Anxiety and Depression Shit Flashcards
“emotional brain”
limbic system: appraisal, response, reversal of arousal
GABA dysfunction in anxiety
GABA calms.
GABA release from post-synaptic sites = anxiety
5HT dysfunction in anxiety
5HT tends to be excitatory (can be either).
increased 5HT, decreased 5HT1
low levels = serotonin reuptake inhibitors to allow more serotonin to be available
NE dysfunction in anxiety
malfunctioning system = decreased arousal
increased HR, O2 use, midbrain activity = NE release
increased NE = excitatory = anxiety
panic disorder is
recurrent, unexpected panic attacks
at least 1 of the attacks is followed by:
– persistent worry about more attacks
– worry about implications/consequences
less of a stressor triggers NE
50% before age 24, 2x women
comorbidity with depression, substance abuse
30% develop agoraphobia
1 medication for panic attacks & why
tricyclic antidepressants, because of effect on NE
(or SSRI ok too)
beta blockers not helpful for panic attacks
1 non-pharm treatment for panic attacks
SAFETY. CBT.
specific phobia is
x2 women, high proportion of men seek help
typically young when manifested, rarely > 25
comorbid with depression (25%), substance abuse
phobia receptor
primarily GABA
social anxiety disorder (social phobia)
is a specific phobia
beta blockers help
phobia pharm
benzos, beta blockers, SSRIs
ocd categories
obsessive compulsive disorder
body dysmorphic disorder (somatic symptom disorder)
hoarding
hair pulling, skin picking , etc
NOT same as obsessive compulsive PERSONALITY disorder
ocd is
difficulty planning because of poor thought filter; compulsions used to deal with anxiety
obsessions: thoughts, compulsions: behavior
primarily 5HT, basal ganglia, cingulum (limbic), smaller caudate size
ocd non-pharm treatment
behavioral therapy
ocd pharm treatment
luvox (fluvoxamine) + other SSRIs
TCAs
generalized anxiety disorder
“chronic” anxiety
likely 5HT
a. Excessive anxiety (worry) for at least six months about a number of events or activities
b. The persons finds it difficult to control the worry c. Three or more of the following symptoms:
(1) Restlessness/feeling keyed up-on edge
(2) Easily fatigued
(3) Difficulty concentrating - “mind going blank”
(4) Irritability
(5) Muscle tension
(6) Sleep disturbance
gad non-pharm
EXTREMELY effective
CBT, cognitive reframing, stress management, lifestyle mod, support groups
gad pharm
buspar, valium, TCA, SSRI
too little 5HT
depression
slightly elevated 5HT
anxiety
too much 5HT
serotonin syndrome, cardiac shit
serotonin syndrome s/s
fever, tremor, coma, seizures, death
