Anxiety disorders Flashcards
What is the physiological role of anxiety?
- The stress response enables us to escape from potentially dangerous situations
- It is primarily mediated by the limbic system, which has neural and endocrine targets
What are the structures of the limbic system?
- Hippocampus
- Amygdala
- ## Prefrontal cortex
What is the role of the hippocampus in coordinating the stress response?
- Receives input from many parts of the cortex and processes their emotional content
- Ultimately projects to the thalamus and hypothalamus
- Role in memory
What does the projection of the hippocampus to the hypothalamus mean?
- This causes autonomic features of emotional responses
- Since hypothalamus sends projections down through the cord to autonomic preganglionic neurones (hypothalamospinal tract)
- This will lead to sympathetic nervous system activation, as well as the release of adrenaline
Describe the amygdala
- Almond shaped structure sitting near the tip of the hippocampus
- Receives many inputs from the sensory system
- Major outputs to cortex and hypothalamus
- Involved in behavioural and autonomic emotional responses
What is the role of the prefrontal cortex?
- Modulation of emotional responses e.g. consciously suppressing features of anxiety
- Perception of emotion
What are the endocrine elements of the stress response?
- The limbic system is able to act on the hypothalamus to stimulate the secretion of stress hormones
- Via the familiar hypothalamo-pituitary adrenal axis
- Release of cortisol from the adrenal cortex is part of the chronic stress response
What are the three stages that the body goes through during prolonged exposure to stressors?
- Stage 1: the alarm reaction - release of adrenaline and cortisol as well as sympathetic activation
- Stage 2: resistance (effect of adrenaline starts to wear off) - chronic stress response, prolonged release of cortisol
- Stage 3: exhaustion (when you cannot escape an ongoing stressor) - chronic side effects of prolonged cortisol secretion start to occur
When does the stress response become pathological?
- When you cannot escape a stressor, or when trivial stressors elicit a strong stress response
What are the symptoms of anxiety?
- Palpitations
- Sweating
- Trembling or shaking
- Dry mouth
- Difficulty breathing
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, faint or light headed
What are some of the classifications of anxiety disorders?
- Social phobia
- Specific phobia
- Generalised anxiety disorders
- Panic disorder
- Obsessive compulsive disorder
- Post-traumatic stress disorder
What is the pathophysiology of anxiety disorders?
- Unclear
- Equivocal findings in studies of brain activation patterns
- GABA levels appear to be low in some anxiety disorders
- Increasing serotonin levels can help treat anxiety disorders
What is the biological treatment of anxiety disorders?
- Short term benzodiazepines
- SSRIs
What is the psychological treatment of anxiety disorders?
- Cognitive behavioural therapy
- Get patients to reflect on their feelings / thoughts / behaviours
What is the social treatment of anxiety disorders?
- Support groups, charities etc.