10.2 Psychiatric Pathologies

This chapter is a little different from the others in that it does not focus on a whole body system, but rather deals specifically with psychiatric pathologies and medications. Also, because neurotransmitters and concepts such as synapses were discussed in the nervous system chapter, this chapter will simply provide a basic review of these topics before delving into pathologies. When discussing psychiatric pathologies and medications, many of the potential causes and treatments revolve around neurotransmitters—either too much or too little of a certain neurotransmitter.

For example, as discussed in Chapter 9, dopamine is strongly linked to motor and cognition. This neurotransmitter influences movement and can be associated with ADHD, paranoia, and schizophrenia. Serotonin is also heavily involved in many body processes, and abnormal levels of serotonin can affect sleep, libido, mood, and temperature regulation. Alterations of serotonin have been linked to many mental health issues such as depression, bipolar disorder, anxiety, and body function disorders. Gamma-aminobutyric acid (GABA) also assists with communication in the brain, and low levels of this neurotransmitter have been linked to issues such as anxiety, seizures, mania, and impulse control.

Although there are numerous potential psychiatric pathologies, only the most common and prevalent will be discussed below. Often the treatments and medications for many of these, and some not discussed here, are very similar, so this chapter provides a good overview of psychiatric pathologies and treatment options.

Anxiety: This is a group of conditions marked by pathological or extreme anxiety or dread. Individuals with anxiety experience disturbances of mood, behaviour, and most systems in the body, making them unable to continue with everyday activities. The psychiatric disorder of anxiety also occurs when the intensity and duration of anxiety does not match the potential for harm or threat to the affected person.

Common signs and symptoms of anxiety:

• • Aches
  • Pains
  • Stomachache
  • Headache
  • Heart racing or pounding
  • Trembling
  • Sweating
  • Difficulty concentrating
  • Increased agitation

Depression: This frequently occurring pathology affects up to 5% of the population. To be diagnosed with depression, five of the symptoms listed below must be present during the same two-week period and represent a change from previous functioning. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Common signs and symptoms of depression:

• • Depressed mood
  • Diminished interest
  • Weight gain or weight loss when not dieting
  • Insomnia or hypersomnia
  • Agitation
  • Fatigue or loss of energy
  • Feeling of worthlessness
  • Inappropriate guilt
  • Diminished ability to concentrate
  • Thoughts of death, suicidal ideation, or suicide attempt

The video below provides an overview of anxiety and depression, as well as the potential causes for such pathologies.

(SciShow Psych, 2019)

Bipolar disorder: This disorder is marked by extreme mood swings. Typically, patients experience extreme highs (called mania or hypomania) alternating with extreme lows (depression). Often those with this pathology will have periods without symptoms between the periods of extreme highs and lows.

Common signs and symptoms of mania:

• • Rapid speech
  • Hyperactivity
  • Reduced need for sleep
  • Flight of ideas
  • Grandiosity
  • Poor judgement
  • Aggression or hostility
  • Risky sexual behaviour
  • Neglect of basic self-care

Schizophrenia: This pathology refers to a group of severe, disabling psychiatric disorders marked by withdrawal from reality, illogical thinking, delusions, hallucinations, and flat affect. Fig. 10.1 provides an overview of some of the changes that may occur in the brain of someone with schizophrenia.

Schizophrenia affects people from all walks of life and usually first appears between the ages of 15 and 30. Not everyone will experience the same symptoms, but many symptoms are common, such as withdrawing, hearing voices, talking to oneself, seeing things that are not there, neglecting personal hygiene, and showing low energy.

Common signs and symptoms of schizophrenia:

There are three types of symptoms related to schizophrenia: positive, negative, and cognitive. Note that in this context, the word positive is not the same as “good.” Rather, positive symptoms demonstrate how the individual has lost touch with reality.

• • Positive symptoms:

• • • Delusions
    • Hallucinations
    • Disorganized thinking and behaviour
  • Negative symptoms:

• • • Apathy (lack of interest in people, things, activities)
    • Lack of motivation
    • Blunted affect
    • Poverty of speech
    • Anhedonia
    • Avoidance of relationships
  • Cognitive symptoms:

• • • Poor decision making
    • Loss of memory
    • Distracted
    • Difficulty focusing

The video below describes some of the more complex aspects of schizophrenia:

(Neuroscientifically Challenged, 2022)

Attention-deficit hyperactivity disorder (ADHD): This condition is characterized by hyperactivity, lack of impulse control, and lack of attention that interferes with how a person functions. ADHD is often diagnosed during childhood, but the signs and symptoms can last through adulthood.

Common signs and symptoms of ADHD:

• • Hyperactivity
  • Inability to concentrate
  • Difficulty with self-control
  • Lack of emotional control

A child with ADHD may have difficulty sitting still and focusing at school or have emotional outbursts. These behaviours often impact their life.

Post-traumatic stress disorder (PTSD): This mental health pathology is often triggered by either experiencing or witnessing a terrifying or traumatic event. Symptoms can vary but may include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event (Mayo Clinic, 2023).

It is common for most people who experience a traumatic event to have temporary difficulty adjusting and coping, but with time and good self-care, they can get better (Mayo Clinic, 2023). If the symptoms worsen, last for longer periods of time, or interfere with day-to-day functioning, the individual may have developed PTSD (Mayo Clinic, 2023). This pathology was originally referred to as “shell shock” in the First World War and was applied to soldiers who had difficulty adjusting to everyday life after fighting in a war. Since then, the definition has evolved and extended to other situations.

Common signs and symptoms of PTSD (Mayo Clinic, 2023):

• • Recurrent, unwanted, distressing memories of a traumatic event
  • Flashbacks—reliving the traumatic event as if it were happening again
  • Upsetting dreams or nightmares about the traumatic event
  • Severe emotional distress or physical reactions to something that reminds the person of the traumatic event
  • Trying to avoid thinking or talking about the traumatic event
  • Avoiding places, activities, or people that remind the person of the traumatic event
  • Negative thoughts about oneself, other people, or the world
  • Memory problems

References

Mayo Clinic. (2023). Post-traumatic stress disorder (PTSD). https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967#:~:text=Post%2Dtraumatic%20stress%20disorder%20(PTSD)%20is%20a%20mental%20health,uncontrollable%20thoughts%20about%20the%20event

Neuroscientifically Challenged. (2022, 3 June). 2-minute neuroscience: Schizophrenia [Video]. YouTube. https://www.youtube.com/watch?v=pjTmZqBNB78

SciShow Psych. (2019, February 28). Why do depression and anxiety go together? [Video]. YouTube. https://www.youtube.com/watch?v=xdAjGRvxGPM

Image Credits (images are listed in order of appearance)

Schizophrenia brain large by Jurgitta, CC BY-SA 4.0