Anxiety Disorders Flashcards
What does fear activate?
The fear response activates the sympathetic nervous system and the sympatho-adrenomedullary (SAM) axis (see the stress lecture for a reminder).
What is fear?
Fear is an immediate alarm reaction to present danger, characterized largely by a strong motivation to escape.
What is anxiety?
Apprehension/worry about real or perceived future threats.
What is a surprising risk that comes with anxiety disorders?
Suicide (20% attempt it).
How is panic disorder characterized?
Panic disorder is characterized by recurrent and sudden debilitating panic attacks that come on unexpectedly.
What are panic attacks?
According to the DSM5, panic attacks are abrupt surges of intense fear or discomfort that reach a peak within minutes.
Prevalence of panic disorder?
Panic disorder affects 3.4-4.7% of the US population at some time in their lives .
How does the amygdala affect fear?
The amygdala is linked to the recognition, expression, and experience of fear in both humans and animals. The amygdala has connections with the sympathetic nervous system, allowing it to affect physiological function.
What happens with the physiological effects of fear?
The amygdala can activate the sympathetic nervous system. Accordingly, the body undertakes a number of adaptations that help is escape or otherwise deal with a threat of some kind.
Neurobiology of panic attacks?
Brain imaging studies of individuals with panic disorder show amygdala activation in response to anxiogenic stimuli.
Is panic disorder genetic?
It is highly heritable (48%).
What gene does ti affect?
The only gene that is clearly linked to the disorder is COMT, which codes for the enzyme Catechol-O-methyltransferase, an enzyme that degrades catecholamine neurotransmitters.
How is generalized anxiety disorder characterized?
Generalized anxiety disorder (GAD) is characterized by excessive anxiety, worry, and rumination.
Prevalence of GAD?
Approximately 2.9% of the US population meets the criteria for GAD during a given 1-year period.
Neurobiology of GAD?
Relatively little is known about the neurobiology of GAD. Unlike panic disorder, GAD and excess worry are not associated with sympathetic nervous system over-activity.
How GAD the opposite of panic disorder?
Rather, individuals with GAD are said to be “autonomic restrictors”, meaning that their sympathetic nervous system is actually less responsive to stressors.
What part of the brain shows increased activation in GAD?
The frontal lobe.
What disorder is comorbid with anxiety disorder?
Alcohol use disorder (AUD).
What are drugs that treat anxiety called?
Anxiolytics
What kind of anxiolytics are given to patients with PD?
Fast-acting drugs.
What kind of anxiolytics are given to patients with GAD?
Slow-acting drugs.
What drugs are agonist to GABA receptors?
Benzodiazepines are drugs that are agonists at GABA receptors. They increase inhibitory signaling in the brain, leading to sedation and relaxation.
What are the risks of fast-acting drugs?
Risk of addiction
What other drugs are used to treat anxiety disorders?
Antidepressant medications, such as SSRIs are often quite effective in treating anxiety disorders.
What drug is typically used for cardiovascular disease but also useful for short-term anxiety?
Beta blockers.
What other treatments are available?
- Cognitive behavioural therapy
- Interoceptive exposure (PD)
- Eye Movement Desensitization and Reprocessing (EMDR)
