You are on page 1of 7

used

lavender andchamomile andinsomnia


fora nxiety
traditionalchinese
m edicine h erbsginkgo
u tilized biloba
ginseng a stragalus
Brief
aceuticalsopium alcohol
ether
morphine bromides u sedtotreat
etcwere illness butinsteadcreated
mental

relies
term
addictionaggression short

1930s somatictherapieslikepsycho
surgeries lobotomy and electroconvulsive treatment
s usheredin 3newdiscoveries
1960

iiiiiiiiiiiiiiiiiiiiiiii
iii
iiiiiiiiiiiiii.fi

symptomsu spsychological
expression

pathologyisconsideredto
some beextensivelyrootedinbiologicalfactors

iii iii ii iii


whataresomeexamplesoft heintegratedexpressionofpathology
as
psychosocialenvironmentals tressor such

b iologicalresponse such
causes as
kindofsymptompicture
what
childandAdolescent psychopharmacology
andpharmacologic ofchildrenand
diagnosis t eens
effective istherapyspecificallyfamilyt herapy
some mentalillnesshaveahigh
m ajor o fbeginninginchildhood133ofOCDis ofBipolar
percentage
untreatedtraumacreatestoxic
levels of neurotransmitters stresshormones e.gcortisol adrenaline
levels
increased prolonged
ofs tresshormonescancauseimpairmentstobrainfunctioningisnotreduced
insomecasesmedicationcanbeneuroprotective
braindamageorpromotingnormal
a gainst
protecting
neuromaturation

issuesofconcern
tomedicationx
consent
informedconsentparental

aboutm edication
stigma
of of
careordoctorsfears addiction
avoidance medical

oversimplified
parental thatapinwinsixeverything
perspective

mayi gnorelarger moresignificant suchasf amily


factors d ysfunctionorsocial
cultural
challenges

maybeexcludedf romthelargerconversation relatedtowhatthemedicationisfor theaimof


children treatment
h ave
children h igherhepaticliver
metabolismuntilpubertyoften
h igher
dosageforanildrenunion
mayfeelcounterintuitive
willhaveaminimalimpacto nthebrain
toolowadosage
to
challenges on
research forchildren teens
medications

studymedicationsonseverelydepressedliecannot
unethicalto just
give bio
p lacebo t hey notb e
m ight a live e ndofit
a tthe

for
symptoms children arecontexts pecific
assessmentq uestions

I fuatonal m ild
trauma
context a buseboredom
ageappropriateness
maniaanxietyb rain
traumab ipolar injuryimpairmentabuse a ffectbx
related
5
neurobiology impairmentto
the in
lobe abnormalities dopaminen eurotransmitters
frontal

arepreferredmedications
dopamineagonistsstimulants

EPRESS
pointst o10 of
i ssuesresearch
gnostic bipolarp resentwdepression
p repubertal
Taniaespecially
mayexacerbatebipolar
antidepression

assessmentq uestions

I Itational
context

ruleout seasonald epressionseparationanxietyADHD

FLYhxofbipolarhypomania
risk
Factors
d atasuggestsincreasedS1inyouthonantidepressants
some

noncomplianceincreased priort odecreaseddysphoricm oodwithdrawals


energy
decreased t resultsactivation restlessnessprovocation ofmania
treatingcliniciansshouldincreaseriskassessment inform
parents

A
i ssues70 beginwMDepisode
diagnostic 30 beginw ithmaniahypomania
forchildrend ifferthanadults
earlydiagnosticsymptoms
assessmentquestions
forainicians

I ital m anic
p resentation depressive h ypomania

ruleo utADHD
on
medicationbased clinical
presentation

antidepressants
mayprovokecycleacceleration
moodstabilizerswantidepressantproperties
t.rs
beprescribedform aniaagitationpsychosis
may
antipsychotics

atypicalantipsychoticsh ave
shown inpediatforma
e fficacy
3cationsingeneral

A
go.rs
ifniiIIiugnis areinharmonywone's
t hat
behaviors feelings selfi mage
egodystoniathe a nd
behaviors
t houghts that
feelings are notinharmonywone'sselfi mage

NEUROBIOLOGY TRAUMA

I toa nyothe
impairment f nerve censinthem ain neurotransmitter
systemsdopamine serotonin norepinephrine

vary
symptoms
dependingon but
conditions
s pecific may include decline
c ognitive motor
impairments or in a
disturbances changes
sensory

hypothalamussmall brainregion t hatplaysacrucial roleinregulatingvariousphysiologicalprocesses iiecortisol


incontrollinghungerthirstbodytemperaturesleep the
involved r eleaseofhormonesfromthep ituitarygland

anima
main brain
p artsreptilian brainstem systemneocortexetc
limbic

3rdFloorB rainstemreptilian
Brain
noconsciousnessinherenthedonistic
instinctive term
short skins
coping

engagement access
system c oregulatorysocial
use for
systems self
soothing regulation

F loorLimbic
2nd s ystem Brain
mammalian

for
responsible learning emotions
memory

a mygdalawhich
houses for
l ooks danger realorperceived
either
bin
houseshippocampus storage oefverythingyou'veever
learned
e ither orknowledgeb ased
experientially

1st
FloorPREFRONTALCORTEX
linear
logical t erm
solvinglong
problem s kills
coping
lixibility
executiveFunctioningfocus
c oncentration i nitial
i nhibitiontask shift
affect
emotion
m anagement memoryorganizingplanningprioritizing
working
DEVELOPMENTALTRAUMA PTSD
traumasymptomology

emotional
heightened reactivitydysregulation avoidant
tendencies

cancreatepathologysuchasdepressionavoidant usedisordersanxietysuicidality antisocialbx conduct


Ptsdsubstance
disordered
personalityattachment

these symptom are


clusters tobe
considered
t heexternalized
displayof and
deficits to
impairments t hemultifacetedneurologicalsystems
that and
control aperson'semotional
o rganize

and
behavioral c ognitive
processes

Then
remains
amygdala inaconstantstateofalertnessasamethodofprotection
by
illustrated extreme
physical emotionaltension
s leep and
d isturbances
be
c an personified byaperson'sintensifiedstartleresponseaoverreactionstoperceiveddangers
ifbrain
existsi nastateofh yper arousal

anindividualtypically significant
experiences anamenges wexecutive ofthe
functions p eciememoryorganizationplanningfocus

has effects
deleterious ona bio
person's psycho s ocial t hep roisresponsibleoremotionalabxregulationthecreationofm entalrepresentationsandt hecapacityfor
as
mentalizationw hichisnecessaryforinhibitionofimpulsivity
andemotional
reactivity

and
impairment l imited
accesst his
to othe
r egion f b rainc ausessignificantdevelopmental
issues topersonalityassensoryprocessing
related foresight control
impulse
insight attention concentran

andlong
regulation areimpacted
t ermproblemsolvingmechanisms
neurobiology trauma

and
duetoearlya dversity t raumathe brain's a ndregulatoryp athwaysarenegativelya ffected
e motionprocessing

toxicneuronalpruning
creates c hangesinbraingrowthdevelopment aprolonged
andintensified
activationofs ns
stress sns
activates p
hypothalamic ituitarya cap
drenal asa xis release adrenalinec ortisolandnorepinephrine orflightresponsivity
fight
triggers

in normative upon
development cessation ofthestressor is
activation mediated
sympathetic e ns
by union
releases slowing
acetylcholine rateainitiatingareturnto
heart restdigest
stresstraumatic
early
prolonged adversity that the
supercedes brain's to
capacity m anage

of and
flood adrenalinecortisol norepinephrine
constant alterneuroanemistry
cont'd
t raumatic
in
stressonanood
canaffect
neuroendocrine
inthe
responses union
b rain the
changes b rain
body's state
nomeoa.name

ieanostasisand alterationsinpsyonphysiological
cause
w hich
cacostasis significant development lead toseveremental health a namenges

to
exposure continuous
adversitythe s izeotfhehippocampus
i mpacts

trauma
early impacts asize ofthea mygdalaand t hecerebellumunion inemotionalreactivityaggressiondisinhibitionself
assists mechanisms
regulatory and
c an
also meamygdalato
cause

inasustainedstateo fhyper
exist arousal

trauma create
compounding complex can anoverproductionorunderproductionofessentialneurotransmitters hormonesinthe
brainiiedopamine oxidase
norepinephrinemonoamine
acetylcholine
serotonin

READINGS

conduction transmission

of
conductionprocess impulse along
movement the a xon

ofthe
transmissionpassage i mpulse the
across space
s ynaptic
effectsofreceptorbinding
dependson the t ypeofreceptor
someareexcitatoryactivatingadjacentneuronsand areinhibitory
o thers
exception isnot
serotonin itself i excitatory
nherently or inhibitory

most areinhibitoryalthough somea reexcitatory soifs erotoninwere intheentireb rainitw ill


increased havem ultiplee ffects
messengermolecules
neurotransmitters
aka n euro
modulators

abasic
properties

are
chemicals found inneuronsareleasedasaresult ofthenerveimpulse
ofa n
ability neurotransmitters
toproduceaphysiologicaleffect
onaneuron

aminescomprisem ainlynorepinephrineepinephrinedopamine
biogenic butpracticallyinvolvesserotoninhistamine acetylcholine

can
neuropeptidesendorphins encephalins tos amereceptorsasmorphinesometimes
bind carednaturally
o ccurring peptides
o pioid

I if III iii a asareb eingstudied


enantiomersmirror
image
excitatory
todetermineift heyconsidered
possesstherequisite
a propertiestobe NT
inhibitory

adenosine acid
isaproposedneurotransmitterandisneitherabiogenicaminenora mino
no
L
atypical
dioxide
carbon

inpresynapticvesicles donotinteractviaa postsynapticreceptorcomplex


thesynapse
across and
receptors
intracamai
L C ELL
NERVE

napdeterminesensitivityexcitabilitylevelsof
the are
c ell by
determined genetics
p artially

last 1224hours
receptors about more they arereabsorbed
anmustcontinuouslymonitorreceptor lost
replace
populations and
receptors a djust i resine

iiiiiii.fi receptor
iiihfhh.iq
in with
populations accord demands
environmental

f
receptors
categorizing
non
ififffifffhff
ffff.fi
fffffffhii fifff ff.fi
fify
eg sensoryperceptionandvoluntarymuscle
action

only meds
p sychiatric that this
utilize m echanismare

ion
chloride channels

involveg radual
actions
metabotropic changes neuronal in
functioning

that
takes hours
o ver
p lace days ore venm onths
weeks

via
activate second
receptors that
systems
m essenger involvea cascade

ofchemicalactions
thatignitea ofintracellularb iochemical
eventsthatc hangeorregulate
caviar partly
activity byinfluencinggeneexpression
BECAUSE m ost
psychotropics of
usemetabolicreceptorsmost these
drugs s everal
r equire weeksofadministrationbefore
the ofnoticeablesymptomatic
o nset

ofstressonreceptors
impact lithhibardment
anronic tonigh
exposure wasostress
f bycertainexcitatory neurotransmitters

toadown
leads
often inthe
r egulationreduction and
number ofexcitatoryreceptors
d ensity

e xposureto
chronic of
lowlevels certainneurotransmitters orhormones
the
spur
may u pregulationofexcitatoryreceptorsasa na ttemptof
the the
tonormalize
c ells

firing
activity of
rates neurons
neuronal
malfunction
common thoughtt ounderlie
ones mi
initial
synthesis ofneurotransmitters
production mayb einhibited
thus is for
neurotransmitter available release
little
neurotransmitters
byenzymese.gMaomonoamineoxidase
mayb esubjectto excessivedegradation
certain based
biologically disorders d rugs either the
or may facilitateorinhibit ofneurotransmitters t hepresynapticbouton
r elease
by
theprocessofreuptakea bsorptionmayb ealtered
e.gcocainea buseleadstoablockingofdopamine reuptake pores
inclinicalmajordepressionreuptakeofserotoninnorepinephrineando rdopaminemayb eaccelerated
receptorsmay b eeitherabnormallyupregulatedodr ownregulatedcausingneuronstomalfunction
pathological can
alterations o ccuringene due
expression t omarkedmangesinsecondmessengersand m ayr esultinnumerousabnormalcellularresponsesi ncludingc ang rowthalteredreceptor
retraction
sensitivitydendrite lossofdendrite spinesand cell
or death

Ehand the
structures central
a djacent core f b rainasincluding
othe thel imbic and
diencephalon
system b asis
ganglia

cerebral
cortex is
major
mental toinvolveneurochemicaldysfunctionsoccurringinvarioussubcortical
innessesappear areaslimbic basal
system ganglia
reticular and
system brainstem

fewifa nypsychiatricdisordershave
b een withdysfunctionorpathologyofa ny
associated b rain
sina.ie s tructure

HYPOTHALAMUS

regulatescircadian sleep
rhythm appetite
c ycles sex a nd
d rive
regulation theANSanda lmostallendocrineglands
ofb oth

c ertain
regulating of
a spects hypothalamicfunctioning
iiiiiii.it
andhippocampus

itiiiiiiiiiii
structures amygdala
septum
cingulate

primary of
functionappraisal emotional
stimuli
initiation emotional of
responses the fightoflight
r down
e.g responses
shutting
after
reactivity and
the
subside r estoring
external n ervous
emand toastateofhomeostasis
b ody
informationprocessing
cortex
structures cerebral andamygdala
amygdala'sappraisalof iscrude
environmentalstressors
e ngagei n
can a ndifsuch
patternrecognition
gross resemble
patterns oevents
ones r provassociated d angerit
with sends

tousealarms
amino.fi
l evelof
att he thehypothalamussprimary
stress
response areactivated
pathways

1stm ost eat toa


immediately response perceived
is bysus susnervesreachan
danger evoked
the
o ver b ody releasen orepinephrine activate
immediately a drenergic

andincreasedheart
receptors rate
blood and
pressure sweat
also t he
p enetrateto otfheadrenalglandadrenalmedulla
c ore discharges

thebloodstream
andadrenalineinto
norepinephrine

a aneuroendocrine pathwayin
pituitarya drenal
pathway hypothalamic a xis ofsteroidhormones
release adrenal
from gland the
cannitate
glucocorticoids
inauding of
releaseglucose

circulation mainglucocorticoidin
into isconison
humans

aneuroendocrinepathway hypothalamic thyroid


pituitary p athway a hormonesthyroxine
releases thyroid
in andtriiodotnyronin.us ofs nsanows
activation
to
body
quickly the
mobilize orrightor
body night
TO
RETURN BASELINE

thevarious stress re the a ndtriggerashutting


hormones enter b rain down f s tressresponsee stutsoff aaxis
othe
hippocampusina sense t urnso ffthes tress
response the
e specially H axis
pa
both hippocampi cone ineartemporallobesaredenselypopulated car
withglucocorticoidreceptors
cortisol binds t oarinhippocampus activateshippocampus exertsinhibitorycontrolover thehypothalamus thus the response
deactivates s tress

and
feedback also
inhibition t akeplaceat he levelof
thehypothalamuspituitary

some tosuggest
evidence
the anterior
cingulategyrus p laysaroleinreducingemotionala rousal
also
PERIPHERALNervous s ystemPNS

EHEE brain
ÉÉicord

in

mn ii iiEEE
i
fi t.fif

IiiIii i
Dee
EE EEiE
DRYMouth
I.IEIEEIEIEIEEE.EEane
constipation BLADDER F luids
EMPTY
urine
RETENTION arteries constrict Revax
PATHWAY
problem orb rainchangesresultingf romstressfulexperiences
transmittedvulnerabilitywhich
genetically in
maymanifest psychiatricd isorder iie schizophreniabipolardisorderMDDADD
others be
may relatedi ncludeonpanic
that disorder use
substance

non thatultimatelyaffect
medicalillnesses
n eurological
legthyroiddiseases
neurochemistry

b raindysfunction
acquired
e.gbrain toxins
trauma ofsubstance
effects
c hronic abuse
p rimary
brain
d iseases
IEaiafact
brain
abnormal d evelopment due
t oexcessives tressconsiderableresearchstronglysuggeststhat can
stress
severe
very brain
alter inmoreoless
functioning r permanentways
brain
damage
bytoexcessively
caused exposure ofstress
levels
high hormones abnormally
e.g ofcortisoloften
levels
high inmenosrevere
seen pain
chronic m ay nerve
damage

t he
cellsi n hippocampus
P.si
essresponsesuprone
em
iii ant sighi.fi
fififffffqq 48k completion

THATrespondtomedications
symptomsofPTSD

is
transient
i ed
n
ii iiiii.IE
treatment PTSD and
resistant g eneration anticonvulsants
a ntipsychotics

depression antidepressants

panicattacks Mao
antidepressants inhibitors
high
p otencybenzodiazepines

DIFFERENTIALDIAGNOSIS

oftenread
events
traumatic to P tsd
than
more depressionadjustmentsubstanceuse

acute eventis
o nsett raumatic recent

o nset
delayed ofs ymptomsat
onsetsevere omo
l east a fter e vent the

Innit T.ggindividualbutshouldbebasedon3elements
DISCONTINY

client'shistory
ofpreviousepisodes
tandthevulnerabilitytorelapse
intosymptomology
it ingot mediafire.fi

antidepressants titrationhelpswDsrelapse
into ortip
d epression m aniaiscommonwsuddendiscontinuation
into
needtobetaperedoffa sitisconsidered self
doesn't
prozaco ften taperingdue n onlife
tolong
be
psychostimulantsshould monitored forsymptomologysuchasdepressionfatigue sleepdisturbances
divinityconcentrating

areg reaterforindividualswamorbidh istoryofsubstancedisorders


issues
dependency

hypnoticsbenzoa nonb enzo arepotentiallyhabit


h ypnotics comingv iatolerance dependency
sx b e
withdrawal can significant evenwtapering
insomniaiscommon

moods tabilizers bet apered


s hould slowly like
antidepressants

EE
a
can
r eduction
dosage and
c auseseverea nxiety attacks
p anic
reduce
d osage stepto 0willbe
by10weeklyl ast mostc hallenging

REDFLAGS formedicationevaluation
t orerefer
w hen

torespondata nd
failure are
t herapists n oprogressaftera sweeksdespiteadequate
seeing trialassumptionthata naccurate has
b een anditisactuallytaking
made meds
for
need adjustmentre
dosage due
referral t ominimalorpartialimprovement
unexplained c linicians
relapse must
consider

failure usemedicalconditionmedicationtolerancebreakthroughsymptomsneurochemicaldisordersorm etabolic


tocomplysubstance activityc ausesr eemergentsymptoms

onsetofn ewmedical forinstancepregnancyepilepsyagingrelatedchanges


condition

sideeffectsm inormoderate
severed angerous

DEPRESSION

aagn.sncriteria
mental that
toremember essential

and
suffering is
debilitation required
oro n
willpowerand
m ental
musae cannot
a lone
runsomeoneoutofthesestates
always

various ax a of
depression requires combo p sychotherapy medsaancillaryinterventions
psychotropic such and
a sm edassistance f amilyassistance
symptomsthat mustc auses ignificantdistressorimpairmentinsocial
occupationaloro therimportant
areas ofunctioning
f
symptoms m ustn otbeattributableto thephysiologicaleffectsofasubstanceoranother medical condition

can
depression
diagnostically b epersistentmajorunspecisiedreactive griefinitiated
postpartuma of b ipolarp remenstrual
dysphoric cemon
disorder

theoretical
on
perspectives depressions

psychodynamicinadequate integration
psychological orage
f anda ggression the
and and
ofaharsh
development super
p unishing ego

www.easaeso.ninginnie
life to and iastthat
experiences and
c ontribute developed internalizedschemas distortions
c ognitive menu
n egative sets and
predict the
p roject f uture

plays
serotonin roleinregulating
akey e motionsabxcommonly
mood for
prescribed depression anxiety

IL init m ood
ns.assoaateaw
norepinephrine p rescribed
regulationscommonly fordepression anxiety

exvenlafaxineEstexor duloxetinecymbal ta
factors
side sexual
insomnia
e ffectsnauseaheadached izziness dysfunction
ideationin
suicidal some
cases inyoung
e specially adults may
antidepressants initially
increase
r iskosuicidal
the f or
thoughts the
ix particularlywhenstartingorc hanging othe
d osage f medication
s yndromepotentiallylife
serotonin
by l evelscan
c aused excessiveserotonin
condition
t hreatening when
o ccur certain
taking a ntidepressants orincombinationwother
alone that
meds affect

Tirupa
withdrawal
symptoms ortoorapidly
canl eadt owithdrawalsymptomscogflulikesymptoms dizziness m ood
irritability swings

interaction o tcherbal
wothermedicationscaninteractwothermedicationsincluding supplements toadverse
leading
potentially effects the
orreducing ofeithermedication
effectiveness

term
long effects
long useofantidepressantsmayb eassociatedwcertainrisksweight
t erm gaindiabetes
osteoporosis

RULE0
TITI an innermanicorHypomaniaE PISODES

You might also like