Lecture 13-Anxiety 1 Flashcards
Name the physical manifestations of anxiety
Sympathetic NS: diaphoresis, mydriasis, tachycardia, tremor
Hyperventilation → dizziness and syncope, parasthesia
Name the psychological manifestations of anxiety
Restlessness, Irritability, Trouble concentrating, worry
Norepi & _____ = anxiety
cortisol
Anxiety symptoms must be present for _____ months
≥6
Traumatic events or extreme stressors (PTSD, Panic attack) may help _____ the anxiety disorder
create
Can anxiety be learned?
YES (GAD)
Gender bias in anxiety (disorder dependent) in that women ______ men are affected (Except OCD men _____ women)
> ; =
In anxiety:
____ Serotonin(5-HT) and ____ GABA activity
____ NorEpi and ____ Glutamate activity
↓,↓; ↑, ↑
Norepi & glutamate increased activity; and serotonin and GABA are decreased in anxiety
A 35 year old female comes to your office asking for help. She claims that she and her husband have been arguing a lot more lately. She says he can’t take her constant worrying. She worries about his job and whether he is making enough money, if the mail will be delivered on time, and about how well she is raising her kids in such a sad and cruel world. She says she has worried about things as long as she can remember. She doesn’t like that she doesn’t sleeps well at night. What is her most likely diagnosis?
Panic disorder
Generalized Anxiety Disorder
Acute Stress Disorder
Obsessive Disorder
Generalized Anxiety Disorder
General anxiety disorder:
Excessive anxiety/worry, occurring more days than not for ≥ ____ months, about ≥ ____ event/activity
Associated with ≥ \_\_\_\_ of the following symptoms: Restlessness Easily fatigued Difficulty concentrating Irritability Muscle tension Sleep disturbance
6; 1; 3
People with anxiety self medicate with what?
alcohol–increases GABA tone
Axiety prognosis?
Without treatment tends to worsen over time. (especially during stressful times)
What type of cognitive therapy do you give for anxiety?
CBT
What type of medical therapy do you give for anxiety?
SSRI or SNRI–Increases SR or NE or both, downregulates or desensitizes receptors (increases in NE desensitizes receptors)
Buspirone (a 5HT1a receptor agonist)–Initially lowers SR activity as these autoreceptors are stimulates but eventually renders them inactive allowing increases in SR output
Benzodiazepines: (GABA-A receptor positive allosteric modulator allows more Cl- channels to open
Beta Blockers. For symptomatic relief of performance anxiety, not GAD!!!
A 35 year old, Caucasian female, presents to your office with complaints of heart palpitations starting a year ago. She doesn’t consider herself a person that worries too much. They are not constant and she hasn’t noticed that they are related to any particular event. She also reports diaphoresis along with the palpitations. She denies any headache, vision change, nausea, vomiting, radiating chest pain, or change in her bowel habits. She denies any past traumatic events.. Her physical exam is normal. What is her diagnosis?
General Anxiety Disorder Atrial fibrillation Panic Disorder Social Anxiety Hyperthyroidism
Panic Disorder
