Psychiatric Disorders, Diseases, and Drugs

Psychiatric Disorders, Diseases, and Drugs Psychiatric disorders and diseases are those conditions defined by the presentation of abnormal behavior. Abnormal behavior is often defined by the mental health profession as behavior which is unusual or atypical. In addition, the individual suffering from a psychiatric disease or disorder may have difficulty with perception of reality or the hindered ability to interpret reality which may cause significant personal distress, self defeating behavior or otherwise dangerous behavior to oneself or others. Often times these behaviors are also socially unacceptable to ones specific culture (Nevid & Rathus, 2005). Schizophrenia is one of the most complex psychiatric diseases of all time. The disease name means “the splitting of psychic functions” (Pinel, 2007, p.481). The individual diagnosed with schizophrenia will commonly present symptoms which include bizarre delusions, inappropriate affect, hallucinations, incoherent thoughts and odd behavior with these symptoms varying in severity (Pinel, 2007). Various theories on schizophrenia have come to fruition over time. It is the belief of some researchers that schizophrenia has a genetic predisposition and that combined with experiences involving immense trauma or stress the disease can be triggered for development. In addition, those individuals with a genetic predisposition for schizophrenia who suffer hindered neurodevelopment at an early life stage may also be more inclined to develop the disease (Pinel, 2007). Another theory suggests schizophrenia to have a connection to an increased amount of dopamine. This theory was stumbled upon in researching Parkinson’s disease and the drug chlorpromazine which was identified as a receptor blocker (Pinel, 2007). Of specific interest under the dopamine theory is the D2 receptors. Through research involving phenothiazines which bind to both D1 and D2 receptors and butyrophenones which bind to the D2 receptors it was discovered that schizophrenia was caused by hyperactivity at the D2 receptor site and not dopamine receptor sites in general (Pinel, 2007). Besides these theories surrounding the complexity of schizophrenia brain imaging studies on schizophrenics reveal the disease is connected with brain damage which lends further merit to the idea of early development issues involving the brain (Pinel, 2007). Affective disorders involving depression, mania or the combination of both as seen in the individual suffering from bipolar affective disorder are psychiatric disorders which have a drastic effect on mood. Various theories related to the affective disorders are open for consideration including the monoamine theory and the diathesis-stress theory (Pinel, 2007). Under the monoamine theory depression is associated with the under-activity of the serotonergic and noradrenergic synapses (Pinel, 2007, p. 492). While various treatments involving the re-uptake of monoamine have shown benefit in treating depressive illness the support for this theory remains weak as only 25% of those treated with monoamine agonists such as the MAOI’s, tricyclic anti-depressants, SSRI’s and SNRI’s are ultimately helped by these treatments (Pinel, 2007). The diathesis-stress model of depression suggests a genetic predisposition for depression which then combined with early life stress result in permanent sensitization. In essence this theory implies these early stress triggers result in life-long overreaction habits to mild stressors (Pinel, 2007). Anxiety disorders are divided into five main classes including generalized anxiety disorder, phobic anxiety disorder, panic disorder, obsessive compulsive disorder and posttraumatic stress disorder (Pinel, 2007). Generalized anxiety disorder is characterized by a general feeling of anxiety in the absence of obvious causal factors. The individual with a phobic disorder has symptoms similar to those of the generalized anxiety disorder with the exception being that the anxiety is able to be linked to specific objects or situations that induce feelings of fear and panic. Panic disorders often go hand-in-hand with one of the two previously mentioned disorders. However, the individual suffering from a panic disorder often experiences extreme and severe physical symptoms of stress and fear (Pinel, 2007). Obsessive compulsive disorder is characterized by the uncontrollable and frequent repetition of anxious thoughts and impulses. The fifth class of anxiety disorders, post traumatic stress disorder, is the result of immense trauma or stress which causes severe psychological distress and impaired function (Pinel, 2007). The anxiety disorders are most commonly treated with use of benzodiazepines and serotonin agonists in the attempt to reduce the associated anxiety symptoms. Theories on anxiety disorders all suggest these disorders to be experience based and not a direct consequence of faulty neural functioning. However, there may be some genetic component involvement in the development likelihood of the anxiety disorders (Pinel, 2007). Tourette syndrome is a disorder involving tics. Tics are involuntary, repetitive, stereotyped movements and vocalizations which can be as minor as twitching of the head or blinking of the eye to the quite severe signs of barking like a dog, outbursts of obscenities or behavior which involves hitting or the making of lewd gestures (Pinel, 2007). Little information is available to provide insight on the disorder although many diagnosed with Tourette’s often have accompanying disorders such as obsessive compulsive disorder or attention deficit disorder (Pinel, 2007). Treatment often involves medications which work to block the D2 receptors. Because of the effect of these medications on the disorder the current theory suggests Tourette’s to be a “neurodevelopmental disorder resulting from excessive dopaminergic innervations of the striatum and the associated limbic cortex” (Pinel, 2007, p.499). Various pharmaceutical methods are available for treating these psychiatric diseases and disorders. Antipsychotic medications aid in the reduction of symptoms experienced from schizophrenia. However, these medications typically take extended time to produce beneficial results (Pinel, 2007). The MAOI’s, SSRI’s and tricyclic anti-depressants used to commonly treat depressive disorders have proven beneficial by affecting the levels of monoamine, serotonin or dopamine re-uptake abilities of by blocking receptor sites (Pinel, 2007). Although the benefits of these medications proves them useful for treatment various side effects including increased risk of suicidal tendencies, addiction, sexual dysfunction, weight gain, impaired motor functioning, anxiety and gastrointestinal problems suggest further improvements and advances remain required in finding effective treatment methods (Morris & Maisto, 2005). As previously mentioned the anxiety disorders are commonly treated with benzodiazepines and serotonin agonists. The benzodiazepines carry a great risk of addiction along with side effects of heavy sedation, motor disturbance, tremor and nausea. The SSRI’s drugs are more beneficial in treating the anxiety disorders, perhaps with the exclusion of generalized anxiety disorder, because they produce the same anti-anxiety effects as the benzodiazepines while elimination the side effects of sedation and impaired motor functioning (Pinel, 2007). In conclusion, psychiatric disorders and diseases are each comprised of their own unique signs and symptoms which may or may not be related to a variety of factors including genetics, neurodevelopment issues, brain damage or experience. While each is unique there is the commonality of all the psychiatric disorders in their ability to cause immense distress to the sufferer. Treatment is as varied as the illnesses and while great progress has been made there is still room for more in the hopes that those diagnosed with these illnesses might be able to live more fulfilling lives.

References
Morris, C.G., & Maisto, A.A. (2005). Psychology an introduction (12th ed.). Upper Saddle River, New Jersey: Pearson Education Inc..
Nevid, J.S., & Rathus, S.P. (2005). Psychology and the challenges of life. Adjustment in the new millenium (9th ed.), John Wiley & Sons, Inc.
Pinel, J.P. (2007). Basics of biopsychology. Boston: Pearson Education.