Analyzing Psychological Disorders, Essay Example

Introduction

A general discussion on schizophrenia should include some of the Seminole work of Harry Stack Sullivan, a Psychiatrist who devoted much of his career to the study of the disease. His early work was influenced by social scientists in the 1920’s and 1930’s at the University of Chicago. Sullivan came to believe that all psychological disorders have an interpersonal origin and can be understood only with reference to the patient’s social environment (Feist & Feist, 2006, p. 231). As our knowledge of the disease advances we learn that schizophrenia is a neurological disorder, but influences of the environment can assist in controlling or exacerbating the affects of the disease.

Areas of the brain affected

Research using functional magnetic resonance imaging (fMRI) showed that when subjects were asked to add two numbers those who were suffering from schizophrenia showed low activity in the prefrontal brain regions (Hugdahl, Lund, Asbjornsen, Egeland, Ersland, Landro, et al. 2004). In subsequent research on schizophrenia conducted by E.K. Miller (2005) it was shown that “learning” which requires a series of interactions between the prefrontal cortex and basal ganglia were indicators of autism and schizophrenia. We are now thinking that an imbalance between these two areas of the brain may be the cause Schizophrenia. (Jones-London, 2007). In further studies it is shown that individuals diagnosed with schizophrenia have a reduced volume of gray matter. “Patients with the worst brain tissue loss also had the worst symptoms, which included hallucinations, delusions, bizarre and psychotic thoughts, hearing voices, and depression”(Fuller, 2004 p. 1).

Causal Factors

We are not sure what causes schizophrenia, however, it appears that the there is a much faster shrinkage off the brain after birth.  Brain shrinkage normally occurs in people, but in those suffering from schizophrenia it occurs at a more rapid rate. “The current understanding is that schizophrenia occurs as a result of damage to the nervous system before or around the time of birth” (Salleh, 2003 p. 1).

Associated Symptoms

Schizophrenia is associated with certain kinds of symptoms. People suffering from schizophrenia can have hallucinations which they claim to see, hear, feel and even smell things that no one else around them experiences. They may experience delusions, especially during acute stages of the disease. This can manifest itself in conspiracy theories and if one attempts to reason with a person having delusions, he or she, may begin to think they are part of the nefarious plot against them. This was illustrated in the movie, “The Beautiful Mind.” People suffering from schizophrenia may create their own language, talking nonsense. They may find what they think is hidden meaning in words or made up words that they give meaning to it. It isn’t usually that a person with the disease will become violent, but like any of us, if they feel threatened they can be violent. Their first response is to run from the treat and if they are held or blocked they can display an unusual strength.

Schizophrenia can be treated from a neurological perspective. Positive social interaction, counseling, and proper medication can abbey some of the symptoms. If the disease is caught in early stages it can be completely cured. “Schizophrenia research is suggesting that the sooner a person with this brain disease is treated, the better the outcome for the person. Delays for treatment result in much worse outcome” (Jones-London, 2007 p. 2).

Drug therapies

The greatest difficulty of drug therapy for these kinds of patients is the denial that they actually have the disease. They believe it is part of the conspiracy to control their mind, so they refuse to take their medications (Jones-London, 2007). The national Institute for Mental Health (NINH) is currently involved in finding medications that have the potential of reversing the cognitive decline cause by schizophrenia. It is anticipated that we will see some significant announcements related to these developments in the next few years. (Filler, 2004 p. 2). Drug therapy is carefully targeted for patients showing symptoms of sleep deprivation, severe lack of concentration and then only a minimal dose is prescribed thioridazine or chlorpromazine (25 to 100 mg daily). When narcoleptic medication is prescribed the patient is closely monitored by a nurse or psychiatrist. Drug therapy has a specified time period and usually lasted no more than a week. Drugs are not the answer alone. A patient needs an integrated crisis management of professional counseling, family intervention, and proper medication. An intake is requisite in determining a patient’s therapy protocol.

Case Study – Anorexia

Beth is a normal child raised in a well-balanced home by caring parents. As a teenager, she began to experience an overwhelming fear of gaining weight and becoming fat. Her fear was unfounded because Beth’s weight was normal for her height and age. Beth began to diet and lose weight, but regardless of how much she weighed, she had a very poor self-image. Beth has become dangerously thin, but she denies the seriousness of her condition. Regardless of how much weight she loses, she feels like she needs to lose more. Beth has missed several menstrual cycles and continues to severely restrict her food intake. Her weight continues to drop. Beth’s mother and father are deeply concerned, but they do not know how to help their daughter (PsychCentral^®, 2006).

Eating Disorders

Many young women experience the pressure that society places on them to fit in during adolescence. How they view themselves is more an internal perspective, rather than how others view them. As young girls look closely at their bodies they see flaws that others may acknowledge as features that make them unique. However, they don’t want to be unique they want to “fit in.” Compounding the problem is the highly competitive youth subcultures in western societies. Young girls in middle school, high school and college spend a inordinate amount of energy, money and time trying to feel acceptable.

Causative factors

Sometimes self-esteem issues originate in the family unit. A mother, for example, that attempts to live vicariously through her daughter may unwittingly cause her daughter to become overly concerned with body image. Other times an authoritarian father controls his daughter to a degree that she feels unable to control her life. Her reaction to her father’s demands may be a passive-aggressive decision to starve herself or binge and purge, because it is something see can control.

Recovery

Beth comes from a seemingly stable family, however, a counselor should not disregard that she may be reacting to her family experiences. A proper intake should include family history, medical history, and assessment and three counseling sessions for a proper diagnosis. If it is determined that Beth has an eating disorder her prognosis is more serious than if it is adolescent struggle with self-esteem. Studies of long-term recoveries suggest between 44 to 75 percent of anorexics respond well to treatment, but relapses are common. (Beers & Berkow, 1999). Recovery for anorexia is a long-term process. People suffering from anorexia are likened to an addict. If she stays with the program she can control the addiction.

Men can struggle with the problem, but it is primarily a woman’s issue.  Recovery programs focus on women’s health and may involve, education about anorexia, counseling, nutritional therapy and medication. It is unusual for a therapist to treat anorexia without addressing family issue and often family counseling is part of the recovery program.  In most cases women seek help when they experience physical problems. Even in ‘milder forms’ of these disorders, the physical cardiac, gastrointestinal, esophageal, and nutritional consequences can be devastating. (DeFife, 2009). If young women have a history of laxative use or self-induced vomiting recovery is more difficult. Health Information Publications. (MedicineNet, 2003).

Case Study – Insomnia

Mary is a single mother of one child. She has had difficulty sleeping for the last month. Her lack of sleep has caused her to be fatigued during the day, which has caused significant impairment in her professional and social life. Mary has no history of mental disorders (such as depression) nor is she on any kind of prescription medication. Mary does not drink alcohol and does not take any type of street drug. Mary has been to her doctor about this problem, but he has been reluctant to give her any kind of sleep medication for her insomnia because he is concerned about her becoming overly dependent on the medication. Mary is facing yet another night with little sleep.

Insomnia is a problem that plagues approximately 60 million Americans. People who lack sleep have a compromised immune system, their time is slowed, they are more irritable and productivity at work and at home is compromised. Mary is a single working parent and needs to be alert to fulfill her many responsibilities. She has not slept well in a month, which means that she needs to “catch up” on her sleep. Physically her body is out of rhythm and she needs time to readjust her schedule. In Mary’s case, her sleep deficit may be exacerbating by her worries that if she is not able to sleep she will eventually have an accident, forget an important task, neglect her child, or worse. These worries build on each other and have a cyclical effect of keeping her from sleep.

Physiological Causation

Chemicals in the body called neurotransmitters signal the body that it’s time to sleep or wake up. These neurons appear to “switch off” the signals that keep us awake. Research also suggests that a chemical called adenosine builds up in our blood while we are awake and causes drowsiness. This chemical gradually breaks down while we sleep. (NIH, 2010). The there are four cycles to sleep and the body goes through each cycle about every 70 to 90 minutes. Throughout the night the REM periods are shorter until morning when we spend most of our time in REM. If we don’t sleep well our bodies will catch up on the deficit starting with REM.

Medication

Mary’s doctor is hesitant to prescribe sleep medication. He may think, and rightfully so, that the medication will only mask the problem. The sleep that the medication gives her may not be the rest she needs. According to the mayo Clinic (2010) sleeping pills shouldn’t be taken for more than a few days to a few weeks as a nutritional supplement, melatonin is most effective in the treatment of certain circadian rhythm sleep disorders. These include jet lag, shift work and delayed sleep phase. Sleep medicaitons should be used as a last resort, because drugs, alchohol, food affect the bodies balance.

Therapy

This learner would recommend that Mary receive a through physical examination and psychological intake.  There are numerous therapies available for her to learn and practice on her own. Mary’s body is changing and she will learn how to adjust to these changes. Cognitive Behavioral Therapy (CBT) is a relatively short-term therapy that is used for a depression, panic attacks, anxiety, eating disorder, and substance abuse. A 2006 review of insomnia treatment studies conducted by the American Academy of Sleep Medicine found that CBT can help improve sleep and that benefits can be sustained over a long period of time. (mayo Clinic, 2010).

References

Beers, M.H. & Berkow, R. (1999). Eating disorders: Anorexia nervosa 17^th ed. NJ: The Merck Manual of Diagnosis and Therapy, Merck Research Laboratories.

DeFife, J. (2009). Psychological counseling for anorexic patients.  Retrieved on May 10, 2010 from http://www.psychiatric-disorders.com/articles/eatingdisorders/anorexia/anorexia-treatment.php

Falloon, I. R.H., Kydd, Coverdale, R. R. J. H., & Laidlaw, T. M. (1996). Early detection and intervention for initial episodes of schizophrenia. Retrieved on 05/09/2010 from http://www.mentalhealth.com/mag1/scz/sb-ear1.html

Feist, J. & Feist, G. J. (2006) Theories of Personality 6^th ed. Boston, MA: McGraw Hill.

Fuller, F. E. (2004). The biology of schizophrenia. Retrieved on 05/10/2010 from http://www.schizophrenia.com/family/disease.htm

Hugdahl K, Rund BR, Lund A, Asbjørnsen A, Egeland J, Ersland L, et al. (2004) Brain activation measured with fMRI during a mental arithmetic task in schizophrenia and major depression.  Retrieved on 05/10/2010 from http://www.ncbi.nlm.nih.gov/pubmed/14754778

Michelle D. Jones-London, M. D. (2007). Leaning new rules about the primitive brain. Retrieved on 05/09/2010 from http://www.ninds.nih.gov/news_and_events/news_ articles/News_article_brain_learning.htm