anxiety and stress related disorders Flashcards
stress related to positive things in our life
*engagements while in school, new job, pregnancy
eustress
negative stress
distress
psychological stress
feelings of guilt, joy
spiritual stress
our faith has been challenged and begin to exam all of our beliefs and whatever higher being we look to, also questioning our reason being here
physical stress
exercise, surgeries creating pain, homeless people, people who are ill
psychosocial stress
loss of support system or don’t have a support system, if we lose our status at place of employment, if something challenges our self esteem
when people use defense mechanisms what are they doing
helping relieve anxiety r/t stressors
*to cope with stress and anxiety
what techniques are used to manage stress
relaxation techniques reframing/decatastrophizing sleep physical exercise reduced caffeine
what is the physiology of street/anxiety
amygdala sends to hypothalamus that there is a threat, the hypothalamus engages the sympathetic and parasympathetic, the SNS releases epinephrine, HR respirations BO all elevate, as adrenaline subsides and stress is prolonged then hypothalamus release ACTH which travels to adrenal glands and releases cortisol (the primary stress hormone), PNS takes over and cortisol levels drop returning to normal hopefully
in anxiety disorders what neurotransmitter is decreased
serotonin thats why we give SSRIs because its a serotonin reuptake
stress disorders have a ____ and that _____ is an exposure to an actual ______
cause; cause; trauma
exposure to actual or threatened death, injury, or sexual violence presence of intrusion symptoms avoidance of associated stimuli neg alterations in mood hypervigilant, hyperaroused *symptoms last longer than one month and watch for suicidal ideation
post traumatic stress disorder
what meds are given for PTSD
SSRIs and others to treat target symptoms like psychosis
for dx criteria, what is the difference between PTSD and acute stress disorder
PTSD symptoms last longer than a month for acute stress the symptoms resolve within 1 month and will see depersonalization and derealization more
what is the tx for acute stress disorder
may resolve on own in a month
benzos prn for severe symptoms (short term and fast acting)
also telling story of what happened can help
what anxiety disorders are we talking about
agoraphobia, socio anxiety DO, specific phobia DO, panic DO, OCD, GAD
state of heightened awareness, but still able to work, learn and solve problems.
*us going into an exam
mild anxiety
*foot or finger tapping, lip chewing, fidgeting
narrowed perceptual field, selective inattention, less able to problem solve, HR and RR are up, somatic complaints
moderate anxiety
perceptual field very limited, scattered attention, distorted perceptions, lessened problem solving ability, tunnel vision and more intense somatic complaints
severe anxiety
unable to focus on environment, feeling of doom, disorganized thinking, no problem solving, emotional paralysis irrational
panic level anxiety
*dilated pupils, unintelligible communication
reoccurring unexpected panic attacks
followed by at least 1 month of fear of reoccurrence or maladaptive change in behavior
R/O drug induced factors
often comorbid with agoraphobia and depression
panic disorder
what is the tx for panic disorder
CBT reframing
and benzos and antidepressents
persistent and irrational fear of specific object or activity
has to result in AVOIDANCE behaviors
*go to extreme measures to avoid something
phobic DOs
marked fear of 2 or more of 5 situations
fear is disproportionate to the risk of danger
fear causes distress or impairment
agoraphobia
*assertiveness training works well
what are the 5 situations of agoraphobia
public transportation, being in an open space, closed space, being in a crowd, or being outside the home alone
what is the primary gain of agoraphobia
they don’t have to deal with anxiety if they had left
what is the secondary gain of agoraphobia
someone else takes care of their necessities, buying groceries, they come to you
fear of rejection by others
fear of exposure to social or performance situations
DO causes disruptions in life
social anxiety DO
*social skills training works well
fear of one or more specific objects or situation
*fear of heights, closed spaces, spiders etc
specific phobias
*best treated with behavioral therapy
excessive worry/ anxiety on more days than not for greater than 6 months
cannot control worry
causes disturbances in personal, scholastic, or employment performance
often cormorbid with depression/panic disorder
generalized anxiety disorder GAD *buspirone works well for chronic CBT stress mngt physical activity
symptoms are direct result of medical condition
*COPD, Parkinson’s, metabolic disorders, hyperthyroidism
anxiety r/t other medical conditions
presence of obsessions, compulsions or both
unable to ignore or suppress thoughts or actions
*obsessions and compulsions are time consuming > 1hr a day
OCD
reoccurring and persistent thoughts, urges or images which are unwanted and intrusive causing distress to the individual
obsessions
repetitive behaviors that the individual is compelled to perform in response to related obsession
- aim is to alleviate anxiety
- these are the actions
compulsions
what are the tx for OCD
exposure/ response prevention
and SSRIs
