Chapter 16.3 Biomedical Therapies and Preventing Psychological Disorders

Antipsychotic Drugs: dopamine

The molecules of most conventional antipsychotic drugs are similar enough to molecules of the neurotransmitter dopamine to occupy its receptor sites and block its activity. This finding reinforces the idea that an overactive dopamine system contributes to schizophrenia.

Modern Electroconvulsive Therapy

The patient receives a general anesthetic and a muscle relaxant (to prevent injury from convulsions) before a psychiatrist delivers 30 to 60 seconds of electrical current - After three such sessions each week for two to four weeks, 80 percent or more of people receiving ECT improve markedly, showing some memory loss for the treatment period but no discernible brain damage.

deep-brain stimulation

an experimental treatment pinpointed at a brain depression center. - focusing on a neural hub that bridges the thinking frontal lobes to the limbic system. This area, which is overactive in the brain of a depressed or temporarily sad person, calms when treated by ECT or antidepressants. -

The drugs given most often to treat depression are called ______________. Schizophrenia is often treated with ______________ drugs.

antidepressants; antipsychotic

Antipsychotic Drugs

began with the accidental discovery that certain drugs, used for other medical purposes drugs used to treat schizophrenia and other forms of severe thought disorder. - dampened responsiveness to irrelevant stimuli. Thus, they provided the most help to patients experiencing positive symptoms of schizophrenia, such as auditory hallucinations and paranoia -

presumed problem of psychosurgery

brain malfunction

aim of drug therapy

control symptoms of psychological disorders

Lobotomy

developed by Moniz (1930's) a psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain. - It usually decreased the person's misery or tension, but also produced a permanently lethargic, immature, uncreative person.

psychoses

disorders in which hallucinations or delusions indicate some loss of contact with reality

aim of psychosurgery

relieve severe disorders

technique of psychosurgery

remove or destroy brain tissue

aim of therapeutic lifestyle change

restore healthy biological state

presumed problem of brain stimulation

severe, "treatment resistant" depression

technique of brain stimulation

stimulate brain through electroconvulsive shock, magnetic impulses, or deep-brain stimulation.

presumed problem of therapeutic lifestyle change

stress and unhealthy lifestyle

Antianxiety Drugs

such as Xanax or Ativan, depress central nervous system activity. - Antianxiety drugs are often successfully used in combination with psychological therapy. One antianxiety drug

Psychosurgery

surgery that removes or destroys brain tissue in an effort to change behavior. - is the most drastic and least-used biomedical intervention for changing behavior

neurogenesis

the birth of new brain cells

Resilience

the personal strength that helps most people cope with stress and recover from adversity and even trauma

Psychopharmacology

the study of the effects of drugs on mind and behavior. - Since the 1950s, it has revolutionized the treatment of people with severe disorders.

technique of therapeutic lifestyle changes

alter lifestyle through adequate exercise, sleep, and other changes.

Not-alternatives/additional aid to depression "therapeutic lifestyle change

Aerobic exercise (increasing fitness and vitality, stimulating endorphins) Adequate sleep (increasing energy and alertness, boosting immunity) Light exposure (amplifying arousal, influencing hormones) Social connection (satisfying the human need to belong) Anti-rumination (enhancing positive thinking) Nutritional supplements (supporting healthy brain functioning)

why does it take time for antidepressants to work

Although the drugs begin to influence neurotransmission within hours, their full psychological effect often requires four weeks (and may involve a side effect of diminished sexual desire). One possible reason for the delay is that increased serotonin promotes new synapses plus neurogenesis perhaps reversing stress-induced loss of neurons

magnetic stimulation

Depressed moods sometimes improve when repeated pulses surge through a magnetic coil held close to a person's skull - The painless procedure (rTMS) is performed on wide-awake patients over several weeks. - Unlike ECT, the rTMS procedure produces no brain seizures, memory loss, or other serious side effects aside from possible headaches.

How, by taking care of themselves with a healthy lifestyle, might people find some relief from depression? How does this reflect our being biopsychosocial systems?

Depressed people who undergo a program of aerobic exercise, adequate sleep, light exposure, social engagement, negative-thought reduction, and better nutrition often gain some relief. In our integrated biopsychosocial system, stress affects our body chemistry and health; chemical imbalances can produce depression; and social support and other lifestyle changes can lead to relief of symptoms.

How are brain stimulation and psychosurgery used in treating specific disorders?

Electroconvulsive therapy (ECT), in which a brief electric current is sent through the brain of an anesthetized patient, is an effective, last-resort treatment for severely depressed people who have not responded to other therapy. Newer alternative treatments for depression include repetitive transcranial magnetic stimulation (rTMS) and, in preliminary clinical experiments, deep-brain stimulation that calms an overactive brain region linked with negative emotions. Psychosurgery removes or destroys brain tissue in hopes of modifying behavior. Radical psychosurgical procedures such as lobotomy were once popular, but neurosurgeons now rarely perform brain surgery to change behavior or moods. Brain surgery is a last-resort treatment because its effects are irreversible.

What are some examples of lifestyle changes we can make to enhance our mental health?

Exercise regularly, get enough sleep, get more exposure to light (get outside and/or use a light box), nurture important relationships, redirect negative thinking, and eat a diet rich in omega-3 fatty acids.

Mood-Stabilizing Medications

For those suffering the emotional highs and lows of bipolar disorder, the simple salt lithium can be an effective mood stabilizer. - Discovered in the 1940's by John Cade. - Lithium reduces bipolar patients' risk of suicide

Preventive Mental Health

Preventive mental health is upstream work. It seeks to prevent psychological casualties by identifying and alleviating the conditions that cause them. - there is abundant evidence that poverty, meaningless work, constant criticism, unemployment, racism, and sexism undermine people's sense of competence, personal control, and self-esteem. Such stresses increase their risk of depression, alcohol use disorder, and suicide.

What is the rationale for preventive mental health programs, and why is it important to develop resilience?

Preventive mental health programs are based on the idea that many psychological disorders could be prevented by changing oppressive, esteem-destroying environments into more benevolent, nurturing environments that foster growth, self-confidence, and resilience. Struggling with challenges can lead to posttraumatic growth. Community psychologists are often active in preventive mental health programs.

What is the difference between preventive mental health and psychological or biomedical therapy?

Psychological and biomedical therapies attempt to relieve people's suffering from psychological disorders. Preventive mental health attempts to prevent suffering by identifying and eliminating the conditions that cause disorders.

What are the drug therapies? How do double-blind studies help researchers evaluate a drug's effectiveness?

Psychopharmacology, the study of drug effects on mind and behavior, has helped make drug therapy the most widely used biomedical therapy. Antipsychotic drugs, used in treating schizophrenia, block dopamine activity. Side effects may include tardive dyskinesia (with involuntary movements of facial muscles, tongue, and limbs) or increased risk of obesity and diabetes. Antianxiety drugs, which depress central nervous system activity, are used to treat anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. These drugs can be physically and psychologically addictive. Antidepressant drugs, which increase the availability of serotonin and norepinephrine, are used for depression, with modest effectiveness beyond that of placebo drugs. The antidepressants known as selective serotonin reuptake inhibitors (often called SSRI drugs) are now used to treat other disorders, including strokes and anxiety disorders. Lithium and Depakote are mood stabilizers prescribed for those with bipolar disorder. Studies may use a double-blind procedure to avoid the placebo effect and researcher's bias.

(rTMS)

Repetitive transcranial magnetic stimulation - the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity - How it works is unclear. One possible explanation is that the stimulation energizes the brain's left frontal lobe. Repeated stimulation may cause nerve cells to form new functioning circuits through the process of long-term potentiation.

Lithium reduces bipolar patients' risk of suicide

Researchers assign people to treatment and no-treatment conditions to see if those who receive the drug therapy improve more than those who don't. Double-blind controlled studies are most effective. If neither the therapist nor the client knows which participants have received the drug treatment, then any difference between the treated and untreated groups will reflect the drug treatment's actual effect.

side effects of anti-psychotics

Some produce sluggishness, tremors, and twitches similar to those of Parkinson's disease - Long-term use of antipsychotics can produce tardive dyskinesia, with involuntary movements of the facial muscles (such as grimacing), tongue, and limbs. - Although not more effective in controlling schizophrenia symptoms, many of the newer-generation antipsychotics, such as risperidone (Risperdal) and olanzapine (Zyprexa), have fewer of these effects. These drugs may, however, increase the risk of obesity and diabetes

Mind-body interaction

The biomedical therapies assume that mind and body are a unit: Affect one and you will affect the other - As we have seen over and again, a human being is an integrated biopsychosocial system

aim of brain stimulation

alleviate depression that is unresponsive to drug therapy

technique of drug therapy

alter brain chemistry through drugs

Criticism of Antianxiety drugs

They reduce symptoms without resolving underlying problems immediate relief reinforces a person's tendency to take drugs when anxious. Antianxiety drugs can also be addictive. After heavy use, people who stop taking them may experience increased anxiety, insomnia, and other withdrawal symptoms.

double-blind procedure

To evaluate the effectiveness of any new drug, researchers give half the patients the drug, and the other half a similar-appearing placebo. Because neither the staff nor the patients know who gets which.

Alternative Neurostimulation Therapies

Two other neural stimulation techniques—magnetic stimulation and deep-brain stimulation—also treat the depressed brain

Electroconvulsive Therapy: Barbaric Image

When ECT was first introduced in 1938, the wide-awake patient was strapped to a table and jolted with roughly 100 volts of electricity to the brain, producing racking convulsions and brief unconsciousness.

Electroconvulsive Therapy

a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient.

Antidepressant Drugs

drugs used to treat depression, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. (Several widely used antidepressant drugs are selective serotonin reuptake inhibitors—SSRIs.) - Many of these drugs work by increasing the availability of neurotransmitters, such as norepinephrine or serotonin, which elevate arousal and mood and appear scarce when a person experiences feelings of depression or anxiety

Severe depression that has not responded to other therapy may be treated with ______________ ______________, which can cause brain seizures and memory loss. More moderate neural stimulation techniques designed to help alleviate depression include ______________ ______________ magnetic stimulation, and ______________ - ______________ stimulation.

electroconvulsive therapy (ECT); repetitive transcranial; deep-brain

presumed problem of drug therapies

neutransmitter malfunction

biomedical therapy

physically changing the brain's functioning by altering its chemistry with drugs; affecting its circuitry with electroconvulsive shock, magnetic impulses, or psychosurgery; or influencing its responses with changes in lifestyle.

Posttraumatic growth

positive psychological changes as a result of struggling with extremely challenging circumstances and life crises.