Treating Mental Illness Bittu Majmudar September 25, 2007 Neuroethics.

Treating Mental Illness

Bittu Majmudar

September 25, 2007

Neuroethics

Categories of Mental Illness

• Anxiety Disorders– Generalized Anxiety Disorder– Post-Traumatic Stress Disorder

(PTSD)– Obsessive-Compulsive Disorder

(OCD)– Panic Disorder– Social Anxiety Disorder– Specific Phobias

• Mood Disorders– Depression– Mania– Bipolar Disorder (Manic

Depression)

Categories of Mental Illness

• Psychotic Disorders – Schizophrenia

• Eating Disorders– Anorexia Nervosa– Bulimia Nervosa

• Impulse Control & Addiction Disorders– Pyromania (starting fires)– Kleptomania (stealing)– Compulsive Gambling

Categories of Mental Illness

• Personality Disorders– Antisocial Personality Disorder– Obsessive-Compulsive

Personality Disorder– Paranoid Personality Disorder

• Adjustment Disorder• Dissociative Disorders

– Dissociative Identity Disorder– Depersonalization Disorder

• Somatoform Disorders• Tic Disorders

– Tourette Syndrome

Mental Health Care Practitioners

• Psychiatrist– medical doctor

• Psychologist – master’s or doctoral degree

• Psychiatric Social Worker – specialized training in

psychotherapy

• Advanced Practice Psychiatric Nurse – training in behavioral health

Mental Health Care Practitioners

• Psychoanalyst– any of the previous with training

in psychoanalysis

• Mental Health Counselor– licensed professional counselors

• Pastoral Counselor– additional religious or

theological training

• Psychotherapist– general practitioner that

provides mental health care

Treatments & Therapies

• Drug Therapy• Electroconvulsive Therapy

(ECT)• Psychotherapy

– Supportive Psychotherapy– Psychoanalysis– Psychodynamic Psychotherapy– Cognitive Therapy– Behavior Therapy (Exposure

Therapy)– Cognitive-Behavioral Therapy

(Dialectical Behavior Therapy)– Group / Interpersonal Therapy

Treatments & Therapies

• Biomedical Treatment• Spiritual Treatment• Self-Help Treatment• Holistic Treatments

– Yoga / Meditation

• Alternative Treatments– Acupuncture– Biofeedback– Hypnosis / Dream

Interpretation– Magnetic Stimulation Therapy

Drug Therapy• Depression

– tricyclics: imipramine, desipramine– monoamine oxidase inhibitors

(MAOIs)– selective serotonin reuptake

inhibitors (SSRIs): fluoxetine, sertraline, paroxetine, citalopram

– new: bupropion

• Schizophrenia– antipsychotic (neuroleptic)

medications: clozapine, risperidone, olanzapine

Drug Therapy• Bipolar Disorder

– antimanic medications: lithium – antidepressants– anticonvulsants: valproic acid,

carbamazepine, topiramate

• ADD / ADHD– stimulant medications:

amphetamine, methylphenidate

– non-stimulant medications: atomoxetine

Drug Therapy• Obsessive-Compulsive

Disorder– buspirone, propranolol– antianxiety medications:

benzodiazepines– antidepressant medications:

fluoxetine, paroxetine, sertraline

Electroconvulsive Therapy (ECT)

• severe depression accompanied by psychosis, suicidal intent, or refusal to eat

• mania that does not improve with medications

• schizophrenia when symptoms are severe or medications aren’t enough

Psychotherapy

• depression• bipolar disorder• personality disorders• dissociative disorders• anxiety disorders• impulse control & addiction

disorders

Questions to Contemplate…

• What criteria should be used to define mental illness and abnormal v. normal behavior?

• Does refusal to accept treatment indicate a lack of decision-making capacity?

• At what point is informed consent inapplicable and involuntary treatment necessary?