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58 Cards in this Set
- Front
- Back
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(T/F): Anyone can have someone involuntarily committed to the hospital if we can prove they are an imminent danger to themselves or someone else. |
True |
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Daniel Kahn |
Won the Nobel Peace Prize in economics to put that our thinking isn't rational |
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What is the social contagion effect (suicide)? |
When a high profile suicide in media occurs, suicide attempt/completion goes up. Also rate of "accidents" goes up |
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What is parasuicidality? |
Engaging in non-suicidal self-harm behavior (using physical pain to cope with emotional pain) NOT LOOKING FOR ATTENTION Addiction to the happy endorphins released with the physical pain |
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(T/F) Up to 2/3 college students have engaged in self harm behavior at some point. |
False; up to 1/3 |
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Who has a higher percent of genetic heritability of depression, men or women? |
*Women (30-40%)
Men (20-30%) |
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What does seratonin do? |
social drive, stress response, located in the amygdala (which regulates emotion), also anterior cingulate
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What is activation syndrome? |
changes in dopamine due to excess seratonin- feel energized, but agitated, restless, and angry/impulsive/aggressive |
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What does dopamine do? |
pleasure/reward center, goal directed, initiative, motivation satisfied when doing things your genes want you to do (eat, sex) |
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What is the one thing that targets every neurobiological problem in depression? |
EXERCISE!!!!! |
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Why don't we just give depressed people dopamine-enhancing drugs instead of seratonin-enhancing drugs? |
When you stimulate the dopamine it is a huge risk to increasing anxiety on a clinical level- also increasing paranoia |
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What is CRH? |
"master protein" regulates neurotransmitters Too much stress = low CRH = decline in seratonin, dopamine, and deep wave sleep = infammation |
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What happens if there is too much cortisol? |
lots of stress to the point of it being toxic to the brain, kills cells in the hippocampus because it decreases BDNF, and increases inflammation |
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What's the Kindling Hypothesis? |
Accounts for why each reoccurance of depression increases chance of remission; like camping. each sucessive episode of depression adds kindling to the fire, making it easier for a "match" of stress to light the flame of depression |
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Physiologically, why are women more prone to depression then men? |
Estrogen!! It has a potent effect on seratonin signaling |
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What demographic of women is most likely to be on an antidepressant? |
Women in perimenopause (5-7 yrs before menopause) 1 out of 4 in the 40-50 range |
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What are the 6 elements of the Therapeutic Lifestyle Change? |
1. Exercise 2. Omega-3 Fatty Acids (cant make themselves) 3. Natural Sunlight 4. Sleep (~8 hrs) 5. Social connection/community 6. Engaging activity vs. idle alone time |
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What is Freud's definition of depression (according to the psychodynamic model)? |
Depression = "anger turned inward" but this doesn't hold up to scientific study Thinks personality has an effect |
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Aaron Beck in relation to depression (cognitive model) |
Model that "depression caused by negatively biased thoughts", came up with because unsatisfied with Freud. |
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automatic thoughts |
involuntary negative interpretation "we passed by each other and I smiled and they didnt so they must not like me." |
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logical errors |
give rise to automatic thoughts; "all-or-nothing" (maybe everything is awesome, or everything sucks?) |
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schemas |
core beliefs, taken as a given "I'm a loner, no one will ever love me" |
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SSRI (name, drugs (5)) |
Selective Seratonin Reuptake Inhibitor -Prozac (fluoxetine) -Paxil (paroxetine) -Zoloft (sertraline) -Celexa (eitalopram) -Lexapro (escitalopram) |
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SNRI (name, drugs (2)) |
Selective Norepinephrine Reuptake Inhibitor -Effexor (venlafaxine)/ Pristique (desuenlafaxine) -Cymbalta (dulozetine) |
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Emotional Blunting |
antidepressant "turns down the volume" of the amygdala, emotions less intense, unprescise. |
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STAR*D |
More than 4000 patients started on Celexa, tracked them for a year. LESS THAN 6% OF ALL PATIENTS FULLY RECOVERED FOR A YEAR. They never printed/published the actual outcomes. |
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According to the FDA, how often to the meds beat placebo in drug testing trials? |
Less than 1/2. |
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Nocebo |
Experience negative side effects while taking a placebo, because they think it's the real drug. |
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What ratio of people with depression go untreated? |
1 out of 2 |
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What percentage of people on antidepressants don't actually meet the diagnostic criteria for depression? |
Over 60% Depression is UNDERTREATED and OVERRATED |
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Iatrogenic |
illness caused by medication/treatment |
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What is the only group of people with depression who the drugs consistently beat the placebo? |
Very severe- top 10-15% |
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What is the percent increase in antidepressant use since 1990? |
400% |
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According to the CDC, how many Americans over the age of 12 have depression? (ratio) |
1/9 |
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Is there a negative or positive association between suicides and antidepressant use? |
Negative |
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What are some of the potential side effects of antidepressants? |
-anorgasm (up to half) -emotional numbing (amygdala) -reduced error detection (anterior cingulate) -weight gain (1 out of 2) -GI distress -Insomnia -withdrawl/activation syndrome -birth defects |
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Atypical Antidepressants (2) |
Welbutrin (bupropion) and Remeron (mirtazapine) Work on dopamine/reward circuits can cause seizures above 300% |
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What portion of the brain is active when we're in a positive mood cortex? |
left frontal cortex- motivated to go after rewarding things |
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What portion of the brain is active when we're in a negative mood cortex? |
right frontal cortex- looking for things that are threatening to us |
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What affect does the microbiome have on a person? |
Regulate immune system, and can release neurotransmitters, can tap into vagus nerve, and can change our neurotransmitters- make us crave food that is good/bad for us |
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What mental disorder to antidepressants treat better than depression? |
anxiety |
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How does placebo compare to drugs? |
it kicks ass over the drugs, changes the frontal lobe circuits ("if this man in the white coat says that this will make me feel better, then i will feel better") |
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Where do Americans take in 20% of their daily calories? |
Added sugars -> makes you hungrier |
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Bruxism |
teeth grinding |
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St. John's Wort (hypericum) |
Acts like SSRI, popular in Europe Went head-to-head with Zoloft and Placebo; St. John's and placebo = same, both above Zoloft |
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Bipolar 1 Characteristics |
swing from mania to depression |
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Biopolar 2 Characeristics |
swing from HYPOmania to depression |
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Emotional Contagion |
Our mirror neurons allow us to simulate the emotions of others |
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What are the four elements of suicide risk assessment? |
ideation, intent, plan, and means |
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If I talk to someone about suicide won't it just plant the idea in their head? |
They would have already thought of it- relieving to have someone else bring it up |
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If someone is determined, wouldn't it be impossible to stop them? |
Nope. You can definitely help! |
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How many college students have engaged in self-harm behavior at some point? |
1 out of 3 |
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Environmental Mutation Model |
humans lived in hunter-gatherer conditions for 99% of existence. modern-day aboriginals rarely get depressed, where more modern societies have higher rates of depression |
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What ratio of american adults is clinically overweight? |
7/10 |
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(T/F) There is a high relapse rate when SSRI/SNRI discontinued. |
True |
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Viibryd |
SSRI+, blocks seratonin reuptake ANDaffects post-synaptic serotonin |
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What was the study by Caspi? |
He studied the effect of the Serotonin Transporter Gene (chromosome 17) on the genetic heritability of depression. He studied people with 4+ severe life events and found that people with the long (protective) gene were much less prone to depression over people with the short (risk) gene. (Long = 17%, short = 43%) |
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Heritability |
Percent of variability in a population (genetics); important but doesn't tell full story |
