The Biomedical Therapies and Preventing Psychological Disorders Module 45 The Biomedical Therapies and Preventing Psychological Disorders

The Biomedical Therapies and Preventing Psychological Disorders Biomedical therapy involves any of the following: Changing the brain’s functioning by altering its chemistry with drugs Affecting its circuitry with electrical stimulation, magnetic impulses, or psychosurgery Influencing its responses with lifestyle changes Drug therapies are the most widely used biomedical treatments. Primary care providers provide most of the drugs for anxiety and depression, followed by psychiatrists (and psychologists in some U.S. states).

Drug Therapies 45-1: WHAT ARE THE DRUG THERAPIES? HOW DO DOUBLE-BLIND STUDIES HELP RESEARCHERS EVALUATE A DRUG’S EFFECTIVENESS? Psychopharmacology Study of drug effects on mind and behavior. Its discoveries have helped make drug therapy the most widely used biomedical therapy and emptied mental hospitals. New drug treatments often treated with enthusiasm that diminishes after considering rates of normal recovery among untreated persons and recovery due to the placebo effect. Double-blind procedures are used to evaluate drug effectiveness.

Drug Therapies Antipsychotic Drugs Antipsychotic drugs Drugs used to treat schizophrenia and other forms of severe thought disorder. Mimic certain neurotransmitters (e.g., blocking activity of dopamine). Reduce overreaction to irrelevant stimuli. First-generation antipsychotic drugs such as Thorazine may produce sluggishness, tremors, twitches, and tardive dyskinesia. Newer-generation antipsychotics have fewer side effects. Successfully used with life-skills programs and family support to treat schizophrenia, allowing many patients to leave hospitals.

Drug Therapies Antianxiety Drugs Antianxiety drugs: Drugs used to control anxiety and agitation. Depress CNS activity, so should not be used in combination with alcohol; Xanax or Ativan are examples. Often successfully used in combination with psychotherapy. May reduce symptoms without resolving underlying problems. Upon stopping, regular users may have increased anxiety, insomnia, and other withdrawal symptoms. Anxiety is increasingly treated not by antianxiety drugs, but by antidepressants.

Drug Therapies Antidepressant Drugs Antidepressant drugs: Drugs used to treat depression, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. (Several widely used antidepressant drugs are selective serotonin reuptake inhibitors—SSRIs.) Many increase availability of norepinephrine or serotonin, which elevate arousal and mood. Increased serotonin promotes neurogenesis, the birth of new brain cells. Effectiveness sometimes questioned due to spontaneous recovery and placebo effect, especially for those with milder symptoms.

Drug Therapies Mood-Stabilizing Medications Mood-stabilizing drugs: Depakote: Originally used to treat epilepsy, but found useful for controlling manic episodes Lithium: Simple salt that levels out the emotional highs and lows of bipolar disorder Reduces risk of suicide for those with bipolar disorder Lower crime rates reported as well Although we do not fully understand why, lithium works.

Brain Stimulation Electroconvulsive Therapy 45-2: HOW ARE BRAIN STIMULATION AND PSYCHOSURGERY USED IN TREATING SPECIFIC DISORDERS? Electroconvulsive therapy (ECT): Manipulates brain by shocking it; used for severely depressed patients. Despite the name, it involves the administration of general anesthetic and a muscle relaxant that prevents convulsions. Causes less memory disruption (just of the preceding hours before treatment) than earlier versions. Editorial in the Journal of the American Medical Association (2001) concluded that ECT methods among the most positive treatment effects in all of medicine ; reduces suicidal thoughts. Researchers are still exploring the reasons for effectiveness.

Brain Stimulation Alternative Neurostimulation Therapies Magnetic Stimulation Neural stimulation technique used to treat depression. Repetitive transcranial magnetic stimulation (rTMS) sends magnetic energy to brain surface through coiled wire held close to brain; used to stimulate or suppress brain activity. Few side effects aside from possible headaches. Initial studies have found a small antidepressant benefit. How it works is unclear; repeated stimulation energize left frontal lobe, prompting new neural circuits.

Brain Stimulation Alternative Neurostimulation Therapies Deep Brain Stimulation Another neural stimulation technique used to treat depression. Manipulates depressed brain via implanted electrodes; inhibits activity related to negative emotions and thoughts. Further research is needed, but deep brain stimulation may help not only depressed patients, but also people with obsessive-compulsive disorder and with drug and alcohol addictions.

Brain Stimulation Psychosurgery Surgery that removes or destroys brain tissue in an effort to change behavior Is irreversible and thus the least-used biomedical therapy Lobotomy Psychosurgical procedure developed by Egas Moniz in the 1930s, and once widely used to calm uncontrollably emotional or violent patients. Procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain. Reduced symptoms, but at great cost. Today, less invasive techniques used; MRI-guided microsurgery used as a last resort for uncontrollable seizures and severe disorders.

Therapeutic Lifestyle Change 45-3: HOW, BY TAKING CARE OF THEMSELVES WITH A HEALTHY LIFESTYLE, MIGHT PEOPLE FIND SOME RELIEF FROM DEPRESSION? HOW DOES THIS REINFORCE THE IDEA THAT WE ARE BIOPSYCHOSOCIAL SYSTEMS? We are integrated biopsychosocial systems. Thus, our exercise, nutrition, relationships, recreation, relaxation, and religious or spiritual engagement all affect our mental health. Reasons Stephen Ilardi (2009) has developed training seminars promoting therapeutic lifestyle change: Human brains and bodies were designed for physical activity and social engagement. Ancestors hunted, gathered, built in groups; some groups still do, with little evidence of disabling depression. Outdoor activity in natural environments reduces stress and promotes health.

Preventing Psychological Disorders and Building Resilience Preventive Mental Health 45-4: WHAT IS THE RATIONALE FOR PREVENTIVE MENTAL HEALTH PROGRAMS, AND WHY IS IT IMPORTANT TO DEVELOP RESILIENCE? Many psychological disorders might be prevented by changing oppressive, esteem-destroying environments into more benevolent, nurturing environments that foster growth, self-confidence. Risk of depression, alcohol use disorder, suicide when a person’s sense of competence, personal control and self-esteem are low. Risk factors include poverty, meaningless work, constant criticism, unemployment, racism, and sexism. Community psychologists focus on creating environments that support psychological health.

Preventing Psychological Disorders and Building Resilience Building Resilience Resilience: The personal strength that helps most people cope with stress and recover from adversity and even trauma. Faced with trauma, most adults exhibit resilience. Can be seen in New Yorkers after 9/11, spinal cord injury patients, and others. Posttraumatic growth may be an outcome when struggling with challenging crises. Positive psychological changes in many cancer survivors, who report a greater appreciation for life, more meaningful relationships, increased personal strength, changed priorities, and a richer spiritual life.