Substance-related, Schizophrenia
and Psychosis, and Mood/Affective Disorders Outline and Case Analysis of
Distinguishing the difference between normal and abnormal behavior
has been the main agenda in the field of abnormal psychology. Normal behavior can be classified as what
society deems as normal as the behavior has to measure up to the standards of
those around you as well as being free from mental illness. Abnormal behavior is defined as “behavior
that is considered to be maladaptive or deviant by the social culture in which
it occurs” ("Abnormal Psychology," 2001). Abnormal psychology examines the abnormal
patterns of behavior, emotion and thought, which could possibly explain the
cause of certain mental disorders. The
field of abnormal psychology seeks to identify several reasons for unusual
conditions by making use of different theories from the field of psychology.
The field of abnormal psychology uses a diagnostic and statistical
manual of mental disorders (DSM-IV) to classify “systems of abnormal behaviors
which aids psychologists and other mental health professionals in diagnosing
and treating mental disorders” ("Abnormal Psychology," 2001). The DSM is published by the American
Psychiatric Association and in addition to assisting mental health providers in
classifying and diagnosing mental disorder it is also “used in education,
research, and other purposes by government agencies, health insurance and
pharmaceutical companies, and universities” (Davey, 2011).
The DSM-IV identifies a smaller group of substance related
disorders “in which psychoactive substance use or abuse repeatedly results in
significantly adverse consequences” ("Substance use disorders,"
2011). The group that is identified by
the DSM-IV consists of disorders that are related to substance abuse and
substance dependence. The diagnosis that
is identified show “a pathological relationship between a user and a drug (or
drugs) is being used” (Hansell & Damour, 2008 p. 314). In order to understand the difference between
substance abuse and substance dependence one must first understand the
criterion that is used for identification of drug misuse. The three C’s of drug misuse are “continued
use despite negative consequences, compulsive use and loss of control of use”
(Hansell & Damour, 2008 p. 314). Substance abuse occurs when an individual
continues to use a particular substance despite the negative consequences,
which is the first C of drug misuse.
Substance dependence occurs when an all three C’s of drug misuse are
involved along with physiological symptoms such as tolerance and
withdrawal.
According to many articles that I have read there has been many
research projects that have taking place to show a link between certain drug
use such as marijuana and the onset of schizophrenia. Some research has also suggested that
amphetamine use is very harmful to those individuals suffering from
schizophrenia as it can severely worsen their symptoms. Schizophrenia is not caused by the use of
drugs; however it can sometimes be classified as a drug-induced disorder in
many people who have substance abuse problems.
Individuals who have substance abuse problems may develop a
drug-induced psychosis, in which the symptoms are similar to schizophrenia but
are not the same. Drug-induced psychosis
is typically short-term and can be reversed; while schizophrenia can also be
drug-induced, genetics also play a major role in an individual developing this
medical condition. Many people who are genetically susceptible to developing
schizophrenia increase their chances in having very severe symptoms when the
schizophrenia is drug induced and they continue to use drugs.
Schizophrenia is defined as “a disorder marked by psychosis and a
decline in adaptive functioning” (Hansell & Damour, 2008 p. 455). Symptoms of schizophrenia include delusions,
which are “fixed, false, and often bizarre beliefs”, hallucinations, which are
“abnormal sensory experiences such as hearing or seeing nonexistent things”,
mumbled speech, behavior that is visibly disorderly or unresponsive and lack of
emotion, speech or motivation. These
cognitive and behavioral symptoms of schizophrenia that last for at least six
months or more can cause a substantial amount of anguish to an individual.
Mood can be defined as “a transitory affective state that is
relatively mild and long lasting” (Cohen-Charash & Boyd, 2007). A change in an individual’s mood is something
that occurs all the time, for instance there may be times when an individual
may be extremely happy or extremely sad for no particular reason. An individual’s mood can also be affected by
certain experiences they may have in their life causing them to be either happy
or sad. No matter the situation, mood is
something that is present at all times in an individual and it has influence on
how an individual feel, think, act, sleep and live (Hansell & Damour,
2008). Ups and down are normal
occurrences in everyday life; however an extremely low mood can be a sign of
depression, which is “a state of abnormally low mood with emotional, cognitive,
motivational, and or physical features” (Hansell & Damour, 2008 p.
164). The opposite of depression is an
extremely high mood, known as Mania, which is a “state of abnormally high mood,
with emotional, cognitive, motivational, and/or physical features” (Hansell &
Damour, 2008 p. 164).
There are five main mood disorders that are recognized by the
DSM-IV-TR, “major depressive disorder; dysthymic disorder (sometimes referred
to as “minor depression”); bipolar I disorder; bipolar II disorder; and
cyclothymic disorder” (Hansell & Damour, 2008 p. 166). Mood disorders are
built from mood episodes and the DSM-IV-TR identifies three different mood
episodes, major depressive, manic, and hypomanic. Major depressive episode occurs when “severe
depression last at least two weeks, including several emotional, cognitive,
motivational, or physical symptoms”. Manic episode occurs when “abnormally
elevated, expansive, or irritable mood that lasts at least one week and impairs
social and occupational functioning”.
Hypomanic episode is considered to be “a less severe version of a manic
episode, lasting four days or more that does not impair functioning” (Hansell
& Damour, 2008 p.166).
Mood/affective disorders such as depression and bipolar disorders
are very common with individuals that suffer from substance use disorders. Over the years researchers have been able to
make a connection between substance abuse and mood disorders, particularly how
the abuse of over the counter prescription drugs as well as illegal drugs can
contribute to substance induced mood/affective disorders such as depression or
mania. Highlights of a drug induced mood
disorder is the beginning of symptoms associated with mood disorders under the
influence of drugs or during the withdrawal.
Sadness is a feeling that everyone experiences at one point or
another in life and normally will pass within a couple of days or when whatever
situation caused the sadness is corrected.
On the other hand, sadness that does not pass can transform into
depression and interfere with an individual’s life causing pain for them and
others that are around them. Depression
is a serious illness that many people never seek treatment for, which can put
themselves as well as others in imminent danger. The case of Joseph Westbecker is a classic
example of how depression gone untreated for a long period of time can cause disruptive
and unusual patterns of behavior in an individual’s life. Joseph Westbecker “consistently showed four
themes central to the diagnosis of affect disorder (depression, suicidal
ideation, mania, and anger) throughout his life, including the first time he
checked himself into a hospital because of his disorder. He also showed evidence of mania-agitation,
but seldom if ever any mania-euphoria” (Meyer, Chapman, & Weaver, 2009 p.
107).
Joseph Westbecker family background showed that there was history
of mental illness because his maternal grandmother was placed in a mental
hospital on more than one occasion because of “depression, suicidal ideation,
and delusions of persecution” (Meyer, Chapman,
& Weaver, 2009 p. 107). That
family history of mental illness was a contributing factor to Westbecker’s
condition but soon after his birth he encountered many traumatic experiences in
his life that created sadness that he never overcame. Westbecker was treated in hospitals several
times and displayed a long history of psychiatric illness that varied from deep
depression, manic depression, confusion, anger, anxiety and suicide attempts. While
on disability leave for his mental disturbances from work, Westbecker purchased
a semiautomatic rifle returned to his place of employment and killed eight of
his coworkers and injured twelve before taking his own life. Prior to the tragic incident that took place,
Westbecker was instructed to stop using Prozac, which is a drug used to treat
major depressive orders but because Westbecker had spoken of wanting to harm
himself and others at the work place as he had told stories of being tormented
by fellow coworkers because of his mental condition, the psychiatrist felt the
Prozac was not working for him. After
Westbecker’s death an autopsy was performed and it “revealed a moderately high
level of Prozac and lithium in his blood, as well as small amounts of three
other antidepressants and a sleeping medication” (Meyer, Chapman, & Weaver,
2009 p.109). The psychiatrist that was
treating Westbecker stated that he was taking these medications on his own,
which presents the question of did the combination of these medications cause
manic depressive episode that lead to the tragic event.
Joseph Westbecker was born with genes that made him susceptible to
mood/affective disorders and the losses his encountered early on in life deprived
him of the chance to develop cognitive and personality traits that are normally
used to aid with emotional problems.
Those early problems went untreated and later lead to “hyperactivity of
the hypothalamic-pituitary-adrenal axis, from overproduction of the hormone
corticotrophin releasing factor (CRF), which in turn leads to an over-secretion
of stimulating hormones under stress, facilitating any agitated depression”
(Meyer, Chapman, & Weaver, 2009 p.
109). Westbecker did not have a good relationship with his mother, which caused
him much pain and sorrow which also kept him from being able to cope with all
the tragic experiences he encountered in his life.
Abnormal Psychology. (2001). The Gale Encyclopedia of Psychology, 1(2), , 1-2.
Cohen-Charash, Y., & Boyd, B. (2007). Mood. Encyclopedia of Industrial and
Organizational Psychology, 2(1), 485-487.
Davey, G. (2011). Diagnostic and Statistical Manual of
Mental Disorders. Encyclopedia of women
in today’s world. doi:10.4135/9781412995962.n207
Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken,
NJ: Wiley.
Meyer, R., Chapman, L. K., & Weaver, C. M. (2009). Case studies in abnormal behavior (8th
ed.). Boston, MA: Pearson/Allyn & Bacon.
National Alliance on Mental Illness. (2010). Substance
use disorders. Retrieved from http://www.nami.org
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