Ch. 19 S. 5 : Biological Therapy Obj: Describe the three major biological treatments for psychological disorders.

The methods of psychotherapy described so far rely on verbal interactions between the psychotherapist and the individual seeking help. Biological therapy, on the other hand, relies on methods such as medication, electric shock, and even surgery to help people with psychological disorders. Because these treatments are medical in nature, they must be administered or prescribed by psychiatrists or other physicians.

Drug Therapy Drug therapy is the most widely used biological treatment for psychological disorders. Four major types of medication are commonly used: Antianxiety drugs Antidepressant drugs Lithium Antipsychotic drugs

Antianxiety Drugs – also called minor tranquilizers are used as an outpatient treatment to help people with anxiety disorders or panic attacks. They are also prescribed for people who are experiencing serious distress or tension in their lives. These drugs work by depressing the activity of the nervous system. They lower the heart rate and respiration rate. They also decrease feelings of nervousness and tension.

Although antianxiety medications help control they symptoms of anxiety, they are not a permanent cure. Thus, most people use them for a short period of time. The longer a person takes this medication, the less effective the drug may become. Higher doses may be needed in order to achieve the same effect. The major side effects are feelings of fatigue and possibility of developing a dependence.

Antidepressant Drugs – People who suffer from major depression, eating disorders or panic disorders are all treated with this type of drug. They work by increasing the amount of one or both of the neurotransmitters norepinephrine (noradrenaline) and serotonin. They tend to be most helpful in reducing the physical symptoms of depression. They increase activity levels and reduce the severity of eating and sleeping problems.

In order to work effectively, antidepressants must build up in the body to a certain level. They may take anywhere for several days to a few weeks. Severely depressed people who are at risk of suicide are sometimes hospitalized until the meds reach the level required to improve their mood. This is to prevent them from ODing, or having adverse reactions such as escalated heart rate and excessive weight gain. These meds are believed to be reserved for people who fail to respond to psychotherapy.

Lithium – The ancient Greeks and Romans may have been the first people to use this metal to treat psychological disorders. Today, lithium carbonate, a salt of the metal lithium, is given in tablet form to help people with bipolar disorder. It seems to flatten out their cycles of mania and depression. How it does this is not completely understood, although it is known to affect the functioning of several neurotransmitters. Side effects may be shakiness, memory impairment, and excessive thirst.

Antipsychotic Drugs – People with schizophrenia are likely to use this medication, also called major tranquilizers. They are effective for reducing agitation, delusions, and hallucinations. Their use has enabled many thousands of people with schizophrenia to live outside of mental hospitals and even to hold jobs. Schizophrenia is associated with high levels of dopamine activity. These meds are thought to work by blocking the activity of dopamine in the brain. Side effects are that prolonged use can lead to problems in balance, coordination, and produce tremors and twitches.

Electroconvulsive Therapy Electroconvulsive therapy (ECT), commonly called electric-shock therapy, was introduced as a treatment for psychological disorders in the 1930s. Before ECT is given, anesthesia is administered to render the person unconscious throughout the procedure. Then an electric current is passed through the person's brain. The electric current produces convulsions throughout the body. In some cases, muscle relaxant drugs are given to prevent injury during the convulsions.

When ECT was first introduced, it was used for many psychological disorders, including schizophrenia. However, once antipsychotic drugs became available, ECT was used much less often. In fact, in 1990 the Am. Psychiatric Association recommended that that ECT be used primarily for people with major depression who do not respond to antidepressant drugs.

ECT is controversial for many reasons ECT is controversial for many reasons. For one thing, many professionals are distressed by the thought of passing an electric shock through a person’s head and producing convulsions. There are also side effects, including memory problems, but this is usually temporary. Despite the controversies surrounding it, ECT appears to help many people who do not respond to antidepressant drugs.

Psychosurgery Psychosurgery is brain surgery that is performed to treat psychological disorders. The best-known technique, prefrontal lobotomy, has been used to reduce the agitation and violence of people with severe psychological disorders. The procedure involves cutting nerve pathways in the brain between the prefrontal lobes and the thalamus. However, the treatment produces several serious side effects; distractibility, reduced learning ability, overeating, apathy, social withdrawal, seizures, reduced creativity, and occasionally even death.

Because of the side effects of the surgery and the availability of antipsychotic drugs, lobotomies are now performed only rarely. Drug therapies, and to a limited extent ECT, seem to be effective for some psychological disorders that do no respond to psychotherapy. It is important to realize, however, that medications and electric shocks cannot help a person develop more rational ways of thinking or solve relationship problems. Changes such as these are likely to require psychotherapy.