Anxiety Flashcards
What are the physical symptoms of anxiety?
Sweating, hot flushes, cold chills, trembling or shaking
Muscle tension, aches/pain, numbness or tingling
Dizziness, unsteadiness, palpitations or racing heart
Dry mouth, feeling of choking, globus or dysphagia
Difficulty breathing, chest pain or nausea
What are the cognitive symptoms of anxiety?
Fear of losing control or dying
Feeling on edge or tense and hypervigilance
Difficulty in concentrating or racing thoughts
Feeling that objects are unreal and depersonalisation
Metaworry and health anxiety
Beliefs about importance of worry
Preference for order and routine
What are the behavioural symptoms of anxiety?
Avoidance of certain situations Exaggerated response to minor surprises Difficulty sleeping due to worry Excessive use of alcohol or drugs Restlessness and inability to relax Persistent irritability Seek reassurance and checking behaviours
What does exposure to stress result in?
Instantaneous and concurrent biological responses
What does the amygdala act as?
Emotional filter of brain for assessing whether sensory material via thalamus requires stress response
What does acute stress lead to?
Dose-dependent increase in catecholamines and cortisol
What acts to mediate the stress response?
Cortisol = acts on pituitary, hypothalamus, hippocampus and amygdala via negative feedback
What are some examples of anxiety disorders?
Generalised anxiety disorder, panic disorder, agoraphobia, social phobia, specific phobia
What is generalised anxiety disorder?
Anxiety that is generalised and persistent but not restricted to particular environmental circumstances
What are the symptoms of generalised anxiety disorder?
Persistent nervousness, trembling, muscular tension, sweating, lightheadedness, palpitations, epigastric discomfort
What are some features of generalised anxiety disorder?
Express fears that they or a relative will shortly become ill or have an accident
Must be long lasting = most days for at least 6 months
Must be uncontrollable and causing significant upset
How common is generalised anxiety disorder?
Lifetime prevalence of 9%
Twice as common in women
Typical onset between age 20-40
How common are comorbidities with generalised anxiety disorder?
90% of cases are comorbid with other psychiatric disorders
How is generalised anxiety disorder treated?
CBT, SSRIs or SNRIs, pregabalin, benzodiazepines for short term
What is panic disorder?
Recurrent attacks of severe anxiety not restricted to any particular situation and are therefore unpredictable
What are the symptoms of panic disorder?
Sudden onset palpitations, chest pain, choking sensation, dizziness, depersonalisation or derealisation
What are some secondary fears that occur in panic disorder?
Secondary fear of dying, losing control or going mad
How common is agoraphobia in panic disorder?
50-67% of panic disorder patients will have agoraphobia
How common is panic disorder?
Lifetime prevalence of 2-3%
Typical onset in late adolescence to mid 30s
Not due to direct physiological effects of substance or medical condition
What are some comorbidities of panic disorder?
Other anxiety disorders, depression and substance misuse
What can trigger panic disorder in susceptible individuals?
Infusions of lactate or rebreathing air
What does a PET scan of patients with panic disorder show?
Increased metabolism in the anterior pole of the temporal lobe
What are some treatments for panic disorder?
CBT, SSRIs or SNRIs, tricyclics, benzodiazepines for short term
When do phobias present?
Typically early onset
Agoraphobia = 50% presented by 20s and 75% by early 30s
Social/specific phobia = 80% presented by early adolescence and 75% by early 20s
