Anxiety Disorders Flashcards
What are the three overarching groups of DSM 5 Anxiety related disorders?
Anxiety disorder
Obsessive compulsive disorders
Trauma & stress related disorders
Medical conditions that mask as anxiety.
Common causes….
Hyperthyroidism,
Cardiac arrythmias,
Seizure disorders,
Vestibular dysfunction
Less common..
Hypothyroidism
Phaeochromocytoma,
PE
Cushings syndrom,
Menopause
Electrolyte disturbances
Drugs & substances that can mask as anxiety
Benzo / alcohol withdrawal,
Intoxication,
Decongestants (beta-adrenergic inhalers)
Caffine effects ie coffe / energy drinks / supplements.
What are the common physical signs of anxiety
- Sweating
- Heart palpitations / racing
- tightness in the chest,
- Stomach discomfort
- Restlessness
What is the difference between fear and anxiety?
Fear is sudden onset and typically directed towards a specific external threat.
Anxiety is an internal response to an anticipated threat which is diffuse and vague in emotion (apprehension / tension) which is commonly accompanied by physical symptoms:
* sweating
* palpitation
* tightness in the chest
* stomach discomfort
* restlessness.
Individuals experience of anxiety includes four facets.
- Physiological experience (tachycardia, sweating, stomach discomfort, muscle tension).
- Cognitive experience (forgetfullness, reduced concentration, fear of losing control, catastrophising, sense of doom).
- Emotional experience (guilt, worry, fear, anger).
- Behavioural experience (avoidance, pacing, fidgeting, hyperactivity, trembling voice, language impairment).
What is the most common anxiety disorder?
Generalised anxiety
What is required to diagnose general anxiety?
- Anxiety cannot be explained by anyother medical condition or medication / substance.
- Anxiety in interferring with the individuals functioning (work, school, home).
- The individual is experiencing three or more of the following symptoms for 6 months or more:
1. Restlessness,
2. Fatigue,
3. Reduced concentration,
4. Irritability,
5. Muscle tension, and / or
6. Difficulty sleeping.
For a diagnosis of generalised anxiety disorder an individual must be experiencing three or more symptoms for 6 months or more.
What are the symptoms
- Restlessness,
- Fatigue,
- Reduced concentration,
- Irritability,
- Muscle tension, and / or
- Difficulty sleeping.
RFCIMS
What are the primary treatments for generalised anxiety.
- Psychological: CBT++
- Pharmacological
- SSRI’s,
- SNRI’s,
- Tryciclics,
- Benzos - last resort & limited use
- Lifestyle - limit alcohol and drugs, good sleep hygine, exercise, healthy diet, medication/ mindfullness /yoga etc.
*NOTE early & transient side effects of increased anxiety and insomnia can occur in SSRI’s and SNRI’s - therefore titrated dose required.
In addition to generalised anxiety symptoms
(restlessness, reduced concentration, muscle tension, fatigue, irritability and difficulty sleeping…
what is unique about agoraphobia?
Agoraphobia is unique in that the anxiety is focused around a specific trigger (at least two of the following):
1. Leaving the house alone,
2. Standing in lines or crowds,
3. Traveling on public transport,
4. Being in open spaces (parks),
5. Being in enclosed spaces (lifts / cinemas.
In addition to generalised anxiety symptoms (restlessness, fatiuge, reduced concentration, difficulty sleeping, muscle tension and irritability), what is unique to* social anxiety disorder*?
Anxiety is usually focused on situations where they feel they will be judged by others and individuals can be specifically sensitive to rejection.
In addition to the symptoms of generalised anxiety disorder (restlessness, fatigue, irritability, sleep difficulty, reduced concentration and muscle tension) what is unique about specific phobias?
The symptoms are arise in conjunction with a specific trigger (topic of phobia ie spiders).
In addition to the symptoms of generalised anxiety disorder (restlessness, muscle tension, fatigue, irritability, difficulty sleeping and reduced concentration) what is unique about panic disorder?
Panic disorder can be diagnosed if the condition is not better explained by generalised (or another) anxiety disorder and if the individual experiences four of the following in an episode (usually 20mins):
* palpitations,
* sweating,
* SOB / dyspnoea,
* trembling,
* paresthesias (pins and needles)
* chest pain,
* throat tightening,
* nausea,
* dizziness,
* hot flushes / chills
* fear of dying,
* fear of losing control, and / or
* feelings of detachment / loss of reality.
In addition to the symptoms of generalised anxiety (restlessness, irritability, fatigue, reduced concentration, difficulty sleeping and muscle tension) what is unique about separation disorder?
The anxiety centers around separating from or anticipating separating from a person of significance to the individual.
