Depression and Anxiety (Final) Flashcards
Neurotransmitters
-Chemicals that enable neurotransmission
-Travels across the synapse and either blocks or facilitate relay of stimulus
-Problems that arise with neurotransmitters are associated with neurologic and psychiatric disorders
-Over 200 neuortransmitters
4 Major Neurotransmitters
Dopamine
Norepinephrine
Serotonin (5HT)
GABA
What is dopamine responsible for?
Attention
Motivation
Pleasure
Reward
What is serotonin responsible for?
Obsessions and compulsions
Happiness and sleep
What is norepinephrine responsible for?
Alertness and energry
Which neurotransmitters are responsible for mood and anxiety?
Dopamine and Serotonin
What is GABA responsible for?
Relaxation
Serotonin Deficit
Depression and Craving
-Obsessive thoughts
-Compulsive behavior
Increase Impulsivity
-Suicide
-Agression
-Cue Triggers
Dopamine Deficit
Depression and Craving
-Parkinson-Like Symptoms
-Slow reaction
-Anergia (LOE)
-AMNEDONIA (Inability to experience pleasure)
-Pleasure center
-Dysfunction
GABA
-Principle inhibitory neurotransmitter
-GABA dysfunction is associated with anxiety disorders (Panic)
-Recently been connected to major depressive disorder
Noerpinephrine
-Excitatory neurotransmitter associated with fight or flight response
-High levels associated with: anxiety, stress, hyperactivity
-Low levels associated with: Lack of energy, focus, and motivation
Depression: More common
-In women
-White
-Those never been married
Those with depression have greater risk of developing
CAD
Depression: Eitology
-Is caused by a complication of genetic, biological, environmental and psychosocial factors
Diagnosis of depression requires the presences of multiple symptoms that are intense enough to cause distress and to
Persistently impair psychosocial functioning
Depressive Symptoms
-Loss of interest or pleasure
-Fatigue
-Restlessness and irritabile
-Impaired concentration
-Low self-esteem
-Negative thinking
-Sleep disturbances
-Appetite disturbances
Depression Treatment
-Medications (most important thing is telling patients that i takes WEEKS for these medications to start working, so keep with it
-Psychotherapy-Talk therapy
-Psychoeduction and support groups
-Brain stimulation therapy
-Works best when all of these are combined together in some way that best fits the patients needs
Anxiety: Panic Disorder two important psychological symptoms
Anticipatory anxiety: Fearful expectation of panic anxiety onset
Avoidance anxiety: Personal strategies used to increase feeling of control and decrease the risk of panic anxiety
Panic Disorder: Etiology
-Biopsychological and Physiologic
Genetics and family history
Early childhood stress linked to adult onset anxiety disorderd
Overwhelming stress can induce circulation stress hormones which stimulates
Glutamate
What is panic?
-Unexpected episodes of reactions that are out of proportion to events going on around patient
-Many (50%) of patients with panic also have depression
-Creates a terrible cycle of panic attacks and anxiety
Panic attacks: What are they and what are the symptoms?
Recurrent uncomfortable episodes with sudden onset with symptoms
-Heart palpitations
-Chest pain
-SOA
-Dizziness
-Nausea
-Fear of Losing control
Treatment of Panic Disorders
-Cognitive Behavioral Therapy
-Anti-dpressants
-SSRI
-SNRI
-TCA
-MAO inhibitors
Benxodiapzepines (Second line)
Generalized Anxiety Disorder
-Chronic condition
-More than 6 months
-Excessive, uncontrolled, unrealistic worry. Going down a rabbit hole
GAD symptoms
-Accompanied by muscle tension, autonomic hyperactivity, exaggerated startle, difficulty concentrating
Risk factors for GAD
-Use of certain substances
-Childhood abuse or family trauma
-Genetics
GAD Treatment
-Cognitive Behavorial Therapy
-SSRI and SRNI
-Buspirone = unknown MOA, no sedation/abuse, does not intensify the effects of CNA depressants, anxiolytic effects slow
-Benzodiazepines
Post-Traumatic Stress Disorder: 3 core symptoms
-Hyper-arousal
-Avoidance of reminders
-Re-experiencing the events
Post-Traumatic Stress Disorder: Characterized
By vivid flashbacks, nightmares, emotional blunting, irritability and exaggerated startle
Memory, sleep and depression problems very common in PTSD
PTSD: Treatment
Psychotherapy-Trauma focused, exposure therapy, CBT
EMDR - Eye movement desensitization and reprocessing
Medications SSRI and SNRI
Social Anxiety Disorder
-Intense fear of being criticized by others
-Persistent fear of humiliation
-Negative evaluation of embarrassment in social situations
-Withdraw from situations or experience intense discomfort
SAD: Causes
-Inherited traits
-Brain structure: amygdala plays role in the fear response
-Environment: May be a learned behavior
Treatment of SAD
CBT
SSRI
BENZO
Propanolol- 1 to 2 hours before activity
Obsessive Compulsive Disorder
Obsession: Repetitive unwanted thoughts
Compulsions: Repeated activités / rituals
Time consuming: May be distressing to individual, friends, family members
OCD Treatment
VERY VERY difficult to treat
-SSRI
-TCA (second line)
-Deep brain stimulation
-EMDR
-Transcranial Magnetic Stimulation: FDA approaved
SSRI and SNRI
Used first line because they are the most safe medicaitons
All anti depressant medications come with the risk of
Suicide and mental imbalance because they affecting the neurotransmitter
After starting drug should be monitor for 4-8 weeks for efficacy
Can increase dose
Switch drug or drug class
Add second drug
