Anxiety Disorders Flashcards
Define: anxiety
Apprehension or fear
- Anticipation of threat
- Source of uneasiness is not always known
What are anxiety disorders?
Psychiatric conditions that involve excessive worry
Define: fear
Emotional response to real or perceived danger
What condition often accompanies anxiety disorders?
Depression
What are characteristics of “Normal” anxiety?
- Response to threatening situation (Fight or flight)
- Increased HR, BP, RR, muscle tension
- SNS sx (Tremor, sweating, polyuria, diarrhea)
- All beneficial responses in the case of a real threat
What is “Abnormal” anxiety?
Response to normal anxiety is out-of-portion to threat & is more prolonged
What physical sx accompany anxiety?
- Twitching/trembling
- Muscle tension
- Headaches
- Sweating
- Dry mouth
- Difficulty swallowing
- Abdominal pain
What are major mediators of anxiety?
- Norepinephrine
- Serotonine
- Dopamine
- Gamma-aminobutyric acid (GABA)
Define: separation anxiety
Distress when a person is away from parents, another caregiver, or home
At what age does separation anxiety peak & diminish?
- Peaks btwn 8-18 mo
- Diminishes by 2 ½ years
Separation anxiety usually co-exists w/ what?
Anxiety disorder
Tx of separation anxiety
- Cognitive-behavioral therapy
- Family psychosocial therapy
- Serotonin-reuptake inhibitors
When is suicide risk increased?
If pt has co-existing anxiety
Define: specific phobia
Marked or persistent fear (>6 months) that is excessive or unreasonable cued by the presence or anticipation of a specific object or situation
Clinical features of specific phobia
- Severe anxiety when exposed to phobic situations/objects
- Anticipation of phobia induces severe anxiety
- Extreme measures to avoid phobic situations
- Substance abuse common to combat anxiety in these situations
Define: acrophobia
Fear of heights
Define: Agoraphobia
Fear of open places
Define: Ailurophobia
Fear of cats
Define: Cynophobia
Fear of dogs
Define: Mysophobia
Fear of dirt/germs
Define: Xenophobia
Fear of strangers
Tx of specific phobia
- Relaxation techniques
- Anti-anxiety meds
- Desensitization
Fear of social situations
- Scrutiny
- Embarrassment
- Eating in public
- Speaking in front of others
Features of panic vs features of social anxiety disorder
Panic:
- Breathlessness
- Dizziness
- Sense of suffocation
- Fear of dying
SAD:
- Blushing
- Muscle twitching
- Anxiety about scrutiny
Tx of social anxiety disorder
- Psychotherapy & pharmacotherapy
- SSRI, benzodiazepines, venlafaxine (Effexor), buspirone (Buspar)
- Beta adrenergic receptor antagonists w/ performance situations
- Cognitive, behavioral, & exposure techniques
Define: panic disorder
Acute attack of anxiety w/ overwhelming feeling of impending doom
Panic-inducing substances
- Substances causing shift in acid-base balance
- Substances acting through neurotransmitters
Examples of substances that cause acid-base shift
- CO2
- Sodium lactate
- HCO3
Examples of substances that act on neurotransmitters
- yohimbine
- flumazenil
- cholecystokinin
- isoproterenol
- caffeine
Panic disorder: Psychosocial factors
- Feel that panic comes out of the blue
- More stressful life events
- Hx of child or sexual abuse
- Unconscious ideas about stressful events
Define: panic attack
Abrupt surge of intense fear or physical discomfort, reaching a peak within mins
What should you worry about w/ regards to panic attacks?
Cardiorespiratory problems
What percentage of people become vasovagal & lose consciousness?
20%
Sx of a panic attack
- Palpitations, tachy
- Sweating
- Trembling, shaking
- SOB
- Chest pain
- Nausea, dizziness
- Chills or hot flashes
& more!
Course/Px of panic disorder
- Late adolescence
- Chronic
- Once the pt realizes he/she has panic, they will often become less concerned over the episodes
- May become worse during certain times in life w/ uptick in sx
Tx of panic disorder
- Cognitive behavioral therapy
- Pharmacotherapy (SSRIs, Benzodiazipines)
What is the length of tx for those w/ panic disorder?
6-12 months
Sometimes long-term
Features of agoraphobia
- Fears/avoids situations bc escape may be difficult
- Provokes anxiety
- Avoidance/fear interferes w/ routine or fxn
- Panic disorder tied to dx
Tx of agoraphobia
- SSRIs (1st-line)
- Benzodiazepines
- Tricyclic antidepressants
- Psychotherapy
Define: GAD
Excessive uncontrollable worry about everyday things
- Affects daily fxn
GAD can occur w/ what?
- Other anxiety disorders
- Depressive disorders
- Substance abuse
What does GAD usually revolve around?
- Job
- Finances
- Health of self or family
- Chores
- Being late to appts
GAD: Psychosocial factors
- Response to perceived dangers is inaccurate
- Focus on negative details in environment
- Distorted info processing & thoughts
- Negative view of own ability
GAD: Px
Life-long
- Drugs do NOT provide cure
- Drug therapy often necessary
GAD: tx
*Recommended long term
- Cognitive-behavioral therapy
- Insight-oriented therapy
- Pharmacotherapy (SSRIs
Benzodiazepines, Buspirone
SNRI)
What medical conditions can cause anxiety disorder & have the highest occurrence of panic?
- Cardiomyopathy
- Those awaiting transplants
- Sjögren’s syndrome
- Grave’s disease
Substance-induced anxiety disorder is a result of what?
- Drug abuse
- Medication use
- Poison
- Alcohol
What substances can cause substance-induced anxiety?
- Sympathomimetics (amphetamines, cocaine, & caffeine)
- Serotonergic drugs (LSD & MDMA)
Clinical features of substance-induced anxiety disorder
- Vary with the substance used
- Cognitive impairments
- Memory impairment
- Using alcohol for anxiety ***
Tx of substance-induced anxiety
- Removal of offending substance
- If a med; find an alternative
- Limit exposure if environmental
- Tx w/ drug therapy & psychotherapy if it persists after discontinuing the substance
