11.2 anxiety Disorders Flashcards
What is anxiety?
A feeling of worry, nervousness, or unease about something with an uncertain outcome. Future focused, linked to threat.
What are symptoms of anxiety?
- Palpitations
- Sweating
- Trembling or shaking
- Dry mouth
- Difficulty breathing
- Chest pain or discomfort
- Nausea or abdominal distress (e.g. butterflies in stomach)
- Feeling dizzy, unsteady, faint or light-headed
What is the physiological role of the stress response?
Previously used to enable us to escape from potentially dangerous situations
What are the 2 main targets of the lambic system when producing the stress response?
Endocrine targets = hypothalamus
Neural targets = hippocampus, amygdala, prefrontal cortex,
Describe the role of the hippocampus in the stress response?
Relates stress response with a perceived threat/experience. Receives inputs from many parts of the cortex and processes their emotional content. Projects to the thalamus (and hence back to the cortex – the Papez circuit) and also to the hypothalamus (causing autonomic features of emotional responses). This will lead to sympathetic nervous system activation, as well as release of adrenaline from the adrenal medulla
Role in memory – Papez circuit may be involved in memory consolidation
What is the acute stress response?
Symptoms that develop after a particularly stressful event.
Caused by the release of adrenalin from the sympathetic nervous system.
Where is the amygdala located?
Almond shaped structure sittin near the tip of the hippocampus.
What is the role of the amygdala?
Receives inputs from the sensory system and is involved in behavioural and autonomic emotional responses. Major outputs to the cortex and hypothalamus
What role does the prefrontal cortex have in the stress response?
Modulation of emotional responses ( consciously suppressing features of anxiety)
Perception of emotion
What are the endocrine elements of anxiety?
The limbic system acts on the hypothalamus to activate the hypothalam-pituitary-adrenal axis. This increases the amount of cortisol released by the adrenal medulla.
Also activates the hypothalamospinal tract, increasing the stimulation of the autonomic preganglionic neurones. (Sympathetic activation)
What are the 3 stages of the general adaptation syndrome?
Stage 1: The alarm reaction. Release of adrenaline and cortisol as well as sympathetic activation
Stage 2: Resistance (effect of adrenaline starts to wear off). Chronic stress response, prolonged release of cortisol
Stage 3: Exhaustion (when you cannot escape an ongoing stressor). Chronic side effects of prolonged cortisol secretion start to occur
What are the 6 classifications of anxiety response?
Social phobia Specific phobias Generalised anxiety disorder Panic disorder obsessive compulsive disorder
What is the pathophysiology of anxiety disorders?
Unclear
Equivocal findings in studies of brain activation patterns
GABA levels appear to be low in some anxiety disorders (maybe
explaining action of benzodiazepines) Increasing serotonin levels can help treat anxiety disorders
(mechanism unclear, but hippocampus may be involved)
What are the treatments for generalised anxiety disorders?
Biological • Short term benzodiazepines • SSRIs Psychological • Cognitive behavioural therapy - Getting patients to reflect on their feelings/thoughts/behaviours Social • Support groups, charities etc
People with OCD exhibit obsessive thoughts. What dose this mean?
Thoughts that persist and dominate an individual’s thinking despite their awareness that the thoughts are either entirely without purpose, or have persisted and dominated their thinking beyond the point of relevance or usefulness
Unpleasant and repugnant, often causing anxiety
