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Biopsych Midterm 4 > Anxiety Disorders (ch.18.3) > Flashcards

Anxiety Disorders (ch.18.3) Flashcards

1
Q

Bipolar Depression:

A

-Characterized by periods of depression alternating with mania

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2
Q

Mania:

A

-Overconfidence, impulsitivity, high energy. This unorganized behaviour makes it difficulties to complete projects and meet responsibilities

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3
Q

Rapid Cycling:

A
  • (Some bipolar patients experience this)
  • four or more cycles of mania and depression within a year, these can be much more frequent including multiple cycles a day
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4
Q

Cylothymia:

A

Cycling between dysthymia (mild depression) and hypomania (mild mania)

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5
Q

Bipolar Depression average age:

A

Average age of onset is earlier than unipolar depression

  • First episode commonly between 15- 30 y with an average of 25 year
  • Age of onset IS tied to genetics
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6
Q

Bipolar Depressions (are men or women more effected)

A

Men and women are equally effected

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7
Q

One gene with Bipolar Depression is isolated as a contributing factor that encodes for…

A

BDNF ( a neurotrophic factor)

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8
Q

Brain changes that are associated with bipolar depression:

A
  • Enlarged ventricles
  • Reduced Grey Matter -> this correlated with the number of episodes (the number of episodes the greater the loss of neurons)
  • Suggests an accumulation of damage over time
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9
Q

What is a problem with using antidepressants in the treatment of Bipolar Depression?

A
  • The depression is oftener educed but mania is triggered
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10
Q

Typical Antipsychotics (for bipolar disorder)

A
  • Would seem an attractive treatment for mania but generally they are not very effective
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11
Q

Mood Stabilizers:

A

Mechanisms of actions not completely understood

  • Used primarily to combat symptoms of mania but not all symptoms of BP
  • side effects: increase in weight, dizziness, lethargy, vision problems
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12
Q

Most commonly used medication for bipolar disorder:

A

Lithium

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13
Q

Problem with Mania and taking medication:

A

Mania can feel “pleasant” in comparison to feeling medicated or depressed therefor there are issues with compliance

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14
Q

Anxiety Disorders:

A

Characterized by chronic fear in the absence of threat

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15
Q

Psychological symptoms of anxiety:

A

fear and worrying

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16
Q

Physiological symptoms:

A
  • autonomic activation - tachycardia (abnormal heart rate)
  • hypertension
  • nausea
  • breathing difficulties
  • sleep disturbances
  • high glucocorticoid levels
17
Q

__% of the population will suffer form an anxiety disorder at some point

A
  • 17%

- Twice as common in females

18
Q

Anxiety Disorders and Major Depressive Disorder (Corse system differences)

A

Anxiety: Characterized by anxiety and worry and disorder dependent symptoms (ex phobia)
Depression: Decreased mood and interest in pleasure

19
Q

Symptoms that overlap between anxiety and depression disorders

A

Fatigue, concentration, sleep

20
Q

How are anxiety disorders triggered?

A
  • By stressful events, the role of experience in shaping the disorder is often observable
  • Heritability 30-40%
21
Q

5 major anxiety disorders:

A
  • Generalized Anxiety Disorder
  • Phobic Anxiety Disorders
  • Panic Disorders
  • Obsessive Compulsive Disorder
  • Post Traumatic Stress Disorder
22
Q

Generalized Anxiety Disorder:

A

Exceissive worrying that interferes with day to day life

- Increased arousal, fatigue, concentration problems, sleep problems, irritability, muscle tension

23
Q

Phobic Anxiety Disorders:

A

Intense fear that becomes centred on a specific object situation or person

24
Q

Panic Disorders:

A

Recurring attacks of fearfulness (panic attacks)

  • Unexpected panic attacks and subsequent avoidance behaviours
  • fear anxiety about social performance
    • worry about exposure to social situations (leads to panic attacks and phobic avoidance/social isolation
25
Q

Obsessive Compulsive Disorder:

A

Obsessions (thoughts_ compulsions (repetitive behaviours) or both

  • Compulsions -> Behaviors that are repeated
  • Obsessions -> reoccurring thoughts (thinking about the behaviour)
  • 4 mil people in the US suffer from OCD
  • average age of onset - 25 to 44 years of age
26
Q

Post Traumatic Stress Disorder:

A

Triggered by traumatic event, includes severe anxiety, flashbacks and fear (e.g: observing or experiencing violence or death)

  • Memories of events intrude consciousness and elicit strong emotional and peripheral responses such as immense fear, trembling, erratic behaviour.
  • Very common in veterans
  • genetics account for 1/3rd of incidences
  • Size of hippocampus may increase risks (smaller)
  • have deficit in the ability to forget
  • involved MGN, amygdala, hippocampus, and brainstem
27
Q

(Generalized Anxiety Disorder) Amygdala centered circuit:

A

FEAR

  • Feelings of fear
  • Avoidancee Behavior
  • Endocrine Output (hormones)
  • Respirator Output
  • Sympathetic tone
28
Q

(Generalized Anxiety Disorder) Cortico striatal thalamic loops:

A

WORRY

- Anterior cingulate cortex to nucleus accumbens to thalamus and back to the anterior cingulate

29
Q

2 Categories for phobic anxiety disorders:

A
  1. Specific phobias: fear of particular objects or situations ( 5 subtypes) - animal, environment, situation blood injection or other
  2. Agoraphobia: fear of leaving home or a ‘safe are’
    - Exposure may elicit broad range of responses to mildly increased arousal to panic attacks
    - Could result from a conditioned response that is strengthened with each exposure
    - Brain regions of interest (amygdala, insula, limbic system)
  • DISORDERS (Suriphobia (rats), aquaphobia (water), acrophobia (heights), hemophobia (blood), claustrophobia (small spaces))
30
Q

Panic Disorders - Brain changes

A
  • Patients with reoccurring panic attacks present with ABNORMAL MRI of the temporal lobe
  • ~40% of panic patients show small lesions in white matter in the temporal lobe and larger lateral ventricles
31
Q

What does OCD respond well to?

A

SSRI

32
Q

Increasingly fMRI suggest what with OCD?

A

SSRI target the orbitofrontal cortex in OCD, SSRI target ventrolateral prefrontal cortex in depression
- Depression often accompanies OCD

33
Q

Anxiety Disorders Medications: B

A

Benzodiazepines: GABAa receptor agonists - GABA in the presence of Benzodiapzepines increase CL influx - neural inhibition

  • At high doses benzodiazepines function as anticonvulsants and sedatives
  • Side effects: sedation, nausea, tremor
  • Stopping treatment - rebound anxiety
34
Q

Anxiety Disorders: S

A
  • Seroteonergic Agonsit: Buspirone 5HTIA agonist prescribed for GAD
  • Produces anxiolytic response without the side effects of Benzodiazepines
  • Common Side effects: nausea, headache, insomnia
  • Of interest: Imaging studies show decreased levels of 5HTIA receptors in anxiety patients
35
Q

Anxiety Disorders Medication: A

A

Antidepressants: SSRI and SNRI are effective at treating anxiety disorders

  • Depression and Anxiety are comorbid - patients with uni or bipolar depression are 50% more likely to have had an anxiety disorder
  • Interestingly antidepressants can increase levels of BDNF the gene that codes for this protein is reduced in patients with anxiety

Biopsych Midterm 4 (3 decks)

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