Anxiety Flashcards
thalamic symptoms of anxiety?
sweating
hot flushes
cold chills
shaking
cardiac symptoms of anxiety?
palpitations
pounding heart
tachycardia
chest pain
GI symptoms of anxiety
nausea
abdo distress eg churning stomach
ENT symptoms of anxiety?
dry mouth
choking sensation
dysphagia/”lump in throat”
how could an anxiety patient describe their loss of consciousness?
dizzy
unsteady
faint
lightheaded
what is meta-worry?
worrying so much that you begin to worry about worrying
what is derealisation?
feeling that objects are unreal
cognitive symptoms of anxiety
derealisation and depersonalisation fear of losing control feeling on edge/tense problems concentrating hypervigilance racing thoughts meta-worry need for order and routine
behavioural symptoms of anxiety
avoidance of situations exaggerated response to surprises insomnia from worrying excessive use of alcohol/drugs restlessness/cant relax irritablity
the emotional filter of the brain is…
the amygdala
how does the amygdala monitor stress?
assesses whether sensory material via the thalamus requires a stress or fear response
why does acute stress increase cortisol levels?
cortisol acts to mediate the stress response so the more stress the more cortisol is needed
generalised anxiety disorder is persistent T or F
T
what symptoms are dominant in generalised anxiety disorder?7
persistent nervousness trembling muscular tensions fatigue/sleep problems sweating lightheadedness palpitations dizziness epigastric discomfort
what kind of fear tends to be expressed by GAD patients?
patient or relative will shortly become ill or have an accident
criteria for GAD?
> 6 month onset
not controllable
causes impairment in function
who gets GAD?
mainly females in their 20-40s
__% of GAD is comorbid with other psychiatric disorders
90
Tx of GAD?
CBT
SSRIs/SNRIs
pregabalin
depersonalisation and derealisation are symptoms of what anxiety disorder?
panic disorder
how does panic disorder present?
recurrent attacks of severe anxiety (panic) which are unpredictable
describe the symptoms of a panic attack
palpitations chest pain choking sensations dizziness derealisation/depersonalisation
patients experiencing a panic attack tend to have a fear of what during the attack?
theyre going to die, lose control or go mad
what is agoraphobia? what anxiety disorder can it present with?
fear of being in situations where escape might be difficult or that help wouldn’t be available if things go wrong;
panic disorder
how common is agoraphobia with panic disorder?
about 2/3 get it
age of onset of panic disorder?
late adolescence to mid 30s
treatment of panic disorder?
CBT
SSRI/SNRI/tricyclics
how should benzos be used in anxiety disorders?
short term only
phobias tend to present late/early
early
name the 3 types of phobia
agoraphobia
social phobia
specific phobia
patient presents with fear of shopping, compulsive drinking to eliminate social anxiety, hates public transport…
agoraphobia
define specific phobia
a marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of something eg heights
Tx of specific phobias?
exposure to the stimulus
CBT
SSRIs/SNRIs if required
define social anxiety disorder/social phobia
a persistent fear of one or more social situation in which the person is exposed to unfamiliar people and is worried theyll be embarassing or humiliating
symptoms of SAD?
panic attacks
blushing/shaking
fear of vomiting
urgency or fear of micturition or defaecation
consequences of SAD for the patient?
poor school performance
school refusal
poor employment Hx
Tx of social phobia
CBT
SSRIs/SNRIs
most common obsessive disorder in OCD?
contamination
most common compulsions in OCF?
checking
cleaning/washing
how to diagnose OCD?
present most days for at least 2 weeks AND be an interference with activities
mean age of onset of OCD?
20
OCD is linked to depression T or F
T
Tx of OCD
CBT
SSRIs
clomipramine
benzodiazepines ___ the effect of GABA
enhance
