Lecture 21 - Mental Health Disorders Flashcards
Two-hit hypothesis
Genetic susceptibility OR infection/inflammatory processes
coupled with
developmental insult (stress/trauma/drugs)
Bipolar 1 - had previous mania
Bipolar II - no history of mania, but current episode
both have MDD symtoms either current or history
prevalence of bipolar
1% of global pop
Brain regions and bipolar
Enlarged ventricles
Hypoactive prefrontal Cortex
reduced hippocamal volume
overactive amygdala
euthymic
brain while not depressed or manic
Bipolar and prefrontal areas
Ventral prefrontal cortex
- Very tightly connected to the amygdala àdeals with what is/isn’t rewarding in our environment.
- Too active in people with bipolar disorder.
Dorsal-lateral prefrontal cortex
- The dorsolateral prefrontal cortex àdeals with rational thinking; figuring out stimuli and strategizing on how to behave.
- Less active in people with bipolar disorder.
- Emotional –overactive, logical-underactive
neurotransmitter theory of bipolar
dopamine hypothesis: faulty homeostasis of dopamine for manic phase
Serotonin hypothesis: serotonin reduced in depressive phase
bipolar treatment medication
lithium, mood stabilizer
antidepressants, second line (mitigates cell death, but usually need pairing with mood-stabilizer, so not the best)
bipolar therapy
psychotherapy
cbt
(good time to catch em is in manic state)
positive schizophrenia symtoms
•present in schizophrenia but not in healthy individuals. (inner voice, hallucination, delusion)
negative schizophrenia symptoms
•-the absence of functions that are present in healthy individuals. These are generally harder to treat (flat affect, lack of motivation, catatonia,
brain and schizophrenia
reduced gray matter volume (esp in frontal and temporal)
•Increased cell density in the frontal and occipital cortex.??…
enlarged ventricles
excessive synaptic pruning,
less activity in PFC
therapy for schizophrenia
cognitive training
family intervention/psychoeducation
PFC in Trauma/PTSD
PFC in Trauma/PTSD:
- PFC is notably less active and less able to override the hippocampus as it flashes fragments of memory, nor to signal the amygdala that the danger is not real.
- Animal studies show that early stress is associated with a decrease in branching of neurons in the medial prefrontal cortex.
Signs and symptoms of PTSD associated with PFC:
•Irritability, difficulty with logical decision making, avoidance (eg.Numbing, avoidance).
Hippocampus in Trauma/PTSD
•When experiencing PTSD, memory becomes fragmented, and the hippocampus has trouble coherently piecing events together, discriminating from past or present, and integrating memory of experiences with feelings and factual knowledge.
Signs and symptoms of PTSD associated with the hippocampus:
•Confusion, disorientation, recurring thoughts, flashbacks, nightmares, difficulty sleeping.
Triune Brain
- Reptilian (basal ganglia): the innermost part of the brain is responsible for survival instincts and autonomic body processes.
- Mammalian (limbic system): processes emotions and conveys sensory relays.
- Neommalian(neocortex): most highly evolved part of the brain, controls cognitive processing, decision-making, learning, memory and inhibitory functions.
- Children who experienced trauma have a difficult time learning in school because their survival brain is fired up,
•
Therapy for Trauma (Current understanding)
- With our new understanding of neurobiological trauma processes in the brain, we have learned that when talk therapy attempts to engage parts of the brain that are “off-line” and deep in a trauma response, the PFC and cognitive part of the brain are not going to able to work through the trauma logically.
- Trauma therapy has therefore shifted to include “bottom up” processing where we first deal with calming arousal systems in the deeper regions of the brain before talking through and processing the trauma on a cognitive level.
- Eg. Trauma focused CBT.
- Firstly in therapy, you teach the client to quiet down their survival brain BEFORE you get them to rationalize with frontal cortex and logic about their problems/problem solve
