Mental Illness Flashcards
Who proposed the separation of body and mind?
Descartes
What are the two major assumptions of Freud?
- That much of mental life is unconscious
- That past experiences, particularly in childhood shape how a person feels and responds throughout life
Mental illness comes about when the conscious comes into conflict with the unconscious
What is the most common psychiatric disorder?
Anxiety disorder
What is a panic disorder?
Where sudden feelings of intense terror that occur without warning (panic attacks) repeatedly occur.
Women twice as likely as men to suffer
What is sever anxiety about being in situations where escape might be difficult or embarrassing called?
Agoraphobia. Eg. being afraid alone in an open market.
Women twice as likely as men to suffer.
What is obsessive compulsive disorder (OCD)?
People that have obsessions (eg. with ideas of being infected) and compulsion (eg. hand washing to address infection).
Usually appears in young adult life and the symptoms fluctuate
What are four hallmarks of the stress response?
- Avoidance behaviour
- Increases vigilance and arousal
- Activation of the sympathetic division of the ANS
- Release of cortisol from the adrenal glands
What mediates the humoral response to stress in the brain?
The hypothalamic-pituitary-adrenal (HPA) axis.
This axis is activated by corticotropin releasing hormone containing neurons in the hypothalamus, resulting in the release of cortisol from the adrenal cortex.
How is the HPA (hypothalamic-pituitary-adrenal axis) activated?
The amygdala and hippocampus activate it
- The amygdala becomes active when sensory information related to fear enters the central nucleus of the amygdala, a stress response follows activation. Downstream from the amygdala, the bed nucleus of the stria terminalis activates the HPA axis and the stress response.
- Hippocampal activation inhibits CRH release from the HPA axis.
How does the hippocampus suppress CRH (corticotropin releasing hormone) release?
Numerous glucocorticoid receptors of the hippocampus respond to the HPA system and inhibit CRH release by feedback inhibition. This prevents cortisol levels from getting too high. Chronic stress can cause hippocampal neurons to whither and die in experimental animals, setting off a vicious cycle where stress response becomes more pronounced. This is perhaps how post traumatic stress disorder (PTSD) becomes so insidious.
How can psychotherapy be used to treat anxiety disorders?
Through the learning component of fear. Where a patient is exposed to adverse stimuli, to diminish fear response by proving that it’s harmless.
What are medications that reduce anxiety called? How do they act?
Anxiolytic drugs, act by altering chemical synaptic transmissions in the brain
Where are two major classes of anxiolytic drugs?
- Benzodiazepines
- Serotonin-selective reuptake inhibitors (SSRIs)
How do benzodiazepines work to reduce anxiety? What are some examples?
Benzodiazepines bind to GABA receptors and make them more effective in opening the channel and producing inhibition of the brain, particularly in brain circuits used in stress response. Ethanol (drinking alcohol) and Valium are well known examples of benzodiazepines.
What is Prozac and how does it work?
A Serotonin-Selective reuptake inhibitor (SSRI). Can treat mood disorders and anxiety disorders (notably OCD). Serotonin originating from Raphe nuclei (and other places) is secreted all over the brain and modulated by G-protein receptors. The action of serotonin is terminated by uptake, SSRIs act to inhibit reuptake
Which work faster for treating anxiety? Benzodiazepines or SSRIs?
Benzodiazepines work almost immediately, SSRIs take weeks.
This implies that immediately having more serotonin activation isn’t immediately benefitting. The nervous system probably adapts to having elevated serotonin action in a way that is anxiolytic. One adaptive response to SSRIs is an increase in glucocorticcoid receptors in the hippocampus, perhaps enhancing feedback inhibition of the HPA axis
What are the 6 symptoms of major depression which must be present everyday for two wakes to make a positive diagnosis?
- Loss of appetite
- Insomnia
- Fatigue
- Feelings of worthlessness or guilt
- A diminished ability to concentrate
- Recurrent thoughts of death
What is dysthymia?
A milder but longer lasting form of depression. Seldom disappears spontaneously like depression does (in about 4-12 months)