Psychiatric_Diseases,_Disorders,_and_Drugs

Psychiatric Disorders, Diseases, and Drugs Depression Whether it be a mild and fleeting case of the downs or a severe and overwhelming since of despair, depression is something that all people encounter during some point in their lives. When a person suffers from clinical depression, he or she may have difficulty performing even the simplest of tasks. Maintaining a job, supporting the family, or just getting out of bed in the morning can become impossible. Depression is usually separated into two categories. When depression becomes triggered by a negative or traumatic experience, such as the death of a loved one, it is called reactive depression. When a person’s depression has no apparent cause, it is called endogenous depression (Pinel, 2007). There is a definite link between affective disorders, such as depression, bipolar disorder and unipolar disorder, and genetics. Twin studies on affective disorders have shown that about 60% of identical twins and 15% of fraternal twins suffer from the same disorder, regardless of whether reared together or apart (Pinel, 2007). The role of stress has also been a focal point of research on affective disorders such as depression. Studies have concluded that stressful experiences can trigger attacks of depression in already depressed individuals (Pinel, 2007). One study showed that over 84% of patients seeking treatment for depression had experienced severe stress in the preceding year, in comparison to 32% of controlled subjects (Brown, 1993 as cited in Pinel, 2007). It is however, difficult to link stressful experiences occurring during youth with the increased likelihood of developing depression later in life (Kessler, 1997 as cited in Pinel, 2007). Mania A disorder that opposes depression is mania. Mania is the affective disorder characterized by overconfidence, impulsivity, distractibility, and high energy (Pinel, 2007). Those with mania tend to be highly energetic, enthusiastic, and extremely talkative; however, the conversations typically drift unintelligibly from topic to topic. Confidence is high-flying, no task may seem too great, and a leap-before-you-look impulsiveness is often common. This behavior leads to a series of disasters, a trail of unfinished projects, unpaid bills, and broken relationships (Pinel, 2007). Drug Treatments for Affective Disorders Four major classes of drugs are used in the treatment of affective disorders: monoamine oxidase inhibitors, tricyclic antidepressants, lithium, and selective monoamine-reuptake inhibitors. Monoamine oxidase inhibitors. The first antidepressant drug, iproniazid, was originally created to treat tuberculosis. Although it proved ineffective in the treatment of the disease, it was soon discovered that the patients that took it felt less depressed about their disease and were happier. The drug was then tested on a mixed group of psychiatric patients and was found to be effective in treating depression (Pinel, 2007). Iproniazid is a monoamine agonist, which means it increases the levels of norepinephrine and serotonin by inhibiting the activity of monoamine oxidase (MAO), the enzyme that breaks down monoamine neurotransmitters in the cytoplasm of the neuron (Pinel, 2007). MAO inhibitors have multiple side effects, including surges in blood pressure and stroke when certain foods containing tyramine, such as cheese, wine, and pickles are consumed (Pinel, 2007). Tricyclic antidepressants. Tricyclic antidepressants are given this name first, because of their antidepressant action; and second, because their chemical structures contain three rings of atoms. Tricyclic antidepressants block the reuptake of both serotonin and norepinephrine, therefore increasing their levels in the brain. They are considered a safer alternative to MAOI’s (Pinel, 2007). Lithium. The primary agent in lithium is a simple metallic ion. Lithium is considered to be a mood stabilizer that blocks the rapid transmission between depression and mania. Lithium was previously the drug of choice used to treat bipolar affective disorder, but has recently been replaced by mood stabilizers that are also effective against depression (Pinel, 2007). Selective monoamine-reuptake inhibitors. Selective serotonin-reuptake inhibitors (SSRI’s) were established for the treatment of depression in the late 1980’s. SSRI’s exert agnostic effects on serotonergic transmission by blocking the reuptake of serotonin from synapses (Pinel, 2007). The first SSRI developed was Prozac. However, since its introduction, there have been many other SSRI’s to hit the market, including Paxil, Zoloft, Luvox, and Remeron. SSRI’s such a Prozac are widely popular because they have few side effects and they are useful in treating a wide range of psychological disorders in addition to depression (Pinel, 2007). Anxiety Disorders Anxiety is defined as a chronic fear that persists in the absence of any direct threat. Anxiety can be deterred through the practice of certain coping mechanisms; however, when it becomes so severe that it disrupts normal functioning, it is referred to as anxiety disorder (Pinel, 2007). Anxiety disorders are the most prevalent of all psychological disorders and it is associated with feelings of fear, worry, and despondency. There are also several physiological stress reactions that accompany anxiety, which include hypertension, nausea, breathing difficulty, tachycardia, and sleep disturbances (Pinel, 2007). There are five major categories of anxiety disorders. Generalized anxiety disorders are characterized by stress responses and extreme feelings of anxiety that occur in the absence of any obvious stimulus. Phobic anxiety disorders are triggered by exposure to particular objects, such as spiders, snakes, or clowns. Panic disorders are characterized by rapid onsets of extreme fear and extreme symptoms of stress. Obsessive-compulsive disorders are characterized by frequent, uncontrollable obsessions and impulses. Posttraumatic stress disorder is a persistent pattern of psychological stress following exposure to extreme stress, such as returning home for a war or enduring years of physical spousal abuse (Pinel, 2007). According to the National Institute of Mental Health, there is a sixth anxiety disorder, social anxiety disorder or social phobia. Social phobia is characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia may be restricted to only one type of situation, such as speaking in public or, in its most severe form; the sufferer may experience symptoms any time they are around other people (National Institute for Mental Health, 2010). Pharmacological Treatments of Anxiety Disorders There are two major drug classes, which are affective in the treatment of anxiety disorders: benzodiazepines and serotonin agonists. Benzodiazepines. Drugs such as Librium and Valium are popularly prescribed for the treatment of anxiety disorders. These drugs are also prescribed as hypnotics, anticonvulsants, and muscle relaxants. While benzodiazepines are the most widely prescribed psychoactive drug, there are severe side effects to them. Some side effects include sedation, disruption in motor activity, tremor, and nausea. Benzodiazepines are also highly addictive and should only be prescribed on a short-term basis (Pinel, 2007). Serotonin agonists. Serotonin agonists, such as buspirone, are widely prescribed for the treatment of anxiety disorders. In some aspects, serotonin agonists are considered a better treatment for anxiety disorders because they produce an anti-anxiety effect without producing ataxia, muscle relaxation, and sedation. However, buspirone does produce side effects such as dizziness, nausea, headache, and insomnia (Pinel, 2007). SSRI’s are also commonly used in the treatment of anxiety disorders. Tourette Syndrome According to the National Institute of Neurological Disorders and Stroke, Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations known as tics (2010). Symptoms of TS onset in childhood, usually between the ages of 7 and 10. Tics can be characterized as both simple and complex. Simple motor tics may be identified as eye blinking, facial grimacing, shoulder shrugging, and head jerking. Slight vocal tics may include the excessive clearing of one’s throat, sniffling, or grunting sounds. Complex tics are distinct, coordinated patterns of movements involving several muscle groups, such as hopping, jumping, bending or twisting. Complex vocal tics include uncontrollable outbursts of words or phrases (National Institute of Neurological Disorders and Stroke, 2010). Treatment of Tourette Syndrome Treatment for TS generally begins by educating the patient, family members, friends, and teachers about the nature of the syndrome. Then, the treatment focuses on any emotional problems such as anxiety or depression. Finally, if drug treatment is used, TS is generally treated with neuroleptics – the same class of drugs that are used to treat schizophrenia (Pinel, 2007). The exact cause of TS is unknown; however, it is believed to be a neurodevelopmental disorder that results from excessive dopaminergic innervations of the stratum and the associated limbic cortex (Pinel, 2007). Conclusion There are several different types of psychological disorders; depression, mania, anxiety disorder, and Tourette syndrome just name a few. Although many people may not seek treatment for severe cases of these diseases, chances are that at some point in life, most will have dealt with some, if not all, of these disorders. Disorders such as anxiety and depression may come and go several times over one’s life span. Often, the symptoms are not severe enough to seek professional help and drug treatment; however, sometimes it is necessary to reach out if the disorders become so severe that they disrupt one’s ability to function normally. Bibliography (2010, June 16). Retrieved November 30, 2010, from National Institute of Neurological Disorders and Stroke: http://www.nimh.nih.gov/health/topics/social-phobia-social-anxiety-disorder/index.shtml National Institute for Mental Health. (2010, November 30). Retrieved November 30, 2010, from http://www.nimh.nih.gov/health/topics/social-phobia-social-anxiety-disorder/index.shtml Pinel, J. P. (2007). Basics of biopsychology. Boston, MA: Allyn and Bacon.