Healthy+Minds

xxxxxxxxxxxxxxxxxxxxxx They all have something in common ... you guessed it, it's not a "totally" healthy mind.

HEALTHY MINDS - SUMMARY OF KEY ISSUES Biological-Person-Basic Process-Sociocultural // edited copy of handout // (right click - open in new tab)

VIDEOS You could spend days rummaging through YOUTUBE clips on MOOD [affective] DISORDERS - So ... here are a few that are informative and provide good insight. Listening to experts as well as also hearing it from the "horses mouth" will really reinforce your understanding. Watching just a few of the Stephen Fry episodes will be worthwhile. But first, start with the shorter " Brain & Depression". (To retain this page for ongoing reference, right click the links below and then click "Open Link in New Tab")

The Brain and Depression – a quick and good coverage Part 1[| http://www.youtube.com/watch?v=IeZCmqePLzM] Part 2[| http://www.youtube.com/watch?v=qVEueGutbSs&NR=1]

Stephen Fry on having bipolar disorder. “This is something I have been suffering with for years and want to give it more exposure”. Part1 Part 2 Part 3 Part 4 :The Play list for all 12 Parts of the series(as serialised on Youtube - in approx 10 min segments) (Note: In original format 'Diary of a manic depressive' is in 2 parts, 100 minutes in total - serialized here on YOUTUBE, hence 12 short parts. Hmm! See if you can borrow the video from your local video store - it seems the links above are no longer active due to copyright issues. Beyond Blue – Great Australian site for Affective Disorders – Also see for content concerning Anxiety Disorders [] Follow the links for signs and symptoms, case studies, therapies, etc. Covers Depression (unipolar), Bipolar, and Anxiety Disorders.

Famous People with Bipolar Depression (music with photographs) - you may be surprised. [] []

Good Lecture Notes (bullet pointed - comprehensive) //**ANXIETY DISORDERS**//: [] //**MOOD DISORDERS:**// http://facultyfp.salisbury.edu/iewhite/Childhood%20Disorders%20Mood%20Disorders.htm //**POWERPOINT SLIDE SHOWS - SELECT THOSE RELEVANT**:// http://facultyfp.salisbury.edu/iewhite/powerpo.htm

The Road To Resilience Source: The American Psychological Association website

How do people deal with difficult events that change their lives? The death of a loved one, loss of a job, serious illness, terrorist attacks and other traumatic events: these are all examples of very challenging life experiences. Many people react to such circumstances with a flood of strong emotions and a sense of uncertainty. Yet people generally adapt well over time to life-changing situations and stressful conditions. What enables them to do so? It involves resilience, an ongoing process that requires time and effort and engages people in taking a number of steps. This brochure is intended to help readers with taking their own road to resilience. The information within describes resilience and some factors that affect how people deal with hardship. Much of the brochure focuses on developing and using a personal strategy for enhancing resilience.


 * Definition:** ' ... a process, capacity or outcome of successful adaptation despite challenges or threatening circumstances … good outcomes despite high risk status, sustained competence under threat and recovery from trauma' From Mind Matters

Psychotherapies There are many different forms of psychotherapy (know those mentioned in your book) - they range from psychoanalysis through to "medical" procedures administered only by psychiatrists such as electroconvulsive therapy (ECT). Only psychiatrists are able to prescribe drugs and often people with disorders will be under the treatment of both medical and psychology professionals. The psychologist aims to improve both cognitive and behavioural function while the patient may be on a course of drug treatment prescribed by a GP or psychiatrist. You should certainly know something about CBT.

What is Cognitive Behaviour Therapy?
Cognitive therapy was developed by Aaron Beck in the 1970s. It grew from empirical and theoretical work undertaken in the Department of Psychiatry at the University of Pennsylvania. To use Aaron Beck’s words: //"Cognitive therapy is an active, directive, time-limited, structured approach used to treat a variety of psychiatric disorders for example, depression, anxiety, phobias, pain problems, etc. It is based on an underlying theoretical rationale that an individual’s affect and behaviour are largely determined by the way in which he structures the world".// (Beck, A, Rush, JA, Shaw, BF, Emery, G 1979 Cognitive Therapy of Depression).
 * Cognitive therapy programs train people to replace maladaptive cognitive styles with helpful thinking patterns and increase behavioural coping skills.**

What is Interpersonal Therapy?
Interpersonal Therapy was developed by psychiatrist Gerald Klerman, M.D., of Harvard, and psychologist Myrna Weissman, Ph.D., of Yale as a short-term therapy to help people identify and resolve their interpersonal difficulties. Interpersonal Therapy (IPT) is a short-term psychotherapy, normally consisting of 12 to 16 weekly sessions. It was developed specifically for the treatment of major depression, and focuses on correcting social or family difficulties. **It is common for depressed people to have unhappy or difficult relationships with their spouse, lover, friend, boss, co-worker, parent, or child. Interpersonal therapy can help to resolve disputes over the person’s role, to improve social interaction, to help with grief that seems to be very long lasting and to assist in role change either at work or at home.**


 * // For any Mental Disorder, summarise your knowledge by organising information under these descriptors: //**
 * Signs and Symptoms: how the disorder presents - behaviour, cognition, physiological signs (Descriptions & Symptoms below)
 * Diagnosis and Underlying bases (etiology): is there a known mechanism or basis for the disorder (genetic, neurochemical imbalance, etc)
 * Prognosis: long term outcomes - is it of short duration [episodic] (acute), or long term & ongoing (chronic) - can the person become free of symptoms with treatment? If untreated, there is considerable risk of suicide in severe sufferers of affective disorders.
 * Treatment: what are the different treatment options? - invariably it is a combination of pharmaceuticals and psychotherapy, which has many forms. There is often a delay for drugs to begin working as neurochemical variables (neurotransmitters) are re-balanced to more normal levels. Ongoing therapy is important as are self help groups, where people with a type of disorder meet and share experiences and provide mutual support.

** Bipolar Disorder ** (acknowledgment of source) **Description:** Extreme mood swings punctuated by periods of generally even-keeled behavior characterize this disorder. Bipolar disorder tends to run in families. This disorder typically begins in the mid-twenties and continues throughout life. Without treatment, people who have bipolar disorder often go through devastating life events such as marital breakups, job loss, substance abuse, and suicide. **Symptoms:** Mania-expansive or irritable mood, inflated self-esteem, decreased need for sleep; increased energy; racing thoughts; feelings of invulnerability; poor judgment; heightened sex drive; and denial that anything is wrong. Depression-feelings of hopelessness, guilt, worthlessness, or melancholy; fatigue; loss of appetite for food or sex; sleep disturbances, thoughts of death or suicide; and suicide attempts. Mania and depression may vary in both duration and degree of intensity. **Formal Diagnosis:** Although scientific evidence indicates bipolar disorder is caused by chemical imbalances in the brain, no lab test exists to diagnose the disorder. In fact, this mental illness often goes unrecognized by the person who has it, relatives, friends, or even physicians. The first step of diagnosis is to receive a complete medical evaluation to rule out any other mental or physical disorders. Anyone who has this mental illness should be under the care of a psychiatrist skilled in the diagnosis and treatment of bipolar disorder. **Treatment:** Eighty to ninety percent of people who have bipolar disorder can be treated effectively with medication and psychotherapy. Self-help groups can offer emotional support and assistance in recognizing signs of relapse to avert a full-blown episode of bipolar disorder. The most commonly prescribed medications to treat bipolar disorder are three mood stabilizers: lithium carbonate, carbamazepine, and valproate.

A view from the real world - read this article: **//How do you live with a husband with manic depression?//**

**Depression** - Unipolar Disorder (acknowledgment of source) **Description:** When a person's feelings of sadness persist beyond a few weeks, he or she may have depression. According to the National Institute for Mental Health, three to four million men are affected by depression; it affects twice as many women. Researchers do not know the exact mechanisms that trigger depression. Two neurotransmitters-natural substances that allow brain cells to communicate with one another-are implicated in depression: serotonin and norepinephrine. **Symptoms:** Changes in appetite and sleeping patterns; feelings of worthlessness, hopelessness, and inappropriate guilt; loss of interest or pleasure in formerly important activities; fatigue; inability to concentrate; overwhelming sadness; disturbed thinking; physical symptoms such as headaches or stomachaches; and suicidal thoughts or behaviors. **Formal Diagnosis:** Four or more of the previous symptoms have been present continually, or most of the time, for more than 2 weeks. The term clinical depression merely means the episode of depression is serious enough to require treatment. Major depression is marked by far more severe symptoms, such as literally being unable to drag oneself out of bed. Another form of depression, known as seasonal affective disorder, is associated with seasonal changes in the amount of available daylight. **Treatment:** Some types of cognitive/behavioral therapy and interpersonal therapy may be as effective as medications for some people who have depression. Special bright light helps many people who have seasonal affective disorder. Three major types of medication are used to treat depression: tricyclics; the newer selective serotonin re-uptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAO inhibitors). Electroconvulsive therapy uses small amounts of electricity applied to the scalp to affect neurotransmitters in the brain. Usually referred to as ECT, this highly controversial and potentially life-saving technique is considered only when other therapies have failed, when a person is seriously medically ill and/or unable to take medication, or when a person is very likely to commit suicide. Substantial improvements in the equipment, dosing guidelines and anesthesia have significantly reduced the possibility of side effects.

Anxiety disorders range from feelings of uneasiness to immobilizing bouts of terror. This fact sheet briefly describes the different types of anxiety disorders. This fact sheet is not exhaustive, nor does it include the full range of symptoms and treatments. Keep in mind that new research can yield rapid and dramatic changes in our understanding of and approaches to mental disorders. If you believe you or a loved one has an anxiety disorder, seek competent, professional advice or another form of support.
 * Anxiety Disorders ** (acknowledgment of source)

**Symptoms:** Chronic, exaggerated worry, tension, and irritability that appear to have no cause or are more intense than the situation warrants. Physical signs, such as restlessness, trouble falling or staying asleep, headaches, trembling, twitching, muscle tension, or sweating, often accompany these psychological symptoms. **Formal diagnosis:** When someone spends at least six months worried excessively about everyday problems. However, incapacitating or troublesome symptoms warranting treatment may exist for shorter periods of time. **Treatment:** Anxiety is among the most common, most treatable mental disorders. Effective treatments include cognitive behavioral therapy, relaxation techniques, and biofeedback to control muscle tension. Medication, most commonly anti-anxiety drugs, such as benzodiazepine and its derivatives, also may be required in some cases. Some commonly prescribed anti-anxiety medications are diazepam, alprazolam, and lorazepam. The non-benzodiazepine anti-anxiety medication buspirone can be helpful for some individuals.
 * Generalized Anxiety Disorder: ** Most people experience anxiety at some point in their lives and some nervousness in anticipation of a real situation. However if a person cannot shake unwarranted worries, or if the feelings are jarring to the point of avoiding everyday activities, he or she most likely has an anxiety disorder.

**Symptoms:** Pounding heart, chest pains, lightheadedness or dizziness, nausea, shortness of breath, shaking or trembling, choking, fear of dying, sweating, feelings of unreality, numbness or tingling, hot flashes or chills, and a feeling of going out of control or going crazy. **Formal Diagnosis:** Either four attacks within four weeks or one or more attacks followed by at least a month of persistent fear of having another attack. A minimum of four of the symptoms listed above developed during at least one of the attacks. Most panic attacks last only a few minutes, but they occasionally go on for ten minutes, and, in rare cases, have been known to last for as long as an hour. They can occur at any time, even during sleep. **Treatment:** Cognitive behavioral therapy and medications such as high-potency anti-anxiety drugs like alprazolam. Several classes of antidepressants (such as paroxetine, one of the newer selective serotonin reuptake inhibitors) and the older tricyclics and monoamine oxidase inhibitors (MAO inhibitors) are considered "gold standards" for treating panic disorder. Sometimes a combination of therapy and medication is the most effective approach to helping people manage their symptoms. Proper treatment helps 70 to 90 percent of people with panic disorder, usually within six to eight weeks.
 * Panic Disorder: ** People with panic disorder experience white-knuckled, heart-pounding terror that strikes suddenly and without warning. Since they cannot predict when a panic attack will seize them, many people live in persistent worry that another one could overcome them at any moment.

**Symptoms:** Many of the physical symptoms that accompany panic attacks - such as sweating, racing heart, and trembling - also occur with phobias. **Formal Diagnosis:** The person experiences extreme anxiety with exposure to the object or situation; recognizes that his or her fear is excessive or unreasonable; and finds that normal routines, social activities, or relationships are significantly impaired as a result of these fears. **Treatment:** Cognitive behavioral therapy has the best track record for helping people overcome most phobic disorders. The goals of this therapy are to desensitize a person to feared situations or to teach a person how to recognize, relax, and cope with anxious thoughts and feelings. Medications, such as anti-anxiety agents or antidepressants, can also help relieve symptoms. Sometimes therapy and medication are combined to treat phobias.
 * Phobias: ** Most of us steer clear of certain, hazardous things. Phobias however, are irrational fears that lead people to altogether avoid specific things or situations that trigger intense anxiety. Phobias occur in several forms, for example, agoraphobia is the fear of being in any situation that might trigger a panic attack and from which escape might be difficult. Social phobia is a fear of being extremely embarrassed in front of other people. The most common social phobia is fear of public speaking.

**Symptoms:** The symptoms of PTSD can range from constantly reliving the event to a general emotional numbing. Persistent anxiety, exaggerated startle reactions, difficulty concentrating, nightmares, and insomnia are common. People with PTSD typically avoid situations that remind them of the traumatic event, because they provoke intense distress or even panic attacks. **Formal Diagnosis:** Although the symptoms of PTSD may be an appropriate initial response to a traumatic event, they are considered part of a disorder when they persist beyond three months. **Treatment:** Psychotherapy can help people who have PTSD regain a sense of control over their lives. They also may need cognitive behavior therapy to change painful and intrusive patterns of behavior and thought and to learn relaxation techniques. Support from family and friends can help speed recovery and healing. Medications, such as antidepressants and anti-anxiety agents to reduce anxiety, can ease the symptoms of depression and sleep problems. Treatment for PTSD often includes both psychotherapy and medication.
 * Post-traumatic Stress Disorder: ** Researchers now know that anyone, even children, can develop PTSD if they have experienced, witnessed, or participated in a traumatic occurrence-especially if the event was life threatening. PTSD can result from terrifying experiences such as rape, kidnapping, natural disasters, or war or serious accidents such as airplane crashes. The psychological damage such incidents cause can interfere with a person's ability to hold a job or to develop intimate relationships with others.