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Anti-depressent medicne for aniety: theyhave a propensity

anxiety n depresson are comorbid


-they work by inceasing the smount of seretonin in the system
-benozodiazepines-allow gaba to transmit nerver signal(increase gaba) has a clam
ing effect, work by incresing the transimition
of gaba to have a cal,ming effect
-to change the neurostramical of the brain is a longer preocess for SSRI's can b
e stressiung because it takes 4-6 week
as a result people would be recommneded benzodiazepens(faster take effect in hou
rs but are not as long lasting
-people who have acute stress use (benzo) become dependednt
-SNRIs-seretonin nonepinephrine reuptake inhibitors
-ssri prevents the reuptake of the post synaptic neuron which means it has more
of an effect, stays on the cleft
-Advantages of medicine: dont require to go or go to sessions, more immediate ef
fect, less stigma attached to it,
its mch more privita
-neg: can be addictive specially(benzo) n overdoze specially(benzo being mixed w
ith alcohol) overtime it stops working
medication may have sideaffect, ssri(stomatch probles, nasea, sexual desires) ca
n have unpleasent withdrawl syndromes
may not get to the root of the problem(serves as a band-aid), if people are just
on medication alone they are more likely
to relapse
-60-90% response rates depending on disorders, good treatment for phobias(les co
mplicate to treat) n less is ocd
main componets is exposing the person what they are trying to avoid(exposure the
raphy)
-cognitve behavior theraphy-if they are scared, get them to change cognitions
-virtually reality exposure(trying to stimulate, recreate the environment spacia
lly for people that have pstd, trying
to access the trigger n simulatee it(some positive data)
-social skills traing-social phobia-more focused on people that have a skill def
cit n teach them the skill they need
such as what to say, compliments form friendships
-Cognitive behavioral theory-expoure , hypothesis testing to see wether bad thin
g actually happens,
generate realistic coping cognitions to counteract the neg thought
-not enough for it to just say its ok, they have to do it themselves n have them
do it in ur office
-repeated exposures specially for panic attacts n show them that nothing happene
d is what u strive to do in CBT approaches
-some data suggest that having relaxing exercises counteracts theraphy because t
hey are not learing that the
situation was not dangerous to begin with, relaxation is usally used after the r
epeated exposure to relax them
before they leave
-ALLOWS S TO LEARN NEW OR ALTERNATIVE COGNITIONS
-steps for ocd: bay steps have them touch te doorknob with napking then without
one n then no sanatizer(baby steps)
Video time: fear of snakes interferes with her life, unless one is willing to ex
pose themselves to what they are scared
then they will never overcome the phobia, only few people are willing to confrom
nt hat fear
-first interview her for 45 min(her cataotrophy belief is that is snakes espaces
she ,might have a heart failure)
-avoidance behavior, deep breathing masks anxiety,
*MOTIVATION TO SUCCED, IF U stay exposed to the situation, try to breath slowly
n camly,
participant is acepting to take in new info, theraphist knows its going to work
so he is patient
-there is an 80% imporvement comapared to ther control group
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mood disorders
-2 key moods
-mania
-depression
-unipolar depressive disorders(only depressive epesodes
-Prevalence is more common for unipolar disorders (7%, lifetime prevalance is 17
%)
-more common in women than men, lifetime prevalance for bipolar
-mojaor derepssive disorder(clinical sadness, people who have a down mood, life
is not geeting better, dont eat as much
things that love dont have an interest for, persists, n there is a type of imper
ament in school,
with familiy n just dont seem themselves
-for a dsm 4 u need 5 of 9 n one of 2 u need to have a sad mood or anemonia(loos
of interestt) must have one or both
-must have to be present 4 out of 7 days for two weeks for th eperson to meet cr
iteria
1) depressed mood or irratable
2) drcrease interest or plasure,
3) signifiant weight change-increase or decrease in eating
4) hang in sleep-sleeping too little ot too much
5) change in activty-mre slow of more active, speech might be slower (change in
motor activity <-next line
6) fatihue or loss of energy
7) guilt/worthlessness-they feel its their fauilt, they blame emselves not feeli
ng good about themselves, their useless
to a certain extent
8)concentration: is diminished n decisions are excrusiating to them
9) Suicidality: fleeting thought, actual intent how they are going to hurt thems
elves
*need number one or two n 3 or 4 of the others (must be present for 2 weeks stra
ight n there must be an imperament
-Dysthymic disorder -more mild n longer lasting
-a person with 2 years or more that have 3 of the previous symptoms (lower n mor
e mild form of depression
that does not meet critieria for depression n does not a time period for a month
or 2 that a person is free
from feelingt that n would not have sigificant impariemt( slight impariment)
lifetime prevalence od 2.6-6%
-DSM has changed n let clinitian design
-grivemtn takes 6 month, n in DSM 5 the clinitian decides when see how long the
depression lasts after mom has given birth
or loss of a memeber, cannot be accredited to drug use n alcohol n , rule out su
btance use, such as hypothirism
-depression is associated with heart diease, cancer, n miranes, anxiety disorder
s (anxiety comes first them depression)
comorbid with several other diseases
-if use of the substance is the onset of the depression, timing of the disorder
(does the
-different patterns of depressions
-major depression does not remot for more than 2 years
-recurrent:discrete disoders n remission n relapse(have it for 2 months then its
gone n it comes back)
-seasonal-recurretn depressive episode with a pattern usually occur in fall or w
inter n remit in spring
hypothesis is carrhyms systems change
*chronic depression has a heritable componet of it
Age risk for uniolar n bipolar is 18-45, typical onset of age is 30
-in children is 2.5%, there is a spike in adolesence(8.3%_
-triple the amount of depression in adolonce
-after adolance rates of depression increases for girls (2 to 1)
-adolence is a special time because : about ability to think, fitting in, who we
re are what do we believe in, pubirty
-must take these fators into account
-causal factors
biological factos , heridity neurtransmitters n hormonal factors, n the gene env
ironment interaction, whether or not
people have depressive episodes depends o genes (2 short alleles are ss are most
at risk)
seretonin gene, sl imtermediate risk , n ll is at least risk
-heratibility rates .3 or .4 regardless of the pattern,
-neutransmitter: the monoamine teory (the lacked norepheneprine or seretonin) in
volved in mood regulation n lower leves
is involved with depression (only some have shown that this might be true, other
neurotranmitter are involves, possibly
dopamine, there are biologivcal environmental factor)
-Stress hormones: some disfunction in negative feedback loop, which leads to mor
e cortisol to more body n this leads to
death of ceel specally in the hypocampus
-structural difference decrease hypocampical campus, lower activity in the left
n less actio or bahvior, more
activity in the right more vigilant n awareness
-amygdula
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