Common Psychiatric Disorders

The first question most patients ask when coming to the Biological Psychiatry Institute is, "what is a biological disorder affecting the brain?" In order to answer the question as stated, I will present a few necessary definitions.

  1. The neuron or brain cell is the primary cell that produces behavior.
  2. Behavior is anything that reflects brain activity.
  3. Overt behavior is behavior we see or perceive without special equipment.
    1. Overt behavior is the primary behavior that is human behavior.
  4. Other behaviors are magnetic behavior, electrical behavior, neuroendocrine behavior, and metabolic behavior.
  5. Systems of neurons that have a common function are called generators of behaviors.
    1. Examples of generators of behavior are as follows:
      1. Mood generator of behavior
      2. Memory generator of behavior
      3. Sense of humor generator of behavior
      4. Obsessive generator of behavior
      5. Anxiety generator of behavior
      6. Instinctual generators of behavior
      7. Sleep generators of behavior
      8. Cognitive generators of behavior
      9. Awareness generators of behavior
      10. Generators of behavior that plan and execute tasks
      11. Others
  6. The overlapping matrix of all the generators of behavior create our personality
  7. When the brain fails, it fails in its usual capacities. Depending on which generator of behavior fails, a unique behavioral cluster will be produced (which is called a syndrome; i.e. a failed generator of behavior cause undetermined).
    1. An example of a neurological disorder is the Parkinson's syndrome, which is caused by the failure of the Basal Ganglia. The Parkinson's syndrome is characterized by slow movement, rigidity, tremors, and unsteady gait. When the Basal Ganglia of the brain fail, the cause of the Basal Ganglia failing could be from many causes, such as genetic, small strokes, manganese poisoning, and carbon monoxide poisoning, or spontaneous and unknown.
  8. An example of a biological psychiatric disorder is a Major Depressive Syndrome. The Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR) defines a major depressive syndrome as follows:

Five or more of the following symptoms have been present during the same two week period and represent a change from previous functioning; at least one of the symptoms is either 1. Depressed mood or 2. Loss of interest or pleasure.

  1. Depressed mood most of the day
  2. Decreased interest or pleasure
  3. Weight loss or weight gain
  4. Insomnia or hypersomnia
  5. Psychomotor agitation or retardation
  6. Fatigue or loss of energy
  7. Feelings of worthlessness or excessive guilt
  8. Diminished ability to think or concentrate, or indecisiveness
  9. Recurrent thoughts of death or suicidal thoughts

When the Limbic System or mood system fails, it uniquely creates a behavioral cluster as described above. The cause of the major depressive syndrome could include genetic causes, low thyroid functioning, strokes, or head trauma, to name a few.

  1. The Dorsal Lateral Prefrontal Cortex (DLPC) of the Frontal Lobe (unique in the human brain) attempts to orchestrate the various generators of the brain in order to be adaptable. Adaptable means that the internal environment and external environment of the brain is maintained for survival and procreation i.e. homeostasis.
  2. When overt behavior is maladaptive in the setting of normal personality mechanisms, the malady is call a personality disorder.
  3. When overt behavior is due to a failed generator of behavior that is independent of personality that interferes with personality behavior, it is a biological disorder.
  4. The bottom line of Biological Psychiatry is to define brain failure, look for causes of brain failure and treat appropriately.
  5. Illness is defined as a generator of behavior within the brain that has an inherent vulnerability to produce behavior independent of personality and content of life that interferes with personality behavior.

MEDICAL ILLNESS

In general, medical illnesses are not cured, but controlled.  For instance, diabetes is controlled with insulin, but is not cured.  The same principles apply to psychiatric disorders.  We control symptoms, lessen or abort attacks, but we offer NO cure.  Sixty percent of psychiatric disorders are readily controlled in one to three months.  Thirty percent are controlled with moderate effort in three to six months, and ten percent of psychiatric disorders are treatment resistant and take great effort and time to control.

 

We are dedicated, and offer the latest technology for the controlling of psychiatric illness.  At times it can be a lengthy process, but it is important that we persist to finally gain control so that a patient may enjoy life again.

 

Biological Stability in the brain is defined by the Williams Three Wells:

1. Sleep Well Sleep is a process that creates neurotransmitter gas and energy that runs the brain engine the next day.
2. Feel Well Feel well means the brain engine or personality is not being interfered with by illness behavior, such as depression or anxiety.
3. Function Well Executive function of the frontal lobes is the driver of the brain engine.  Function well is when the driver of the brain engine is able to orchestrate the different generators of behavior in the personality matrix to be adaptable to content of life.

 


TREATABLE BRAIN DISORDERS

Most of our medically treatable brain disorders are either:

  1. Mood Disorders, such as Depression
  2. Anxiety/Panic Disorders
  3. Obsessive Compulsive Disorders
  4. Psychotic Disorders
  5. Sleep Disorders

MEDICAL DIAGNOSIS

Our psychiatric medical diagnosis is based on:

  1. Clusters of signs and symptoms
  2. Family history
  3. Laboratory tests
  4. Neurophysiological tests
  5. Prior response to medications
  6. Psychiatric history

 


SUBSTANCE ABUSE

Another major problem concerning brain disorders is substance abuse.  Although these disorders, such as alcoholism, are biologically based, the main treatment is non-medical.  In other words, treatment involves modifying behavior in a way that a person refrains from abusing substances.  Therefore, we refer out substance abuse problems to substance abuse programs.  More recently, there are medications that can help with drug abuse.  These medications are usually presented in the setting of a substance abuse program.