1. Film Reflection “The Bridge”
psychology discussion question and need a reference to help me learn.
Watch the documentary attached in the word document and respond to the following
questions in the word document. Please don't use other sources, and be aware of
plagiarism. I will attached notes that the professor provide to the class and answer to the
questions using those notes.
Discuss your reactions and feelings (at least 2 total) to this documentary (one short
paragraph)
Why do you think people are drawn to the Golden Gate Bridge to commit suicide? Provide at
least 2 reasons (one short paragraph)
Select one of the individuals who suicided or attempted suicide in the documentary. What
disorder do you believe this person has? Explain by using the DSM-V criteria and provide at
least two (2) specific examples from the documentary of his/her behavior that supports the
criteria (at least one paragraph)
4. Why do you think your selected individual committed suicide? -Do you think his/her
support system helped or hindered his/her life and mental disorder? Explain is a specific
manner, using at least two examples. (At least one paragraphs)
5. What did you learn (about life, death, people, etc.) from this documentary? Explain at
least two (2) specific examples from the documentary and two meaningful things you
learned from those specific examples (at least one well-developed paragraph)
Requirements: in the word doc
Film Reflection “The Bridge”
From “The Bridge”
“People suffer largely unnoticed while the rest of the world goes about its business. This is a
documentary exploration of the mythic beauty of the Golden Gate Bridge, the most popular
suicide destination in the world, and those drawn by its call”.
The Bridge
Discuss your reactions and feelings (at least 2 total) to this documentary (one short
paragraph)
Some reactions I had for this film were, I was s
Why do you think people are drawn to the Golden Gate Bridge to commit suicide? Provide
at least 2 reasons (one short paragraph)
Select one of the individuals who suicided or attempted suicide in the documentary.
2. What disorder do you believe this person has? Explain by using the DSM-V criteria and
provide at least two (2) specific examples from the documentary of his/her behavior that
supports the criteria (at least one paragraph)
4. Why do you think your selected individual committed suicide?
-Do you think his/her support system helped or hindered his/her life and mental disorder?
Explain is a specific manner, using at least two examples.
(At least one paragraphs)
5. What did you learn (about life, death, people, etc.) from this documentary? Explain at
least two (2) specific examples from the documentary and two meaningful things you
learned from those specific examples (at least one well-developed paragraph)
Bipolar Disorders
Learning Objectives:
-Know, understanding, be able to apply disorders of Bipolar 1, Bipolar 2, and Cyclothymic;
-evaluate the problem of diagnosis
1) Bipolar I:
SLP
involves full-blown mania (one or more) with episodes of major depression
DSM-V Criteria; 1 week, at least 3 symptoms…
Inflated self-esteem or grandiosity
Decreased need for sleep
Increased talkativeness
Racing thoughts
Distracted easily
Increase in goal-directed activity or psychomotor agitation
Engaging in activities that hold the potential for painful consequences, e.g., unrestrained
buying sprees
Mania is different from elated mood
Mania is clearly excessive; inappropriate and potentially dangerous behavior, irritability,
pressured or rapid speech, and a false sense of well being
Dramatic shifts in mood, energy, and ability to function
During depressed period – all but immobile
During manic period – full of energy
At either extreme, the person has difficulty coping with the demands of everyday life
Rapid cycling; four or more severe mood disturbances within a single year
Mixed state; simultaneous mania and depression
DSM-V Criteria; 2 weeks, at least 5
Depressed mood most of the day, nearly every day
Loss of interest or pleasure in all, or almost all, activities
Significant weight loss or decrease or increase in appetite
Engaging in purposeless movements, such as pacing the room
Fatigue or loss of energy
Feelings of worthlessness or guilt
3. Diminished ability to think or concentrate, or indecisiveness
Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide
attempt
Depressive symptoms don’t have to be present, usually are,
-unipolar
2) Bipolar II – hypomania or “mild mania,” with episodes of major depression
4:44
Hypomania – may be overly talkative, excitable, or irritable, but there is no impulsive acts or
gross lapses of judgment
Hypomania lasts at least 4 days (96 hrs)
More common than bipolar I (!!!)
Person has one or more depressive episodes along with at least one hypomanic episode
More depressive episodes
Problem????
3) Cyclothymic Disorder:
Mood changes that aren’t as severe or common as in bipolar I and II
fluctuations that alternate between hypomanic and depressive symptoms
but not as severe as with full mania or major depression (aren’t as severe as in bipolar I and
II)
Unpredictable mood changes
no evidence of major manic episode pr major depressive episode during the first 2 years of
displaying cyclothymic disorder
Untreated, can get worse…
Genetics of Bipolar Disorder
Genes associated with bipolar disorder and schizophrenia overlap
Bipolar and Creativity
Since early Greek times people have linked bipolar symptoms to creativity
It’s likely bipolar disorder mood swings contribute to productivity and artistic insight
Anecdotal ties exist, with many great artists showing signs of bipolar disorder & creativity
-Brain Imaging and Bipolar Disorder
fMRI studies suggest processes underlying the symptoms seen in bipolar disorder involve
the anterior limbic brain networks consistent with emotional tasks
-Environmental Factors, stress is associated with greater chance of relapse into bipolar
disorders
Treatment
-Psychological Treatments for Bipolar Disorder involve stress reduction, reduction of
negative interactions with others, and education about the condition
-Medications for Bipolar Disorder involve
lithium salts (lithium bicarbonate, lithium chloride, etc.), which aren’t as effective in those
who rapidly cycle
antipsychotics such as those used for schizophrenia
-Antidepressants may cause shift to mania or rapid cycling
Intro
4. Behaving dangerously; internal/external; Abnormal?
-sufficient?
Behaving dysfunctionally, “maladaptive”; Abnormal?
-sufficient?
Several factors; “different”
1) There are significant disturbances in thoughts, feelings, and behaviors.
Inner states
Thoughts
behaviors
2) The disturbances reflect some kind of biological, psychological, or developmental
dysfunction.
3) The disturbances lead to significant distress or disability in one’s life.
-inner experiences and behaviors are considered to reflect a psychological disorder impair
function
4) The disturbances do not reflect expected or culturally approved responses to certain
events.
Inconsistent with an individual’s developmental, cultural, societal norms…distress &
functioning
Abnormal behaviors in general U.S. populations?
Mental Health Treatment in the Past
1. Ancient Views
Supernatural; evil spirits
Somatogenic; body
Psychogenic; stress
Rx; Trephination- a method to create a hole in the skull
2. Greek and Roman Views
Hippocrates (460–377 BC)
-to identify psychological symptoms: hallucinations, delusions, melancholia, hysteria, and
mania -Environmental factors caused imbalance in“4 humours”
-eg., black bile= melancholia; diet
Hysteria, wandering uterus
3. Middle Ages
-Roman Catholic Church
…demons
-plague, famines
-Supernatural theories; superstition, astrology
-treatments; prayers, confessions, atonements
-persecution of women
-Witchcraft 1400s-1700s (100,000 women slain)
EX: Dancing Mania
1000s of people; bloody feet, days & weeks, screaming, begging priests to save their souls,
5. trance state
4. Middle Ages to the Twentieth Century
Dix, 1840 "confined in this Commonwealth in cages, closets, cellars, stalls, pens! Chained,
beaten with rods, lashed into obedience." The most common complaints were that they
were dark, cramped cells,with the lack of necessities, poor bathrooms and cruel chains and
restraints. Not only that, but the lack of actual treatment they were receiving was appalling.
One girl was "chained in a cage and whipped to control her acts and words.''
-moral treatment = “kindness & occupation”
Philippe Pinel, William Tuke, Benjamin Rush, Dorothea Dix, and Emil Kraepelin
Nineteenth Century moral treatment characterized by:
-removal of patients from “warehouse”…
Psychoanalytic Revolution
20th Century….
1. Sigmund Freud
2. Unconscious; id, ego, & superego
3. Environment = parents
5. Infancy, particularly the first five years of life; oral, anal, phallic, latency
6. -Sex & aggression
Is it fair to blame the parents as the “root cause” for the development of mental illness?
-Are there other factors to take into consideration when assessing one’s development of
mental illness- and why?
Lobotomy
Ch 7: Bipolar and Depressive Disorders
Learning Objectives; know, understand & apply…
-Major Depressive Disorder
Etiology of depression, Genetics, Environmental Factors
Treatment
-other types of depression
-Perspectives of Disorders
-Bipolar Disorder
Bipolar I, Bipolar II, Cyclothymic disorder
Genetics, Biology, Environmental Factors
Treatment
-Suicide
Rates and Cultural Considerations,
Prevention and Warning Signs
“I am a prisoner, locked up behind Xanax bars / I have just boarded a plane without a pilot”
“Black vs Gray Cloud”
Depressive Disorders
1. Not temporary
weeks, months, or years
2. Impairment, work or be with friends and/or family
6. 3. Other physical and behavioral symptoms
E.g., reduced appetite, sleep disturbance, loss of interest in usual pursuits
“Normal” Sadness
More easily shaken off
Less severe
No/minimal physical/behavioral symptoms
What are they feeling? Depression?
Heads Up, Class Activity
I) Major Depressive Disorder
i) Characteristics
Diagnostic Criteria (DSM-V) see posted files
5 or more of symptoms present for same two-wks, change, at least 1 must be #1 or #2
-Depressed mood all day
-Markedly diminished interest & pleasure in activities
-Significant weight loss or gain (40% gain)
-Insomnia or hypersomnia
-Psychomotor agitation or retardation
-Fatigue or loss of energy nearly every day
-Feelings of worthlessness or excessive or inappropriate guilt nearly every day
-Diminished ability to concentrate nearly every day
-Recurrent thoughts of death, suicidal ideation
Episodic disorder; from single to multiple
1 episode two weeks or more; impairs function
16% one episode; recurrent
ii) Familial Connections
intergenerational transmission depression
Offspring of depressed people have 5 times the risk of depression
People who develop depression have higher levels of anxiety prior to puberty
Familial major depressive disorder has earlier onset, is more severe, is less responsive to
treatment
iii) Developmental Aspects
Rise in adolescence; after adolescence, females > males (2-1)
Shows in physical symptoms in children
Areas of the brain linked to cognition are different in depressed adolescents
iv) Comorbidity; anxiety, substance abuse
Perspectives, Models, Theories
Psychodynamic Theories
Biological Models
Existential/Humanistic Theories
Behavioral Theories
Cognitive Theories
Sociocultural Theories
7. 1) Psychodynamic Theories
Freud
Normal/abnormal behaviors unconscious forces
Early childhood; unresolved conflict
Abn behaviors fr dysfunctional relationships
- Defense mechanisms; way to prevent or cause abnormal behavior
- Rx options: dream analysis, psychoanalysis, insight therapy…
-Defense mechanisms; prevent & cause…
-repression
-sublimation
-displacement
-projection
-reaction formation
-insight, bringing patterns of behavior, feelings, & thoughts into awareness
2) Psychological Treatment:
Emotion-Focused Therapy (EFT)
experience past emotional experiences
don’t avoid them!
change
process memories, in present
identify maladaptive emotions
depression, “bad” sense of self…
feel ashamed, EXPERIENCE IT!!...
…rather than name/categorize it
Emotions, not cognitions
develop emotional intelligence
effective when person functional
Therapy specific to the individual
-critical, felt like failures
-felt abandoned and sad
-felt empty, aimless
…effective
2) Psychological Treatment:
Psychodynamic therapy
Role of insight; past & present…patterns
-how depressive symptoms related to past experiences
-client’s behavior/relationships, how contribute to depression
-helpless
-dependent/responsible
-anger
Where did the depression come from?
-experiences w/loss or disappointment?
-critical parents? Negative relationships?
8. - Freud’s Mourning and Melancholia
“Anger turned inward”
Play dysfunctional relationships out
in safe place!!!
Role of transference
Play out past conflicts in therapy
-significant others
EX: critical upbringing;
never succeed/never fail
Which psychological treatment most effective? Why?
how thoughts can change brain….
V) Biological Treatments
-direct manipulation of brain
-psychotropic medications
1) Medications; 2 types
Old generation (50’s/60’s)
Tricyclic & MAO inhibitors
i) MAO inhibitors, “monoamine oxidase…”
-Inhibits enzyme breaks down “feel good” neurotransmitters
Disadvantage; no food w/tyramine, hbp…
Side effects; dizziness, dry mouth, constipation, etc…not the first choice!
ii) New generation
-“Prozac”; SSRIs; more serotonin at the synapse; and SNRIs
ease of use, overprescribed…
don’t understand how they work
-Side effects, tolerate
-Youth, suicide, “black box” warning
mismatch, physical energy & mood
2) Electroconvulsive Therapy (ECT)
-treatment resistant depression
History of concerns!!
-violent seizures, injuries, bilateral electrodes, memory loss
-now, muscle relaxants and unilateral
-electrical current, seizure
-mystery
-6-12 treatments
-confused, temporary memory loss
Ch 7 Etiology & Treatments
The Etiology of Bipolar and Depressive Disorders: Biological Perspective
Genetic and family studies for bipolar disorder
Family, twin, and adoption studies support a genetic component with heritability ranging
from 59% to 87%
9. Genetic and family studies for major depressive disorder
First-degree relatives of those with depression are two to three times more likely to suffer
to depression
Heritability is about 31% to 42%
Environmental factors and life events
Major depressive disorders may be associated with stress, loss, grief, relationship problems,
occupational problems, and health challenges
Teasing apart the relationships between stressful life events and mood disorders is difficult
Genetic control of sensitivity to the environment
-Two people can encounter the same stressful life event but experience it differently
The Etiology of Bipolar and Depressive Disorders: Psychological Perspective
Psychodynamic theory – explains depression as “anger turned inward”
After a real or imagined loss
Melancholia
Depression and mania are interlinked – mania is a defense against unwanted or intolerable
depression
Attachment theory
Disruptions in attachment lead to vulnerability to depression
Treatment of Bipolar Disorder
Medications are the primary treatment
Psychological treatments
Cognitive-behavioral therapy (C B T)
-Change inappropriate or negative thought patterns and behavior (journal); precursors,
mood shifts, seek treatment, reduce relapse; family based treatment
-Results of the effectiveness have been inconsistent
i) Interpersonal and social rhythm therapy (I P S R T)
-Adherence to regular daily routines
- based on Interpersonal therapy with social zeitgeber hypothesis “time givers”; loss leads
to unstable rhythms; sleep, physical activity
Biological treatments
-Lithium most commonly used medication
-until recently, did not know how it works
-Modulates glutamate levels; too much/too little
-Intended as long-term therapy; problems, euthymic…relapse
Anticonvulsant medications in combination with lithium
Electroconvulsive therapy (ECT)
-Used when medication and psychotherapy are ineffective, in high suicide risk, or when
medication is contraindicated
