Psychiatric Disorders Flashcards
what is the definition of wellness when it comes to psychiatric disorders?
the integrated and coordinated function of many neurotransmitter systems
What are the meaningful outcomes of psychiatric disorders?
functional status and quality of life
What is a psychiatric disorder?
a CNS disease characterized by disturbances in emotion, cognition, motivation and socialization
Are their specific biological markers and syndromes to diagnose someone with psychiatric disorders?
no, because there are heterogenous syndroms (different from one person to the next). Diagnosis is made on clinical observations and criteria (DSM-V)
why is mental health important to physical health?
Physical and mental health is two-way and perpetual. Someone with physical health issues, if mental health declines, physical health does too
why do anxiety and sleep disorders have a very high co-occurence?
- an excess of stimulating neural flow relative to calming neural flow
- overlap between physical and psychiatric symptoms are high
What is the difference between a short term symptom of anxiety vs an anxiety disorder?
people with anxiety disorders are anxious all of the time when there is nothing to be concerned about in that moment. Also not transient.
what does GAD stand for?
Generalized Anxiety Disorder
What is the diagnostic criteria for GAD?
- excessive anxiety & worry occurring more-days-than-not for at least 6 months
- person finds it difficult to control the worry and associated with 3 or more of the following 6 symptoms:
(a) restlessness or feeling keyed up or on edge
(b) being easily fatigued
(c) difficulty concentrating or mind going blank
(d) irritability
(e) muscle tension
(f) sleep disturbance
What is gravol used for? how does it work?
- off label use as a sleep aid
- acts as CNS depressant causing drowsiness and sedation due to antihistamine and anticholinergic
What are the stages of sleep?
1,2,3,4 and REM
Which stages of sleep are considered Delta Sleep?
3 and 4
What happens during delta sleep?
muscle atonia & restorative
where in the brain does the circadian rhythm originate?
suprachiasmic nucleus
how do sleep medications affect sleep cycles?
Most medications that help people sleep alter sleep cycles. The medication may not be as restorative
What neurotransmitters contribute to alertness or wakefulness?
- domapine –> alerting effect
- norepinephrine, acetylcholine, histamine, substance P and cortisol
*there is usually an excess in one of these in people who have sleep issues
true or false: improvement of sleep disorders without medication is ideal
TRUE
what are the steps of Sleep Hygiene/Sleep Stimulus Control?
- Establish regular times to wake up and to go to sleep
- sleep only as much as necessary to feel rested
- Go to bed only when sleepy. Avoud long periods of wakefulness in bed
- If you do not fall asleep within 20-30 minutes, leave the bed and do something relaxing
- Avoid daytime naps
- Schedule worry time during the day. Do not take your troubles to bed.
- Exercise routinely, but not close to bedtime
- Minimize sensory stimulation in the bedtime (light, sound, temp)
- Reduce the use of alcohol, caffeine and nicotine - especially in the evening
- Avoid large quantities of liquids in the evening
- Do something relaxing and enjoyable before bedtime
What is the effect that changes in Anxiety, Depression, Pain, and Sleep Disorder symptoms can have on each other
- these problems can further aggravate each other. For example, people with chronic pain may have higher instances of depression, anxiety and sleep disorders.
- if we treat one, we can help something else indirectly. ex. helping someone sleep can help with anxiety
True or False: Addressing Reversible Causes and Utilizing Sleep Hygiene techniques to treat insomnia is secondary to treatment with a drug
FALSE: jumping right into a medication is not the best thing to do
What neurotransmitters do drugs used to treat insomnia target?
- enhance/restore: GABA, Serotonin
2. Inhibit/normalize: Histamine, Ach, NE, DA, substance P, Corticotropin Releasing Factor - Cortisol
How do benzodiazapines work in treating insomnia?
They are GABA agonists
What is a Non-Benzo GABA agonist?
zopiclone
What are other drugs other than benzodiazapines that can be used to treat insomnia?
- antihistamines
- antidepressents (i.e Trazodone)
- Melatonin agonists (i.e. valerian)