Week Nine - Anxiety Disorders Flashcards
What is anxiety?
An individuals specific internal reaction to a perceived threat or stress
What can anxiety help do?
motivate, focus, warn of danger, activate flight/fight
When does anxiety become.a disorder?
When feelings of tension and anxiety persist for most days for 6 months or more - not to a proportional threat/stressor
What 2 things become apparent when anxiety becomes a disorder?
Behavioural disturbances and physical symptoms
Mental symptoms of anxiety? (7)
racing thoughts uncontrollable thinking concentration issues panic, dread, impending doom irritable heightened alertness sleep/appetite problems dissociation
Physical symptoms of anxiety? (7)
sweating heavy/fast breathing blushing/hot flushes dry mouth shaking tiredness/dizziness stomach aches
DSM5 definition of GAD? 4 main points
Excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events or activities
- find it difficult to control the worry
Causes clinically significant distress or impairment in social, occupational or other important areas of functioning
Not attributable to the physiological effects of a substance or another medical condition.
Not better explained by other mental disorders
Three or more what symptoms must be present over the 6 months?
- Restlessness/on edge
- Being fatigued
- Difficulty concentrating/mind going blank
- Irritability
- Muscle tension
- Sleep disturbance
Main psychotherapy for anxiety?
CBT
Main medications used to treat anxiety?
SSRI’s/SNRI’s (antidepressants)
Benzodiazepines
Beta-blockers
Anxiety includes higher risk of?
Developing depression, alcohol or other drug dependence disorders
Other anxiety disorders
Established drug treatments for anxiety target what NTs?
Serotonin, noradrenaline and GABA
Positives of Benzodiazepines?
Reduce the somatic and psychological symptoms of anxiety in panic disorder, GAD and SAD.
Problem with benzodiazepines
The withdrawal symptoms (syndrome) is frequently mistaken by patient as indicating that the anxiety for which the drug was originally started has returned
What is similar to benzodiazepines?
Barbiturates
Problems with barbituates?
Highly addictive and extremely dangerous (overdosing)
What do Benzodiazepines and barbiturates do?
The both act on the gabaergic chloride channel
Benz acts on the inside of the channel and aim to block
Barb acts on the outside on the and acts on gating abilities
Which drug increases duration of GABA channel opening? Which one increases frequency?
Barbiturates = duration Benzo = frequency
How do beta-blockers work?
By activation in the sympathetic NS (noradrenaline is released) - dampens down the heart rate, sweating etc
First-line recommendation for anxiety?
Antidepressants
Evidence of a dose-response relationship with antidepressants?
Little evidence - most patients will respond to standard doses
Difference between anxiety and depression with antidepressants?
Anxiety is generally slower to respond
Enhanced outcomes of anxiety associated with?
Addition of psychotherapy as well as using antidepressants
How do SSRI’s work?
Inhibits the transporter that reuptakes serotonin - takes 4-6 weeks to work
How does Buspirone work? How long?
Acts as an agonist on the 5HT1A receptor (full at presynaptic but only partial at postsynaptic) - takes 2 weeks
Where does serotonin start?
raphe nuclei (then divided up)
What is the two-systems model of fear?
one system used for generating conscious feelings of fear (cognitive circuit)
One system is fr controlling behavioural and physiological reactions (defensive survival circuit)
