Anxiety Flashcards
List 5 physical symptoms of Anxiety.
- light headedness
- dry mouth
- palpitations
- lump in throat- difficult to breathe or swallow
- nausea or abd. pain
(chest pain, choking muscle ACHES)
What are 5 cognitive symptoms of Anxiety?
- fear of LOSING control
- mentally tense
- loss of concentration
- Derealization (objects feel unreal)
- Depersonalization
(racing thoughts. met-worry, hypervigilance)
What are 5 behavioural symptoms of Anxiety?
- avoidance
- EXAGGERATED response to MINOR surprises
- unable to fall asleep (too worried)
- excessive use of DRUGS/ ALCOHOL
- irritable
(can’t relax)
What is the role of the Amygdala in the stress response?
- acts as the EMOTIONAL filter of the brain for assessing whether sensory material (via the THALAMUS) requires a STRESS or FEAR response
What sites in the brain are responsible for the release of Cortisol by the Adrenal gland?
- Pituitary
- HYPOTHALAMUS
- hippocampus
- amgydala
- —cortisol THROUGH NEGATIVE FEEDBACK will act on ALL these sites
When is anxiety considered as a disorder? (2)
- when the symptoms of anxiety are MORE extreme than normal
- when they occur in an otherwise not anxiety provoking situitation
- a disorder when it causes SIGNIFICANT DISTRESS to social/occupational function
What does a pt with Generalized Anxiety Disorder experience? (3)
- PERSISTANT and generalized anxiety (“free floating”)
- typical anxiety symptoms
- constant fear of loved one falling ill/getting in an accident
What is the criteria for GAD to be diagnosed?
- should be LONG LASTING (most days for at least 6 months)
- no control
- impairs normal function
What are the physical symptoms seen with Generalized Anxiety D.O?
- restlessness
- easily fatigued
- irritable and muscle TENSION
- SLEEP disturbance
- hard to concentrate
Which demographic group is predominantly affected by GAD?
- 20-40 y.o FEMALE
90% of GAD cases have other co-morbidities. Name a few.
- depression
- substance abuse
- other anxiety disorders
What is the treatment for GAD?
- SSRIs is first line; esp. SERTALINE
- CBT
- Pregabalin
- Benzodiazepines for short-term use during CRISISES
What occurs in CBT ?
-it is an evidence based PSYCHOLOGICAL treatment
- based on identifying the pt’s THOUGHTS, COGNITIVE biases and schemas
-
What are schemas?
- an avalanche effect of how people with GAD have this tendency of having negative thoughts ONE after the OTHER.
How is a Panic disorder diff.?
- RECURRENT, Unexpected attacks of SEVERE anxiety
- holds the same physical symptoms of anxiety ( dizziness, chest pain, palpitations, feelings of unreality )
What is common between GAD and Panic disorder?
- similar symptoms
- both NOT due to substance misuse or other medical condition (hyperthyroidism, caffeine intoxic)
What are some ESSENTIAL clinical fts of Panic Disorder? (3)
- 50-67% also have AGORAPHOBIA
- onset late ADOLESCENCE-MID 30s
- high prevalence in cardiology clinic
What are the co-morbidities of Panic disorder?
- depression
- drug and ALCOHOL misuse
-other anxiety d.os
How may panic attacks be triggered?
- in susceptible individuals by INFUSIONS of lactate
- by re-breathing AIR (more CO2)
What is seen on the PET scan during panic attacks>
- increased METABOLISM of the ANTERIOR pole of the TEMPORAL lobe
- parahippocampal gryus
How do you treat panic d.o?
- SSRIs/SNRIs/TRICYCLICS
- CBT
-BENZOs (for panic crisis)
What are the 3 forms of phobias?
- Agoraphobia
- Social Phobia
- Specific Phobia
At what age, do half the cases of agoraphobia present in patients?
50% presents by 20
75% BY EARLY 30s
At what age do social phobias become more apparent?
- 80% by early adolescence
- 75% by early 20s
