Anxiety Flashcards
What hormone is important in the stress response?
Cortisol
What does chronic stress lead to?
Chronic raised cortisol - can damage the hippocampus.
What is pathological anxiety?
Anxiety to such an extreme that it exceeds normal, or is present in a situation where it is not needed.
Is anxiety normal?
Yes, it is a natural response to a stressful situation.
What is generalised anxiety disorder (GAD)?
Anxiety which is generalised and persistent but not fixed (said to be free-floating).
What is commonly seen in GAD?
A fear of the future.
When is GAD not diagnosed?
If there is a co-morbid condition or substance misuse.
How long must symptoms persist for a diagnosis of GAD?
Atleast 6 months.
What is the first-line treatment for GAD?
Psychoeducation/CBT
If therapy fails, what is given in GAD?
SSRIs, SNRIs or Pregabalin.
Benzodiazepines can also be given short term.
How long is GAD drug therapy continued for?
Atleast 18 months - review after 12 weeks.
Gradually reduce dosage prior to cessation.
What is panic disorder?
Anxiety that occurs for a short period of time only - it is intense in nature.
Is panic disorder predictable?
No
What is agoraphobia?
Avoidance of places/situations that may cause anxiety.
What age group is most commonly affected by panic disorder?
Young people.
It is not caused by a medical condition or drug therapy.
Is there a genetic link to panic disorder?
Yes
How is panic disorder treated?
Mild cases- self help.
Moderate/Severe cases - treat with CBT/medication.
What drugs are used to treat panic disorder?
SSRIs SNRIs Pregabalin Tricyclics Benzodiazepines (short term)
How long is treatment continued for in panic disorder?
6 months
What is a phobia?
Fear characterised by avoidance and anticipatory anxiety.
Patient will know their fear is irrational.
How is phobia treated?
Behavioural exposure therapy (may also have CBT).
What is social anxiety disorder?
A persistent fear of scrutiny from a small group. Terrified of being humiliated.
How is social anxiety disorder treated?
CBT
SSRIs, SNRIs or MAO inhibitors.
Benzodiazepines can be given for short-term relief.
What is OCD?
A disorder of obsessional thought and/or compulsive acts.
Tends to run in families.
What are common co-morbidities of OCD?
Schizophrenia
Tic disorders
Eating disorders
Depression
How is OCD treated?
CBT
If unresponsive, give SSRIs or clomipramine (can be augmented by citalopram therapy).
How are thoughts experienced in OCD described?
Ego-dystonic
Unpleasant to the individual experiencing them.
What are the 2 core symptoms of anxiety?
Fear
Worry
