Lecture 10 Flashcards
In the context of depression, the most established and utilized form of psychotherapy is ________.
CBT
Cognitive Behavioural Therapy
In Ontario, it takes about _________ months to see a psychiatrist without going to an emergency room.
3-12 months
Who prescribes the majority of ADMs in Canada?
family physicians (GPs)
why would psychiatrists treat depression with ADM when psychotherapy works well?
Imaginary population of 100,000, minimum 1500 people with clinical depression
- 1 psychiatrist could treat 100 patients with 16 weeks of CBT each year
- Ontario is estimated to have 15 psychiatrists per 100,000 population: all psychiatrist time would be consumed treating just the 1500 cases of depression
- Access problem: health insurance (OHIP) does not cover psychologists and counsellors
- Waitlist for psychiatrist in Ontario is 3-12 months
- Costs of 90 days of ADMs costs less than 1 psychotherapy session
How might social media reshape our experience and understandings of mental health and illness
- Media heavily shape our understanding of mental health and illness
- Many depictions of mental illness are highly stigmatizing and negative (e.g.,
violence and criminality)
positive: awareness/education, community, reaching out to people with similar experiences, share or see personal experiences
negative: stigma, misleading, false information, self-diagnosis
How does social media play a role in the experience and the meaning of mood disorders
- allows for a more participatory approach to communication (everyone has a voice/platform)
- can provide space for meanings of mental illness other than what has been portrayed by mass media
- people with mental illness report that sharing their experiences and connecting to others with similar experiences was empowering (relatable stories)
- potentially positive force in the lives of people with mental illness (may fight stigma and raise awareness of real struggles as well as help and treatment
EXTRA:
- many studies point to social media and its association with increasing rates of depression, particularly among youth
- one study found a positive correlation between the amount of time youth spend on social media and negative mental health symptoms (not all studies agree tho)
- it is likely that the quality of media use, not just frequency, is linked to rates of depression (need more detailed understanding of what people are doing on social media and how)
How does Art and Popular Culture play a role in experience and the meaning of mood disorders
- artistic and literary depictions can help convey the complexity of experiences of mental illness and describe, as well as move beyond medical disagnostic categories
EXTRA :
- some clinicians are exploring ways in which clinical treatment/understanding and metaphor and literary analysis might intersect
- making sense of mental health in this way allows us to evaluate the assumptions and limitations of scientific knowledge
—- and be a way for people experiencing mental illness to express their experiences and challenge commonly held views and beliefs
define anxiety
- nervousness, concern, apprehension, and agitations associated largely with thoughts … of future events
What are useful purposes of anxiety?
- motivates us to take actions to avoid negative consequences
- helps us avoid dangerous situations
What are unhelpful, excessive or disproportionate ways of anxiety?
- can limit our ability to respond to challenges
When may a person be diagnosed with an anxiety disorder? define the disorder
- when anxiety becomes dysfunctional
- defined by (irrational) fear of potential future events
EXTRA:
- not always been a high priority among medical professionals and researchers (we’ve discussed how they were previously somewhat neglected, with more attention paid to “severe mental disorders”)
Individuals diagnosed with this disorder often feel as though they are suffocating or “losing control”
A) Generalized Anxiety Disorder
B) Specific Phobia
C) Social Phobia
D) Panic Disorder
D
According to research cited in the textbook, up to _____% of people are estimated to have a needle phobia
25%
Define specific phobia
- these are the most diverse, most common, and most recognized forms of anxiety disorder
What can be involved in specific phobia?
- fear of specific situations
- fear of objects/things
- fear of biological entities
Give some examples of fear of specific situations
- Acrophobia (heights)
- Claustrophobia (small confined spaces)
- Aerophobia (flying)
- Thanatophobia (death)
- Autophobia (abandonment)
Give some examples of fear of objects/things
- Trypanophobia (needles)
- Aquaphobia (water)
- Trypophobia (holes)
Give some examples of fear of biological entities
- Arachnophobia (spiders)
- Mysophobia (germs)
- Cynophobia (dogs)
What percentage of the general population suffer from specific phobia?
5-10%
Give stats for specific phobia
- twice as prevalent in women (more severe among women too)
- usually develop in childhood
- believed that these can be inherited (but is this only genetic or also social?)
- often associated with previous trauma
How is fear a common and (sometimes) useful expereince?
- responding to fear protects us from harm
how are phobias different from other types of fear?
- they are irrational
- the fear experienced is strongly disproportionate to the actual likelihood or risk of the outcome feared or harm (very small chance of feared outcome actually occurring)
- people with phobias are often aware that their experience of fear is irrational - but this does not lessen their symptoms
what are physical symptoms of phobias
- shortness of breath
- sweating
- nausea
- irregular heartbeat
what are psychological symptoms of phobia?
- panic
- dread
- fear
- anxiety
how is avoidance related to phobia?
- people with phobias often take steps to minimize their exposure to the feared situation, which can have social or health impacts
What is Agoraphobia?
- non-specific phobia
- fear of situations from which one cannot escape - and/or a fear of entrapment
- can include fear of crowds, open spaces, leaving home, unfamiliar environments, being alone
- avoidance of triggering situations, which can be almost anything as the fear/phobia is non-specific, can be very problematic - some people rarely leave home
- fear of experiencing the panic increases the severity of the phobia
- what are symptoms of agoraphobia?
- panic attacks
- feelings of helplessness and embarrassment
What is the prevalence of agoraphobia?
approximately 1%
- 1 in 100 Americans experience agoraphobia
What is social anxiety disorder?
- also called social phobia
- fear of being judged negatively or rejected by others
- also includes fear of being judged for having this worry or fear
What situations may people with social anxiety disorder avoid?
- public speaking
- meeting new people
- anywhere they might be the focus of attention
What are the symptoms of social anxiety disorder
- symptoms include those common to other anxiety disorders
ex. shortness of breath, sweating, racing thoughts, palpitations
What may social anxiety lead to?
- may lead to substance use (often alcohol, to “help” manage anxiety in social situations and limit symptoms (may have negative repercussions and lead to risk/harm)
What is the prevalence of social anxiety disorder?
- approx. 12 % of the American population experience social anxiety disorder
What is panic disorder?
- involves recurring panic attacks
- may be triggered by stressful situations and contexts, but may be unexpected/spontaneous
-What may people with panic disorders experience
- fear
- discomfort
- dizziness
- sweating
- shortness of breath
- feelings of suffocation
- feelings of losing control
What may panic disorder lead to?
- may lead to avoidance behaviour
— this is particularly disabling because of the wide variety of situations that a person may feel they need to avoid
— may also involve social and emotional distancing in order to avoid attacks (relationships may suffer)
- What is the prevalence of panic disorders
- approx. 15% of Americans experience panic disorders
What is generalized anxiety disorder?
- low-level worry often without obvious trigger (non-specific)
- may be about immediate or future situations, often revolve around work, finances, health, and relationships (what if____ happens?)
- person experiences worry even when there is no immediate reason to be concerned
What are psychological symptoms of generalized anxiety disorder
- tension
- restlessness
- problems focussing
What are physical symptoms of generalized anxiety disorder?
- muscle tenions
- general stress responses
What is the global prevalence of generalized anxiety disorder?
- about 4% of the population (worldwide)
- What are 2 critiques of health sciences research from a critical social science perspective?
- research often conducted in healthcare settings, but most people experiencing anxiety disorders are undiagnosed/untreated - may be due to lack of appropriate services or stigma by healthcare system in addition to personal choice
- research is often quantitative, but this type fo research is not adequate to examine complexity/depth of lived experience
- critical social science (ex. sociology, anthropology, etc.) can address the above 2 limitations
What can critiques from critical social science enable?
- can enable understanding of non-medical factors affecting anxiety severity
ex. how social environments may affect anxiety
- awareness of natural disasters and climate change consequences
- technology changes (ex. increased social media use)
review this about critiques from critical social science
- evidence-based practice used in mental health fiels and medicine favours some research methodologies (ex. quantitative research designs like RCTs) while excluding or categorizing others as lower on the hierarchy of evidence (ex. qualitative research designs)
- the hierarchy above often does not generate much evidence about or insight into lived experiences of anxiety
- research designs used in health sciences and critical social sciences together needed for fuller understanding
- textbook: “only in this way will a full picture of anxiety disorders be gained and will positive change be achievable in social understanding and acceptance, lives lived, and care
What is acrophobia?
- fear of heights
-read about the case study of acrophobia
- in this study, interviews were conducted with ten people who had acrophobia
- Andrews wanted to understand the mathematical height at which anxiety was triggered for these people
- participants spoke about their coping mechanisms, and anxiety about having to respond to situations which trigger acrophobia
what is the conclusion to the case study of acrophobia?
- acrophobia not simply a matter of heights
“it is a complex time-space experience that determines where and when acrophobia impacts sufferers”
What is trypanophobia?
- needle phobia
- irrationally high fear of clinical procedures involving needles
read about the case study about trypanophobia
- affects 4% to 25% of the population, with varying severity
- evidence for evolutionary/genetic links to the disorder, as well as aspects of learned behaviour
- people with this disorder will often avoid health care, which is potentially harmful to personal health and public health (ex. avoiding vaccinations or untreated medical conditions)
- in this study, 11 participants interviewed talked about things that trigger and things that help with their anxiety
What is the likelihood of receiving treatment for needle phobia related to?
- personal impact of condition
- health seeking behaviours
- access to services
— most sufferers do not receive treatment
What did the authors conclude about the case study about trypanophobia?
- concluded that this type of information is important in developing responses (ex. policies/practices) to needle phobia (critical social science perspective important; not just medical)
review this about mental disorder
- anxiety, like many illnesses, has both physical and psychological symptoms
- mental disorder is an incomplete description of the experience
- dividing mental illnesses from physical illnesses is particularly problematic for anxiety disorders
