Anxiety Disorders Flashcards
Adolescents with anxiety have a higher risk of:
What does this indicate
- Suicidal behaviour
- Early parenthood
- Drug and alcohol dependence
- Educational underachievement
Considered prodromal symptoms of mental health disorders. A kind of self- medication
What is anxiety
An uncomfortable feeling of apprehension or dread
Occurs in response to internal or external stimuli
Can result in physical, emotional, cognitive and behavioural symptoms
Common etiology of Anxiety disorders:
Speculative
- Early life traumas
- History of physical or sexual abuse
- Socioeconomic or personal disadvantages
- Behavioural inhibition by adults
- Genetic Inheritance
3 broad categories- Genetic, neurobiology, psychodynamic
What is DSM
Diagnostic and statistical Manual (ver 5)
How do you differentiate anxiety symptoms in all of us to those with a “disorder”
Healthy persons can be somewhere on the spectrum. Severity looks at social, occupational, interpersonal functioning
Name all the anxiety disorders
Generalized Anxiety Disorder Social Anxiety Disorder Panic Disorder Specific Phobias Posttraumatic Stress Disorder* Obsessive Compulsive Disorder*
Describe Generalized anxiety Disorder
Excessive anxiety over more then 6 months related multiple events/activities
Has insight, Not r/t other psych disorder or substance abuse
3 or more of: restlessness, easily fatigued, concentration issue, irritability, muscle tension, sleep disturbance
Early onset, often chronic, severity depends on life events and stressors
Describe social anxiety disorder
Fear of social or performance situations (could lead to panic attack). Rarely speaks up. Includes test taking anxiety
Experiences difficulty in dating and sexual relationships
Person HAS insight, Early Onset (adolescence) common
Specific Phobias
Marked fear or anxiety about a specific object or situation
The phobic object/situation always provokes immediate fear or anxiety and object is actively avoided
The fear/anxiety is out of proportion to the actual danger posed.
Has Insight
Describe Panic Disorder
Extreme, overwhelming form of anxiety. May include co-morbidities
Recurrent unexpected Panic Attacks with the attacks been followed by one month (or
more) of one of the following (or more):
- Persistent concern about having additional attacks
- Worry about the implications of the attack
- Significant change in behaviour related to the attacks
What is a panic attack
Sudden, short periods of intense fear or discomfort that are accompanied by significant physical and cognitive symptoms (similar symptoms to a heart attack)
Physical: palpitations, rapid pulse, trembling, short of breath
Cognitive: (disorganized thinking, irrational fears, fear of going crazy, fear of death)
Describe key interventions during a panic attack
Encourage Slow breathing through nose,
Provide short clear sentences. specific instruction, reassurance.
Name and describe 4 domains of tx for anxiety disorders
Tx for Anxiety Disorders
• Biologic
o Pharmacotherapy
• Psychological
o CBT (anxiety is VERY treatable)
o Noticing negative thought patterns and
• Social
o Anxiety often family illness (assess family response)
o Support groups, social supports
• Spiritual
o Mindfulness exercises
o Reduce alienation, fear of death
What causes PTSD?
How long must symptoms present?
Exposed to a traumatic event (all present):
- Experienced, witnessed or confronted with an event that involved actual or threatened death, injury and/or sexual violence
- Response involved intense fear, helplessness or horror
- Symptoms last >1 month
Three central criteria for PTSD
o Avoidance of stimulus
• Persistent avoidance of associated stimuli
• Avoids activities places and people
• Restricted range of affect
• Emotional detachment
• Avolition (Lack motivation for basic tasks)
• Suicidal ideation common
o Reexperioence
• Recurrent/intrusive recollections, nightmares
• Act as trauma is actually reoccurring
o Persistent symptoms of hyper-arousal
• Often manifest in violence or outburst
Trouble falling asleep, hyper vigilance
What is the Key intervention for PTSD?
Other interventions?
Suicide risk assessment! is ESSENTIAL
o Prevent harm to others?
o Addictions control
What Tx options exist for PTSD
o Medication
o Tx for substance abuse (withdrawl tx)
o CBT (Gain insight, reduce stigma, understand)
What is Prazosin
Bp med helps tremendously with reducing nightmares in PTSD may be r/t to Norepinephrine.
What is acute stress disorder
Involves the same diagnostic criteria as PTSD
Development of characteristic symptoms lasting from 3 days to 1 month following exposure
Risk factor for the development of PTSD
What is an obsession (OCD)
Recurrent and persistent thoughts, impulses or images that are experienced as intrusive and inappropriate and cause marked anxiety
What is a compulsion (OCD)
Repetitive behaviours that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
The behaviours or mental act are aimed at preventing or reducing distress or preventing some dreaded event
What is OCD?
Provide examples
obsessions or compulsions cause marked distress, are time consuming (>1hour/day) or significantly interfere with the person’s normal routine
- Compulsion allows anxiety to be reduced
- Recurrent persistent thought or impulse that is intrusive and inappropriate with anxiety
- Not based in reality, Pt HAS insight
- Contamination, harming, religious obsessions, fear of causing harm, obsession r./t perfectionism.
- Checking, repeating, washing, mental compulsions (in 3’s?)
Common treatment options for OCD
Cognitive Behavioural Therapy
-Exposure Response Prevention
Medication
Deep Brain Stimulation
What is Bruxism
teeth grinding
Anhedonia
It is the loss of interest in previously rewarding or enjoyable activities
Akathisia
a state of agitation, distress, and restlessness that is an occasional side-effect of antipsychotic and antidepressant drugs.
Rumination
Rumination refers to the tendency to repetitively think about the causes, situational factors, and consequences of one’s negative emotional experience
Basically, rumination means that you continuously think about the various aspects of situations that are upsetting
Agoraphobia
extreme or irrational fear of crowded spaces or enclosed public places.
Delusion
Fixed belief that is outside cultural context and without basis.
A belief that is held with strong conviction despite superior evidence to the contrary
What’s the problem with using Benzodiazepines?
Addictive, not dealing or understanding underlying cause, tolerance develops quickly)
