UNIT 4- ANXIETY & STRESS RELATED DISORDERS Flashcards
Anxiety & stress disorders are often comorbid with….
- Depression
- Eating disorders
- Bipolar disorder
- Substance abuse
Anxiety & stress disorders….
- Have low recovery rates and high recurrence rates
Anxiety and stress disorders interfers with…
- Personal
- academic
- occupational
- social functioning
What is eustress?
- Good stress (what motivates us)
What is distress?
Bad stress- can cause emotional, physiological issues
What are different types of stress
- Psychosocial- stress about the way they feel about themselves
- Psychological stress- anciety/guilt, even postive emotions can be stressful in certain events. Like a letter of acceptance to nursing school
- Phsycial- extreme temp, choatic environment, ex. scratchy tag in a tshirt..
- Spiritual- crisis of faith. Difficulty in the moment connecting with faith. “what is my purpose”
What are some healthy coping strategies/defense mechanisms?
- Altruism
- Sublimation-transfer something not acceptable into somethings acceptable.. instead of punching a wall… go to the gym.
- Humor
- Suppression-Short term can be useful. Sometimes we can’t fall apart in a certain time.
What are intermediate coping strategies/defense mechanisms?
- Repression
- Displacement
- Reaction formation
- Somatization
- Undoing
- Reationalization
What are immature/primitive coping strategies/defense mechanisms?
- Passive agression
- Acting out behavior
- Dissociation
- Devaluation
- Idealization
- Splitting
- Projection
Everyone has a threshhold… when it comes to coping strategies/defense mechanisms… once its crossed…
we eventually get to the point they cope with with immature primitive coping strategies.
Relaxation/calming techniques include…
- Reframing/decatastrophizing– reframing a situation to be more manageable.
- Sleep
- Phsycial exercise- increases endorphins that make you feel good it doesnt have to be super intense it can be a simple walk, yoga
- Reduced caffeine- increased anxiety which makes it harder to settle down
What is the patho of anxiety and stress
- Anxiety as an experience orignates in the amygdala
- Stress signal alerts hypothalamus which responds
- Engages the SNS resulting in
- Physiological/symptoms of anxiety
- Limbic system sends neural messages to
- Cerbral cortex, which generates
- Thought about anxiety
Serotonin in anxiety disorders is believed to be…
decreased which is why we give SSRs for anxiety disorders
Norepinephrine in anxiety is belived to be..
Increased- why we give noradrenegic drugs (porpanolol or clonidine for anxiety disorders)
GABA in anxiety adn stress disorders is belived to be….
altered- benzodiazepine receptors sensitivity is deminished which is why we give benzodiazepine for actue anxiety
What are the short-term effects of epi & norepi
- Elevated heart & resp rate
- Elevated FFAs, glucose and triglycerides
- increased platelet aggregation
- Increased kidney clearance
- Increased blood to skeletal muscles
- Increased muscular tension
What are long-term effects of epi & norepi?
- High resting heartrate
- Heart disease
- Platelet aggregation
- Reactive high BP
- Hypercholesteremia & hyperlipedmia
- Renal/hepatic problems
- Glucose intolerance
- Chronic muscle tension
- Hyperventalation
- Digestive problems
- Chronic anxiety/anger
What are short-term effects of cortisol/corticoids
- Decreased fluid loss
- Increase glucose/gluconeogenesis
- Less inflammation
- Less brain norepinephrine
What are long-term effects of cortisol/corticoids?
- Immune system compromise
- Athrosclerosis
- Depression
- Insulin insensitivity
- Obestiy
- Hyperlipidemia
- Protien breakdown in blood, bones (osteoprosis), Muscle (heart) immunoglobulins
What are some end results of chronic stress?
- Essential hypertension
- Heart disease/stokes
- Diabetes
- Cancer
- Ulcers/chronic GI problems
- Atherosclerosis
- Arthritis
- Autoimmune diseases/allergies/eczema
- Kidney and liver diseases
- Chornic GI problems
- Headaches
What is PTSD dignostic criteria?
- Exposure to actual or threatened death, injury, or sexual violence
- Presence of intrusion symptoms
- avoidance of associated stimuli
- Negative alt. in cogntions/mood
- Altered arousal & reactivity
- Symptoms lasting longer than one month
- Often presents with suicidal ideation & depression
Using TRAUMA for PTSD what should we remember?
T-Traumatic event
R- Re-experiencing the trauma
A-Avoiding things associated with the trauma
U-Unable to focus (can come off as irritability)
M- For 1 Month
A- Increased arousal (hyervigilance, startle response)
What are some treatment modalities for PTSD?
- Cogntive behavioral therapy
- Prolonged exposure therapy
- EMDR: eye movement and reporcessing
- Adaptive disclosure (specific to military)
- Meds SSRI
- Meds: other to treat target symptoms such as psychosis
Prozosin may be used to help with nightmares
What is acute stress disorder diagnostic criteria?
- Exposure to actual or threatened death, injury or sexual violecne
- Negative mood
- Dissociative & Avoidance behaviors
- Arousal symptoms
- Intrusion symptoms
- Hypervigilance
- Resolution of symptoms within 1 month
must last at least 3 days but less than 1 month
What is our treatment of acute stress disorder?
- May resolve without treatment
- Meds: Benzos PRN for severe symptoms
Long term anxiety meds are not ideal because of the timeframe of this disorder by the time those kick in there over it
Dissociative identiy disorder formaly known as
Multiple personality disorder