Anxiety Flashcards
what are the components of anxiety
physical/biological
cognitive
behavioural
list biological/physical symptoms of anxiety
tremor/shaking difficulty breathing tight chest tingling/numbness muscle aches/tension headache palpitations hyperventilation dizziness dry mouth nausea sweating flushing globus hystericus
list cognitive symptoms of anxiety
fear of losing control and feeling on edge meta worry difficulty concentrating depersonalisation derealisation hypervigilance preference for order and routine racing thoughts hypochondriosis
list behavioural symptoms of anxiety
avoidance social isolation alcohol/drug misuse checking behaviours exaggerated startle response restlessness irritability seeking reassurance
list the anxiety disorders
Generalised anxiety disorder GAD Panic disorder Agoraphobia Social phobia Specific phobias Obsessive Compulsive Disorders OCD
what is GAD
generalised and persistent anxiety
“free floating”
worried about lots of different things
not due to any substance misuse or any other medical condition
epidemiology of GAD
onset 20-40 yo
chronic fluctuating course
F>M
a lot of comorbidity
management of GAD
1st = CBT
SSRI/SNRI, pregabalin, BZD
when can benzodiazepines be given for anxiety disorders
acutely only!
for symptomatic relief
how severe should symptoms be for it to be classified as GAD
long lasting - most days for 6 months
not controllable
causes significant distress and impairment in function
what is CBT based on
identifying an individual’s automatic thoughts, cognitive biases and schemas and helping to identify own thoughts, assumptions, misinterpretations which perpetuate the anxiety
what is panic disorder
recurrent attacks of severe anxiety due to an unpredictable trigger
in panic disorder there is often a secondary fear of dying, losing control or going mad, true or false
true
epidemiology of panic disorder
onset late teens-30s
comorbidities
chronic
management of panic disorder
1st = CBT
SSRI/SNRI/tricyclics
BZD short term
when is the onset of phobias and in what order
early onset
social and specific phobias = really early
agoraphobia = early
what is agoraphobia
fear of public spaces
what is the main feature of agoraphobia
avoidance is prominent
what is a specific phobia
marked persistent fear that is excessive and unreasonable from the presence of something specific
what is the difference between a phobia and just being scared of something
someone with a phobia recognises their fear is irrational
features of specific phobia
exposure to stimulus provokes anxiety response
person recognises fear is irrational
avoidance symptoms
impaired normal functioning
management of specific phobias
1st = behavioural therapy + exposure Graded exposure/systematic desensitisation if needed: CBT SSRI/SNRI
what is social phobia/social anxiety disorder
fear of social scrutiny
fear of acting in a way that is embarrassing
features of social phobia
blushing shaking fear of vomiting fear of micturition/defaecation poor school/employment performance avoid new situations
management of social phobia
1st = CBT
SSRI/SNRI
BZD
what is obsessive compulsive disorder OCD
recurrent obsessional thoughts +- compulsive acts
features of obsessional thoughts in OCD
ego-dystonic ie cause discomfort thinking about them
recognised as the patient’s own thoughts
features of compulsive acts in OCD
repeated rituals or stereotyped behaviours
not enjoyable or functional
recognised as pointless
“if I keep doing x, prevents something bad happening”
what are some common obsessions in OCD
contamination + dirt harm order + symmetry health sexual thoughts hoarding violence
what are some common compulsions in OCD
checking cleaning + washing repeating acts mental compulsions - words or prayers ordering + symmetry collecting counting
comorbidities with OCD
Tourettes Schizophrenia tic disorders body dysmorphic disorder eating disorders trichtillomania
Management of OCD
1st = CBT including response prevention
SSRIs / clomipramine
criteria of OCD
present for most days for at least 2 weeks AND must be a source of distress
obsessions must be own thoughts + repetitive
resistance must be present
rituals are NOT pleasant
what class of drug are benzodiazepines and what is their mechanism fo action
anxiolytics
GABA agonist (promote inhibitor effects of GABA)
Also anticonvulsants
agonising GABA results in influx of which ion
Cl- influx and hyperpolarisation
Benzodiazepines can be used long term, true or false
FALSE
only short term/acutely
side effects of benzodiazepines
addiction + abuse sedation psychomotor impairment alcohol interaction can worsen co-morbid depression
heretibility is/is not significant in OCD
is significant
what is a rumination and in which condition is it seen
repetition of same thought in your head over and over again
OCD
