Anxiety I & II Flashcards
List some physical manifestations of anxiety
- sympathetic NS symptoms: diaphoresis, mydriasis, tachycardia
- GI/GU symptoms (diarrhea, increase urinary frequency)
- hyperventilation –> dizziness and syncope
- numbness and tingling in extremities and around mouth
List some psychological manifestations of anxiety
restlessness
irritability
trouble concentrating
worry
What 3 symptoms must someone have to be diagnosed with anxiety
1) be persistent (generally >/- 6 months)
2) interfere with normal functioning
3) cause significant distress
In general, what are the levels of NTs like in someone with anxiety?
decrease 5-HT, decrease GABA, increase NE, increase glutamate
General anxiety disorder is defined as excessive anxiety/worry, occurring more days than not for >/- 6 months. It’s difficult to control worry and causes signifcant impairment. There is also no other explanation for the anxiety. It must have at least 3 of the 6 symptoms. List the 6 symptoms
- restlessness
- easily fatigued
- difficulty concentrating
- irritability
- muscle tension
- sleep disturbance
Can general anxiety disorder improve without treatment?
No, it tends to worsen over time.
What’s the psychotherapy of choice for someone with generalized anxiety disorder?
-Cognitive behavioral therapy
List the classes of drugs that can be used in the treatment of generalized anxiety disorder
- antidepressants
- buspirone (a 5-HT1a receptor agonist)
- benzo
- beta blockers –> for relief of performance anxiety & symptoms; not really for GAD
What defines a panic attack?
abrupt surge of intense fear or discomfort, peaks within minutes that is unexpected with at least 4 of the long list of symptoms (palpitations, sweating, shaking, SOB, choking feeling, chest pain/discomfort, nausea, dizziness, chills, etc)
What defines a panic disorder?
- recurrent unexpected panic attacks
- concern abt additonal panic attacks or conseq, significant maladaptive change in behavior related to attacks
- no other explanations for symptoms
What is Agoraphobia?
- fear/anxiety about >/- 2 of the following situation:
1. using public transportation
2. being in open spaces
3. being in enclosed spaces
4. standing in line or in a crowd
5. being outside the home alone - fear of not being able to escape situations
- situation almost always produces fear/anxiety
- avoids situations
- fear/anxiety out of proportion to actual danger
- > /- 6 months
- causes significant impairmnet
- no other explanation for symptoms
Social anxiety disorder (social phobia). What are some symptoms.
- > /- 6 months
- causes significant impairmnet
- marked fear/anxiety when exposed to social situation w/ possible scrutiny by others
- fear of acting in ways that will be negatively scrutinized
- social situations provokes fears
- avoids social situations
- fear/anxiety out of proportion to actual threat
- no other explanation for symptoms
What is performance anxiety? what’s the firstline treatment?
- fear is restricted to public speaking or performing and does not generalize to other social aspects of life
- first-line treatment is beta blockers
Do patients with OCD have insight?
Like other patients with anxiety disorder, they do.
What’s the difference btw obsessive compulsive disorder (OCD) and obsessive-compulsive personality disorder (PD)?
OCD involves an obsession that is relieved by performing repetitive actions (compulsions) while PD is when there’s a conscious need for perfection that is manifested in repetitive behavior. In PD, there is no insight. Also, rituals like hand-washing isn’t prominent.