“Actually the bill is part of your

Psychology reality therapy.”

Treatment and Therapy for

Psychological Disorders
Early Theories
 Music or singing was
often used to chase
away spirits.
 In some cases
trepanning was
used: cutting a hole
in the head of the
afflicted to let out
the evil spirit.
Trepanning
 Philippe Pinel
A French doctor
who was one of
the first to take
the chains off
and declare that
these people are
sick and “a cure
must be found.”
Dorothea Dix
 American reformer who worked
to get better care for the
mentally ill
Defining Mental Disorder
Psychosurgery
 Surgical procedures, usually directed
at the brain, used to affect
psychological reactions
 Split-brain procedure – epilepsy
 Small lesions of limbic system – violent
behaviors
 Cingulotomy – extreme anxiety and
symptoms of obsessive-compulsive
disorder
 Surgical techniques – Parkinson’s
 Psychosurgery
 Lobotomy – severs the major
neural connections between the
prefrontal lobes and the lower
brain centers
Problem: patients were
calm after the procedure
but also had changed
personality and drive
 Creating permanently
lethargic, immature
and uncreative people
 Electroconvulsive Therapy–
ECT (hyperlink)

 ECT shock treatment) – involves passing

an electric current between 70-150
(usually 100) volts across one of the brain
hemispheres
 30 – 60 seconds of electrical current
 Anesthesia is given to minimize trauma
 Mainly used for profound depression
 No one knows exactly why it works
 Perhaps because of placebo effects, rebooting
the computer, calming neural centres?
 No more than 10-12 treatments
 rTMS Repetitive Transcranial
Magnetic Stimulation
 Repeated pulses surge through a
magnetic coil held close to the skull
 Painless and produces no seizures,
memory loss or other serious side effects
 Studies have shown modest benefits
 Unclear how it works but possibly because it
energizes the left frontal lobe
 Repeated stimulation may cause nerve cells
to form new circuits
 Deep Brain Stimulation
 For patients whose severe depression
has resisted drugs and ECT
 Experimental treatment focusing on a
neural hub that bridges the frontal lobes
to the limbic system (over active in a
depressed brain)
 Electrodes are implanted

 Excites neurons that inhibit activity

 12 / 20 experienced relief for three to six

years of follow up
 Drug Therapy
 Biomedical therapy may administer
drugs to improve abnormal behavior
 Drug classes include:
 Antianxiety drugs relieve muscle tension
 Antipsychotic drugs improve thought
processes
 Can have major adverse side effects
 Antidepressant drugs can reverse
depression (hyperlink)
 Tricyclics
 MAO inhibitors
 Selective Serotonin Reuptake Inhibitors (SSRIs)
 Anti-Anxiety Drugs
 Help reduce the felt aspect of
anxiety
 Majority are benzodiazepines (e.g.,
Valium, and Xanax), which act
directly on CNS
 Very effective and most commonly
prescribed of all medications
 Dependency and addiction may develop

 Muscle relaxants (e.g., Miltown)

 Antimanic compounds

 Used for bipolar disorder

 Lithium carbonate – most effective
at treating the manic phase (once
the mania is eliminated, depression
usually does not follow).
 Lithium reduces risk of suicide
 Do not fully understand why Lithium
works, but it does…
 Lithium side effects
 Low level:
 nausea, vomiting, diarrhea, abdominal
pain; tremor, lethargy, impaired
concentration, dizziness; slurred
speech, ataxia, muscle weakness;
memory impairment; weight gain
 Long term lithium use:
 may enlarge the thyroid, cause skin
rashes, and increase urine output;
impaired motor activity, creativity,
and cognitive activity.
 Antipsychotic drugs
 The first generation were aimed at the
positive symptoms of schizophrenia -
dopamine receptor blockers
 The dopamine hypothesis suggests that
the positive symptoms of schizophrenia
are caused by overactivity of DA
synapses.
 Atypical (second generation)
antipsychotics also impact the negative
symptoms
 e.g. Clozapine and Risperidone
 Anticholinergic side effects
(acetylcholine inhibitors)
 Dry mouth
 Blurred vision
 Rapid heart rate (tachycardia)
 Urine retention
 Constipation
 Confusion and memory impairment
 Tardive Dyskinesia
• a movement disorder characterized
by involuntary movements of the face
and neck
 Drug Therapy
 Antidepressant drugs – elevate
the mood of persons who are
feeling depressed, and there are 3
major classes
1. MAO (monoamine oxidase) inhibiters
2. Tricyclics
3. SSRIs (selective serotonin reuptake
inhibitors)
Drug Therapy: MAO Inhibiters
 Inhibit the enzyme monoamine
oxidase, which normally breaks
down levels of serotonin,
norepinephrine, and dopamine in
the brain
 Major drawback is that they can
be toxic and interact with foods
containing tyramine
 Foods with high levels of
tyramine
 strong or aged cheeses like cheddar, blue cheese, or
gorgonzola
 cured or smoked meats or fish, such as sausage or salami
 beers on tap or home-brewed
 some overripe fruits
 soy products like miso soup, bean curd, or tofu
 certain beans, such as fava or broad beans
 some sauces or gravies like soy sauce, teriyaki sauce, or
bouillon-based sauces
 pickled products like sauerkraut
 sourdough breads
Drug Therapy: Tricyclics
 These drugs generally are safer
and more effective that the older
MAO inhibitors
 They mainly affect the operation
of the neurotransmitters
serotonin and norepinephrine
Drug Therapy: SSRIs
 These drugs act faster to relieve
symptoms and have fewer side
effects
 Work by inhibiting the reuptake
of serotonin, increasing serotonin
levels, which elevates mood
 Prozac, Zoloft, Luvox, and Paxil
Antidepressant drugs prolong the activity of the
neurotransmitters dopamine, norepinephrine, and serotonin.
(a) Ordinarily, after the release of one of the
neurotransmitters, some of the molecules are reabsorbed by
the terminal button, and other molecules are broken down by
the enzyme monoamine oxidase (MAO). (b) Selective
serotonin reuptake inhibitors (SSRIs) prevent reabsorption of
serotonin. Tricyclic drugs prevent reabsorption of dopamine,
norepinephrine, and serotonin. (c) MAO inhibitors (MAOIs)
block the enzyme monoamine oxidase and thereby prolong
the effects of the neurotransmitters.
Drug Therapy –
Antidepressants
 Drawbacks:
 Usually take 2-4 weeks to show
any effect, and may take 6 weeks
to be effective
 Unpleasant side effects(hyperlink)
 Efficacy
 Pharmaceutical vs. Psychotherapy
 Depression and Anxiety
 Less Effective to just as effective
 More effective when combined

 Therapeutic lifestyle change show to be

the most effective
 Extreme Disorders
 More effective/Necessary
 More effective when combined
Therapeutic Lifestyle change
 Aerobic Exercise
 30 mins 3 times a week
 Outdoors(nature) more effective
 Adequate Sleep
 7-8 hours a night
 Light Exposure Therapy
 30 Minutes each morning
 Especially effective for S.A.D
 Social Connections
 Two meaningful social connections per week
 Nutritional Supplements
 Specifically omega-3 fatty acids