Week 4 - Anxiety disorders Flashcards
Compare anxiety to an anxiety disorder
Anxiety - normal human response of apprehension or stress about an event or experience
* is not usually debilitating, and is often motivating
* has a clear trigger eg. an exam
Anxiety becomes a disorder when symptoms are persistent, prolonged, excessive, and cause significant distress/disability
* debilitating
* with no obvious trigger
* response is disproportionate to the trigger
Physical symptoms of anxiety
- tachucardia
- dry mouth
- chestb pain
- sweating
- shortness of breath
- headaches
- muscle tension
- insomnia/not switching off
- trembling/shaking
- N+V
Psychological symptoms of anxiety
- feeling of impending doom
- feeling on edge
- extreme or irrational fear
- rumination - the repetitive dwelling on negative feelings which perpetuates distress
- hypervigilance - the elevated state of constantly assessing/being aware of threats around you caused by excessive stress
- low tolerance for stress
- irritable
- impaired concentration
Behavioural symptoms of anxiety
- Catastrophising - a way of irrationally imagining the worst possible outcome of a situation or event will come true
- avoidance behaviours
- isolation
- agression
- increased substance consumption
- shutting down
Physiological cause of anxiety
The amygdala (which tempers fear and anxiety) is overactive of people with anxiety
* therefore the stress response and fight flight freeze response in response to stressors or stimuli is increased
* sometimes there is anxiety with no stimuli
Also serotonin, norepinephrine and dopamine irregularities in brain, similar to depressive disorders
Internal factors causing anxiety
Childhood temprament/temprament in general
* shyness
* distress when separated from parents
* fear of new situations
* reluctance to interact with new people/things
* withdrawal from social situations
External factors causing anxiety
- serious physical illness
- school/work stress
- overuse of caffeine
- relationship issues
- trauma eg. death of a loved one
- use of illicit drugs
- financial worries
- abuse
- sudden life changes eg. pregnancy
Environmental factors causing anxiety
Childhood trauma
* sexual
* physical
* neglect
Parenting style
* controlling
* over-protective
* over-involved
* critical/cold
rates are higher where parents are also anxious
Generalised anxiety disorder
An anxiety disorder characterised by anxiety or worry about a number of events or activies which is excessive, difficult to control, debilitating, and often chronic
- restlessness
- poor concentration
Social anxiety disorder (social phobia)
An anxiety characterised by excessive or inappropriate worry in social situations which is debilitating and chironic
- fear of being judged or scrutinused
- fear of being observed
- hyperaware
- leads to isolative or avoidant behaviours
Specific phobia
eg. agoraphobia
Marked and disproportionate fear or anxiety about a specific object or situation which consistent provokes intense fear and consequent avoidant behaviour, and is debilitating
- most of the time are aware the fear is irrational, but cant control the response
- can develop in response to traumatic event eg. afraid of spiders after being bitten
Obsessive compulsive disorder
An anxiety disorder charactersed by a pattern of uneanted throughts and fears (obsessions) which lead to repetetive behaviours (compulsions), which is extreme and debilitating
- cleaning
- checking (eg. is the door locked)
- counting
- ordering
- reassurance
- hoarding
- repetitive thinking
Agoraphobia
An anxiety disorder characterised by a fear of being in unfamiliar open or enclosed spaces which is debilitating
* catastrophising
* avoidant behaviour - may never leave the house
* may have panic attacks at thought of fear or when confronted by fear
Panic disorder
A physically symptomatic anxiety disorder characterised by reccuring, unexpected panic attacks, and is debilitating
Panic attacks - experience of a distressing array of symptoms with or without trigger (typically no trigger or in certain situations)
* hyperventilation
* sudden impending feeling of stress or danger
* dizziness
* loss of concentration
- happen when resting, relaxing, waking from sleep
- sometimes leads to avoidant behaviours
Panic disorder is common in conjunction with any of the other anxiety disorders
SSRIs
long term
Long term treatment alongside beta blockers
MOA: inhibits the reuptake of serotonin at the synaptic cleft to increase serotonin activity
* reduce anxiety symptoms
takes 2-4 weeks to take therapeutic effect
eg. prozac, zoloft, lexapro, luvox
Side effects: fatigue, hot flashes, insomnia, headache, tremor, sexual dysfunction
Avoid concurrent administraation with other SSRIs, MAOIs and St John’s Wort
