Psychiatric Disorders - Essay Example

Psychiatric Disorders Introduction Psychiatric disorders are impairments of the psychological functioning of an individual, usually to severe levelsthat make life unbearable without assistance. Psychiatric disorders have clinical manifestations and symptoms that can be intervened through various psychiatric or clinical approaches including drug regimes. A wide spectrum of disorders affect the psychological wellbeing of the patients and specialized psychiatric attention may be needed in the diagnosis. Generally, the diagnosis procedure is aimed at determining the severity of the condition and finds out if there is a pathological manifestation for specialized psychiatric intervention. A very complex relationship of causation factors and manifestation of the various psychiatric disorders makes it difficult to diagnose and treat them, with a huge gap still existing on their development mechanisms. In this discourse, a number of psychiatric disorders are discussed with a presentation of views on theory and effective drug regimes also accompanying the presentation. Schizophrenia Schizophrenia(s) involves a spectrum of disorders characterized by disjointed psychic functioning earlier though to be constituted by the breakdown in the coordination of emotions, thinking and actions among the victims. Usually, extreme mental illnesses such as madness are linked with schizophrenia. A major observation in the spectrum of disorders referred to as schizophrenias is a changing pattern of manifestation as the victim progresses in age. The difficulty in devising appropriate interventions in this category of disorders is spelt by several overlapping symptoms that may also be experienced by victims of neurological disorders. Some of the key diagnosis symptoms for schizophrenia include; delusional thoughts, inappropriate affect, hallucinations, incoherent thinking, and odd behavior. Repetitive occurrence and manifestation of any tow of these symptoms is sufficient to suspect schizophrenia (Pinel, 2009). Major theoretical explanations to the establishment of schizophrenia are developmental and dopamine theories. Developmental theories attach meaning to possibilities of faulty brain development at the fetal or infant stages that subsequently affect psychological development. Dopamine theory relies on the premise that high concentration of dopamine leads to schizophrenia. Drugs of choice over the research period have included chlorpromazine and other phenothiazines (inactivation of dopamine receptors D1 and D2 and its activity but reduces severity in some schizophrenias but activates others), reserpine (abandoned because effective dosage generates severe drops in blood pressure). Haloperidol, spiroperidol and other butyrophenones act in a similar way as chlorpromazine but only on D2 receptors and have a higher receptor binding effectiveness than chlorpromazine. Both drugs cause Parkinson’s related symptoms. Affective Disorders (Depression and Mania) Depression Depression is the deep psychological and emotional response to feelings of intense loss and grief such as during the loss of loved ones with the exception of people suffering from anhedonia, which does not involve grief, and loss. Anhedonia is clinical depression where individuals suffer from despair and loss of appetite for pleasure, usually affecting normal life processes. Depression therefore represents a class of disorders that severely alter normal psychotic emotional functions. Mania This condition is the perfect opposite of depression manifested by overconfidence and distractibility. Individuals suffering from mania possess high emotional energy and impulsivity. Mild mania symptoms may include excited talkativeness, high positivity and high levels of confidence. Extreme manifestation of mania is exhibited by excessive enthusiasm, distractibility and overconfidence that results in several unrecognizable mistakes. Some depression victims express both extremes of emotional dysfunction as depression and mania defines, which represents a psychiatric class of disorder referred to as bipolar affective disorder. Unipolar affective disorder does not manifest episodes of mania (Pinel, 2009). Reactive depression disorder is triggered by a specific cause whereas endogenous depression such as mania does not have a particular trigger. Acceptable theoretical explanations include monoamine theory of depression and diathesis-stress model of depression. Monoamine theory of depression is based on dysfunctional serotonergic and adrenergic synaptic activity. Diathesis-stress model of depression relies on the premise that certain individuals inherit susceptibility to stressors, which activate the depressive tendencies early in life when the individuals are exposed to stressors. These individuals release more stress-hormone-releasing hormones and stress hormones wile remaining unresponsive to negative inhibition of their release when administered with synthetic glucocorticoids. Drugs of choice for management of depression include monoamine oxidase inhibitors such as iproniazid through inhibition of monoamine oxidase (cause cheese effect which increases blood pressure risking stroke), tricyclic antidepressants such as imipramine (inhibit reuptake of serotonin and norepinephrine), lithium blocks mania (causes nausea, thirst, urinary discomfort, fatigue) and selective monoamine reuptake inhibitors such as fluoxetine branded as, Prozac, Paxil, Zoloft, Luvox and Remeron (block reuptake of sereotonin and have few side effects), valproate (causes liver problems and dizziness), carbamezapine (causes skin rash and nausea). Other drugs include Gabapentin, Topiramate and, Lamotrigine. Anxiety Disorder Individuals suffering from chronic fear and worry without a specific threat and without a specified adaptive motivation are said to suffer from anxiety disorder. Symptoms of severe anxiety leading to stressing experiences include tachycardia, disruptive sleeping, dysfunctional breathing, vomiting, hypertension and high stress hormone levels. Apparently, there are various classes of anxiety disorders which include generalized anxiety disorders, phobic anxiety, panic disorder, obsessive-compulsive disorder and posttraumatic stress disorder (Greist and Jefferson, 2007). Theoretical backgrounds of anxiety disorders explain that animals naturally respond to offensive stimuli through anxiety with a possibility of heightened elevation of sensitivity. Common drugs in the management of anxiety disorders include benzodiazepines (also sleep inducing- cause sedation, lost motor coordination, vomiting, shaking, addiction, and rebound anxiety). Serotonin agonists also constitute anxiety disorder treatment regime (mechanism is not clear, but causes vomiting, lack of sleep, headaches and dizziness). Antidepressants are effective due to the comorbidity with depression. Tourette Syndrome Perhaps the only psychiatric disorder with a specific diagnosis without complex overlapping symptoms as observed in other disorders. Tourette syndrome is manifested through tics (unintentional, stereotyped actions or talking). This disorder commences in childhood or adolescence but subsides as the victims progresses in age. In a few cases, the occurrence of the tics continues into adulthood and fail to respond to drug, with only promising intervention being deep brain stimulation. Major symptoms include simple motions such blinking or head motion gaining vocalization complications as age progresses. Motor tics may include gesticulations, jumping and squatting. Major vocalizations may include coughing and barking which may graduate to coprolalia, echolalia and palilalia. The occurrence of the tics is seemingly affected by certain factors such as stress, despite the general involuntary nature of occurrence. Alternatively, the tics may be suppressed for long spells of time before occurrence, a time during which high concentration levels are realized. There is scanty information on theoretical perspective of the disorder. Only a hypothetical premise has been made to the effect that it manifests in cases of abnormal basal-ganglia-thalamus-cortex feedback circuit. However, treatment has been designed for the condition with neroleptics (D2 monoamine receptor inhibition agents) showing favorable results in reduction of tics. Drugs of choice are also determined by the hypothetical position of impact of dopaminergic activity. Anxiety and depression variable are highly important in explaining the mechanism of the appropriate drug regimen for the treatment of Tourette syndrome. Management of the syndrome through appropriate care can be facilitated by counseling and training of family members to avoid depression, which causes devastating results in the victims (Clare, Jones and Wadland, 2000). Conclusion Brain disorders are among the most complex disorders to treat and manage. One of the main challenges in the treatment is a clear diagnosis for the actual disorder, bearing in mind that there is a high overlapping manifestation for brain disorders as well as comorbidity. Alternatively, it is difficult to treat the disorders due to the varied response to drugs, where one drug is reported to reduce a symptom while elevating another. Psychiatric disorders present a challenging psychiatric area of interest and immense research input is required for satisfactory management and treatment. References Clare, L., Jones, E., & Wadland, L. (2000). “Triage: A Waiting List Initiative in a Child Mental Health Service,” Psychiatric Bulletin, 24(1):57-59 Greist, J. H., & Jefferson, J. W. (2007). “Obsessive-Compulsive Disorder,” Retrieved from: http://focushw.psychiatryonline.org/cgi/content/abstract/5/3/283 Pinel, P. J. (2009). Biopsychology, (7th Edn.), Upper Saddle River, NJ: Pearson Education, Inc Read More