Schizophrenia, Depression, Mania, Anxiety Disorder, and Tourette Syndrome

Psychiatric disorders used to be thought of as problems of the mind. Now it is no longer believed to be so. Instead, psychiatric disorders are considered disorders of dysfunctional brains. Schizophrenia, depression, mania, anxiety disorder, and Tourette syndrome are all psychiatric disorders, each with their own symptoms and treatments.

First, schizophrenia affects about 1% of the population of the United States. According to the National Institute of Mental Health (2009), "People with schizophrenia sometimes hear voices others don't hear, believe that others are broadcasting their thoughts to the world, or become convinced that others are plotting to harm them" (¶ 1). It is hard to diagnose schizophrenia because its symptoms are complex and often share the symptoms of other psychiatric disorders (Axia College Week 7 reading Chapter 15, 2009). The most common symptoms are bizarre delusions, inappropriate affect, hallucinations, incoherent thought, and odd behavior, but only one of these symptoms must occur for eight months in a row to be diagnosed with schizophrenia (Axia College Week 7 reading Chapter 15, 2009). Genetics play a factor in who develops schizophrenia, as well as toxins, stress, autoimmune reactions, and other traumatic injury (Axia College Week 7 reading Chapter 15, 2009). Drugs can sometimes alleviate the symptoms of schizophrenia. Chlorpromazine reduces the symptoms and sometimes allows people with schizophrenia to be discharged when they had once been hospitalized (Axia College Week 7 reading Chapter 15, 2009). Research on Parkinson's disease gave way to more drugs for schizophrenia. According to the Axia College Week 7 reading Chapter 15 (2009), "Thus was born the dopamine theory of schizophrenia-the theory that schizophrenia is caused by too much dopamine and, conversely, that antischizophrenic drugs exert their effects by decreasing dopamine levels" (p. 483, ¶ 2). Through further study, Carlsson and Lindqvist found that the main factor in schizophrenia was probably high levels of activity at dopamine receptors rather than just high dopamine levels (Axia College Week 7 reading Chapter 15, 2009). More research furthered the theory in that D₁ and D₂ receptors in dopamine receptors are different at how drugs bind to them. According to the Axia College Week 7 reading Chapter 15 (2009), "It suggested that schizophrenia is caused by hyperactivity specifically at D₂ receptors, rather than at dopamine receptors in general (p. 485, ¶ 3).

In addition to these theories, it was found that other receptors other than D₂ receptors are involved in schizophrenia like glutamate, serotonin, and GABA (Axia College Week 7 reading Chapter 15, 2009). Clozapine is a drug that works for schizophrenics that have not responded to other drugs because it binds itself to other receptors (Axia College Week 7 reading Chapter 15, 2009).

Furthermore, it takes weeks of drug therapy to help alleviate the symptoms of schizophrenia, mainly because drugs that focus on D₂ receptors slow the response of the brain to the drugs. The worst problem is that some drugs do not help the schizophrenic patient at all. Also, schizophrenia is associated with a great deal of brain damage. According to the Axia College Week 7 reading Chapter 15 (2009), "Two things about the pattern of brain damage observed in many schizophrenics are problematic for the dopamine theory: One is that there is little evidence of structural damage to dopaminergic circuits; the other is that the dopamine theory provides no rationale for the diffuse pattern of brain damage that is often observed" (p. 487, ¶ 2).

Another psychiatric disorder is depression. Depression, or clinical depression, is more than just a reaction to something bad in one's life. A reaction to a negative experience is known as reactive depression (Axia College Week 7 reading Chapter 15, 2009). Depression goes beyond the normal reactions of sadness, often for no reason at all, otherwise known as endogenous depression (Axia College Week 7 reading Chapter 15, 2009). It can adversely affect a person's life, because the person may not have any interest in life anymore - even so much so that they will not even get out of bed. Bipolar affective disorder is when a person with depression has mania as well - the extreme opposite of depression. Unipolar affective disorder is when depression occurs without the mania (Axia College Week 7 reading Chapter 15, 2009). Genetics and stress both greatly affect whether a person will develop depression or not. Monoamine oxidase inhibitors increase the level of norepinephrine and serotonin in the brain. Taking MAO inhibitors increases the chance of strokes when they eat certain foods that elevate the blood pressure (Axia College Week 7 reading Chapter 15, 2009). According to the Axia College Week 7 reading Chapter 15 (2009), "Tricyclic antidepressants block the reuptake of both serotonin and norepinephrine, thus increasing their levels in the brain" (p. 489, ¶ 5). Lithium is a mood stabilizer because it inhibits the transitions between depression and mania. According to the Axia College Week 7 reading Chapter 15 (2009), "Selective serotonin-reuptake inhibitors exert agonistic effects on serotonergic transmission by blocking the reuptake of serotonin from synapses" (p. 491, ¶ 4).

In addition, there are two theories of depression. According to the Axia College Week 7 reading Chapter 15 (2009), "The monoamine theory of depression holds that depression is associated with underactivity at serotonergic and noradrenergic synapses" (p. 492, ¶ 6). It is based on the positive reactions that drugs have on serotonin, norepinephrine, or both (Axia College Week 7 reading Chapter 15, 2009). Another theory is the diathesis-stress model. The diathesis-stress model is the idea that some people have a genetic susceptibility, or diathesis, to depression. It is based on the idea that people with depression release more stress hormones than those that do not have depression (Axia College Week 7 reading Chapter 15, 2009).

In addition, anxiety, or fear of an indirect threat, is a psychiatric disorder when it interferes with everyday life. Rapid heartbeat, high blood pressure, nausea, breathing difficulty, sleep disturbances, and high glucocorticoid levels are all physical symptoms of an anxiety disorder (Axia College Week 7 reading Chapter 15, 2009). Generalized anxiety disorders are extreme feelings of anxiety when there is no threat present. Phobic anxiety disorders are triggered by exposure to feared objects or situations. Panic disorders can occur with generalized and phobic anxiety disorders, but often appear on their own when symptoms of severe stress appear. Obsessive-compulsive disorders occur when obsessions and compulsiveness cannot be controlled. Posttraumatic stress disorder is persistent stress after an extremely stressful situation (Axia College Week 7 reading Chapter 15, 2009). Genetics and stressful events can trigger anxiety disorders.

Consequently, certain drugs are needed to treat anxiety disorders. Benzodiazepines are used in the short term and create a calming effect to the person. According to the Axia College Week 7 reading Chapter 15 (2009), "Benzodiazepines bind to a GABAA receptor at a different site than the one at which GABA molecules bind and, in so doing, increase the binding of GABA molecules to the receptor (p. 495, ¶ 7). Serotonin agonists have the same effect as benzodiazepines other than the bad side effects, like sedation. Animals and their behaviors are studied in their responses to fear and anxiety in three different tests. According to the Axia College Week 7 reading Chapter 15 (2009), "The elevated-plus-maze, defensive-burying, and risk-assessment tests of anxiety have all been validated by demonstrations that benzodiazepines reduce the various indexes of anxiety used in the tests, whereas nonanxiolytic drugs usually do not" (p. 496, ¶ 2). However, many cases do not respond well with benzodiazepines.

Lastly, Tourette syndrome is involuntary repetitious movements or vocalizations, also known as tics. It often begins with simple tics in childhood and develops into more severe tics over time. According to the Tourette Syndrome Association (2009), "No definite cause has yet been established, but considerable evidence points to abnormal metabolism of at least one brain chemical called dopamine" (¶ 3). It is also genetic. However, it is hard to study because there are no animals with Tourette syndrome to test, patients cannot stay still while tics are occurring for brain imaging, and not one particular gene has been determined to be the cause of Tourette syndrome (Axia College Week 7 reading Chapter 15, 2009). It is theorized that Tourette syndrome is caused by abnormalities in the basal ganglia and limbic and association cortex (Axia College Week 7 reading Chapter 15, 2009). According to the Axia College Week 7 reading Chapter 15 (2009), "The current hypothesis is that Tourette syndrome is a neurodevelopmental disorder that results from excessive dopaminergic innervation of the striatum and the associated limbic cortex" (p. 499, ¶ 7). Therefore D₂ receptor blockers can be effective in treating the symptoms of Tourette syndrome.

In conclusion, psychiatric disorders are extremely complex and sometimes difficult to diagnose. They are no longer viewed merely as disorders of the mind. It is now recognized that these disorders are directly affected by disorders of the brain. More and more information is obtained about these disorders as models are developed and theories are examined. Through research and drug treatments, sometimes the symptoms of these debilitating disorders can be alleviated and hopefully one day be cured.

Axia College of University of Phoenix. Chapter 15. The Brain, the Body, and the Mind Course.

National Institute of Mental Health. Schizophrenia. NIMH.

Tourette Syndrome Association. Facts About Tourette Syndrome. TSA-USA.