Anxiety Disorders Flashcards
1
Q
What are the anxiety disorders? Types
A
They share features of excessive fear and anxiety
- Panic attack
- Panic disorder
- Agoraphobia
- Specific phobia
- Social anxiety disorder
- Generalised anxiety disorder
- Substance/medication induced anxiety disorder
- Anxiety due to medical condition
PANICKING when a GORA has SPECIFIC PHOBIA in SOCIAL setting and GENERALISING without SUBSTANCE and MEDICAL CONDITION
2
Q
What is a panic attack?
A
Panic attack is an abrupt surge of intense fear or discomfort that reaches a peak and subsides, within minutes, accompanied by at least 4 of the following symptoms.
- Palpitations
- Sweating
- Trembling
- Sensations of shortness of breath
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, light-headed, faint
- Chills or heat sensations
- Parenthesis (numbness or tingling sensations)
- Derealisation or depersonalisation
COGNITIVE SYMPTOMS
- Fear of losing control or “going crazy”
- Fear of dying (having a heart attack, seizures)
3
Q
Types of panic attacks.
A
- Expected - occur with an obvious cue or trigger, such as when a feared object or situation (usually associated with panic attacks) is confronted.
- Unexpected - With no obvious cue or trigger (“out of the blue”) such as when individual is relaxing (nocturnal panic attacks)
4
Q
- Panic disorder
A
- The individual experiences recurrent unexpected full-symptom panic attacks and worries constantly about new panic attacks.
- They fear that the panic attacks indicate life threatening illness (cardiac disease, epilepsy, mental disorder) would be embarrassed at receiving a panic attack in public i.e. avoids physical exertion
- They worry excessively about their abilities to complete daily tasks, intolerant of medication side effects, anticipate catastrophic outcome from mild physical symptoms e.g. headache - brain tumour
- Severe avoidance of specific foods
5
Q
Functional consequences of panic disorder
A
- Physical disability
- Frequent doctor and emergency room visits
- Unemployment and absences from school/university
6
Q
DD of panic disorder
A
- in panic disorder the attacks are unexpected
7
Q
- Agoraphobia
A
Extreme fear of leaving home or going to public places.
The individual exhibits fear or anxiety triggered by real or anticipated exposure to some situations.
- Using public transportation (e.g. automobiles, buses, trains)
- Being in open spaces (parking lots, marketplaces, bridges)
- Being in enclosed spaces (shops, theatres, cinemas)
- Standing in line or being in crowd
- Being outside of home alone.
8
Q
Agoraphobia symptoms.
A
- The individual avoid public situations due to fears that something terrible might happen; that escape might be difficult (cant get outta here), or help might be unavailable
- Panic attack, fear of dying or other incapacitating or embarrassing symptoms (e.g. vomiting, incontinence)
- They vary with age
- They are actively avoided
9
Q
DD of agoraphobia
A
- In depression patients may avoid leaving home, however the cause is apathy, loss of energy, low self-esteem and anhedonia
10
Q
- Specific phobia
A
- The person is fearful or anxious about the real or anticipated exposure to specific objects or situations (e.g. flying, heights, animals) termed phobic stimuli
- Phobic stimuli almost always provokes immediate fear or anxiety, or sometimes a panic attack (i.e. expected) and that’s why it’s actively avoided - avoid going to dark room due to fear of spiders, avoid taking job that involves travel.
- It sometimes develops following traumatic encounter with the feared object or situation often in childhood (bitten by dog, stuck in the elevator)
11
Q
Social anxiety disorder
A
- Individual is fearful or anxious about social situations in which they may be scrutinised and negatively evaluated by others (e.g. having a conversation; meeting unfamiliar people)
- Anxiety symptoms are (blushing, trembling, sweating, stumbling over one’s words); will be judged as weak, stupid, boring, intimidated and will be mocked by others.
- The social situations almost always provoke fear, anxiety, or sometimes a panic attack (i.e. expected)
- Anxiety may also be anticipatory (far in advance of upcoming situations) e.g. worrying before a social event, over preparing a speech for days in advance
- Shy, or withdrawn, less open in conversations, disclose little about themselves, seek jobs that do not require social contact
- It can be due to childhood history of social inhibitions or shyness or after a stressful or humiliating experience (being bullied)
12
Q
Functional consequences of social phobia
A
- Fear, anxiety, or avoidance cause clinically significant distress or impairment in social, academic and occupational functioning
- Delayed leaving home; being single, not having children, elevated rates of school dropouts, unemployment, poor work productivity, leisure activity and quality of life
- ## Onset is in puberty and course is chronic
13
Q
Differential diagnosis of social phobia
A
- Normative shyness: shyness is common personality trait, not by itself pathological. Only when it causes social impairment the social phobia diagnosis should be considered
- Medical condition. When the fear of negative evaluation is due to a medical condition that produces embarrassing sync-TOMS (e.g. trembling in Parkinson’s diseases) the diagnosis of social phobia is not appropriate
14
Q
Generalised anxiety disorder (GAD)
A
- The person exhibits persistent excessive anxiety and worry. (Apprehensive expectations) about multiple events or activities (work or school performance, health, finances, misfortune to family members); minor everyday matters (doing household chores)
- With time the focus might shift from one worry to another
- Anxiety and worry are accompanied by physical symptoms.
15
Q
Physical symptoms of GAD
A
- Restlessness or feeling keyed up or on edge
- Being easily fatigued
- Difficulty concentrating or mind going blank
- Irritability
- Muscle tension (associated with trembling, twitching, muscle soreness)
- Sleep disturbance
- Other somatic symptoms (sweating, IBS, headache)
