lecture 13

Question 1

what did Bendedict Augustin Morel believe about anxiety

Answer 1

– is severe anxiety due to a
dysfunction in nervous system?
- Neurasthenia: late 19th century catch-all diagnosis for a wide range of symptoms – tiredness, panic, inability to cope, restlessness, morbid fears

Question 2

what did Freud believe about anxiety

Answer 2

• regarded a a sexual dysfunction or guilt
• treated with psychotherpy
• evionmental stress was a critical factor
• conflict in the unconscious mind

Question 3

What are the types of ways to treat anxiety back in the day

Answer 3

• bromide
• Barbiturates: act as depressants on central nervous system
• meprobamate
• benzodiazepines

Question 4

what was the first benzodiazepines

Answer 4

• The first benzodiazepine, chlordiazepoxide, discovered
  accidentally in 1955
• Marketed in 1960 by drug company Hoffmann-LaRoche as Librium
• Librium was marketed to medical professionals as a means to an end – getting the patient to engage with and benefit from
  psychotherapy

Question 5

What was the second benzodiazepines

Answer 5

diazepam developed 1963
- 3 to 10 times the potency of
chlordiazepoxide (Librium)
- Best-known brand name: Valium

Question 6

What were the negatives of valium

Answer 6

• toxicity and dependence issues
• psychological and physical dependance
• withdrawal symptoms: anxiety, agaitation, restlessness
• can be dangerous with alcohol

Question 7

who discovered depression

Answer 7

• Robert Burton, The Anatomy of Melancholy (1621)
• Melancholy could be either transitory or habitual
• No one could expect to escape it completely in their life
• During 1850s and 1860s, the term ‘depression’ was introduced to psychiatry

Question 8

what did they treat depression with

Answer 8

tricyclic antidepressants
- provided relief to 60-80% of patient
- side effects: sluggishness, weight gain, overdose
MonoAmine Oxidase Inhibitors
- more dangerous
Nardil
- these were advertised as a means to get patients to accept and benefit from psychotherapy

Question 9

when did depression take over from anxiety

Answer 9

• In 1975, depression overtook anxiety in the US as a major condition
• 18 million diagnoses that year, compared to only 13 million diagnoses for anxiety

Question 10

what are the two theories about depression

Answer 10

1- monoamine theory: underactivity at serotonergic and noradrenergic sites
2- neuroplasticity theory: of depression: decrease of neuroplastic processes in the prefrontal cortex, hippocampus, amygdala = loss of neurons

Question 11

what are criticisms of the
antidepressant
industry

Answer 11

• biogenetic explanations of mental disorders do not reduce stigma
• Cosmetic psychopharmacology = using drugs to enhance normal
  personalities
• The medicalisation of normal human mood changes, eg. shyness, grief, transient sadness
• targeting women as life long users

Question 12

what is ‘prozac poop out’

Answer 12

‘antidepressant treatment tachyphylaxis’

• Abrupt discontinuation can lead to anxiety, depression, psychosis, nausea, vomiting, dizziness, panic attacks
• Not ‘addictive’ but definitely create chemical changes that cause withdrawal when not continued

Question 13

what is the optium time to use medication for depression

Answer 13

• 6-24 months

- short term

Question 14

what are physical treatments for depression used today

Answer 14

• ECT
• rTMS repetitive transcranial magnetic stimulation
• Electromagnetic stimulation causes neurons to fire