Anxiety Disorders

Question 1

What happens in GAD?

Answer 1

General anxiety disorder

Often chronic,massc with alcohol and substance abuse, env factors, stressful life events,and childhood experiences.

Question 2

Sx of GAD?

Answer 2

Initial insomnia, diff getting to sleep
Tesne posture
Restlessness
Sexual dysfucntion
General anxiety about everything
Concentration is poor 
treatment is with CBT and SSRIs if sx warrant.

Benzodiazepines and pregabalin also help - relieve the tension.

Question 3

What happens in panic disorder?

Answer 3

State of continuous fear, intesne anxiety,
W>M
Early twenties ot late adolescants

Sx
CVs: palpitations, tachycardia, ⬆️BP
Resp: breathlessnes and hyperventilation (resp alkalosis)
CNS: tension headaches, tremor, dizziness
Gi: nausea, frequency, dry mouth, thirst, dysphagia
Other: polyurea, heat, flushing and sweating
Derealisation of reality

Often assc with mitral valve relapse

Question 4

How would u treat panic disoders?

Answer 4

Exclude organic: glucose, diabetes,TFTs, alcohol dependance.
CBT in NICE- making cognitive model of panic to reduce anxiety

Diazepam and benzodiazepines- to reliefe sx in acute panic- have in mind dependancy issues.
SSRIs esp Sertaline- helpful in long term

Beta blockers- useful for CVS sx (vasodilatation) but CI in Asthma (bronchoconstriction) as always.

Question 5

What happens in phobic anxiety disorders?

Answer 5

Intense fear triggered by a stimulus that is otherwise normal to others.
Pts undertsnads that its irrational but cannot control it.
CBT, SSRIs and benzos.

Question 6

Agoraphobia?

Answer 6

Fear of market place, fear of being awat feom home, avpidance of travelling,
Often assc with claustrophobia- enclosed plases.

Question 7

Obsessive compulsive disorder

Answer 7

Obsessive ruminations and compulsive rituals.
Need to recheck and check everything

Assc with depression and Gilles de la Tourettes syndrome
Perfectionism in aspects of life
Ruminations: unpleasant, vioelnt, past, dirty thoughts
Time consuming Obsessions

Tx: as with most anxiety disorders, CBT and SSRIs

Question 8

What happens in post traumatic stress disorder?

Answer 8

Flashbacks,
Insomnia, Emotional blunting,
Anxiety
Avoidance
Hypervigilance 

Delayed response to a stasful event or situation of an exceptionally threatening or catastrophic nature, likelynto cause persvasive distress in likely anyone.

Any age onset,
Witnessing deaths, torture, terrorism,

CBt and SSRIs