Anxiety 1 Flashcards
What are some physical manifestations of anxiety?
- diaphoresis, mydriasis, tachycardia, tremor
- diarrhea and inc urination
- dizziness, syncope, parathesia
psych: restlessness, irritability, trouble concentrating, worry
Withdrawal from what medications can cause symptoms that appear similar to anxiety?
alcohol, benzos, opiates
What are some medical causes of symptoms that resemble anxiety?
- hyperthyroidism
- arrythmia
- hypoglycemia
- pheochromocytoma
- vit B12 deficiency
- asthma, COPD
- MI
- PE
symptoms of anxiety must be present for how long?
> 6 months
How does gender affect the risk of anxiety?
women are more common in men in all except OCD
-equal for OCD
What NTs are affected in anxiety?
decreased: serotonin, GABA
increased: NE, Glutamate
In addition to excessive anxiety occuring more days than not for >6 mos about >1 event, Generalized anxiety Disorder is associated with what symptoms? How many must be present?
> 3 of:
- restlessness
- easily fatigued
- difficulty concentrating
- irritability
- muscle tension
- sleep disturbance
If GAD isn’t treated, does the patient typically get better or worse?
worse!
What kind of therapy should you use with patients who have GAD?
cognitive behavioral therapy
What medications would you use to treat GAD?
SSRIs, SNRIs
Buspirone - 5HT1a agonist
Benzos
Are beta blockers used to treat anxiety disorders?
ONLY performance anxiety
In order to diagnose someone with panic disorder, they need to have how many symptoms and which?
> 4 of:
- palpitations, heart pounding, accelerated ht rate
- sweating, trembling, SOB, choking, chest pain
- nausea, dizziness, light headedness
- chills or heat
- paresthesias
- derealization - out of body
- fear of losing control
- fear of dying
-need BOTH physical and psych
How would you diagnose someone with panic disorder?
> 1 attack followed by >1 month of >1 of the following:
- concern about additional attacks, consequences
- significant maladaptive change in behavior
How would you diagnose someone with agoraphobia?
> 3 of:
- fear of using public transportation
- being in open spaces
- being in enclosed spaces
- standing in lines
- being outside the home alone
- fear of not being able to escape
- avoids these situations
- fear is out of proportion to actual danger
How long do the symptoms of agoraphobia need to persist for?
> 6 months
What kind of therapy would you use for a patient that has panic disorder?
CBT
systemic desensitization or flooding
What are the medications used to treat panic disorder?
- emergency - fast acting benzos - alprazolam
- first line long term: SSRI/ SNRI
- Benzos
How would you diagnose someone with a phobia
- symptoms have lasted >6 mo
- causes significant impairment
- marked fear/anxiety about specific object/situation
- actively avoids situation
- fear is out of proportional to danger
What is the therapy for phobias?
CBT
systemic desensitization
flooding
What is the questionable treatment used for phobias?
benzos
How would you diagnose someone with social anxiety disorder?
> 6 months
- causes significant impairment
- marked fear when exposed to social situation
- fear of acting in ways that will be scrutinized
- social situation provokes fear
- avoids social situations
- fear is out of proportion to actual threat
What are the therapy strategies used on patients with phobias?
CBT
assertiveness training
group therapy
What meds are used to treat patients with phobias?
SSRI/SNRI
MAOIs
beta blockers - only for performance induced
are phobias more common in men or women?
women
