Week Nine - Anxiety Disorders

Question 1

What is anxiety?

Answer 1

An individuals specific internal reaction to a perceived threat or stress

Question 2

What can anxiety help do?

Answer 2

motivate, focus, warn of danger, activate flight/fight

Question 3

When does anxiety become.a disorder?

Answer 3

When feelings of tension and anxiety persist for most days for 6 months or more - not to a proportional threat/stressor

Question 4

What 2 things become apparent when anxiety becomes a disorder?

Answer 4

Behavioural disturbances and physical symptoms

Question 5

Mental symptoms of anxiety? (7)

Answer 5

racing thoughts
uncontrollable thinking
concentration issues
panic, dread, impending doom
irritable
heightened alertness 
sleep/appetite problems
dissociation

Question 6

Physical symptoms of anxiety? (7)

Answer 6

sweating
heavy/fast breathing
blushing/hot flushes
dry mouth
shaking
tiredness/dizziness
stomach aches

Question 7

DSM5 definition of GAD? 4 main points

Answer 7

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

Question 8

Three or more what symptoms must be present over the 6 months?

Answer 8

1. Restlessness/on edge
2. Being fatigued
3. Difficulty concentrating/mind going blank
4. Irritability
5. Muscle tension
6. Sleep disturbance

Question 9

Main psychotherapy for anxiety?

Answer 9

CBT

Question 10

Main medications used to treat anxiety?

Answer 10

SSRI’s/SNRI’s (antidepressants)

Benzodiazepines

Beta-blockers

Question 11

Anxiety includes higher risk of?

Answer 11

Developing depression, alcohol or other drug dependence disorders

Other anxiety disorders

Question 12

Established drug treatments for anxiety target what NTs?

Answer 12

Serotonin, noradrenaline and GABA

Question 13

Positives of Benzodiazepines?

Answer 13

Reduce the somatic and psychological symptoms of anxiety in panic disorder, GAD and SAD.

Question 14

Problem with benzodiazepines

Answer 14

The withdrawal symptoms (syndrome) is frequently mistaken by patient as indicating that the anxiety for which the drug was originally started has returned

Question 15

What is similar to benzodiazepines?

Answer 15

Barbiturates

Question 16

Problems with barbituates?

Answer 16

Highly addictive and extremely dangerous (overdosing)

Question 17

What do Benzodiazepines and barbiturates do?

Answer 17

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

Question 18

Which drug increases duration of GABA channel opening? Which one increases frequency?

Answer 18

Barbiturates = duration
Benzo = frequency

Question 19

How do beta-blockers work?

Answer 19

By activation in the sympathetic NS (noradrenaline is released) - dampens down the heart rate, sweating etc

Question 20

First-line recommendation for anxiety?

Answer 20

Antidepressants

Question 21

Evidence of a dose-response relationship with antidepressants?

Answer 21

Little evidence - most patients will respond to standard doses

Question 22

Difference between anxiety and depression with antidepressants?

Answer 22

Anxiety is generally slower to respond

Question 23

Enhanced outcomes of anxiety associated with?

Answer 23

Addition of psychotherapy as well as using antidepressants

Question 24

How do SSRI’s work?

Answer 24

Inhibits the transporter that reuptakes serotonin - takes 4-6 weeks to work

Question 25

How does Buspirone work? How long?

Answer 25

Acts as an agonist on the 5HT1A receptor (full at presynaptic but only partial at postsynaptic) - takes 2 weeks

Question 26

Where does serotonin start?

Answer 26

raphe nuclei (then divided up)

Question 27

What is the two-systems model of fear?

Answer 27

one system used for generating conscious feelings of fear (cognitive circuit)

One system is fr controlling behavioural and physiological reactions (defensive survival circuit)