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Mod 73: The Biomedical Therapies Great chart! Table 73.1
Biomedical therapy intended for more severe symptoms/disorders
Changing chemistry & functioning of the brain
Drugs, ECT, magnetic impulses, psychosurgery
Regular Dr. can write a ‘script for drugs, esp those used to treat anxiety & depression
For more severe disorders, should seek psychiatrist or in some states licensed psychologists
73.1 Drug Therapy
Psychopharmacology: the knowledge & study of how the mind, body & behavior are affected by drugs
Had a HUGE mostly positive impact released people from hospitals/institutions [deinstitutionalization!]
Very successful with the most severe disorders schizophrenia
Measured effectiveness against 2 factors
1. Compare treated to those who are not on drug protocol [control group]
2. Placebo effect: simply taking a drug can affect behavior
Drugs generally are more effective than the placebo effect
Antipsychotics already covered!!
Antianxiety [more clinical term is anxiolytic]: Xanax & Ativan also already covered!!
Antidepressants…again, covered!!
Remember, SSRIs do not lift a person’s mood right away, even though they are affecting neurot’s
Could be due to neurogenesis which is the forming of new neurons (new circuits)
Besides drug treatment for depression
 Vigorous exercise mild & moderate depression
 Cognitive therapy work on negative thinking, best way to stop a relapse
 Use drugs bottom up to change at neuronal level WITH cognitive-behavior therapy top down (literally changing
frontal lobe activity—increase left hemisphere which is more positive)
 Placebo effect75% of those with mild/moderate depression will get better taking a placebo, effect drops
dramatically for severely depressed
Leads some critics to say that drug therapy should only be used with severely depressed
Mood Stabilizing Medication
Generally, goal is to treat mania, depression may also be slightly affected
LITHIUM just a common salt
Also affective in decreasing risk of suicide
DEPAKOTE actually a drug used for epilepsy works as well, in some cases, better than lithium
73.2 Brain Stimulation
ECT
Def: electroconvulsive shock treatment, only used for severely depressed; pass electric current through the brain
Patient is sedated & takes a muscle relaxer
Causes a seizure which in some way shape of form changes the brain & can dramatically increase mood
Current lasts 30 seconds to a minute, asleep for about an hour
Three or more sessions between 2 to 4 week period—80% or more treated
Can have some memory loss—should not be severe (book describes horrors of its first usage)
[It is interrupting LTP: long term potentiationneurons actually forming neural arcs/networks for new
memories]
Still not sure how/why this therapy works
Definitely more effective than placebo
An altered form is unilateral ECT; only pass current thru one side of the head [skull actually absorbs most of the current]
Still, like drug therapy can relapse into depression
Alternative Neurostimulation Therapies
Magnetic Stimulation
Repetitive transcranial magnet stimulation (rTMS) use magnetic impulses to stimulate and/or suppress brain activity
Unlike ECT, fully awake, NO seizures, memory loss or other destruction to the brain
Think it is stimulating the left frontal lobe
BUT do not know exactly how it works just like ECT
Could be working like LTP—see above!
Deep Brain Stimulation
Focus on the neural connection between frontal lobe & limbic system appears to be overactive when depressed
Use electrodes used in treating Parkinson’s
Jury is still out on its effectiveness
Psychosurgery
Def: remove/ destroy brain tissue
Moniz: lobotomy: original procedure was to cut neurons connecting frontal lobe to emotional centers [limbic sys] using ice pick
LIKE instrument; [American Walter Freeman “improved” surgery—shoved an actual ice pick thru tear duct & swiped it
around to sever whole prefrontal cortex from rest of the brain. He actually had people time him. Sick!]
Used to calm people who were violent and overly emotional
Caused lethargy & reversal to childish behavior
Mostly stopped w/introduction of drug therapy
Brain surgery is used today; sparingly & use CAT or MRI’s to guide surgery; people kept awake if necessary to map important
brain structures like speech & movement
73.3 Therapeutic Lifestyle Change
Our health is affected by our cognitionbiopsychosocial system
Possible ways to affect depression
 Aerobic exercise: 30 minutes 3x a week (or more) increase fitness & endorphins
 Sleep: 7 to 8 hours increases energy, alertness & immune system
 Light exposure: look at a light box for 30 minutes, increases arousal & effects hormones
 Social connection: close friendships helps coping & immune system
 Antirumination: stop obsessing over negative thoughts & enhance positive energy
 Nutrition supplements: fish oil increases omega-3s which increase brain functioning