Psychological Disorders and Treatments Marshall High School Mr. Cline Psychology Unit Five AA * Psychological Disorders • Much of psychology is concerned with studying and understanding the way healthy minds naturally think and behave. • For example, psychologists might look at how you perceive things with your senses and how you learn new information and behaviors. • You can't go a single day without learning (though there are some teachers who might make you feel like you do!) and certainly not without perceiving. • These are normal functions of the brain that allow you to experience and interact with the world around you. • But imagine someone whose perception is out of whack. • Where most of us would hear silence, this person--let's call him Tom--hears a few distinct voices talking amongst themselves. • These voices aren't actually in the real world; they're created in Tom's head, but to Tom they seem just like a conversation you might overhear on a bus or in a restaurant. * Psychological Disorders • He perceives voices that aren't real. • This is called a hallucination, and it's typically a symptom of a disorder called schizophrenia. • Tom's psychological disorder is the result of something going wrong with his brain's normal functioning. • Tom's disorder interferes with his ability to perceive. • Jenny has a different problem. Jenny is deathly afraid of birds. She can blame her unusual fear or phobia to disordered learning. • When she was growing up, Jenny's mailbox was right underneath a mean blackbird's nest, and when her parents sent her out to get the mail, the blackbird would attack her to protect its babies. • This happened enough times that Jenny became conditioned to fear all birds. • A natural and necessary process like 'learning' can lead to unusual or disordered patterns of thinking. * Psychological Disorders • Psychologists who specialize in treating and diagnosing disorders like Tom's and Jenny's are known as clinical psychologists. • Unlike research psychologists, who study how the average, healthy mind processes information, clinical psychologists help patients who are hurting or are in trouble due to psychological disorders. • In the same way most doctors deal with problems of the body, psychological therapists deal with problems of the mind. • Clinical psychologists, along with psychiatrists--medical doctors trained to specialize in mental illness--social workers and counselors are collectively known as therapists. • Psychological disorders are defined as normal brain functioning gone wrong. • There are many ways that our perception and learning can be off, but luckily, there are many treatments that can help. • Tom took antipsychotic drugs to quiet the voices in his head, and behavioral therapy helped Jenny get over her extreme fear of birds. * Psychological Disorders • Diagnosis • When you go to the doctor with a fever and a sore throat, he'll talk to you, examine you, maybe listen to your breathing, and he'll use this information to figure out an explanation for your symptoms. • This explanation is his diagnosis, which is the identification of a nature and cause of an illness. • In other words, the doctor's diagnosis is what he thinks has gone wrong with you and why he thinks it's gone wrong. • The doctor determines that your sore throat is infected (that's the 'what') and does a quick swab test to determine that it's caused by the bacteria strep (that's the 'why'). • Diagnosis in psychology is the same thing. • If you think about it, though, it can be a lot harder to figure out what's going on in someone's mind than what's going on in someone's body. * Psychological Disorders • Diagnosis • You can describe to your doctor that your throat is sore and he can look at you and run tests to figure out why. • If you're depressed or if you're suffering from hallucinations or delusions, your description of your own symptoms can be more difficult to follow and interpret, and there's no equivalent of a throat swab to test for depression. • There are some ways that psychologists can diagnose patients, though. • Let's look closer at the diagnosis and classification of mental illness, and the book that makes it possible for psychologists to figure out what's wrong with patients. • Problems with Diagnosis • Over the years, psychologists have worked hard to figure out ways to improve diagnoses. * Psychological Disorders • Problems with Diagnosis • Psychologist David Rosenhan suspected that psychiatric hospitals often gave patients the wrong diagnoses. • To prove it, he decided to send in pseudopatients, or healthy people pretending to be mentally ill, to test the doctors and nurses in the hospitals. • The pseudopatients (including Rosenhan himself) pretended to hear voices. • Once admitted to the psychiatric hospital, though, they acted normal and said their symptoms had stopped. • So, you might think, 'well, if they were acting normal, then they must have been released, right?' That's where the story gets interesting. • They were not released and were not identified as having faked their symptoms. * Psychological Disorders • Problems with Diagnosis • Because they had said they had one symptom at the very beginning, they were considered to have a mental illness for the rest of their life. • Interestingly, the actual patients in the hospital were suspicious of the pseudopatients. • It turned out that the patients were better at identifying pretenders than the staff! • After Rosenhan announced these rather embarrassing results, one prominent hospital asked him to send them some pseudopatients, confident that in their hospital, the pretenders would easily be identified. • Following the challenge, the hospital identified 48 pseudopatients out of the next 195 people who were admitted. But Rosenhan hadn't actually sent anyone! * Psychological Disorders • The DSM • Experiments like Rosenhan's show how difficult it is to come up with a reliable scientific system of diagnosing mental illness. • For this reason, the psychiatric community has a book that's used to identify mental illness, based on the symptoms that a patient presents with. • The Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, has been undergoing constant revision since its creation in 1952. • The DSM lists all the recognized mental disorders and their symptoms, so that when a patient comes to a psychologist and says, 'I feel this,' or 'I experience that,' the psychologist can look up the symptoms and know what mental disorder the patient has and how to treat it. • It's just like when you go to the doctor and tell him that you have a sore throat: the psychologist is gathering information about your symptoms to diagnose you. * Psychological Disorders • The DSM • The most recent edition of the DSM is the DSM-5, which groups mental illnesses together based on similarities. • For example, someone with a phobia and someone with social anxiety disorder both have high levels of anxiety. • As such, they are both found together under the umbrella of anxiety disorders. • Grouping psychiatric disorders together is called classification. • The DSM-5 has twenty different classifications, all with multiple disorders. • As you might imagine, it's a very big book! • Examples of DSM-5 classifications include neurodevelopmental disorders, bipolar and related disorders, sexual dysfunctions, dissociative disorders, and personality disorders, among others. * Psychological Disorders • The DSM • When do we cross the boundary between natural worry and the debilitating types of anxiety associated with disorders? • Let’s explore some common anxiety disorders and their potential causes. • Have you ever felt anxious, maybe before a big test or an important job interview? • A half an hour, or even an hour before, you get butterflies in your stomach or find yourself nervously pacing your living room. • You go over questions and answers in your head, and despair that you should have started prepping months ago instead of just last week. • Once the test or interview is over, you feel relieved; it went fine, you remembered everything you needed to and your heart rate's returned to normal. • This kind of anxiety is a natural and normal response to a stressor like an interview. * Psychological Disorders • The DSM • But imagine if you'd started worrying about that interview a week in advance and had been unable to concentrate on anything else in the meantime; imagine if afterward, instead of feeling relieved, you continued to worry. • This kind of anxiety is out of proportion to the stressor that triggered it and represents one kind of anxiety disorder, a disruptive condition that can interfere with functioning in daily life. • Generalized Anxiety Disorder • There are many types of anxiety disorder. • The kind we just described, which would cause you to worry for weeks about an interview, is known as Generalized Anxiety Disorder, abbreviated GAD. * Psychological Disorders • Generalized Anxiety Disorder • GAD affects approximately 3% of American adults and is characterized by excessive and uncontrollable worry that is disproportionate to circumstances; it's fine to worry about the interview, but it's worrying all week that is the symptom of the disorder. • GAD can also cause physical symptoms like fatigue, headache, nausea, trembling and insomnia. • You may have felt some of these in response to normal, passing anxiety. • Maybe you've felt queasy before a big important test. But imagine feeling that way all the time, in response to little things, and you've got some idea of what it's like to live with GAD. • The disorder seems to have many possible casuses. * Psychological Disorders • Generalized Anxiety Disorder • It's probably genetic, since it tends to run in families, but has environmental causes as well, since it's sometimes triggered by experiencing normal stress. • It's also been associated with addictions to alcohol or sedatives. • The part of the brain that processes fear, called the amygdala, has also been related to GAD; it seems like if its connections to the rest of the brain are interrupted, it can result in increased anxiety.