Anxiety Flashcards
what happens in the stress response?
exposure to stress results in instantaneous and concurrent biological responses
- assess danger and organise a response
amygdala acts as emotional filter for assessing whether sensory material via the thalamus requires a stress or fear response
this is modified by later-received cortically processed signal
there are a series of responses to the stressor prior to the point at which stimulation of the adrenal gland causes the release of cortisol
categories of pathological anxiety disorder?
in extent (more extreme anxiety than normal) In context (anxiety in situations what don't require it)
types of anxiety disorder?
generalised anxiety disorder panic disorder agoraphobia social phobia specific phobia OCD
describe generalised anxiety disorder
anxiety that is generalised and persistent but not restricted to any particular environmental circumstances
people commonly express fear that patient or relative will soon become ill/ijured
criteria for GAD?
severe enough to be
- long lasting (most days for 6 months)
- not controllable
- causing significant distress/impaired function
clinical features of GAD?
onset usually between 20-40
chronic, fluctuating course
more common in females
90% have other psychiatric disorders
how is GAD managed?
CBT
SSRIs/SNRIs
pregabalin
benzodiazepines (Only in short term acute management)
what is CBT?
based on identifying an individuals automatic thoughts, cognitive biases and schemas
helps the individual identify thoughts, assumptions, misinterpretations and behaviours that reinforce and perpetuate the anxiety
describe panic disorder
recurrent attacks of severe anxiety (panic) which are not restricted to any particular situation or set of circumstances and are therefore unpredictable
dominant symptoms of panic disorder?
sudden onset of palpitations chest pain choking sensation dizziness feelings of unreality can often have secondary fear of dying, losing control or going mad
what causes panic disorder?
may occur with or without agoraphobia
not due to direct physiological effects of substance/drug or medical condition
not due to another mental disorder
essential clinical features of panic disorder?
50-67% have agoraphobia
onset usually late adolescence - mid 30s
chronic waxing and waning course
often have comorbid disorders (anxiety, depression, drug and alcohol misuse)
biology of panic attacks?
can be triggered in susceptible individuals by infusions of lactate (muscle activity) or by re-breathing air (increased CO2)
PET shows increased metabolism in anterior pole of temporal lobe (parahippocampal gyrus)
how is panic disorder managed?
CBT
SSRIs/SNRIs/Tricyclics
benzodiazepines (acutely)
3 types of phobia?
agoraphobia
social phobia
specific phobia