Anxiety Flashcards
(46 cards)
What is the stress response?
Exposure to stress results in instantaneous and concurrent biological responses to asses the danger and organise an appropriate response
What is the role of the amygdala in the stress response?
Acts as the emotional filter to assess if sensory material via thalamus requires a stress/fear response, then goes to cortex for decision
Describe what happens chemically in the stress response.
Acute stress causes dose-dependent increase in catelcholamines and cortisol
Cortisol acts to mediate and shut down the stress response through negative feedback acting on the pituitary, hypothalamus, hippocampus and amygdala
What sites of the brain are responsible for stimulation of cortisol release?
Hypothalamus
Pituitary
Hippocampus
Amygdala
List 7 types of anxiety disorder
Generalised anxiety disorder Panic disorder Agoraphobia Social phobia Specific phobia OCD PTSD
Describe GAD
Generalised, persistent, free-floating - not specific to environmental circumstances
Describe presentation of GAD
Typically presents with physical symptoms
Restlessness/on edge
Irritability
Easily fatigued
Mind blank
Muscle tension
Sleep disturbance
Fear that something bad is going to happen
Lasts almost every day for approx. 6 months
What is typical age of onset of GAD
20-40
WHat is female to male ratio of GAD
2:1 F:M
50% of GAD are co-morbid with other psychiatric disorders. True/false?
False - 90% co-morbid
What is management of GAD?
CBT
SSRIs/SNRIs
Pregabalin
Benzodiazepines (short term only for acute anxiety)
What is CBT based on and how does it help the individual?
Based on identifying individuals automatic thoughts, cognitive biases and schemas
Help the individual identify thoughts, assumptions, misinterpretations and behaviours that perpetuate the anxiety
What is panic disorder?
Recurrent attacks of severe anxiety or panic which are not restricted to any particular situation so are unpredictable
What are dominant symptoms of panic disorder?
Sudden onset physical symptoms e.g. palpitations, chest pain, choking sensations, dizziness
Feelings of unreality
Secondary fear of dying, losing control or going mad
GAD and panic disorder can be due to the direct physiological effects of a substance or medical condition e.g. hyperthyroidism or caffeine. True/false?
False - they are NOT due to these
Approximately what percentage of patients with panic disorder have agoraphobia?
50-70%
What is typical age of onset of panic disorder?
Adolescence - mid 30s
WHat is usual course of panic disorder?
Chronic - fluctuates
Lifetime prevalence of GAD is approx. 3%/9% and lifetime prevalence of panic disorder is approx. 3%/9%.
GAD - 9%
Panic disorder - 3%
The following are what kind of symptoms of anxiety?
Sweating, hot flushes, cold chills Trembling Muscle tension Numbness/tingling Dizzy/faint Dry mouth Feeling of choking Lump in throat Difficulty breathing Palpitations Chest pain Nausea/abdominal distress
Physical/biological symptoms
The following are what kind of symptoms of anxiety?
Fear of losing control/going crazy Feeling on edge Difficulty concentrating Derealisation Depersonalisation Hyper vigilance Racing thoughts Meta-worry (worrying about worrying) Health anxiety Beliefs about needing to worry Preference for order and routine
Cognitive symptoms
The following are what kind of symptoms of anxiety?
Avoidance Exaggerated response to minor surprises Difficulty in getting to sleep Excessive use of alcohol/drugs Restlessness Irritability Checking behaviours
Behavioural symptoms
What type of anxiety disorder has higher prevalence in cardiology clinic than in general population?
Panic disorder
What are two mechanisms of inducing panic attacks that people with panic disorder are more susceptible to panic attacks with?
Infusing lactate
Re-breathing CO2
