1 / 25

Mental Illness – Part 1

Mental Illness – Part 1. Intro to Psych 5/6/14. Mental illness . What are we going to talk about today? How modern clinical psychology looks at mental disorders Some of the ways we think about what makes a mental disorder Characteristics common across mental disorders

mala
Download Presentation

Mental Illness – Part 1

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Mental Illness – Part 1 Intro to Psych 5/6/14

  2. Mental illness • What are we going to talk about today? • How modern clinical psychology looks at mental disorders • Some of the ways we think about what makes a mental disorder • Characteristics common across mental disorders • How we think about mental disorders • Mood disorders • Depression • Bipolar Disorder • Theories • Treatments

  3. Abnormality • Most basic and foundational question in clinical psych: “What is abnormality?” • Where do we draw the line between healthy behavior & unhealthy behavior? • Psychologists don’t have an easy way to diagnose abnormality • They use a series of 3criteria to help them diagnose different mental disorders • Behavioral criteria: Set of symptoms the person reports • How they feel • How they think • What the psychologist observes about their behavior and how typical or atypical it is • These observed & reported criteria get matched against the clinical criteria psychologists know go with different disorders

  4. Abnormality • Many of these criteria are very subjective and can be influenced by many factors • Social Norms: what your society or culture views a normal • Example: A Muslim woman wearing a veil is typical behavior in a Muslim community • A woman wearing a veil in a non-Muslim community appears atypical • Characteristics of the target person • Example: Gender • A man crying in our culture is often seen as unusual, but a woman crying is much less unusual • A woman beating the crap out of someone is unusual but less so for a man • Stereotypes for acceptable behavior can influence whether something is normal or abnormal

  5. Abnormality • Influences on normal vs abnormal, continued • Context • Example: Paranoia • Paranoid and hyper-vigilant and live in downtown Kabul, that’s adaptive behavior and not necessarily abnormal • Paranoid and hyper-vigilant in a tiny farm town in Western MA, that’s not as normal or adaptive

  6. Abnormality • Three characteristics of abnormality: • 1) Distress • Behaviors that cause the person or others around them distress • Example: Depression • You’re unhappy, sad, may even feel bad enough to want to kill yourself • Example: Antisocial Personality Disorder • The person has no regard for the rights of others, has no hesitation to steal or hurt other people, has no empathy or sympathy for others’ feelings – harms other people

  7. Abnormality • 2) Dysfunction • A set of behaviors that prevents the person from functioning in daily life • Example: Depression • People who are depressed often become non-functional: can’t get up & go to class, can’t go to work, can’t hang out with their friends. They withdraw and become totally isolated and cease to function • 3) Deviance: highly unusual behaviors and feelings • Most controversial of the 3 – heavily influenced by social norms. What’s deviant in one culture may not be in another

  8. Abnormality • How is all of this pulled together to make a diagnosis? • Diagnostic & Statistical Manual (DSM) • Been around since the 1950’s • Currently in its 5th edition • Early editions were HIGHLY subjective • Since the 80s, there has been an effort to make it more objective • The DSM gives lists of symptoms required for diagnosis and the number of symptoms that have to be present • Notions of distress, dysfunction, and deviance are built in to the symptoms

  9. Mood Disorders • One of the most common problems people face • 22% of women will have an episode of serious depression in their lives • 13% of men will • Late adolescent years and the early 20s are the peak time for first onset of mood disorders such as depression and bipolar disorder • Divided in to 2 categories: • Unipolar Depression Disorders • Depression only • Bipolar Disorders • The person cycles between depression and mania

  10. Unipolar Disorders • DSM criteria for Major Depression • Sadness or diminished interest or pleasure in usual activities (anhedonia) • At least 4 of the following symptoms: • Significant weight or appetite change • Insomnia or hypersomnia • Psychomotor retardation or agitation • Fatigue or loss of energy • Feelings of worthlessness or excessive guilt • Diminished ability to concentrate, indecisiveness • Suicidal Ideation or behavior • Duration of at least 2 weeks (average length of a depressive episode is 6 months, if not treated)

  11. Unipolar Disorders • It’s important to understand the difference between an everyday sad mood and the debilitating, overwhelming depression of Major Depression • You may be bummed because you got dumped or bombed a test, but it’s very different from the non-functional, vegetative experienced of MD • This doesn’t mean nothing is wrong though. Depression runs on a continuum • There are many people who may not be severely depressed, but that doesn’t mean they wouldn’t benefit from help • Moderate forms of depression can morph into more severe forms if left untreated

  12. Bipolar Disorders • Bipolar Disorder is characterized by a periods of depression and periods of mania • DSM Criteria for a Manic Episode • Abnormally and persistently elevated, expansive, or irritable mood for at least 1 week • 3 or more of the following: • Inflated self-esteem or grandiosity • Decreased need for sleep • More talkative than usual, pressure to talk • Flight of ideas, racing thoughts • Distractibility • Increase in goal-directed activity, agitation • Excessive involvement in pleasurable but dangerous activities

  13. Bipolar Disorders • Here is an example of a guy who is pressured to speak. He’s just talking and talking even though there’s no one there to talk to or prompting him to talk http://youtu.be/Lm0VZX2_Ir8 • Just like depression, mania runs on a continuum from mild to extremely severe or psychotic. This guy’s mania may not be on the severe end of the continuum, but you can see it still affects him • Those on the severe end may lose touch with reality and they'll believe that they are a supernatural being. They may believe that they are the Messiah or that they are Albert Einstein come back to life, or that they have supernatural powers

  14. Bipolar disorders • Mania can get people into trouble • Sexual promiscuity with the risk of STDs • Illegal drug activity and/or arrest • Bankruptcy for them and/or their families • These negative consequences are what motivate people to get help • Mania itself isn’t usually what drives a person to help; mania can be pleasurable to have • The eventual cycle into debilitating depression also drives people to seek help – the mania will eventually end • Bipolar disorder occurs in 1% of the population

  15. Theories and Treatments • There are 3 different categories of theory and treatment: • Biological Theories and Treatments • Cognitive Behavioral Theories and Treatments • Interpersonal Theories and Treatments

  16. Theories and Treatments • Biological • Genetics play a big part in mood disorders, especially bipolar disorder • Identical twins: if one twin has bipolar disorder, the other twin has over a 60% chance of also having the disorder • Fraternal twins: if one twin has bipolar disorder, the other twin has a 12% chance of also having it • The farther away you are on the family tree from a relative with bipolar, the lower your genetic chances of having it are • Genetics and major depression • Some versions of depression have higher genetic likelihood • “Early Onset Depression” begins in childhood and has a higher genetic component to it • Depression trigger by a major life event (trauma, loss) is less clearly linked to genetics

  17. Theories and Treatments • Biological, continued • Neurotransmitters and mood disorders • Serotonin • Norepinephrine • Dopamine • An imbalance of any of these 3 neurotransmitters can lead to depression or bipolar disorder

  18. Theories and Treatments • Biological, continued • Prefrontal Cortex is where complex thinking, problem solving, and goal-directed behavior happens • In people with depression, there is lowered activity in the prefrontal cortex • Amygdala is where the processing of emotion info happens • People with mood disorders (both bipolar & depression) have overactive amygdala responses to emotional info • Hippocampus has a big role in memory and concentration • People with chronic depression have hippocampi that have shrunk, which may be related to their problems with concentration and paying attention

  19. Theories and Treatments

  20. Theories and Treatments • Biological Treatments • Medications • Monoamine oxidase inhibitors (MAOI) • Tricyclic antidepressants • 60% of people who take these do well • Lots of side effects, can be fatal in overdose • Selective serotonin re-uptake inhibitors (SSRIs) • Paxil, Prozac, etc • Most commonly prescribed, have fewer side effects • Lithium for bipolar disorder • Tons of side effects • Dangerous for women to take while pregnant • Only treats manic episodes, does not treat depression

  21. Theories and Treatments • Cognitive Behavioral Theories • Applies mostly to depression • People who are depressed have a negative view of the self, the future, and the world • These beliefs are fed by biases in the person • People who are depressed show distortions in thinking • “All-or-nothing” thinking: things are good or bad only • “Emotional Reasoning”: if I feel like a loser, I must be a loser • “Personalization”: Self-blame • These distortions in thinking & interpreting situations feed the general negative view of the self and hopelessness about the future

  22. Theories and Treatments • Cognitive Behavioral, continued • People with depression make attributions for negative internal events (they blame themselves) • They see bad things as lasting forever • They see bad events as affecting many areas of their life • All of these feelings feed their depression and their general belief that life is terrible

  23. Theories and Treatments • Cognitive Behavioral Therapy (CBT) • Identify themes in negative thoughts and triggers for them • Challenge negative thoughts • What is the evidence for this interpretation? • Are there other ways of looking at the situation? • How could you cope if the worst did happen? • Help clients recognize negative beliefs or assumptions • Change aspects of environments related to depressive symptoms • Teach person mood-management skills that can be used in unpleasant situations • CBT is extremely effective

  24. Theories and Treatments • CBT, continued • CBT has been shown to be effective in helping people out of a current depressive episode and also in preventing future episodes • Patients learn new coping skills for dealing with new stressors and are better able to keep from falling into a depressive state again • One of the most important parts of CBT is that what happens in therapy is important, but what happens OUTSIDE of therapy that’s most important • The patient must practice the skills CBT has taught them so they can learn how to use them once therapy has concluded

  25. Theories and Treatments • Interpersonal Therapy • Based on the theory that negative views of the self and expectations about the self and relationships are based on upbringings in environments that fostered these kinds of negative self-views • Interpersonal therapy works to help the patient understand that their negative self-views are rooted in past relationships • Interpersonal Therapy is very focused on the past • CBT is focused only on the present and future The good news is there are many medications and therapy treatments to help people overcome their depression

More Related