Famous People

Mental illness is more common than you think….

Abraham Lincolnsuffered suffered from severe from severe and and debilitating debilitating and on and on occasion occasion suicidal suicidal depressionsdepressions

Mary Todd Lincoln Ambitious and Ambitious and

educated, she spend educated, she spend considerable time considerable time and money trying to and money trying to contact her dead son contact her dead son and (and later her and (and later her husband)husband)

She was known to She was known to suffer from suffer from Schizophrenia. Schizophrenia.

Beethoven bipolar disorder bipolar disorder His “manic” His “manic”

episodes seemed to episodes seemed to fuel his creativity. fuel his creativity. He wrote his most He wrote his most famous works famous works during times of during times of torment, loneliness, torment, loneliness, and suffering and suffering psychotic delusions.psychotic delusions.

Isaac Newton

He suffered from He suffered from several “nervous several “nervous breakdowns” in breakdowns” in his life his life

known for great known for great fits of rage fits of rage towards anyone towards anyone who disagreed who disagreed with him which with him which some have labeledsome have labeled

Bipolar DisorderBipolar Disorder

Vincent van Gogh The famous artist The famous artist

was labeled was labeled peculiar with peculiar with unstable moods unstable moods most of his short most of his short life. life.

He suffered from He suffered from epileptic seizures epileptic seizures

Severely Bi-PolarSeverely Bi-Polar committed committed

suicide at age 37.suicide at age 37.

Winston Churchill

Prime Minister Prime Minister of Great of Great Britain during Britain during WWIIWWII

Suffered from Suffered from what he called what he called “black dog” “black dog”

severe and severe and serious serious depression. depression.

Linda Hamilton well known for her well known for her

part with Arnold part with Arnold Schwarzenegger in Schwarzenegger in "The Terminator“ "The Terminator“

diagnosed with Bi-diagnosed with Bi-polar disorder polar disorder

claims that claims that medication is helpful medication is helpful and understands she and understands she

will have to be on will have to be on medication for the medication for the

rest of her life. rest of her life.

…lots more…. Edgar Allen Poe (poet, writer – bipolar disorder)• Elton John (singer, composer – depression)• Harrison Ford (actor – depression)• Jim Carrey (actor, comedian – depression)• John Nash (Nobel Prize winner – schizophrenia)• Mark Twain (author, humorist – depression)• Marlon Brando (actor – depression)• Alanis Morissette (singer – eating disorder)• Janet Jackson (singer – depression)• Marie Osmond (singer – postpartum depression)• Courtney Love (singer – depression)• Mike Wallace (news correspondent –

depression)• Sheryl Crow (singer – depression)• Ray Charles (singer – depression)• Paula Abdul (dancer, singer – eating disorder)• Trent Reznor (musician – depression)• Drew Carey (show host – depression)• Patty Duke (actress – bipolar disorder)• Eric Clapton (musician, singer – depression)• Billy Joel (musician, singer – depression)• Charles Dickens (author – depression)• Terry Bradshaw (football great, announcer –

depression)• Princess Diana (Princess of Wales – eating

disorder

Psychological Disorders

What do you think?

Write a definition for a psychological disorder.

Do not give examples or define specific disorders- what does it mean to have a psychological disorder?

–distressing & harmful; disruptive

–behavior is uncontrollable

–Unjustified, Irrational

Psychological Disorder

Psychological Disorders

Must have personal distress and impaired functioningPotential harm

to self or others

Impairs FunctioningDaily life functioning

is impaired (one or both)–Work/School life–Home life–Varies throughout time/ culture

Diagnosis DSM-IV-TR

Diagnostic and Statistical Manual of Mental Disorders

describes specific symptoms and diagnostic guidelines for psychological disorders

– Provides a common language & comprehensive guidelines to help diagnose

Diagnosis

Axis I 296.21 Major Depressive Disorder , Single Episode

Axis I 303.90 Alcohol Dependence Axis II 301.6 Dependent Personality

Disorder Axis III None Axis IV Recent Divorce, unemployment Axis V 58

Insanity legal

definition only

unable to determine between right & wrong or understand consequences

Anxiety Disorders

An unpleasant emotional state characterized by general, vague feelings of tension, fear and apprehension

Anxiety Anxiety ==

Anxiety Disorders differ from general feelings of anxiety in that…

• Distressing, persistent

And/or •The behaviors that reduce anxiety…

… … begin to control and dominate lifebegin to control and dominate life!!

Anxiety Disorders are…Irrational (exaggerated or

non existent threats, response is out of proportion)

Uncontrollable (can not be “turned off, even if the person wants to)

Disruptive (interferes with life)

Types of Anxiety Disorders

GADPanic

AgoraphobiaPhobiasPTSDOCD

Generalized Anxiety Disorder (GAD)

ConstantConstant worryworry about many issues about many issues without any real without any real causecause, seriously , seriously interferes with interferes with functioningfunctioning

Panic Disorder Panic attacks—

sudden episode of helpless terror with high physiological arousal (increased blood pressure, heart beat, temp., sweating) Very frighteningVery frightening —sufferers live

in fear of having an attack

Agoraphobia often develops

NOT FEAR OF OUTDOORS Fear of being in situations in which escape might be escape might be difficultdifficult, they don’t feel safe- public places, crowds, wide open spaces–Mostly confined to homes- they are safe safe there

Specific Phobias

Intense, irrational irrational fears fears that may focus on …….

Inappropriate Inappropriate response response to ………..

Natural environment

type•the fear of lightning and thunderstorms (astraphobia).

•the fear of heights (acrophobia)

Situational type–being "afraid of the dark,"

(nyctophobia). –Monophobia—fear of being alone–Gephyrophobia - Fear of crossing bridges.

–Ligyrophobia — Fear of loud noises. –Xenophobia — Fear of strangers, foreigners, or aliens.

– the fear of small confined spaces (claustrophobia)

Blood/injection/injury type

– the fear of medical procedures including needles and injections (aichmophobia)

Algobphobia—fear of pain Pyrophobia—fear of fire Emetophobia — Fear of vomiting. Radiophobia— Fear of radiation or x-

rays Hemophopia (Haemophobia) — Fear

of blood

Animal type the fear of spiders (arachnophobia)

Ailurophobia—fear of cats Myrmecophobia — Fear of ants. Cynophobia — Fear of dogs or of

rabies. Mottephobia — Aversion to

moths and butterflies. the fear of snakes

(ophidiophobia).

Otherthe fear of clowns

(coulrophobia). Anthropophobia—fear of men Ephebiphobia — Fear/dislike of

teenagers. Zapatophobia - Fear of shoes,

socks, or sandals. the fear of the number 13

(triskaidekaphobia)

Posttraumatic Stress Disorder (PTSD)

Follows events that produce Follows events that produce intense horror or helplessness intense horror or helplessness (traumatic episodes)(traumatic episodes)

Actual or threatened death Actual or threatened death and/or injuryand/or injury– War, Rape, Accidents, Attacks, War, Rape, Accidents, Attacks, Abuse, Rescue workersAbuse, Rescue workers

May be delayed May be delayed after event- onset after event- onset with triggerwith trigger

–Avoidance of situations that trigger recall of the event

–Increased physical arousal associated with stress

Core symptoms include:–Frequent recollection of traumatic event, often intrusive and interfering with normal thoughts

Obsessive-Compulsive

Disorder (OCD)ObsessionsObsessions—irrational, disturbing thoughtsthoughts that intrude into consciousness

Compulsions—repetitive actionsactions performed to alleviate obsessions

The compulsions (actionsactions) help to keep away the obsessions (thoughtsthoughts)

If the actions are not performed==anxiety

Observable or mental compulsions

OCD ExamplesObsessions about getting hurt, getting hurt,

hurting someone, getting hurting someone, getting sick, contamination, sick, contamination, symmetry symmetry

Compulsions= cleaning, cleaning, checking, hoarding, touching, checking, hoarding, touching, counting, arranging, counting, arranging, ordering, repeating phrasesordering, repeating phrases

Personality DisordersInflexible pattern of thoughts,

emotions and behaviors - regardless of situation!

deviate from the expectations of the individual’s culture

Antisocial, Borderline, Dependent, Narcissistic

Antisocial Personality

DisorderManipulative, charming, “con man”

Cruel, destructive behavior

Lacking “conscience”, no guilt, no responsibilitystart as conduct disorder (children)

Borderline Personality Disorder

Instability of self-image, frantic to retain relationships

Self-destructive Self-destructive behaviorsbehaviors, impulsive

Fear of abandonment Fear of abandonment

Dependent Personality Disorder

Unable to Unable to make make decisions or decisions or do things on do things on ownown

NarcissisticNarcissistic Personality Personality DisorderDisorder self self importanceimportance

need for increased increased attention attention

EnvyEnvy

arrogancearrogance – others are inferior

Dissociative Disorders

–literally a dis-associationdis-association of memorymemory–person suddenly becomes unawareunaware of some aspect of their identityidentity or historyhistory

–unable to recall except under special circumstances (e.g., hypnosis)

–dissociative amnesia, dissociative fugue, dissociative identity disorder

Dissociative Amnesia

Memory loss the only symptom

Often selective memory loss surrounding traumatic eventstraumatic events–person still knows identity and most of their past

Dissociative Amnesia

Margie and her brother were recently victims of a robbery. Margie was not injured, but her brother was killed when he resisted the robbers.

Margie was unable to recall any details from the time of the accident until four days later.

Dissociative FugueAmnesia with a journeyjourney

involved – often with identity replacementreplacement

– leaves home– develops a new identity– apparently no recollection of former life

If fugue wears off– old identity recovers– new identity is totally forgotten

Dissociative Fugue

Jay, a high school physics teacher in New York City, disappeared three days after his wife unexpectedly left him for another man.

Six months later, he was discovered tending bar in Miami Beach. Calling himself Martin, he claimed to have no recollection of his past life and insisted that he had never been married.

http://www.msnbc.msn.com/id/21134540/vp/15384724#15384724

Dissociative Identity Disorder

Most report recall of torture or torture or sexual abuse sexual abuse as children and show symptoms of PTSDPTSD

Pattern typically starts prior to age 10 (childhood)

2 or more distinct personalities personalities manifested by the same person at different times, VERY rare VERY rare and controversial disorder

Dissociative Identity Disorder (DID)

Norma has frequent memory gaps and cannot account for her whereabouts during certain periods of time.

While being interviewed by a clinical psychologist, she began speaking in a childlike voice. She claimed that her name was Donna and that she was only six years old.

Moments later, she seemed to revert to her adult voice and had no recollection of speaking in a childlike voice or claiming that her name was Donna.

Psychotic Disorders

“Psychotic” loss of contact w/reality- irrational, distorted

SchizophreniaDisordered thoughts/ communications/

inappropriate emotions, bizarre behavior

Symptoms of Schizophrenia

–HallucinatioHallucinationsnsSeeing & hearing things that are not there

Command (something/ someone giving orders)

Symptoms of Schizophrenia

–DelusionsPersecutionPersecution (they’re out to get me! paranoia)

GrandeurGrandeur (“God” complex, megalomania)

being controlled being controlled (the CIA is controlling my brain with a radio signal)

Symptoms of Schizophrenia

disorganized speech disorganized speech (e.g., word salad)– jumping from idea to idea without the benefit of logical association

–Paralogic—on the surface, seems logical, but seriously flawede.g., Jesus was a man with a beard, I am a

man with a beard, therefore I am Jesus

Symptoms of SchizophreniaDisorganized behavior Disorganized behavior

–behavior is inappropriate for the situatione.g., wearing sweaters and overcoats on hot days

–Emotion is inappropriately expressedno emotion at all in face or speech, laughing at very serious things, crying at funny things

Types of SchizophreniaParanoid type

delusions of persecution, believes others are spying and plotting

delusions of grandeur, believes others are jealous, inferior, subservient

Catatonic type

unresponsive to surroundings, purposeless movement,

parrot-like speechusually marked by immobility for extended periods

Disorganized type–disorganized speech and behavior

–Childlike–Inappropriate emotions

–delusions and hallucinations with little meaning

Early Causes:

Genetic Predisposition

Prenatal Factors

Vulnerability:

•Cognitive impairments

•Social Anxiety

•Odd ideas

Reinforcement:

Social stress

Isolation

Drug/Alcohol abuse

PSYCHOSIS!

WHERE DOES IT COME FROM?

Nature AND Nurture!

Mood DisordersSignificant and persistent disruption in moodmood, causing impaired cognitive, behavioral, and physical functioning–Major depression

Dysthymic disorderSAD

–Bipolar disorder

Major Depression

extremeextreme and persistentpersistent feelings of despondency, worthlessness and hopelessness that disturb everyday functioning

•Difficulty Difficulty sleeping, eating, concentrating

•May have suicidal thoughts, may not be able to carry out plan

Dysthymic Disorder

Chronic, low-grade depressed feelings that are not severe enough to be major depression (I’m sad all the time and I’m not sure (I’m sad all the time and I’m not sure why…)why…)

May develop in response to trauma, but does not decrease with time

Usually does not severely impair functioning

Over two years

Seasonal Affective Disorder

Episodes of depression depression occur in fall and winter fall and winter then subside in spring and summer (Seasonal regularity)

Bipolar Disorders

Mood levels swing from severe severe depressiondepression to extreme euphoria (mania)euphoria (mania), can have “normal” in between

No regular relationship to time of year (SAD)

Can vary in length of time for depression and mania

When MANIC:MANIC:– Supreme

self-confidence

– Grandiose ideas and movements, little effort in carrying out plans

– Flight of ideas

Aggressive, hostile, wild, incomprehensible, violent

Depressed state Manic state Depressed state

PET scans show that brain energy consumption rises and falls with emotional swings

Therapies

There are over 250 identifiable types of psychotherapy, though the most influential are:– Psychoanalytical Therapies– Humanistic Therapies– Cognitive Therapies– Behavior Therapies– Group and Family Therapies– Psychosurgery– Psychopharmacology

Any therapist who uses a combination of therapies is said to be using an “eclectic” approach to therapy

Therapeutic Perspectives

Psychoanalysis - assumes that many psychological problems are fueled by the childhood repression of impulses and conflicts

Humanistic - goal is to boost self-fulfillment by helping people grow in self-awareness and self-acceptance.

Therapeutic Perspectives

Cognitive - attempt to teach people new, more adaptive ways of thinking and acting

Behaviorists - believe that problem behaviors are the problem, and the goal is to simply eliminate or unlearn the problem behavior

Types of Behavior Therapies

Systematic Desensitization attempt to gradually substitute a positive response for a negative response to a harmless stimulus.

Implosive Therapy floods patients with their worst fears first, in hopes that by confronting them, they’ll overcome them.

Aversive conditioning replace a positive response to a harmful stimulus with a negative response.

Benefits: others have same

disorder share therapy ideas receive feedback you are not alone

Group therapy is generally for people experiencing family conflicts or those whose behavior is distressing to others.

Therapeutic Perspectives

Methods:– Usually groups of six to ten individuals– Averaging up to 90 minutes per week

– Family Therapy promotes the idea that families are a unit that depends on each member to be positive and to communicate

Therapeutic Perspectives

Psychosurgery:– Surgery that removes or destroys brain tissue in

an effort to change behavior.– Once popular, but no more, a lobotomy cuts the

nerves that connect the frontal lobe to the emotion-controlling centers in the inner-brain.

Therapeutic Perspectives

Psychopharmacology:

– The study of the effects of drugs on the mind and behavior

– Introduced in the 1950’s– Greatly reduced those confined to a

hospital– currently applied to just about

anything

Therapeutic Perspectives

Types of DrugsAntianxiety Drugs:

– Are used for the purpose of alleviating the symptoms stemming from frightening situations and fear-inducing stimuli

– IE. Xanax, Valium

Types of Drugs Antipsychotic Drugs:

–Drugs used for the purpose of calming psychotic patients; those patients with fundamental mental derangement (such as schizophrenia)

–IE. Thorazine, Clozaril, Haldol

Types of Drugs

Antidepressant Drugs–The purpose is to lift people up from a state of depression

– IE. Prozac, Paxil, Zoloft–Lithium is an anti-depressant used mainly for manic-depressives (bipolar)

Some Criticisms of Drug Therapy:

–Doesn’t address the root causes of behavior disorders

–May cause addiction

–Increased risks for suicide with some drugs?

–May cause other symptoms, disorders or diseases

Alternative Therapies

A practitioner moves their hands a few inches from a patient’s body, purportedly “pushing energy fields into balance”

Therapeutic Touch:

Eye Movement Desensitization

Reprocessing (EMDR):– Usually for disorders associated with

trauma and anxiety.

– A patient is asked to close their eyes and to think about a traumatic scene from their life.

– A therapist waves their hand in front of their eyes as they are thinking, causing rapid eye movement

Does this Does this resemble the resemble the

stress-less stress-less REM of sleep?REM of sleep?

– Especially for seasonal affective disorder, or depression brought on seasonal changes from summer to winter (less light). The therapy includes timed doses of intense light in “light boxes”.

Light Exposure Therapy:

Electroconvulsive Therapy:

– Patients are given an anesthetic so that they are not conscious, and a muscle relaxant to prevent any injuries that may occur from convulsions.

–Patient’s brains are given momentary shock treatments, generally for about 30 seconds.

Electroconvulsive Therapy:–Used in cases of deep depression, but historically used for almost anything determined to be abnormal behavior.