not responsible for the obesity section of eating disorders

-not sure if unopolar mania exists n they need more reasearch to find out if uni
polar mania exist as a disoders
-cyclothymic-they may be reward seeking n becuase they are not developing full b
low manic n depressive episodes they
dont have
an imparement n can be a full driven n succssuful people
-49-60% of people have delusions bipolar 1
-mood disorders with pyshotic fatures (lady in hte video) n msnia with cycotic f
eature shen was on the more
severe end of people wh suffer from bipolar disorder
-its not uncommon to have delusions n fear of perseccution
-an increase rate of physical fight in people that are bioplar compared to depre
ssion
-
some psychological contributuons, by stressful life events, neurosim, personalit
y trat for more ager, sadness
-personality varibles, reward sensitivity, getting a lot of reward,
-people with low social support, pessimistic life-style, attributions are stalbe
in a global n neg direction
-if bipolar in the parents then kids have 6 times the risk of developing the ill
ness as oppoed to kid's parent
who do not suffer from the disoder, neurotism increases ur risk for various pysh
cologicl disorders
-we see higher rates in industrialized societies (U>S france, hngry, Italy), ver
y low rates in asian counties
n latin countries (the diffrences might be due to certain sympotms here are noti
ntepreted as depressive symptoms
over there, it might be expressed in different ways, expresience depression as p
hysical complaints than congnitve
events, more somatic complaints (ex:head hurts) then cognitive distress)
-buddasim (life is about suffereing n the sooner we accept it the better we will
be, religoius differences, belief
n principles, they have an acceptance approach to suffering
-society shapes our values, n set expectations that are too high,
-in the us, native americans have higher rates of depression n blacks have less
depression,
-n the lower socioeconomic status individuals also suffer from depression
-native ameicans (chicken n egg, substance use or depression, istorically speaki
ng they were robbed of their land,
n high rates of substance abuse to cope/ the context of being forced to assimila
te, lose cultural identity , who
u are is not acceptable, n be placed in reservations
-program,s that target to rebuild identy n give them pride about their identy we
see an improvemtns in depression
-african americans have low rates of depression->
-the fear that d stagtized, n being resilient (having to overome adversity), soc
ial structure n support
TREATMENTS
-pharmacotheraphy-anti-depressants
for unipolar depression medications used are MAOIS inhibotors, trycyclyis, seret
onin reuptake,
for bipolar: lithium (70% showing partial inpreovemt), anticonvulsants dont knoe
how it works,but we know that it does
the front line tratment for biopar 1 is medication, its hard to treat without me
dication n they dont to use
medication because it mellows teir highs, n comocomrid conditons are self-medica
tion to manage their
highs in their own n they become addictive to the drugs, n quite common to not b
e adherant n go back into
their manic phases when not using it the medication is not a cure, its through l
iefe that they weiil
need to take medication
-sideeffects include: insomina,psysical agitation, less interest in seuxual acti
vites, thyroid problmes.
weight gain, decreased motor activity
-SSRI
-bran names n generi names: they rehibit the intake the reptake of seretonin
MAOI's shown to be effective alternative of ssris n inhibitinghte activity, stop
s the effect of an enyne so it
does not allow for the breaksdown for the nuerotranmitter, inhibit the activity
of the MAO enzyme, thus limiting breakdown of monoamines,
which increaes the ability of it inthe ir brain
sideeffects: they are not used frequnelty becuase u take certain food then u he
va a lethel allegic effect
-tryciclis: produce anxiety n depression , book 250 increase njerotransmittion o
f the monoanimes primariy nonepinephreing n
to a lesser extent seretoninside effects are weight gain, constipation, n sexual
ysfunction
to deactivate nuerotansmitters in the synspse by
-affect the reuptae of tranmitter
-affect
-does nto respons to medications or psychotheraphy then electroconvulsve shock t
heraphy is an option, they dont
expreience musch pain n given in low enough doses n aregiven a muscle relaxer at
the same time, very severe
sysmptoms nothing works this is still an option
-people improve after ect(they repost significant improvemtemtn)
-downside: must go for represt trials, cognitive slowing, language deficits, mem
ry loss, that are irreversable
for those reasons u must weight the pros n cons, but if they are suicidal then m
ore liely to do it
-not alot os reasearc hon transrnial magnetic stimulation-with this its non-inva
sive, but ur putting elcetrodes
on certain parts of the brains to stimulate areas of the brain, there are case s
tusies n they has not been large
randomized trials
-psychotherpahy:
CBT n meications are equally effective: 50-60% improvemt
-higher rates of relapse for people using medicantions than receicing CBT
-check slide 40
The behavioral activation treatment:
goal: to increase activity n access to reinforce ment thorugh overt behavior cha
nge
get people moving, do somehting different, get them out of house, out of bed,
mantra: do something even though u feel bad
-assesment of contigiesncies that maintain depressive tramtenemt
-have them motnitor their activities, somethimes fill in the gaps, n have them m
oniotr their mode before, while n
after they engaged in the activity
-how might the use of activities affect mood, we try to look at pattern n what t
hey are doing, see decreases in
increass in teir mood, get htem to take a shower, n brush teeth small steps
TRanscranial mgnetic stimulation cortex: is a noninvasice technique aloowing foc
al stimultion of the brain for patients who
are awake, brief bur intense pulsating magnetic fields that that induce electric
al activity in cretain parts of the cortext
are delivered.
-cognitive behavior heraphy
-u are going to work in their thought, way they misinterprest sitiatons n people
behaviors n help them to challenge
their interpretations especially if they are negative. once we change beliefs th
ean thats going to affct
n imprve their mood,
goals: if we get them to tink differently then change inemotianal reaction shoul
d follow
-a CBT: list situations (three column technique gotta study to do better in the
quizzes)
-event in one column, automatic negative thought in second columns, n in thrid c
olumns is rational replies
interpersonal theraphy: it has a psychodynamic component to it, idea is that ur
trying to build social support,
skills that ur going to try to help individuals, help them impreve their communi
tal skills, better ways to expresses they
needs n thought, help them with converstation n friwndships skills eye contact,
taking turn wile speaking, helping them
with social skills, the therapist is more focused, the way u interact with ur th
erapist is a good representation
to know how interact with other people. theraphy interaction to see how their in
teractions are n are trying to imorve
people's relationship
-familyt theraphy n marital theraphy: main social support n if they go back to h
ouse with hostile, negative,
n critism->then higher chance for relapse
Intrapersonal theraphy: focuses on current relationshp issues, trying to help a
person understand n change maladaptive
inteaction patterns
Family n marital theraphy:
-for families intervantions aimed at reducing the levels of levels of expressed
emotion n hostility, n increasing info of
how to cope with the disorder have been found useful to prevent relapses
-partners: focusing on marital discord than the depresed spouse is shown to be e
efective
sUICIDE:
when u looks at statistics its in the top ten
can range to have suicidal thought, to plans
-active suicidal ideation having the thoughts n plans
passie suicidal ideation is just wishing they were dead, not talking about an in
tent(30-40 make an intent)
-parasuicisdes (superficial cutting n OD on nonleathal medications), with cuttng
that expreincing physical pain
is better than physical pain, cry for help , not always in intent to escalate
-u make a risk asement to make sure they are not going to go thorught with their
plan, have u spoke to anyone else
-anybody who has a history of suicide u should monitor closely
-suiicde attempst are common in 18-24
-completed suicides n age (65 and older)
-gender differences: women have more aatempts, men have more completed suidices
n they use more lethal weapons such as
gun n women use medication
-rates of attempst have trippled between mid 1950 n mid 1980's
-8-10% in hish school stuendts n collefe students (ex: bullying)
mutiple ris factors- adjeutmen, stress, bullying, relatiosnhips, detaing, growin
g up in a troublesome household, greater
expectations, increased comorbity with drepressive disorder, academic stress, co
py cat,
-approxaimatly 50% patient with bipolar disorders attmept sucide during their li
fe times
-most peple who made an attempt or completed suicide had a psychiatric disorder
-90% of suiicde behavior had a psychiatric illnesses
-look at slide 46 for reasons of suicide, feeling of hoplessness, gentics, low l
vels of seretonins, can be risk or
protective factors, n religions, social connectedness (feeling alone), we are be
coming more disconnected
-47 ANSWER IS FALSE
30-40 PERCENT OF PEOPLE WHO COMMITED SUICIDE HAVE TALKED ABOUT IT