Anxiety Flashcards
What is the least restrictive environment?
each patient needs to be in the safest and least restrictive environment
What are risk factors for mental and physical illnesses?
-early environment
-genetic predisposition
-psychosocial distress
-behavioral issues
-neural responses to threat
What is the pathophysiology of anxiety?
fear/anxiety in the amygdala and hypothalamus cause changes in the hypothalamic-pituitary-adrenal axis (HPA), which results in hormone release, leading to SNS
amygdala circuit->stress response->anxiety->avoidance
What is the purpose of anxiety?
It is adaptive and used to keep us safe
What is the worry loop called?
Cortico-striato-thalamo-cortical circuit
When does anxiety defined as a disorder?
-feelings of anxiety occur at inappropriate times or situations
-the frequency of anxiety increases
-the intensity of anxiety affects a person’s ability to function
-the duration of anxiety becomes increasingly prolonged
Risk factors for anxiety?
-genetic predisposition
-environmental factors
-brain chemistry imbalances
-medical conditions
Are females or males diagnosed more?
females
Symptoms of mild anxiety?
-sharpened senses
-increased motivation
-alert
-restless
-butterflies
-irritable
-hypersensitive to noise
What are symptoms of moderate anxiety?
-selectively attentive
-perceptual field limited to the immediate task at hand
-can be redirected
-muscle tension
-diaphoresis
-dry mouth
-headache
-pounding pulse
-GI upset
-increased nervous mannerisms
What are symptoms of severe anxiety?
-perceptual field reduced to one detail or scattered details
-cannot complete tasks
-cannot solve problems or tasks
-behavior geared toward anxiety relief
-chest pain
-doesn’t respond to redirection
-ritualistic
-feels awe, dread, or horror, etc.
What are symptoms of panic anxiety?
-perceptual field reduced to focus on self
-distorted perceptions
-loss of rational thought
-possibly suicidal
-can’t communicate verbally
-delusions or hallucinations are possible
What is state anxiety?
can be circumstantial, environment, new transition in life
What is trait anxiety?
some people might just naturally have more anxiety
What are the heritability rates of anxiety?
30-50%
What brain chemistry imbalances can lead to anxiety?
-serotonin, norepinephrine, and GABA
What is Beck’s theory of anxiety?
thinking distortions and negative self talk
What is Freud’s theory on anxiety?
id, ego, superego, and the use of defense mechanisms
What is OCD?
obession-recurrent and persistant thoughts, urges, or images
compulsions-repetitive behaviors or mental acts that indicidual feels drive to perform
ritual-act of doing the compulsion
What is social anxiety?
fear provoked by exposure to a social or performance situation
What are risk factors or social anxiety?
-childhood experience
-shyness has a 2x genetic risk of transmission
What are panic attacks?
sudden onset of extreme apprehension or fear usually associated with feelings of impending doom
What is a phobia?
-persistent irrational fear of specific object, activity, or situation that lead to avoidance and panic
What is generalized anxiety?
worry that is out of proportion to true impact of events
What are some common names of SSRIs?
Prozac, Lexapro, Zoloft
What are some examples of SNRIs?
Effexor and Cymbalta
What are benzos? examples?
they are short term, highly addictive, sedation, and decreased cognitive fx
MOA:enhance GABA inhibitory effects in CNS
Alprazolam, Dieaxepam, lorazepam
What are atypical anxiolytics? examples?
MOA: binds to serotonin and dopamine receptors
advantages: less potential for dependency, no sedation
key consideration: slow onset of action (1-4)
example: Buspirone
What are key considerations of using SSRI?
sexual dysfunction and risk of serotonin syndrome
What are key considerations for SNRI?
potential for HTN and sexual dysfunction
