Exam 2 Flashcards
symptoms of panic attack
- Palpitations, pounding heart, or accelerated heart rate
- Sweating
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint
- Derealization (feelings of unreality) or depersonalization (being detached from oneself)
- Fear of losing control or going crazy
- Fear of dying
- Paresthesias (numbness or tingling sensations)
- Chills or hot flushes
panic disorder
recurrent, unexpected panic attacks (false alarms) lasting one month or longer
amount of adult population who’s experienced a panic attack
30%
lifetime prevalence of panic disorder
Gender ratio (F:M)
5%
2:1
role of blood pH in panic
respiratory control center (brain stem) may register that you’re suffocating if your pH level is high; higher amounts of acidity in our blood for any reason can lead us to feel more anxious
sodium lactate infusion challenge
if you hook up a person with panic or an immediate relative without the disorder to an IV and fuse sodium lactate, it will likely induce a panic attack
revised lactate infusion challenge
Barlow told one group that the IV was safe, the other group he told nothing; those who were told it was safe were less likely to panic (cognition matters)
Barlow’s CBT model of panic
- patients misinterpret interoceptive cues
- catastrophic thoughts lead to panic
- modify thoughts –> reduce panic
- Exposure to interoceptive cues (extinction of conditioned alarms)
efficacy of benzos for panic disorder
over 80% accute
efficacy of SSRI/SNRI/impiramine for panic disorder
60% accute
efficacy of CBT for panic disorder
60-75% accute
short term vs. long term efficacy of benzos
high efficacy in the short term; brain neutralizes effects of the drug in the long term
GABA receptors
1/3 of brain cells use this neurotransmitter; benzos slow down the firing of these signals and impairs mental functions including memory
1 best selling psych drug
Xanax
Benzos
Ativan, Klonopin, Valium, Versed, Rohypnol, Xanax
side effects of benzos
loss of restorative phase of sleep, can trigger depression, impaired memory/concentration, sedation, impaired reasoning, reduced insight/awareness, loss of inhibition, emotional numbing, increased dementia risk
symptoms of agoraphobia
person begins to fear and avoid places associated with occurrence of panic attacks (open spaces, cars, malls); generalize one panic attack to all locations similar to where it occurred; person may be homebound
how many patients with panic disorder have agoraphobia?
half
symptoms of GAD
high anxiety and excessive worry > 6 months, restlessness, fatigue, insomnia, irritability, concentration difficulties, muscle tension
uncertainty intolerance
Michael Dugas: people with GAD suffer from feeling of not knowing outcomes (worse than the negative outcome itself)
error detection
anterior cingulate cortex (behind frontal cortex) gives us sensation that something’s wrong and motivates us to fix it; for GAD patients these circuits don’t calm down
______________ meditation added to CBT leads to 75% success response for GAD patients
mindfulness
GAD treatments
magnesium supplement, mindfulness meditation, exercise (aerobic), probiotics
subtypes of social anxiety disorder
performance-linked (public speaking), generalized (pervasive social anxiety)
beta blocker
very effective for treating performance-linked subtype
Nardil
MAO inhibitor; highest efficacy of any treatment of social anxiety disorder (80%); blood pressure/hypertensive crisis risk from aged foods (cheese, sausage, wine)
lifetime prevalence of social anxiety disorder
12%
activation syndrome
agitation & possible suicidality/aggression during first few weeks of taking drug or during withdrawal (2-5% of ppl)
Rohypnol
type of benzo; also a date rape drug
Versed
type of benzo; also used during surgeries to erase memories - reduces likelihood that they’ll be sued if you wake up (you won’t remember it)
Cymbalta Case
1 out of 200 participants would make a suicide attempt on an antidepressant
Dissociation
- derealization: things feel dreamlike
- depersonalization: out of body experience; watching it happen to someone else
SSRIs:
Prozac, Paxil, Zoloft, Celexa, Lexapro
SNRIs:
Effexor, Pristiq, Cymbalta
What do antidepressants do with serotonin?
These drugs do not increase brain’s “serotonin levels” (they block serotonin synaptic re-uptake)
Xanax also known as
alprazolam
Obsession
recurrent intrusive thought, impulse, or image that causes anxiety and cannot be dismissed or put out of one’s mind
Compulsion
repetitive action (ritual) person feels compelled to do
Subtype of social anxiety disorder
performance-based anxiety (treated with beta blockers)
