditions are required to produce a disorder. A model that takes a multidimensional approach Individuals inherit tendencies to express certain traits or behaviors, which may then be activated under conditions of stress. Each inherited tendency is a diathesis, which means, literally, a condition that makes one susceptible to developing a disorder. |
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What is the reciprocal Gene-Environment Model and how does it work?
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PREDISPOSITION+TENDANCY TO CREATE RISK FACTORS=DISSORDER
Hypothesis that people with a genetic predisposition for a disorder may also have a genetic tendency to create environmental risk factors that promote the disorder. Ex: people with a genetic vulnerability to develop a certain disorder, such as blood-injury-injection phobia, may also have a personality trait—lets say impulsiveness—that makes them more likely |
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What is serotonin? What does the serotonin system regulate? What happens with extremely low activity levels of serotonin? Low serotonin activity has been associated with what? What drugs affect the serotonin system?
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Neurotransmitter involved in processing information and coordination of movement as well as inhibition and restraint; it also assists in the regulation of eating, sexual, and aggressive behaviors, all of which may be involved in different psychological disorders. Its interaction with dopamine is implicated in schizophrenia and Parkinsons.
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What is GABA (you don’t need to remember its full name)? What does it do? What does it inhibit primarily? What class of drugs makes it easier for the molecules to attach themselves to the receptors of some neurons? What disorder does GABA play a large effect? Is it specific to that disorder?
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Neurotransmitter that reduces activity across the synapse and thus inhibits a range of behaviors and emotions, especially generalized anxiety.
Dissorders: anxiety |
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What is norephinephrine? What system is it a part of? What two groups of receptors does it stimulate? How are beta blockers related? Where are the primarily located?
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Neurotransmitter that is active in the central and peripheral nervous systems controlling heart rate, blood pressure, and respiration, among other functions. Because of its role in the body's alarm reaction, it may also contribute in general and indirectly to panic attacks and other disorders.
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What is dopamine? In what disorders has it been implicated? What kinds of behaviors are dopamine receptors associated with? How does L-Dopa relate?
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Neurotransmitter whose generalized function is to activate other neurotransmitters and to aid in exploratory and pleasure-seeking behaviors (thus balancing serotonin). A relative excess of dopamine is implicated in schizophrenia (though contradictory evidence suggests the connection is not simple) and its deficit is involved in Parkinson's disease
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Define learned helplessness
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Seligman's theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether in reality they do or not).
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Whose name is linked to modeling? And what is modeling or observational learning?
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Whose name is linked to modeling? And what is modeling or observational learning?
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Define clinical assessment
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Systematic evaluation measurement of:
psychological biological social factors in a person presenting with a possible psychological disorder. -Understand -Predict behavior -Plan treatment -Evaluate treatment outcome |
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What is a behavioral assessment?
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Behavioral Assessment-
Measuring, observing, and systematically evaluating (rather than inferring) the client’s thoughts, feelings and behavior in the actual problem situation or context. Focus on here and now Direct and minimally inferential Target behaviors are identified and observed |
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What are the ABCs of Observation?
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The ABCs (antecedents, behaviors, and consequences)
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What does Serotonin Regulate?
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eating
sexual aggressive behaviors |
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What happens with low levels of Serotonin?
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less inhibition
instability impulsivity overreact to situations Aggression suicide impulsive overeating excessive sex |
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What drugs effect Serotonin?
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SSRIs
Tricyclic antidepressants: imipramine (brand name Tofranil) Serotonin Specific Reuptake Inhibitors: SSRIs (Prozac) Used to treat anxiety, mood, eating disorders (fen/phen) |
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What is GABA and what does it do?
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Neurotransmitter that Reduces Postsynaptic Activity, or activity across the synapse and thus inhibits a range of behaviors and emotions,
Reduces Anxiety, and tempers emotional responses |
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What class of drugs makes it easier for the molecules to attach themselves to the receptors of some neurons?
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Benzodizepines (mild tranquilizers) make it easier for GABA molecules to attach themselves to the receptors of specialized neurons. Higher the level of benzodianzepines, the more GABA that becomes attached to neurotransmitters and the calmer we become. Relax muscles and reduces spasams
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What disorder does GABA play a large effect?
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Anxiety
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What is norephinephrine?
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Neurotransmitter that is active in the central and peripheral nervous systems controlling heart rate, blood pressure, and respiration, among other functions.
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What system is norepinephrine a part of?
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Endocrine System
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What two groups of receptors does GABA stimulate?
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1.alpha-adrenergic 2.beta-andrenergic receptors
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How are beta blockers related to norephinepnrine?
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Beta Blockers block the beta-receptors so their response to a surge of norepinephrine is reduced.
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Where are norepinephrine receptors the primarily located?
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Central Nervous System: one major circuit begins in the hindbrain
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What is dopamine?
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Neurotransmitter whose generalized function is to activate other neurotransmitters
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What does dopamine balance?
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Seratonin
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In what disorders has it been dopamine implicated?
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A relative excess of dopamine is implicated in schizophrenia (though contradictory evidence suggests the connection is not simple) and its deficit is involved in Parkinson's disease.
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What kinds of behaviors are dopamine receptors associated with?
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Exploratory and Pleasure Seeking
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How does L-Dopa relate to dopamine?
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L-Dopa is a dopamine agonist, thus increasing levels of dopamine. Since Dopamine switches on the locomotor system, L-dopa has been successful in reducing some of the effects of Parkinson's such as tremors, rigidity in muscles, and difficulty with judgment.
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There is quite a bit of evidence that depression is related to the biological effects of stress. Which of the following is NOT evidence for this?
a)Depressed patients show greatly increased levels of cortisol in their blood. b)Depressed patients in one study each had a smaller hippocampus than nondepressed patients. c)Individuals with underactive thyroid glands (hypothyroidism) show many of the features of depression. d)The infusion of CRF (corticotropin releasing factor) in the brains of animals produces many of the signs of depression. |
D
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______________ are prescribed less frequently because of the potential fatal side effects when combined with foods such as wine or aged cheese.
a)Tricyclic antidepressants b)MAO inhibitors c)SSRIs d)Atypical antidepressants |
B
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4. Which of the following is NOT associated with a high suicide rate?
a)generalized anxiety disorder b)alcohol abuse c)schizophrenia d)homicidal people |
D
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Tricyclic antidepressants
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are heterocyclic chemical compounds used primarily as antidepressants. The TCAs were first discovered in the early 1950s and were subsequently introduced later in the decade; [1] They are named after their chemical structure, which contains three rings of atoms. The tetracyclic antidepressants (TeCAs), which contain four rings of atoms, are a closely related group of antidepressant compounds.
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)MAO inhibitors
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are a class of antidepressant drugs prescribed for the treatment of depression. They are particularly effective in treating atypical depression.
Because of potentially lethal dietary and drug interactions, monoamine oxidase inhibitors have historically been reserved as a last line of treatment, used only when other classes of antidepressant drugs (for example selective serotonin reuptake inhibitors and tricyclic antidepressants) have failed |
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SSRIs
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Selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitor[1] (SSRIs) are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders. They are also typically effective and used in treating some cases of insomnia.
SSRIs are believed to increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin in the synaptic cleft available to bind to the postsynaptic receptor. They have varying degrees of selectivity for the other monoamine transporters, with pure SSRIs having only weak affinity for the noradrenaline and dopamine transporter. |
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Atypical antidepressants
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is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. According to Gelder, Mayou &*Geddes (2005) people with a depressive illness will experience a therapeutic effect to their mood, however this will not be experienced in healthy individuals. Drugs including the monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), tetracyclic antidepressants (TeCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) are most commonly associated with the term. These medications are among those most commonly prescribed by psychiatrists and other physicians, and their effectiveness and adverse effects are the subject of many studies and competing claims. Many drugs produce an antidepressant effect, but restrictions on their use have caused controversy and off-label prescription a risk, despite claims of superior efficacy.
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generalized anxiety disorder (GAD): sociocultural perspective
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Danger
societal stress stressful events |
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suicide rate alcohol abuse
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Alcohol abusers make up 20 percent of suicides
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suicide rate schizophrenia
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There is a higher than average suicide rate associated with schizophrenia. This has been cited at 10%, but a more recent analysis of studies and statistics revises the estimate to 4.9%, most often occurring in the period following onset or first hospital admission.[91] Several times more (20 to 40%) attempt suicide at least once.[92][93] There are a variety of risk factors, including male gender, depression, and a high intelligence quotient.
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generalized anxiety disorder (GAD): The psychodynamic perspective
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Freud believed that all children experience anxiety
Realistic anxiety when they face actual danger -Neurotic anxiety when they are prevented from expressing id impulses -Moral anxiety when they are punished for expressing id impulses - One can use ego defense mechanisms to control these forms of anxiety, but when they don’t work or when anxiety is too high…GAD develops Some support for psychodynamic perspective |
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Generalized anxiety disorder (GAD):
The humanistic approach |
-Theorists propose that GAD, like other
psychological disorders, arises when people stop looking at themselves honestly and acceptingly -Carl Rogers’s explanation:-Lack of “unconditional positive regard” in childhood leads to “conditions of worth” (harsh self-standards) -These threatening self-judgments break through and cause anxiety, setting the stage for GAD to develop |
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GAD: The Cognitive Perspective
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Psychological problems are often
caused by dysfunctional ways of thinking Ellis: Basic irrational assumptions Beck: Maladaptive assumptions that imply danger Perceptions of control New wave cognitive explanations In recent years, three new explanations have emerged: Metacognitive theory Developed by Wells; suggests that the most problematic assumptions in GAD are the individual’s worry about worrying (meta-worry) Intolerance of uncertainty theory Certain individuals believe that any possibility of a negative event occurring means that the event is likely to occur Avoidance theory Developed by Borkovec; holds that worrying serves a “positive” function for those with GAD by reducing unusually high levels of bodily arousal All of these theories have received considerable research support |
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GAD: The Cognitive PerspectiveAvoidance theory
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Developed by Borkovec; holds that worrying serves a “positive”
function for those with GAD by reducing unusually high levels of bodily arousal |
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GAD: The Cognitive Perspective Intolerance of uncertainty theory
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Certain individuals believe that any possibility of a negative event
occurring means that the event is likely to occur |
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meta-worry
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which involves beliefs about the positive and negative effects of worry, is considered to have a functional role in the development and maintenance of GAD.
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GAD: The Cognitive Perspective
Metacognitive theory |
Developed by Wells; suggests that the most problematic
assumptions in GAD are the individual’s worry about worrying (meta-worry) |
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Beck: Maladaptive assumptions
cognitive PERCEPTION |
• “I should be successful at everything I try”
• “If I am not successful, then I am a failure” • “If I fail, then I’m worthless (I’m unlovable, life is not worth living etc.)” • “Failure is intolerable and unacceptable” • “I should get the approval of everyone” • “If I am not approved of, then I am unlovalbe3 (ugly, worthless, hopeless, alone, etc)” • “I should be certain before I try something” |
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Ellis; Basic irrational assumptions
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LOOK
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GAD:Perceptions of control
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LOOK
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GAD: Cognitive Perspective
Two kinds of cognitive therapy: |
Changing maladaptive assumptions
Based on the work of Ellis and Beck Helping clients understand the special role that worrying plays, and changing their views and reactions to it |
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GAD: The Biological Perspective
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Biological theorists believe that GAD is
caused by biological factors Supported by family pedigree studies Twin studies suggest a modest genetic link GABA inactivity 1950s – Benzodiazepines (Valium, Xanax) found to reduce anxiety |
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GAD: The Biological Perspective
Therapy and treatment history |
Biological treatments
Antianxiety drug therapy Early 1950s: Barbiturates (sedative-hypnotics) Late 1950s: Benzodiazepines Provide temporary, modest relief Rebound anxiety with withdrawal and cessation of use Physical dependence is possible Produce undesirable effects (drowsiness, etc.) Mix badly with certain other drugs (especially alcohol) More recently: Antidepressant medications Relaxation training Biofeedback |
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Phobias
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From the Greek word for “fear”
Formal names are also often from the Greek Persistent and unreasonable fears of particular objects, activities, or situations People with a phobia often avoid the object or thoughts about it |
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Distinguish between fear and anxiety
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The difference between anxiety and fear is that, unlike fear, symptoms leading to anxiety occur even though there is no apparent risk or cause for physical harm. More often than not, the reason the individual feels anxious cannot be pinpointed. This is in stark contrast to fear, where the individual can readily determine the root cause of their fear.
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Distinguish between obsessions and compulsions.
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OBSESSIONS
Fear of dirt Fear of becoming ill Constant thoughts of a certain number Need to have something done in a certain order or a certain way Fear of germs Worry about whether something has been done "right" COMPULSIONS; Washing hands Brushing teeth Checking to see if appliances are turned off Checking to see if doors are locked Arranging items in a certain way Keeping items, such as containers, even if they are no longer needed Requiring constant approval from people around them. |
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Specific Phobias
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Persistent fears of specific objects or
situations When exposed to the object or situation, sufferers experience immediate fear Most common: Phobias of specific animals or insects, heights, enclosed spaces, thunderstorms, and blood |
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Social Phobias
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Severe, persistent, and unreasonable
fears of social or performance situations in which embarrassment may occur May be narrow – talking, performing, eating, or writing in public May be broad – general fear of functioning poorly in front of others In both forms, people rate themselves as performing less adequately than they actually do |
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agoraphobia
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AFRAID OF PANIC ATTACK. FEAR OF UNFAMILIAR PLACES . OUTSIDE
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What Causes Phobias
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Psychoanalytic theory
Little Hans Behavioral Theories Classical Conditioning Prepared Classical Conditioning Operant Conditioning Little Albert |
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What Causes Phobias? Biological Theories
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Studies have shown that those who suffer from anxiety disorders, including phobias, have a problem with the regulation of serotonin levels in their brains. Serotonin is a chemical that acts as a neurotransmitter. Neurotransmitters modulate the signals between neurons and other cells.
Genetic Predisposition An increasingly popular theory of mental disorders is based on the concept of triggering events. This model is commonly used to explain schizophrenia, but may also explain the development of phobias. Serotonin acts in the brain and, among other things, moderates mood. A serotonin level that is too high or too low can cause both depression and anxiety. Consequently, phobias are often treated with a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). |
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What Causes Phobias?
Cognitive Theories |
LOOK
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What Causes Phobias?
Other behavioral explanations |
LOOK
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How Are Phobias Treated?
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Behavioral techniques are most widely
used, especially for specific phobias Shown to be highly effective Include desensitization, flooding, and modeling – together called “exposure treatments” Often combined with cognitive techniques |
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flooding
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Flooding is a form of behavior therapy and based on the principles of respondent conditioning. It is sometimes referred to as exposure therapy or Prolonged exposure therapy. As a psychotherapeutic technique, it is used to treat phobia and anxiety disorders including post traumatic stress disorder. It works by exposing the patient to their painful memories,[1] with the goal of reintegrating their repressed emotions with their current awareness. Flooding was invented by psychologist Thomas Stampfl in 1967.[2] It still is used in behavior therapy today.
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desensitization
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is a process for mitigating the harmful effects of phobias or other disorders. It also occurs when an emotional response is repeatedly evoked in situations in which the action tendency that is associated with the emotion proves irrelevant or unnecessary. Agoraphobics, who fear open spaces and social gatherings outside their own home, may be gradually led to increase their interaction with the outside world by putting them in situations that are uncomfortable but not panic-provoking for them. Mastering their anxiety in very small doses can allow them to take greater steps to self-reliance. Desensitization can be an alternative or a supplement to anxiety-reducing medication.
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modeling
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1. a method used in certain techniques of psychotherapy whereby the client learns by imitation alone, without any specific verbal direction by the therapist (See Cognitive Behavior Therapy) and
2. a general process in which persons serve as models for others, exhibiting the behavior to be imitated by the others[1][2] This process is most commonly discussed with respect to children in developmental psychology. |
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exposure
treatments |
desensitization, flooding, and
modeling |
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Treatments for Social Phobias
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Two components must be addressed:
Overwhelming social fear Address fears behaviorally with exposure Lack of social skills Social skills and assertiveness trainings have proved helpful |
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Panic Disorder
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Panic, an extreme anxiety reaction, can result
when a real threat suddenly emerges The experience of “panic attacks,” however, is different Panic attacks are periodic, short bouts of panic that occur suddenly, reach a peak, and pass Sufferers often fear they will die, go crazy, or lose control Attacks happen in the absence of a real threat |
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Panic Disorder:
The Biological Perspective What biological factors contribute to panic disorder? |
Genetics
Neurotransmitters Research conducted in recent years has examined brain circuits and the amygdala as the more complex root of the problem |
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Panic Disorder:
The Biological Perspective Drug therapies |
Antidepressants are effective at preventing
or reducing panic attacks Some benzodiazepines (especially Xanax [alprazolam]) have also proved helpful |
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Panic Disorder:
The Cognitive Perspective Cognitive theorists recognize that biological factors are only part of the cause of panic attacks |
Anxiety sensitivity: Misinterpreting bodily
sensations as dangerous Interoceptive sensitivity: Sensing slight anxiety as signal that panic attack is imminent Perceptions of control |
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Panic Disorder:
The Cognitive Perspective Cognitive therapy |
Tries to correct people’s misinterpretations
of their bodily sensations May also use “biological challenge” procedures to induce panic sensations |
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Obsessive-Compulsive Disorder
Made up of two components: |
Obsessions
Persistent thoughts, ideas, impulses, or images that seem to invade a person’s consciousness Compulsions Repetitive and rigid behaviors or mental acts that people feel they must perform to prevent or reduce anxiety |
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What Are the Features of
Obsessions and Compulsions? |
Obsessions
Thoughts that feel both intrusive and foreign Attempts to ignore or resist them trigger anxiety Take various forms: Wishes Impulses Images Ideas Doubts Have common themes: Dirt/contamination Violence and aggression Orderliness Religion Sexuality |
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What Are the Features of
Obsessions and Compulsions? |
Compulsions
“Voluntary” behaviors or mental acts Feel mandatory/unstoppable Most recognize that their behaviors are irrational Believe, though, that catastrophe will occur if they do not perform the compulsive acts Performing behaviors reduces anxiety ONLY FOR A SHORT TIME! Behaviors often develop into rituals |
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OCD:
The Psychodynamic Perspective |
Anxiety disorders develop when children come to fear
their id impulses and use ego defense mechanisms to lessen their anxiety OCD differs from other anxiety disorders in that the “battle” is not unconscious; it is played out in dramatic thoughts and actions Id impulses = obsessive thoughts Ego defenses = counter-thoughts or compulsive actions At its core, OCD is related to aggressive impulses and the competing need to control them |
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Id impulses
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obsessive thoughts
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Ego defenses
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counter-thoughts or compulsive actions
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How does OCD differ from anxiety disorders
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the "battle” is not unconscious; it is played out in dramatic
thoughts and actions |
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OCD:
The Behavioral Perspective |
Behaviorists have concentrated on
explaining and treating compulsions rather than obsessions Although the behavioral explanation of OCD has received little support, behavioral treatments for compulsive behaviors have been very successful |
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OCD:
The Cognitive Perspective |
Cognitive theorists begin by pointing out
that everyone has repetitive, unwanted, and intrusive thoughts People with OCD blame themselves for normal (although repetitive and intrusive) thoughts and expect that terrible things will happen as a result Overreacting to unwanted thoughts To avoid such negative outcomes, they attempt to “neutralize” their thoughts with actions (or other thoughts) |
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OCD:
Cognitive Therapy |
Cognitive therapists focus on the
cognitive processes Cognitive-Behavioral Therapy (CBT) Research suggests that a combination of the cognitive and behavioral models is often more effective than either intervention alone May include: |
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Cognitive-Behavioral Therapy (CBT)
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is a psychotherapeutic approach, a talking therapy, that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure. The title is used in diverse ways to designate behavior therapy, cognitive therapy, and to refer to therapy based upon a combination of basic behavioral and cognitive research.[1]
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OCD:
The Biological Perspective |
Family pedigree studies provided the
earliest hints that OCD may be linked in part to biological factors Two other lines of research: Abnormal serotonin activity Abnormal brain structure and functioning |
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OCD:
The Biological Perspective Two other lines of research: |
Abnormal serotonin activity
Abnormal brain structure and functioning |
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OCD:
The Biological Perspective |
Some research provides evidence that
these two lines may be connected Serotonin (with other neurotransmitters) plays a key role in the operation of the orbitofrontal cortex and the caudate nuclei Abnormal neurotransmitter activity could be contributing to the improper functioning of the circuit |
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The cause of bipolar disorder is unknown, but evidence suggests that the _____________ approach is the most useful in understanding the disorder.
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Much of the evidence is consistent with the biological model. For example, disturbances in biochemistry, disturbances in various systems of the brain, and evidence for genetic transmission have all been noted in conjunction with bipolar disorder.
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Who is least likely to experience a depressive episode?
a) Kelly, who has several relatives with depression b) Jill, who just separated from her spouse c) Jennifer, who has experienced past depressive episodes d) Genetics, bad life events, and past depressive episodes all predict depression equally well. |
Prior depression and genetic predisposition both overshadow life events in predicting depression. In fact, about 90 percent of people who experience bad life events do not become depressed.
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Why are women more likely than men to be diagnosed with depression?
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Several hypotheses have been advanced to account for why women have higher rates of depression: women are more willing to admit they are depressed; they experience hormonal changes such as premenstrual depression or postnatal depression; the depressive gene is expressed as depression in females, but as alcoholism in males; women have a tendency to ruminate about bad life events; and women can fall into a cycle of failure and helplessness through the pursuit of thinness.
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Suicide is the __________ most frequent cause of death among high school and college students.
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Suicide is the third most frequent cause of death among high school and college students. This age group now accounts for more than 15 percent of all suicides.
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Who is the least likely to experience a depressive episode?
a)Mike, a fifty-year-old African American businessman b)Sheila, a thirty-five-year-old Caucasian teacher c)Benjamin, a sixteen-year-old Latino high school student d)Mike, Sheila, and Benjamin are equally at risk for depression. |
Young people, females, and Latinos are all more likely to experience depression than older people, males, Caucasians, and African Americans.
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personalization
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Personalization refers to incorrectly taking responsibility for bad events in the world.
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arbitrary inference
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Arbitrary inference refers to drawing conclusions when there is little or no evidence to support them.
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overgeneralization
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Overgeneralization refers to drawing global conclusions about worth, ability, or performance on the basis of a single fact.
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minimization
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Minimization occurs when large good events are minimized.
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Fatigue, oversleeping, and carbohydrate craving are symptoms that are typical of:
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seasonal affective disorder.
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depression with melancholia
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LOOK
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Cyclothymia
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is a serious mood and mental disorder that causes both hypomanic and depressive episodes. It is defined medically within the bipolar spectrum. To be specific, this disorder is a form of bipolar II disorder, consisting of recurrent disturbances between sudden hypomania and dysthymic episodes. A single episode of hypomania is sufficient to diagnose cyclothymic disorder; however, most individuals also have major dysthymic periods. The diagnosis of cyclothymic disorder is not made when there is a history of mania or major depressive episode or mixed episode. The lifetime pre-eminence of cyclothymic disorder is 0.4-1%. The rate appears equal in men and women, though women more often seek treatment. Unlike some forms of bipolar disorder (to be specific, bipolar I disorder), people with cyclothymia are almost always fully functioning, sometimes even hyper-productive.
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dysthymia.
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is a chronic mood disorder that falls within the depression spectrum. It is considered a chronic depression, but with less severity than major depressive disorder. This disorder tends to be a chronic, long-lasting illness.[1] The term was first used by James Kocsis during the 1970s.[2]
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Beck’s cognitive therapy
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Detecting automatic thoughts, reality testing automatic thoughts, training in changing attributions, and changing depressogenic assumptions
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interpersonal therapy
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is a time-limited psychotherapy that focuses on the interpersonal context and on building interpersonal skills. IPT is based on the belief that interpersonal factors may contribute heavily to psychological problems. It is commonly distinguished from other forms of therapy in its emphasis on interpersonal processes rather than intrapsychic processes. IPT aims to change the person's interpersonal behavior by fostering adaptation to current interpersonal roles and situations.
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therapy for learned helplessness.
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s the view that clinical depression and related mental illnesses may result from a perceived absence of control over the outcome of a situation.[1]
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rational-emotive therapy.
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previously called rational therapy and rational emotive therapy, is a comprehensive, active-directive, philosophically and empirically based psychotherapy which focuses on resolving emotional and behavioral problems and disturbances and enabling people to lead happier and more fulfilling lives. REBT was created and developed by the American psychotherapist and psychologist Albert Ellis who was inspired by many of the teachings of Asian, Greek, Roman and modern philosophers. REBT is one form of cognitive behavior therapy (CBT) and was first expounded by Ellis in the mid-1950s; development continued until his death in 2007.
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Which of the following is true about electroconvulsive shock treatment (ECT)?
a)It is not used anymore. b)It is used, but it doesn’t really work very well. c)It is used, but only in the worst situations, because it has profound side effects. d)It works very well, but it is associated with a high rate of recurrence. |
ECT is used and is very effective. The side effects have been greatly reduced by modern techniques and up to 80 percent of patients respond to it. It is associated with a high rate of recurrence, with almost 60 percent of those treated becoming depressed again the next year.
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SSRIs
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are prescribed often because they have fewer side effects than the other types and because of the low risk of overdose.
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most useful way to understand phobias?
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Phobias develop as a result of classical conditioning; however, only objects and situations that were dangerous to pretechnological humans appear to act as phobic objects.
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. All of the following frequently occur along with agoraphobia EXCEPT:
a)depression b)substance abuse c)avoidant personality disorder d)obsessive-compulsive disorder |
avoidant personality disorder
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Which of the following is true regarding the relative effectiveness of drug therapy versus extinction therapies in treating phobias?
a)Improvement is shown in 60 to 80 percent of patients being treated with drug therapy; extinction therapies are probably better than a placebo. b)The cost for both is about the same. c)Both involve moderate side effects. d)Drugs involve high relapse rates, whereas extinction therapies result in low relapse rates. |
Drugs involve high relapse rates, whereas extinction therapies result in low relapse rates.
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4. Though there is evidence that panic can be explained by at least two different levels of analysis, the ______________ level subsumes, or totally explains, all the evidence from the ________________ level.
a)biological; behavioral b)biological; cognitive c)behavioral; biological d)cognitive; biological |
The cognitive explanation can completely account for all the biological correlates of panic disorder.
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What percent of patients with panic disorder are panic free following cognitive therapy?
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Studies indicate that more than 75 percent of patients are panic free and remain panic free up to two years following cognitive therapy.
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modeling
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employs vicarious learning
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Systematic desensitization, exposure, and modeling are highly effective treatments for phobias. What do each of these treatments have in common?
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They all extinguish fear conditioning.
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Systematic desensitization and exposure
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employ relaxation techniques,
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Three techniques are mentioned in the text for coping with everyday anxiety: meditation, relaxation, and tranquilizers. Which is the least effective of these three techniques?
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c)tranquilizers
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Malcolm, who is suffering from PTSD, is encouraged by his therapist to relive the trauma in his imagination, while overcoming the tendency to dissociate from the experience. His therapist is using:
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exposure therapy involves reliving the trauma in the imagination while overcoming the tendency to dissociate from it
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disclosure therapy.
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LOOK
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Phobic fears are quite resistant to extinction. Which of the following explains this resistance to change?
a)People with phobias rarely test the reality of their fears. b)Brain circuits in the amygdala are difficult or impossible to delete. c)There may be a genetic predisposition to phobias. d)all of the above |
All of the explanations given are valid explanations of why it is difficult to extinguish a phobic fear.
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People with obsessive-compulsive disorder (OCD) often also suffer from ______________, during which the incidence of obsession triples.
a)substance abuse b)schizophrenia c)depression d)panic |
! As many as 67 percent of people with OCD also experience depression, which exacerbates the occurrence of obsessions.
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The treatments of choice for agoraphobia include:
a)in vivo (real life) exposure and cognitive therapy. b)in vivo exposure and modeling. c)imaginal exposure and cognitive therapy. d)imaginal exposure and modeling. |
Several studies indicate that in vivo exposure and cognitive therapy are the psychological treatments of choice for agoraphobia.
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The effectiveness of benzodiazepines in treating GAD is probably due to that fact that the benzodiazepines:
a) enhance the release of serotonin. b) enhance the release of GABA. c) enhance the release of dopamine. d) enhance the release of norepinephrine. |
Benzodiazepines enhance the release of GABA (a neurotransmitter that inhibits anxiety), which helps GAD patients who probably have too few GABA receptors or otherwise process GABA inadequately.
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Which of the following models best explains OCD?
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Psychodynamic ID vs Superego, cognitive-behavioral, and neuroscience models of OCD together yield an integrated picture of how OCD is caused.
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Of the following, which provides the best explanation for generalized anxiety disorder (GAD)?
a)the behavioral model b)the humanistic model c)the biological model d)the psychodynamic model |
the biological model is the best choice among the options given.
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15. Which of the following best describes fear and anxiety?
a) Disorders involving fear and anxiety are simply the extreme end of the continuum of normal fear and anxiety, and the difference between fear and anxiety is primarily in the emotional content. b) Disorders involving fear and anxiety are simply the extreme end of the continuum of normal fear and anxiety, and the difference between fear and anxiety is primarily in the cognitive content. c) Disorders involving fear and anxiety are fundamentally different from normal fear and anxiety, and the difference between fear and anxiety is primarily in the emotional content. d) Disorders involving fear and anxiety are fundamentally different from normal fear and anxiety, and the difference between fear and anxiety is primarily in the cognitive content |
The fear and anxiety experienced in mental disorders is similar to normal fear and anxiety; it is just excessive compared to the threat. The difference between fear and anxiety is in the cognitive content. With fear, the person thinks there is a clear and specific danger; with anxiety, there is an expectation of a more diffuse and uncertain danger.
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stress disorder
The Psychological EXPLANATION |
By definition, are the consequences of
experiencing extreme stressors Acute stress disorder (ASD) Symptoms begin within four weeks of event and last for less than one month Posttraumatic stress disorder (PTSD) Symptoms may begin either shortly after the event, or months or years afterward As many as 80% of all cases of acute stress disorder develop into PTSD |
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posttraumatic stress disorder,
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is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma.[1][2][3] This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity,[1] overwhelming the individual's ability to cope. As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress response.
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Acute Stress Disorder
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Occurs in response to similar traumas
as does PTSD Diagnosed when symptoms arise within 1 month of exposure to the stressor and last no longer than 4 weeks Dissociative symptoms are prominent At high risk of developing PTSD |
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Events that can precipitate
PTSD |
Combat and War-Related Traumas
Combat fatigue syndrome, “Shell Shock” Disasters Tornadoes, floods, earthquakes, fires Common Traumatic Events Car accidents, sudden deaths of loved ones Abuse Physical, emotional, sexual |
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Why Do People Develop a
Psychological Stress Disorder? |
Clearly, extraordinary trauma can cause a stress
disorder However, the event alone may not be the entire explanation To understand the development of these disorders, researchers have looked to the: Survivors’ biological processes Personalities Childhood experiences Social support systems/cultural backgrounds Severity of the traumas |
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Why Do People Develop a
Psychological Stress Disorder? Childhood experiences |
Researchers have found that certain childhood
experiences increase risk for later stress disorders Risk factors include: An impoverished childhood Psychological disorders in the family The experience of assault, abuse, or catastrophe at an early age Being younger than 10 years old when parents separated or divorced |
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Why Do People Develop a
Psychological Stress Disorder? Social support Multicultural factors Severity of the trauma |
People whose social support systems are weak are more
likely to develop a stress disorder after a traumatic event A careful look at research literature suggests that there may be important cultural differences in the occurrence of PTSD It seems that Hispanic Americans might be more vulnerable to PTSD than other racial or ethnic groups The more severe the trauma and the more direct one’s exposure to it, the greater the likelihood of developing a stress disorder |
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How Do Clinicians Treat the
Psychological Stress Disorders? |
About half of all cases of PTSD improve within 6
months; the remainder may persist for years Symptoms have been found to last an average of 3 years with treatment and 5½ years without treatment Treatment procedures vary depending on type of trauma General goals: End lingering stress reactions Gain perspective on painful experiences Return to constructive living |
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Traditional Psychophysiological
Disorders |
Ulcers
Asthma Insomnia Chronic Headaches Hypertension Coronary Heart Disease |
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Traditional Psychophysiological
Disorders |
LOOK
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Psychological Treatments for
Physical Disorders |
Behavioral Medicine
Techniques Relaxation Training Biofeedback Meditation Hypnosis Cognitive Interventions Insight Therapy & Support Groups |
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New Psychophysiological
Disorders |
Psychoneuroimmunology
Immune System Factors related to effects of stress on Immune System Biochemical Activity Behavioral Changes Personality Style Social Support |
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mania
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Mania, the presence of which is a criterion for certain psychiatric diagnoses, is a state of abnormally elevated or irritable mood, arousal, and/or energy levels.[1] In a sense, it is the opposite of depression.
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unipolar depression
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is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities.
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bipolar disorder
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LOOK
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How Common Is Unipolar
Depression? |
Major Depressive Episode: Overview and
Defining Features Extremely depressed mood – Lasting at least 2 weeks Anhedonia – Loss of pleasure/interest in usual activities Behavioral symptoms Cognitive symptoms Disturbed physical functioning Major Depressive Disorder Single episode – Highly unusual Recurrent episodes – More common |
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Diagnosing Unipolar
Depression |
Criteria 1: Major depressive episode
Marked by five or more symptoms lasting two or more weeks In extreme cases, symptoms are psychotic, including Hallucinations Delusions Criteria 2: No history of mania |
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Diagnosing Unipolar
Depression |
Two diagnoses to consider:
Major depressive disorder Criteria 1 and 2 are met Dysthymic disorder Symptoms are “mild but chronic” Depression is longer lasting but less disabling Consistent symptoms for at least two years When dysthymic disorder leads to major depressive disorder, the sequence |
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What Causes Unipolar
Depression? |
Stress
Genetic factors Biochemical factors NTs: serotonin, norepinephrine, Hormones: cortisol, melatonin Brain anatomy and circuits |
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What Causes Unipolar Depression?
The Psychological Views |
Three main models:
Psychodynamic model No strong research support Behavioral model Modest research support Cognitive views Considerable research support |
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What Are the Symptoms of Mania?
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last one week
Increased energy * Decreased sleep * Little fatigue * An increase in activities * Restlessness |
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Diagnosing Bipolar Disorders
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Criteria 1: Manic episode
Three or more symptoms of mania lasting one week or more In extreme cases, symptoms are psychotic Criteria 2: History of mania If currently experiencing hypomania or depression |
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Diagnosing Bipolar Disorders
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DSM-IV-TR distinguishes between two kinds
of bipolar disorder: Bipolar I disorder Full manic and major depressive episodes Most sufferers experience an alternation of episodes Some experience mixed episodes Bipolar II disorder Hypomanic episodes and major depressive episodes Cyclothymia Onset usually occurs between 15 and 44 years of age Between 1% and 2.6% of all adults in the world suffer from a bipolar disorder at any given time, and as many as 4% over the course of their lives The disorders are equally common in women and men and among all socioeconomic classes and ethnic groups |
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What Causes Bipolar
Disorders? |
Neurotransmitters
Norepinephrine and Serotonin Ion Activity Brain Abnormalities Neuroendocrine Factors Genetics |
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What Causes Unipolar Depression?
The Psychological Views |
Cognitive views
Two main theories: Negative thinking Learned helplessness theory Reformulated Learned Helplessness Theory |
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What Causes Unipolar Depression?
Sociocultural Views |
Sociocultural theorists propose that unipolar
depression is greatly influenced by the social context that surrounds people This belief is supported by the finding that depression is often triggered by outside stressors There are two kinds of sociocultural views: The family-social perspective The multicultural perspective The Multicultural Perspective Cultural Background and Depression |
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Integrative Model of Depression
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LOOK
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Treatments for Unipolar Depression:
Psychological Approaches |
Psychodynamic therapy
unconscious grief over real or imagined losses compounded by excessive dependence on other people Psychodynamic therapists use the same basic procedures for all psychological disorders Psychoanalytic vs Psychodynamic Interpersonal Therapy for Depression |
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Psychoanalytic
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It is primarily devoted to the study of human psychological functioning and behavior, although it can also be applied to societies. Psychoanalysis has three main components:
1. a method of investigation of the mind and the way one thinks; 2. a systematized set of theories about human behavior; 3. a method of treatment of psychological or emotional illness.[1] |
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Psychodynamic
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is the theory and systematic study of the psychological forces that underlie human behavior, especially the dynamic relations between conscious motivation and unconscious motivation.[1] The psychologist Sigmund Freud (1856–1939) developed “psychodynamics” to describe the processes of the mind as flows of psychological energy (Libido) in an organically complex brain.[2]
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Interpersonal Therapy for Depression
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LOOK
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Treatments for Unipolar Depression:
Psychological Approaches |
Behavioral therapy
– Lewinsohn, whose theory tied a person’s mood to his/her life rewards, developed a behavioral therapy for unipolar depression in the 1970s: – The behavioral techniques seem to be of only limited help when just one of them is applied Combining behavioral techniques Adding cognitive techniques |
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Treatments for Unipolar Depression:
Psychological Approaches Cognitive |
Cognitive therapy
– Beck viewed unipolar depression as resulting from a pattern of negative thinking that may be triggered by current upsetting situations Maladaptive attitudes lead people to the “cognitive triad” – Negatively viewing oneself, the world, and the future These biased views combine |
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Treatments for Unipolar Depression:
Sociocultural Approaches |
Unipolar depression is understood in the
broader social structure in which people live, and to the roles they are required to play – Multicultural treatments – Family-Social Treatments |
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Treatments for Unipolar Depression:
Sociocultural Approaches |
Interpersonal therapy (IPT)
Couple therapy – The main type of couple therapy is behavioral marital therapy (BMT) – If marriage is conflictual, BMT is as effective as other therapies for reducing depression |
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Interpersonal therapy (IPT)
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LOOK
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Treatments for Unipolar Depression:
Biological Approaches |
Biological treatments can bring great relief
to people with unipolar depression Usually biological treatment means antidepressant drugs, but for severely depressed individuals who do not respond to other forms of treatment, it sometimes includes electroconvulsive therapy or brain stimulation |
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Treatments for Unipolar Depression:
Biological Approaches |
Electroconvulsive therapy (ECT)
– Controversial – The procedure consists of targeted electrical stimulation to cause a brain seizure – The procedure has been modified in recent years to reduce some of the negative effects – Patients generally report some memory loss – ECT is clearly effective in treating unipolar depression |
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Treatments for Unipolar Depression:
Biological Approaches |
Antidepressant drugs
– In the 1950s, two kinds of drugs were found to be effective: Monoamine oxidase inhibitors (MAO inhibitors) Tricyclics – These drugs have been joined in recent years by a third group, the second-generation antidepressants |
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Treatments for Unipolar Depression:
Biological Approaches |
Antidepressant drugs: MAO inhibitors
– Originally used to treat TB, doctors noticed that the medication seemed to make patients happier – The drug works biochemically by slowing down the body’s production of MAO – Dietary restrictions – Side effects – Overdose risk |
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Antidepressant drugs: Tricyclics
Treatments for Unipolar Depression: Biological Approaches |
– In searching for medications for schizophrenia,
researchers discovered that imipramine lessened depressive symptoms Imipramine and related drugs are known as tricyclics because they share a three-ring molecular structure Block reuptake of Norepinephrine and Serotonin Anticholinergic side effects Overdose risk |
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Treatments for Unipolar Depression:
Biological Approaches |
econd-generation antidepressant drugs
– A third group of effective antidepressant drugs is structurally different from the MAO inhibitors and tricyclics Most of the drugs in this group are labeled selective serotonin reuptake inhibitors (SSRIs) – These drugs act only on serotonin (no other NTs are affected) This class includes fluoxetine (Prozac) and sertraline (Zoloft) – Selective norepinephrine reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are also now available |
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Treatments for Unipolar Depression:
Biological Approaches |
Brain stimulation
– As one third or more of people with unipolar depression are not helped by any of the treatments discussed previously, clinical investigators continue to search for alternative approaches, including: Vagus nerve stimulation Transcranial magnetic stimulation Deep brain stimulation |
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Treatments for Bipolar Disorder:LITHIUM
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Lithium is extraordinarily effective in treating
bipolar disorders and mania Too low = no effect Too high = lithium intoxication (poisoning) |
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Treatments for Bipolar Disorder:
Mood Stabilizers |
All manner of research has attested to the effectiveness of
lithium and other mood stabilizers in treating manic episodes – More than 60% of patients with mania improve on these medications – Most individuals experience fewer new episodes while on the drug – Findings suggest that the mood stabilizers are also prophylactic drugs, ones that actually help prevent symptoms from developing – Mood stabilizers also help those with bipolar disorder overcome their depressive episodes to a lesser degree |
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Treatments for Bipolar Disorder:
Adjunctive Psychotherapy |
Psychotherapy alone is rarely helpful for persons
with bipolar disorder Mood stabilizing drugs alone are also not always sufficient – 30% or more of patients don’t respond, may not receive the correct dose, and/or may relapse while taking it As a result, clinicians often use psychotherapy as an adjunct to lithium (or other medication-based) therapy |
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Underlying Causes of Suicide:
The Psychodynamic View |
Depression and from anger at others that is
redirected toward oneself Freud proposed that humans have a basic death instinct (“Thanatos”) that operates in opposition to the life instinct |
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Underlying Causes of Suicide:
The Sociocultural View |
Durkheim: probability of suicide is determined
by how attached a person is to such social groups as the family, religious institutions, and community Based on this premise, he developed several categories of suicide, including egoistic, altruistic, and anomic suicide… |
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Underlying Causes of Suicide:
The Biological View |
Family pedigree and twin studies
Shared environment must also be considered Recent laboratory research |
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What Treatments Are Used After
Suicide Attempts? |
Therapy goals in general:
Keep the patient alive Help them achieve a nonsuicidal state of mind Guide them to develop better coping strategies |
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What Is Suicide Prevention?
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Suicide prevention centers
Suicide hot lines Suicide prevention also occurs in the therapist’s office and in other settings (e.g., doctor’s office, school) |
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Do Suicide Prevention
Programs Work? |
Difficult to measure
Education |
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Myths vs Facts
MYTH: People who talk about suicide don't complete suicide. FACT: Many people who die by suicide have given definite warnings to family and friends of their intentions. Always take any comment about suicide seriously. MYTH: Suicide happens without warning. FACT: Most suicidal people give clues and signs regarding their suicidal intentions. MYTH: Suicidal people are fully intent on dying. FACT: Most suicidal people are undecided about living or dying, which is called “suicidal ambivalence.” A part of them wants to live; however, death seems like the only way out of their pain and suffering. They may allow themselves to "gamble with death," leaving it up to others to save them. |
MYTH: Men are more likely to be suicidal.
FACT: Men are four times more likely to kill themselves than women. Women attempt suicide three times more MYTH: Asking a depressed person about suicide will push him/her to complete suicide. FACT: Studies have shown that patients with depression have these ideas and talking about them does not increase the risk of them taking their own life. MYTH: Improvement following a suicide attempt or crisis means that the risk is over. FACT: Most suicides occur within days or weeks of "improvement," when the individual has the energy and motivation to actually follow through with his/her suicidal thoughts. The highest suicide rates are immediately after a hospitalization for a suicide attempt. MYTH: Once a person attempts suicide, the pain and shame they experience afterward will keep them from trying again. FACT: The most common psychiatric illness that ends in suicide is Major Depression, a recurring illness. Every time a patient gets depressed, the risk of suicide returns. MYTH: Sometimes a bad event can push a person to complete suicide. FACT: Suicide results from having a serious psychiatric disorder. A single event may just be “the last straw.” MYTH: Suicide occurs in great numbers around holidays in November and December. FACT: Highest rates of suicide are in May or June, while the lowest rates are in December. |
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Mental Disorders
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Attempting suicide does not necessarily indicate
the presence of a psychological disorder, but the majority of completed suicides are linked to a diagnosable mental disorder |
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Suicide: Common predictors
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Depressive disorder and certain
other mental disorders Alcoholism and other forms of substance abuse Suicide ideation, talk, preparation; certain religious ideas Prior suicide attempts Lethal methods Social withdrawal, isolation, living alone, loss of support Hopelessness, feeling trapped, cognitive rigidity Impulsivity and risk taking behavior Being an older White male Modeling, suicide in the family, genetics Economic or work problems; certain professions Marital problems, family pathology Dramatic changes in mood Anxiety Stress and stressful events Anger, aggression, irritability Psychosis Physical illness |
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Is Suicide Linked to Age?
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The likelihood of committing suicide increases with age,
but people of all ages may try to kill themselves Suicide is infrequent among children Attempts preceded certain behavioral patterns Suicides based on understanding of death & wish to die Suicidal actions become much more common after the age of 14 than at any earlier age In Western society the elderly are more likely to commit suicide than people in any other age group |
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Patterns and Statistics
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Suicide rates vary from country to country
The suicide rates of men and women also differ: Women have a higher attempt rate (3x men) Men have a higher completion rate (3x women) Suicide is also related to marital status and level of social support In the U.S., suicide also seems to vary according to race |
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Unsuccessfully attempt suicide
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Such attempts are called “parasuicides”
Approximately 600,000 attempts per year in the U.S. |
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suicide RATE
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2007: 11th elading cause of death in the US
A leading cause of death worldwide Approximately 700,000 suicides per year worldwide Approximately 31,000 suicides per year in the U.S. |
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Manic episode:
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A manic episode is diagnosed if elevated mood occurs with 3 or more of the other symptoms most of the day, nearly every day, or for 1 week or longer. If the mood is irritable, 4 additional symptoms must be present.
Mania is the signature characteristic of bipolar disorder and, depending on its severity, is how the disorder is classified. Mania is generally characterized by a distinct period of an elevated mood, which can take the form of euphoria. People commonly experience an increase in energy and a decreased need for sleep, with many often getting as little as 3 or 4 hours of sleep per night, while others can go days without sleeping.[10] A person may exhibit pressured speech, with thoughts experienced as racing.[11] Attention span is low, and a person in a manic state may be easily distracted. Judgment may become impaired, and sufferers may go on spending sprees or engage in behavior that is quite abnormal for them. They may indulge in substance abuse, particularly alcohol or other depressants, cocaine or other stimulants, or sleeping pills. Their behavior may become aggressive, intolerant, or intrusive. People may feel out of control or unstoppable, or as if they have been "chosen" and are "on a special mission" or have other grandiose or delusional ideas. Sexual drive may increase. At more extreme phases of bipolar I, a person in a manic state can begin to experience psychosis, or a break with reality, where thinking is affected along with mood.[12] Some people in a manic state experience severe anxiety and are very irritable (to the point of rage), while others are euphoric and grandiose. To be diagnosed with mania according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a person must experience this state of elevated or irritable mood, as well as other symptoms, for at least one week, less if hospitalization is required.[13] |
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Depressive episode:
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A depressive episode is diagnosed if 5 or more of these symptoms last most of the day, nearly every day, or for a period of 2 weeks or longer.
is the cluster of symptoms of major depressive disorder. The description has been formalised in psychiatric diagnostic criteria such as the DSM-IV and ICD-10, and is characterized by severe, highly persistent depression, and a loss of interest or pleasure in everyday activities, which is often manifested by lack of appetite, chronic fatigue, and sleep disturbances (somnipathy). The victim may think about suicide, and indeed an increased risk of actual suicide is present.[1] Signs and symptoms of the depressive phase of bipolar disorder include persistent feelings of sadness, anxiety, guilt, anger, isolation, or hopelessness; disturbances in sleep and appetite; fatigue and loss of interest in usually enjoyable activities; problems concentrating; loneliness, self-loathing, apathy or indifference; depersonalization; loss of interest in sexual activity; shyness or social anxiety; irritability, chronic pain (with or without a known cause); lack of motivation; and morbid suicidal ideation.[7] In severe cases, the individual may become psychotic, a condition also known as severe bipolar depression with psychotic features. These symptoms include delusions or, less commonly, hallucinations, usually unpleasant.[8] A major depressive episode persists for at least two weeks, and may continue for over six months if left untreated.[9] |
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Hypomanic episode
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Hypomania is generally a mild to moderate level of mania, characterized by optimism, pressure of speech and activity, and decreased need for sleep. Generally, hypomania does not inhibit functioning like mania.[16] Many people with hypomania are actually in fact more productive than usual, while manic individuals have difficulty completing tasks due to a shortened attention span. Some people have increased creativity while others demonstrate poor judgment and irritability. Many people experience signature hypersexuality. These persons generally have increased energy and tend to become more active than usual. They do not, however, have delusions or hallucinations. Hypomania can be difficult to diagnose because it may masquerade as mere happiness, though it carries the same risks as mania.
Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.[17] Also, the individual may not be able to recall the events that took place while they were experiencing hypomania.[6] What might be called a "hypomanic event", if not accompanied by complementary depressive episodes ("downs", etc.), is not typically deemed as problematic: The "problem" arises when mood changes are uncontrollable and, more importantly, volatile or "mercurial". If unaccompanied by depressive counterpart episodes or otherwise general irritability, this behavior is typically called hyperthymia, or happiness, which is, of course, perfectly normal. Indeed, the most elementary definition of bipolar disorder is an often "violent" or "jarring" state of essentially uncontrollable oscillation between hyperthymia and dysthymia. If left untreated, an episode of hypomania can last anywhere from a few days to several years. Most commonly, symptoms continue for a few weeks to a few months.[18] |
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FEAR
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Fear is referred to as an emotional response to a situation in which an individual feels threatened. The cause of the threat is realistic in nature.
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ANXIETY
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anxiety is considered to be a psychological disorder where the individual experiences symptoms similar to those experienced by those who face fear-inducing situations or circumstances.
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