Anxiety Disorders Flashcards
how many Americans have an anxiety disorder at some point
25%
people with anxiety disorders often also have what?
more than 1 anxiety disorder
or anxiety + depression/ other psych disorders
how long must persistent anxiety last for w/ GAD?
6 months
What are people w/ GAD constantly worried about
Minor matters, anticipating the worst
muscle tension, restlessness, irritability, fatigue
is it typical to have GAD as the only dx?
No, typically comes w/ a mood disorder
1st line tx for GAD
SSRIs
drugs to use if SSRIs don’t work for GAD. FDA approved, works equally well as SSRI’s. Also a longer onset of action.
Venlafaxine
how long does it take for SSRI to help w/ anxiety
3-6 months
when are benzos used for GAD
while waiting for the SSRI to work
short term
drug for GAD. FDA approved. Non-sedating, non-addictive. Requires twice daily dosing, studies show it does not work as well as antidepressants, and it would not treat co-morbid depression. Best for people haven’t tried other meds and don’t have hx of substance abuse.
Buspirone
what is acute PTSD
more than 1 month but less than 3 months
3 areas of PTSD symptoms
Re-experiencing
Numbing and avoidance
Hyper arousal
intrusive recollections of the trauma, flashbacks of the trauma, nightmares about the trauma, distress at exposure to things that remind the patient of the trauma
re-experiencing
hyper vigilance; difficulties sleeping; angry outbursts; poor concentration; exaggerated startle reflex
hyper arousal
avoid thoughts, feeling or conversations associated with the trauma; avoid activities, people or places that remind them of the trauma; unable to remember important aspects of the trauma; feeling like they won’t have a future; restrict emotions and feeling detached from others
numbing and avoidance
what can be used to tx nightmares and flashbacks w/ PTSD
Prazosin
what antipsychotic is sometimes used for PTSD
Quetiapine
when should benzos be reserved for w/ PTSD
limited tx of extreme arousal, insomnia, and axiety
problem w/ benzos and PTSD
may make PTSD worse in acute stress disorder or increase risk
_________ __________ CBT is an approach helpful for children and adolescents ages 4-18 who have experience trauma.
Trauma focused
A period of intense fear that develops abruptly and reaches a peak within 10 minutes.
Panic attack
4 of what 10 symptoms must be present for a panic disorder
Palpitations or pounding heart
sweating trembling or shaking,
shortness of breath or feeling like you can’t breath, choking sensation,
chest pain,
nausea,
dizziness or lightheadness,
feeling “unreal” or detached from yourself,
fear of losing control or going crazy,fear of dying, numbness or tingling,
chills or hot flushes
what is the most disabling part of panic attacks
worrying about having another panic attack
fear of being in a situation or place where escape or rescue would be difficult if a panic attack occurred.
agoraphobia
first line tx for panic attacks
SSRIs
other drugs for panic attacks
venlafaxine
TCAs, MAOIS
benzos (may not be beneficial)
treatment for phobias
systematic desenitization-gradual exposure to the feared object
biggest fear
fear of public speaking
tx for performance anxiety for public smeaking
beta blockers (propranolol)
first lines for general social phobias
SSRIs
what is first line psychotherapy for social phobia
CBT
common themes of obsessions
agression, sex, religion
Repetitive behaviors or mental acts the person feels driven to perform in response to an obsession. Includes praying, counting, repeating words, hand washing, ordering things, and checking rituals
Compulsions
first line tx w/ OCD
CBT “exposure and response prevention”
how much time a day must a person take w/ obsessions and compulsions for it to be considering interfering w/ daily life
at least an hour
first line meds for OCD
SSRIs
