BM - Anxiety Disorders Flashcards
Define anxiety
Apprehension, tension, or uneasiness from anticipation of danger/threat
What is the adaptive function of anxiety
anxieties help us be safe
Define pathological anxiety
When anxiety interferes with effectiveness in living, achievement of desired goals or satisfaction, or reasonable emotional comfort
What are the physical symptoms of anxiety
Chest pressure/pain, choking, dyspnea, tachycardia, palpitations, sweating, twitching/tremor, G/I distress, difficulty swallowing, dizziness, paresthesia, difficulty concentrating
What should be considered when diagnosing anxiety
History, mental status exam, physical exam, laboratory tests, psychological evaluations
What is panic disorder
The presence of recurrent, unexpected panic attacks followed by at least 1 month of one of the needed symptoms
What are the symptoms that patients must have at least one of to meet criteria for panic disorder
- Persistent concern about having additional attacks
- Worry about the implications or consequences of the attacks
- A significant change in behavior related to the attacks
What is a panic attack
A discrete period of intense apprehension, fearfulness, or terror, often associated with a feeling of impending doom all in the absence of any real danger
What are the symptoms of a panic attack (need at least 4)
Palpitations, sweating, trembling, SOB, chest pain, feeling of choking, nausea, dizziness/lightheaded, paresthesia; All develop abruptly and peak within 10 minutes
What is the average age of onset for panic disorder
adolescence through mid 30s
What is panic disorder often comorbid with
Mood and substance disorders
What is the etiology of panic disorder
Neurotransmitters, genetics, psychological factors (stressors, triggers)
What is the criteria for specific phobia
Marked and persistent fear provoked by presence or anticipation of a specific object or situation (animals, heights, planes, blood); recognizes that the fear is excessive or unreasonable (with the exception of children)
What is the criteria for social anxiety disorder
Marked and persistent fear of social or performance situations where there are unfamiliar people or potential scrutiny by others; fear that they will act in a way (or have anxiety sx) that are humiliating/embarrassing; also aware that the fear is excessive or unreasonable
What is the criteria for obsessive-compulsive disorder
Presence of obsessions or compulsions; recognition that obsessions/compulsions are excessive/unreasonable; the obsessions/compulsions cause marked distress, are time consuming (>1 hour/day), or significantly interfere with normal routine, functioning, relationships
Define obsession
Anxiety provoking thought
Define compulsioin
Repetitive behavior that patient performs to reduce obsession/thoughts
What are common symptom patterns with OCD
Contamination/germs, performing compulsions a set number of times, symmetry, not stepping on cracks, pathological doubt
What is the onset and trend of OCD
Male and female have equal rate; onset in adolescence/young adulthood
What are the symptoms of Post traumatic stress disorder
- Exposure to actual or threatened death/injury, or sexual violence
- Intrusion symptoms (memories, dreams, dissociative reactions/flashbacks)
- Persistent avoidance of stimuli associated with the trauma
- Negative alterations in cognition/mood
- Alterations in arousal
- Duration of symptoms is greater than 1 month
- Clinically significant impairment/distress in social, occupational, other functioning
Give examples of the negative alterations in cognition/mood
- Inability to recall important aspect of trauma
- Negative belief/emotional state; unable to experience positive emotions
- Diminished interest/participation in significant activities
- Feeling detached/estranged from others
Give examples of alterations in arousal
- Irritability, angry outbursts
- Reckless/self-destructive behavior
- Hypervigilance
- Exaggerated startle response
- Can’t concentrate
- Sleep disturbance
What are the risk factors of PTSD
occupation with high risk of traumatic experiences such as first responders and military
What is the criteria for generalized anxiety disorder
Excessive anxiety and worry about a number of events or activities occurring more days than not for at least 6 months; Difficult to control the worry; Need at least 3 symptoms (1 in children)
What are the symptoms of which 3 are needed for GAD
Restlessness, fatigue/sleep disturbances, difficulty concentrating, irritability, muscle tension*, sleep disturbances
What is other information about GAD
- Most worries are unlikely to happen
- Many bodily representations of anxiety
- Lifelong disorder
What are some anxiety disorders that are caused by a medical condition
Asthma, allergies, PE, angina, arrythmias, CHF, alterations in BP, hyperthyroid, hypoglycemia, electrolyte disturbances, seizures, PMS
Substance/medication-induced anxiety disorder
Stimulants, anticholinergics, drug withdrawal, hallucinogens, indomethacin
What is good to establish to begin treatment with anxiety patient
Good rapport with patient and empathetic response to the patient’s story
What are some treatments for anxiety
Psychotherapy should be the first treatment method; Pharmacotherapy w/ SSRI’s and SNRI’s
What is the role of prescribing benzodiazepines for anxiety
prescribe short-term while waiting for SSRI’s or SNRI’s to begin working or as PRN for panic attacks; they are very addicting but can be very helpful, ex) Xanax, valium
How to treat social phobia
Inderal - blood pressure medication that controls physical symptoms of anxiety; may need to be on SSRI or SNRI if more severe
How to treat specific phobia
take small steps to overcome phobia with coping techniques and possibly benzos
What are other ways to treat all anxieties
Adequate sleep, decrease caffeine, exercise
