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psychodynamic approach to depressive disorders

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believing that unipolar depression results from unconscious grief over real or imagined losses, they suggest interpretations of free association to gain awareness of their losses and deal with them more effectively. Only occasionally helpful in unipolar depression since not a quick fix.

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behavioral approach to depressive disorders

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reintroduce depressed clients to pleasurable events and activities, appropriately reward non-depressive behaviors and withhold rewards for depressive behaviors, and help clients improve their social skills. Developed by Lewinsohn. Most effective when all techniques are incorporated, not just one

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behavioral activation

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behavioral therapeutic idea that involves adding positive activities to a person's life to improve mood and lessen depression

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contingency management

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approach in which therapists will systematically ignore a client's depressive behaviors while praising or otherwise rewarding constructive statements and behaviors, such as going to work. Sometimes family members are recruited in this

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cognitive therapy

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a therapy developed by Aaron Beck that helps people identify and change the maladaptive assumptions and ways of thinking that help cause their psychological disorders and hence improve their mood. Four stages and usually requires fewer than 20 sessions

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increasing activities and elevating mood

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phase 1 of cognitive therapy

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challenging automatic thoughts

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phase 2 of cognitive therapy

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identifying negative thinking and biases

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phase 3 of cognitive therapy

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changing primary attitudes

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phase 4 of cognitive therapy

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acceptance and commitment therapy (ACT)

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type of therapy which somewhat disagrees with Beck's proposition that individuals must fully discard their negative cognitions in order to overcome depression. Guides depressed clients to recognize and accept their negative cognitions simply as streams of thinking that flow through their minds, rather than as valuable guides for behavior and decisions

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interpersonal psychotherapy (IPT)

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developed by Klerman and Weissman, holds that any of the four interpersonal problem areas may lead to depression and must be addressed: interpersonal loss, interpersonal role dispute, interpersonal role transition, and interpersonal deficits. Way of treating depression through fixing relationships. Pretty successful

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important loss

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loss of a loved one. Therapists would encourage clients to explore relationship with the lost person and express any feelings of anger they may disover

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interpersonal role dispute

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occurs when two people have different expectations of their relationship and of the role each should play. Therapists attempt to have clients develop ways of resolving them

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interpersonal role transition

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brought about my major changes such as divorce or birth of a child. Therapists help them to develop social supports and skills the new roles require

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interpersonal deficits

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extreme shyness or social awkwardness that prevent clients from having intimate relationships. Therapists may help clients recognize these and teach them social skills and assertiveness to improve social effectiveness

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couple therapy

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general term for therapy for couples, may help relieve drepression that has resulted from marital discord

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integrative behaviorial couples therapy

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therapy that teaches specific communication and problem-solving skills to couples and further guide them to be more accepting of each other. May help to alleviate depression caused my marital discord

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electroconvulsive therapy (ECT)

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a treatment for depression in which electrodes are attached to a patient's head and send an electrical current through the brain, causing a convulsion. Effective and fast-acting. Can be bilateral or unilateral. 6-12 treatments over 2-4 weeks. Initially thought to cure schizophrenia, but doesn't work well with that. Only effective with depression. Muscle relaxants and anesthetics are given. May lead to memory loss.

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metrazol

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initially given to patients suffering from psychosis to induce brain seizures. By Meduna (Hungarian physician)

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insulin coma therapy

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when insulin is given to patients suffering from psychosis to induce brain seizures. By Sakel (Viennese physician)

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continuation therapy

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ongoing antidepressant medications or periodic ECT sessions. Effective in treating unipolar depression

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monoamine oxidase (MAO) inhibitors

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an antidepressant drug that prevents the action of enzyme monoamine oxidase, which break down norepinephrine. This leads to rise in norepinephrine activity and reduction of depressive symptoms. Rises blood pressure because of tyramine chemical. Available in skin patches

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iproniazid

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drug being tested on patients with tuberculosis and made patients happier. Led to further discovery of antidepressant drugs

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tricyclics

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antidepressant drug such as imipramine that has three rings in its molecular structure. Blocks neurotransmitter "reuptake" mechanisms, allowing NTs to sit in synaptic cleft longer. Increase norepinephrine and serotonin activity. Must be taken at least 10 days before such improvements hold because neurons initially release smaller amounts of NTs and then finally adapt to drugs. No dietary restrictions. Higher rates of improvement. May produce dry mouth and constipation.

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imipramine

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drug that was initially used to try to cure schizophrenia but after some tests, say it relieved depression. A type of tricyclic

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selective serotonin reuptake inhibitors (SSRIs)

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second-generation antidepressants that work by increasing serotonin activity by inhibiting reuptake. Include fluoxteine (Prozac), setraline (Zoloft), and escitalopram (Lexapro).

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selective norepinephrine reuptake inhibitors (SNRIs)

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second-generation antidepressants that work by increasing norepinephrine activity by inhibiting reuptake. Include atomoxetine (Strattera)

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serotonin-norepinephrine reuptake inhibitors

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second-generation antidepressants that work by increasing both norepinephrine and serotonin activity by inhibiting their reuptake. Include venlafaxine (Effexor)

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second-generation antidepressants

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include SSRIs, SNRIs, and serotonin-norepinephrine reuptake inhibitors. On par with tricyclics in terms of effectiveness and speed of action, but they are preferred because harder to overdoes on them. No dietary problems. May lead to weight gain or have reduced sex drive.

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brain stimulation

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biological approaches that are used to treat depressive disorders. Include vagus nerve stimulation, transcranial magnetic stimulation, and deep brain stimulation

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vagus nerve stimulation

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a treatment procedure for depression in which an implanted pulse generator sends regular electrical signals to a person's vagus nerve. Nerve then stimulates the brain. For people who have not improved even after use of at least four other treatments

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transcranial magnetic stimulation (TMS)

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a treatment procedure for depression in which an electromagnetic coil, which is placed on or above a patient's head, sends a current into the individual's brain. Helps to stimulate areas of the brain that are underactive. For people who have been unresponsive to other forms of treatment

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deep brain stimulation (DBS)

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a treatment procedure for depression in which a pacemaker powers electrodes that have been implanted in Brodmann Area 25, thus stimulating that brain area. In addition to improved mood, also improves short-term memory and quality of life

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lithium

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metallic element that occurs in nature as a mineral salt and is an effective treatment for bipolar disorder. Less effective now compared to other drugs for bipolar disorder. Requires an extremely precise dose as to avoid it being effective or causing intoxication. Has more profound effect on manic episodes.

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mood stabilizing (antibipolar) drugs

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psychotropic drugs that help stabilize the moods of people suffering from bipolar disorder. Include lithium. Has more profound effect on manic episodes. Seem to effect the second messengers in neuronal communication. May also increase neuroprotective protein production. May change ion activity. Must be used in adjunct with therapy for effectiveness.

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antiseizure drugs

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used to treat bipolar disorder. Mood stabilizer. Include carbamazepine (Tegretol) and valproate (Depakote).

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What is an important reason for those with bipolar disorder to participate in psychotherapy?

answer

to emphasize the importance of continuing to take their medication

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Which is NOT a reason why those with bipolar disorder do not stay on their medication?

answer

They are cured and no longer need the medication.

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More than _____ percent of patients with mania improve through the use of mood-stabilizing agents.

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60

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The risk of relapse is _____ times greater if patients stop taking a mood stabilizer.

answer

28

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_____ percent or more of patients with bipolar disorders may not respond to lithium or a related drug, may not receive the proper dose, or may relapse while taking it.

answer

30

question

The medications used for bipolar disorders are called:

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mood stabilizers

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This was a watershed medication for bipolar disorder when it was approved by the FDA in 1970.

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lithium

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What is a common side effect of electroconvulsive therapy when used today?

answer

broken bones

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Lexapro and Zoloft are:

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SSRIs

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About _____ percent of patients who take tricyclics are helped by them.

answer

65

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These medications were discovered accidentally as researchers were looking for a new drug to combat schizophrenia.

answer

tricyclics

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After 6 to 12 ECT treatments, spaced over _____ weeks, most patients feel less depressed.

answer

2 to 4

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Depressive symptoms disappear in _____ percent of clients who receive interpersonal psychotherapy.

answer

50 to 60

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This is a treatment for unipolar depression that is based on the belief that clarifying and changing one's interpersonal problems will help lead to recovery.

answer

interpersonal psychotherapy

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What is NOT expected to happen during psychodynamic therapy?

answer

clients will forget the losses in their lives

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Depressed adults who receive cognitive-behavioral therapy improve much more than those who receive placebos or no treatment at all, with _____ percent showing a near-total elimination of their symptoms.

answer

60

question

Studies find that _____ percent of ECT patients improve.

answer

60 to 80

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People who take _____ may experience a dangerous rise in blood pressure if they eat foods containing the chemical tyramine.

answer

MAO inhibitors

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In a practice called _____ therapy, clinicians typically keep patients on tricyclics for five months or more after being free of depressive symptoms.

answer

continuation

question

This technique to treat depression involves stimulating the brain and includes the use of a pulse generator.

answer

vagus nerve stimulation

Chapter 8 – Treatments for Depressive and Bipolar Disorders – Flashcards

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