Anxiety and Depression Flashcards
What is Social Anxiety Disorder (SAD)?
Fear or anxiety about one or more social situiations in which the invidiual is exposed to possible scrunity by others
How does an individual act if they have Social Anxiety Disorder?
Social situations are avoided or endured with marked fear or anxiety
What is the stress response?
Threatening stimulus causing fear
What does the stressor cause?
- Increased vigilance and arosual
- Increased avoidance behaviour
- Activation of the sympathetic nervous sytem
What occurs when stress is detected?
Release of corticotropin-release hromone (CRH) in the Hypothalamus
What happens in the Pituitary gland when stress is detected?
Releases adrenocorticotropic hormone (ACTH)
What happens in the adrenal gland when stress is detected?
Releases cortisol
What effect does cortisol have on the body?
- Increases smpathetic neevrous sytem activation and the associated physiological symptoms
How is the stress response regulated?
- The amygdala activates the stress response
What type of medicines are usually prescribed for anxiety and depression?
SSRI - Selective serotonin reuptake inhibitors
What is indirectly involved in anixety disorders?
Serotonin
Why do SSRIs help in anxiety disorders?
- SRIs increase density of glucocorticoid receptors in the hippocampus
- hippocampus can better modulate CRH release in the hypothalamus
- Leading to HPA axis being less activated
What type of drugs can help with serve anxiety?
Benzodiazepines
Why are GPs relcuatate to prescribe Benzodiazepines?
Highly addictive class of drug
What is GABA?
An hibitory neurotransmitter - more activity = more inhibitory effect on brain
Where does antidepressants act on?
Monoamine transmission
What is the controversy around antidepressants?
Drugs (e.g fluoxetine) are not effective for most cass of depression
What is the monoamine theory?
Depression due to underactivity of monoaminergic systems - drugss which increase transmission in this system reduce depression
What is the Neuroplasticity theory?
- Depression associated with reduced neuroplasticity
- Drug treatments like SSRIs indirectly reduce depressive symptoms (promote neuroplasticity via increased BDNF)
What are tDCS and rTMS used for?
To treat severe or treatment resistant depression
What is the cocordance rates of depression in identical twins?
60%
How many people does depression affect?
10%
What is the treatment for mild depression?
Low intensity psychotherapy
What is treatment for severe depression?
High intensity psychotherapy
What is treatment for severe unresponsive depression?
Brain stimulation
What are the 3 alterative brain stimulation techinques?
tDCs (Transcranial direct current stimulation)
rTMS (repetitive transcranial magnetic stimulation)
ECT (Electroconvulsive therapy)
What does both tDCS and rTMS cause?
Stimulation of the prefrontal regions of the cortex
What are structural differences in depression in the brain?
- Reduction in grey matter volue in key regions
(e.g PFC, OFC, ACC< amygdala, hippocampus in depression)
What are the functional differences in an individual with depression in the brain?
- Reduced activity in dIPFC, vIPFC, mPFC (controlled related regioins)
- Increased activtiy in ACC, amygdala, insula (emotion related regions)
What are cognitive effects of dpression?
- Bias towards negative thinking
- Struggle on tasks requiring execution
