Psychology for Dummies (59 page)
Read Psychology for Dummies Online
Authors: Adam Cash
Tags: #Psychology, #General, #Body; Mind & Spirit, #Spirituality
Schizophrenia is one of the most difficult mental disorders to treat. Its effects are often debilitating for both the individual with the disease and his family. There are numerous approaches to treating this illness ranging from the use of medication to helping individuals develop important functional skills such as money management or social skills.
Antipsychotic medications such as Haldol and Zyprexa are typically the first line of treatment for people suffering from schizophrenia or related psychotic disorders. While extremely beneficial, these medications are known as palliatives because they don’t cure disease, they merely lessen the intensity of symptoms.
The areas of psychosocial treatment and rehabilitation have also showed some promise. Patients are taught social skills and self-care skills that can help reduce the number of stressors they face.
Although seemingly out of fashion in recent years (too labor intensive and therefore too expensive), psychotherapy, specifically cognitive therapy, has been used in recent years to teach patients to challenge their delusional belief systems and become better “consumers” of reality.
The majority of recent research indicates a combination of medication and talking therapy is the most effective treatment intervention. Early intervention and solid social support are also factors associated with a favorable prognosis. With medication, psychotherapy, and support from family and friends, many people suffering from schizophrenia can lead productive lives. The problem is that their symptoms are often so severe they may have a difficult time achieving levels of emotional and behavioral consistency necessary to maintain jobs and conduct effective relationships. In addition, perhaps because of damaged self-esteem, poor self-image and ambivalent attitudes about relating and succeeding, schizophrenics are notorious for their inconsistent medication compliance.
Two other forms of psychosis are
delusional disorder
and
substance-induced psychotic disorder.
Delusional disorder:
Characterized by the presence of delusions that are not particularly bizarre or out in left field. A husband may be obsessed with the idea that his wife is having an affair but be unable to prove it or find any evidence. This belief may turn into a delusion if it persists for at least one month. Someone may think that the water in his home is poisoned, contrary to evidence that it is not. Another example is that an office coworker is madly in love with another coworker and keeps sending “signals” of that affection. The key thing about a delusional disorder is that the delusional person has no other signs of psychosis, like those found in schizophrenia.
Substance-induced psychotic disorder:
Exists when prominent hallucinations or delusions are present that are connected to being under the influence of a substance or withdrawing from a substance. People under the influence of LSD or PCP often exhibit psychotic symptoms, and it’s not unusual for people who have used cocaine or amphetamines to look psychotic when they “come down” (the mimicking of psychotic symptoms). This problem can be very serious, and anyone considering using drugs, or even alcohol for that matter, should know that there’s a fair chance they may experience psychotic symptoms as a consequence of their use.
I wonder if blues music would be around if all those musicians were psychotherapy patients. Those songs don’t seem particularly sad though — they seem more pitiful than anything else. Sometimes I ask new patients if they’ve ever been depressed, and some of them reply, “Sure, doesn’t everyone get depressed?” Not exactly.
Sadness is a normal human emotion typically felt during experiences of loss. The loss of one’s job, lover, child, or car keys may trigger sadness. But that’s just it — this is sadness, not depression!
Depression
is an extreme form of sadness that also includes a number of other symptoms. Most of us, well maybe some of us, have experienced being dumped by a boyfriend or a girlfriend at one time or another. How did we feel? Sad, fatigued, unmotivated, sleepless, not hungry. But all of these feelings eventually went away. We got over it. The same thing can happen when a loved one or someone who we’re close to dies. We call this
mourning
or
grief.
Again, when we are grieving, we are not depressed. Depression is something different.
When someone is depressed to the degree of needing professional attention, they experience at least a majority of the following symptoms of
major depressive disorder:
Depressed mood for most of the day and for most days
Anhedonia
(marked disinterest or pleasure in all or most activities)
Significant weight loss or weight gain, without trying, and decreased or increased appetite
Difficulty sleeping or excessive sleeping
Physical feelings of agitation or sluggishness
Fatigue or lack of energy
Feelings of worthlessness or excessive guilt
Difficulty concentrating and focusing
Repeated thoughts of death or suicide
Hopefully, most people who ask, “Don’t we all get depressed?” won’t have that same response after seeing all of these symptoms. If you are experiencing three or more or if you have any doubts, get thee to a doctor!
Sometimes, depression can become so severe that the sufferer may think about committing suicide. There are many myths about suicide floating around out there. One is that people who talk about suicide don’t do it. This is false! In fact, talking about suicide is one of the most serious signals that someone might actually do it. All talk about suicide or self-harm should be taken seriously. If you are worried about someone or even yourself, contact a mental health professional or call a local crisis or suicide hotline.
Depression is one of the most common forms of mental disorder in the United States, occurring on average in about 15 percent of the population. Major depressive disorder can occur just one time in a person’s life or over and over again, lasting for months, years, or even a lifetime. Most people who suffer from a recurring major depressive disorder have periods of recovery in which they don’t experience symptoms, or they experience the symptoms in a less intense form. Depression can occur at any point in a person’s life and doesn’t discriminate against age, race, or gender.
Depending on whom you ask, the search for the causes of depression can be divided into two kinds of explanations:
Biological:
Biological theories of depression place blame on the brain and the malfunctioning of some of the chemicals that comprise it.
Psychological:
The psychological theories focus mostly on the experience of loss.
The
biogenic amine hypothesis
is the most popular theoretical explanation of the biological underpinnings of depression. According to this hypothesis, depression is a function of the dysregulation (impaired ability) of two neurotransmitters in the brain, norepinephrine and serotonin.
Neurotransmitters
are chemical substances in the brain that allow one neuron to communicate with another neuron across the
synapse
(the gap between neurons). The brain contains many different neurotransmitters, each having relative concentrations in specific regions of the brain. Specific neurotransmitters aid localized brain regions in their monitoring of particular human activities. The parts of the brain seemingly most affected in depression are those involved with mood, cognition, sleep, sex, and appetite.
Psychological theories of depression come from several sources:
Object relations theory:
Melanie Klein proposed that depression was the result of an unsuccessful child developmental process that may result in a difficult time coping with feelings of guilt, shame, and self-worth.
Attachment theory:
John Bowlby’s theory gives us another view on the cause of depression. All our relationships with other people originate from the initial attachment bonds we formed with our primary caregivers as infants. When there is a disruption in the attachment relationship and a healthy bond is not formed, the child is vulnerable to depression when faced with future losses and relationship difficulties. In infancy, bonding and attachment can be disrupted for numerous reasons ranging from a drug-addicted parent to growing up in an unloving foster home. Children with poor attachment relationships are often left feeling helpless. Helplessness is a hallmark of depression.
Learned helplessness:
Many people throughout their lives have experienced failure or the inability to achieve what they’ve desired. Under normal circumstances, most of us just keep on keeping on. We don’t give up and don’t typically develop any serious sense of pessimism about the likelihood of our future successes. However, some people, because of adverse circumstances or because of a general tendency to view their efforts as worthless, may become depressed in the face of what they’ve experienced as insurmountable odds.
Cognitive theory of depression:
Aaron Beck’s theory has become extremely popular and is well supported by research. Beck proposed that depression is a type of thinking disorder that produces the emotional outcome of depressed moods and the other related symptoms. Several cognitive “distortions” may be involved:
•
Automatic thoughts:
Automatic thoughts are statements we make to ourselves that we are not aware we say that produce depressive experiences. For example, if I get in my car in the morning and it doesn’t start, I might consciously say, “Dang, just my luck.” But unconsciously, I might be having the automatic thought, “Nothing ever goes right for me.”
•
Mistaken
assumptions and
self-other schemas:
The assumptions and self-other
schemas
(beliefs about who I am in relationship to others) I assume to be true, as well as my views of the world, myself, and the future all greatly influence how I move in the world. Beck introduced the
cognitive triad
as follows:
Each point in the triangle contains a set of beliefs that reflect a negative evaluation of oneself, a hopeless view of the future, and a view of the world as excessively harsh. A final component of the cognitive view is the cyclical nature of depressive thinking.
An example best illustrates it. I may have the belief that I can’t do anything. This belief won’t exactly have me fired up, so my motivation is affected. Then, I’ll obviously do nothing because of my lack of motivation, and in turn, I will “prove” to myself that I really can’t do anything. This twisted and self-confirmatory bias in thinking will likely lead to the depression.