Anxiety Flashcards
(138 cards)
1
Q
What is anxiety and how can it manifest?
A
Anxiety appears in many ways—some common and normal, and some as manifestations of mental illness.
2
Q
What are some common triggers of everyday anxiety?
A
Going to the dentist, walking down a dark street, public speaking, test-taking, being in new situations, concern for a loved one, or noticing a worrisome new health symptom.
3
Q
How long does everyday anxiety typically last?
A
It is short-lived and limited to specific situations.
4
Q
What is the purpose of situational anxiety?
A
It makes a person more alert or careful—it’s a normal survival mechanism that can trigger the ‘fight or flight’ sympathetic nervous system response.
5
Q
What happens when anxiety becomes prolonged?
A
It becomes characterized by apprehension, nervousness, worry, and physical/emotional discomfort.
6
Q
How can anxiety result from overload?
A
When prolonged, it can leave the person feeling stretched beyond capacity for too long.
7
Q
What is state anxiety?
A
It is short-term anxiety experienced in response to a specific stressful circumstance, like being hospitalized or taking a high-stress exam.
8
Q
How does state anxiety vary?
A
It ranges in intensity among individuals and situations.
9
Q
How can state anxiety be relieved?
A
Remedies like talking with a friend, going for a walk, or physical nurturance (e.g., hugs) can help.
10
Q
What is trait anxiety?
A
It refers to having an anxiety-prone personality and being more consistently inclined to worry or feel anxious in everyday situations.
11
Q
How does trait anxiety affect state anxiety?
A
It tends to intensify state anxiety and makes it harder to manage.
12
Q
What nickname is often used for individuals with trait anxiety?
A
“Worry warts.”
13
Q
What is the STAI?
A
It is a validated questionnaire that assesses levels of both state and trait anxiety.
14
Q
How is the STAI used?
A
It is frequently used as a measurement tool in research studies.
15
Q
What are common physical signs and symptoms of anxiety?
A
Muscle tension (especially neck), paleness, sweating, shakiness, trembling, lightheadedness, headache, ↑ heart rate/palpitations, pupil dilation, stomach pain, nausea, diarrhea, numbness/tingling, chills/hot flashes, shortness of breath, chest constriction, ↑ blood pressure, dry mouth, choking sensations, frequent urination.
16
Q
What are common psychoemotional symptoms of anxiety?
A
Blank mind, negative thoughts, confusion, indecision, poor decision-making, limited concentration, irritability, panic, derealization, apathy, loss of confidence, difficulty coping, easy discouragement or fatigue.
17
Q
What are common behavioural symptoms of anxiety?
A
Avoiding eye contact, nail biting, pacing, fidgeting, reliance on smoking/drinking/drugs, disinterest in sex, under-/overeating, being clumsy or accident-prone.
18
Q
When does anxiety become problematic or a sign of mental illness?
A
When it is very prolonged or frequent, out of proportion, disconnected from specific circumstances, negatively impacts daily functioning, causes low self-esteem, frequent anger/irritability, and includes panic or anxiety attacks.
19
Q
What are physical health manifestations of problem anxiety?
A
Insomnia, exhaustion, nightmares, flashbacks, hypertension, poor appetite, GI issues, ulcers, recurring headaches, chest pain, palpitations, restricted breathing, hyperventilation, fainting.
20
Q
How does prolonged anxiety affect the immune system?
A
It lowers immune resilience and predisposes the individual to frequent illness.
21
Q
How does prolonged anxiety affect a person’s perception of its cause?
A
The original cause may be forgotten or unclear; anxiety may feel constant and be triggered by a variety of daily events.
22
Q
What are common anxious fixations that emerge in problem anxiety?
A
Money, relationships, job/boss, health, and children.
23
Q
What are key themes of anxiety illness?
A
Pathological worry, hypervigilance, avoidance of people/places/activities, anxious fixations, obsessive thoughts/behaviours, controlling behaviour, violent/suicidal ideation, and self-medication.
24
Q
What is the function of the amygdala in anxiety neurology?
A
The amygdala is a limbic system center that acts as a communication hub between brain areas that process incoming signals and those that interpret them. It alerts the rest of the brain to threats and can trigger a fear/anxiety response. It also helps store emotional memories and forms associations between them and dysfunctional anxiety reactions via its close relationship with the hippocampus.
25
What role does the hippocampus play in anxiety?
The hippocampus encodes painful or threatening events into memory. It can shrink in people exposed to prolonged stress (e.g., child abuse or military combat) due to damage from cortisol. This damage can result in memory fragmentation and flashbacks.
26
What did the 2014 Stanford study on anxiety in children find?
The study found that children with higher anxiety levels had larger amygdalae and more extensive connections between their amygdalae and brain areas related to attention and response regulation. This size difference could predict anxiety behaviours. The children only had subclinical anxiety, and no cause-effect was established.
27
What neurotransmitters are involved in anxiety?
Key neurotransmitters involved in anxiety include:
• Serotonin: linked to mood, well-being, calm thinking
• Dopamine: affects pleasure, pain, motivation, and reward
• GABA: promotes relaxation and sleep
• Norepinephrine: sympathetic neurotransmitter that mobilizes fight-or-flight, focus, memory, and energy
• Endorphins and enkephalins: mood stabilizers, can be suppressed in anxiety
Prolonged anxiety leads to neurotransmitter imbalances; stress alters their homeostasis, but some people may have a genetic predisposition.
28
How is prolonged anxiety related to depression?
Prolonged anxiety can lead to depression. They are often intertwined because:
• Life circumstances can cause both anxiety and depression.
• Anxiety activates the sympathetic nervous system, increasing adrenaline, pain perception, and suppressing digestion/sleep.
• It reduces the ability to return to parasympathetic (rest) state.
• Overuse of mood-balancing neurochemicals and poor sleep lower their availability, which contributes to the development of depression.
29
30
What is meant by “anxiety disorder” or “anxiety illness”?
These are blanket terms for prolonged states of pathological fear, anxiety, or phobia. “Pathological” means the anxiety is not based in fact, is out of proportion, or unrelated to current circumstances. It may involve dysfunctions in fight-or-flight activation or limbic memory processing.
31
How long must symptoms last for an anxiety condition to be considered a disorder?
Generally, symptoms must last 6 months or more to be considered an anxiety disorder. It may involve a single episode, recurrence, or chronic debilitation.
32
How prevalent are anxiety disorders in North America?
Anxiety disorders affect between 18% (average stats) and 30% (common estimate) of the population. Around 8% have more serious diagnoses. They are more common in women and less common in societies with strong family/community norms.
33
When do anxiety disorders usually begin?
Usually before age 30, often before adulthood. They are more active during transitional life phases like adolescence or menopause.
34
What are the forms anxiety presentations can take?
Presentations range from persistent generalized uneasiness to immobilizing worry or terror. Panic attacks and phobias often derive from the foundational anxiety state.
35
What is the relationship between anxiety disorders and depression?
They very commonly co-exist. It is rare for one to occur without some component of the other.
36
How is substance abuse related to anxiety disorders?
There is a strong correlation. Substance abuse is frequently a form of self-medication, often unacknowledged, that stems from anxiety.
37
What are the general causes of anxiety disorders?
While each anxiety disorder may have specific causes, general causes include:
1. Family patterns (genetic and nurture-related)
2. Traumatic experiences
3. Disease states
4. Drugs/chemicals
38
What family-related factors contribute to anxiety disorders?
• Genetic inheritance patterns (over 50% incidence) convey inherited susceptibility.
• Insecure maternal bond, abusive or unsafe home, and overprotective/restrictive parenting can be contributing nurture factors.
39
How do traumatic experiences contribute to anxiety disorders?
• Traumas such as abuse, bullying, or witnessing shocking events, especially in childhood.
• Lack of mature processing or later therapy can prolong/exacerbate the condition.
• Unprocessed trauma makes individuals more vulnerable to future triggers.
40
What diseases are often co-found with anxiety disorders?
• Physical diseases: Multiple sclerosis, heart disease, asthma, hyperthyroidism, diabetes.
• Mental health conditions: Bipolar disorder, eating disorders.
41
Which drugs and chemicals can trigger anxiety disorders?
• Prescription drugs with anxiety side effects.
• Stimulants like caffeine, cigarettes, and marijuana.
• Chemical exposures (especially with experiential symptoms like dyspnea).
42
What does the "Window of Tolerance" concept suggest in relation to trauma?
Traumatic histories can create a diminished window of tolerance, making individuals more reactive or overwhelmed by stress.
43
What are the main types of anxiety disorders?
• Generalized Anxiety Disorder (GAD)
• Panic Disorder
• Post-Traumatic Stress Disorder (PTSD)
• Obsessive-Compulsive Disorder (OCD)
• Phobias: Specific Phobias, Agoraphobia, Social Phobia
44
What characterizes Generalized Anxiety Disorder?
• Persistent anxiety without clear cause
• Excessive worry about daily matters
• Unrealistic threat perception
• Restlessness, fatigue, irritability, trouble concentrating
• Chronic symptoms: muscle tension, headaches, nausea, frequent urination
• Sleep disturbances
• Avoidance of activities and responsibilities
• Fear of going crazy, doom, or death
• Diagnosed after 6 months (or sooner if symptoms are disabling)
• More common in women (2:1), has genetic roots
• Often coexists with other anxiety disorders
45
What is a panic attack?
• Sudden, intense anxiety episode (few to 10 mins)
• Overactivation of sympathetic nervous system ('fight or flight')
• Symptoms: racing heart, chest pain, nausea, shaking, dizziness, sweating, choking feeling, tingling, derealization, crying, hyperventilation
• Can cause irrational thinking and terror
• Ends with exhaustion
46
What defines panic disorder?
• Recurrent panic attacks
• Belief that attacks are serious health crises
• Avoidance of triggers (places, people, events)
• Fear attacks can happen anytime
• Triggers include: stress, lack of sleep, caffeine, physical exertion, medication, hypoglycemia
• Can occur during sleep
• May lead to agoraphobia
• Hypervigilance about health
• Often overlaps with GAD
• Linked with family history, passive personality, and trauma
• Higher in females; onset in adolescence/young adulthood
• Associated with amygdala hyperactivity, substance abuse, depression
• Desensitization therapy can help
47
What causes PTSD?
• Trauma, war, abuse, accidents, near-death, captivity
• Chronic stress exposure (e.g., bullying, domestic abuse)
• Exposure to age-inappropriate events
• Witnessing injury or death
• PTSD can arise from buried memories or delayed onset
48
What are the symptoms of PTSD?
• General anxiety signs: hypervigilance, exaggerated startle, irritability, poor concentration
• Flashbacks, reliving trauma
• Triggers include smells, sounds, anniversaries
• Avoidance of reminders
• Nightmares, disordered sleep
• Emotional numbness, isolation, loss of intimacy
• Anger/rage problems
• Substance abuse
• High risk of self-harm and suicide
• Diagnosed if symptoms persist >3 months
• Gender differences depend on trauma types (e.g., male soldiers, female sexual abuse victims)
49
What characterizes OCD?
• Persistent intrusive thoughts (obsessions) often about germs, safety, inappropriate urges
• Ritualistic behaviors (compulsions) done to neutralize anxiety
• Common compulsions: excessive cleaning, checking, arranging
• Rituals are irrational but feel necessary
• Obsessions and compulsions are distressing and time-consuming
• Temporary relief, not pleasure, is gained
• Awareness of irrationality is present
• Associated with: depression, anorexia, addiction, body dysmorphia
• Brain chemistry and wave patterns are altered
• Genetic links: serotonin transporter gene, striatal processing gene
• Onsets in childhood/adolescence
50
What are phobias and who do they affect more?
• Intense, irrational fear of objects/situations with little or no threat
• Occur 2x more often in females
• Often familial and may have identifiable triggers
51
What are common specific phobias and how do they affect people?
• Examples: spiders, heights, flying, water, needles, blood
• Cause imaginative exaggeration (e.g., drawings of spiders with evil features)
• Cause intense anxiety or panic attacks upon thought or exposure
• Avoidance may be easy or disruptive depending on object
52
What is agoraphobia and how does it relate to panic disorder?
• Fear of public situations due to fear of no escape
• Avoidance of leaving home without support
• Linked to feelings of helplessness
• Often progresses from panic disorder (36%) or social phobia
53
What defines social phobia (social anxiety disorder)?
Fear of social or performance situations
Intense fear of embarrassment or judgment
Can be disabling and affect everyday life
54
What is the difference between coping and not coping in the context of anxiety?
Coping vs. not coping is a key factor in stress handling and in the prevention/management of problem anxiety.
55
What does psychologist Richard Lazarus propose in his cognitive-mediational theory?
He asserts that emotions about a stimulus are determined by our appraisal of it, which is immediate and often unconscious, based on pre-existing psyche, knowledge, memory, and experience.
56
What are the two types of appraisal in Lazarus' theory?
• Primary appraisal: Assesses the significance/threat level of a situation.
• Secondary appraisal: Assesses the person’s ability to cope with the situation effectively.
57
What leads to the feeling of being “stressed” according to Lazarus?
A threatening appraisal combined with no or few effective coping strategies.
58
What are common manifestations of anxiety when stress is not managed?
Panic and avoidance.
59
What characterizes anxiety-prone individuals?
They are more likely to perceive situations as harmful/disastrous and show less coping resilience.
60
What is one measure of success in anxiety treatment?
Improved self-efficacy (subjective/objective coping capacity).
61
What has research shown about massage and coping in people with anxiety?
Massage can improve coping, though the mechanisms aren't always clear.
62
What is central sensitization?
A heightened sensitivity or hyper-reactivity of the central nervous system, often due to intense sympathetic activation.
63
What is the function of central sensitization in acute stress?
It promotes focused thought, safeguarding behaviors, and acute protective awareness in situations of threat.
64
What can lead to being “stuck” in the central sensitization state?
Predisposition elements and traumatic recurrence.
65
What are symptoms of prolonged central sensitization?
• Intense pain perception, lowered pain threshold
• Allodynia (pain from non-noxious stimuli)
• Hyperalgesia (over-intense pain)
• Pain that persists without stimulus
• Chronic avoidance, hypervigilance, anxiety/depression cycle
• Sleep, digestion, and immune issues; headaches
66
How does anxiety relate to central sensitization?
Anxiety predisposition makes one more likely to enter and less likely to exit hyperarousal; neurochemical depletion worsens coping and sleep.
67
What role does neuroplasticity play in central sensitization?
It can reinforce hyperarousal as the new normal in the brain and spinal cord.
68
What are the best predictors of anxiety treatment success?
Early diagnosis, consistent treatment commitment, and multi-therapeutic participation.
69
What must often be addressed first if anxiety co-exists with another disorder?
The co-existing condition (e.g., substance abuse, eating disorder, physical or mental illness).
70
What are some goals/approaches of psychotherapy for anxiety?
• Processing triggers
• Understanding family/contributing factors
• Self-acceptance of predisposition or biochemical needs
• Addressing low self-esteem, passivity, avoidance
• Reframing extreme perceptions of external threats
• Building assertion, control, accountability, support systems
71
What are the two key approaches in interoceptive desensitization?
1. Intentional exposure to the fearful item/situation
2. Intentional symptom provocation (e.g., of panic) to reduce fear and promote control
72
When are medications most effective for anxiety?
When paired with psychotherapy.
73
What are medication goals in anxiety treatment?
To counteract, balance, or restore depleted neurochemicals like serotonin or norepinephrine.
74
What types of medications are commonly used in anxiety treatment?
Anxiolytics, antidepressants, sleep medications.
75
What should massage therapists check for regarding medications?
Side effects that may affect treatment or assessment (e.g., muscle weakness, orthostatic hypotension, insomnia).
76
How long can it take for medications to take effect?
2–8 weeks; side effects may diminish slowly.
77
What are examples of benzodiazepines?
Klonopin, Ativan, Xanax, Diazepam – used short-term for acute anxiety, but may be addictive or have unpleasant side effects.
78
What is Buspar used for?
Generalized anxiety disorder (GAD); newer and less addictive.
79
What are MAOIs and what are their limitations?
Older drugs (e.g., Nardil, Parnate) – require food/beverage restrictions and are incompatible with SSRIs and birth control.
80
What are examples of SSRIs?
Prozac, Zoloft, Paxil, Celexa, Lexapro.
81
What are examples of tricyclic antidepressants and when are they favored?
Tofranil, Anafranil – favored for panic disorder and social anxiety disorder (SAD), especially when anxiety co-exists with depression.
82
How do beta-blockers help with anxiety?
They are blood pressure medications that help control anxiety symptoms.
83
What should be considered when using supplements for anxiety?
They should be used with expert advice, especially alongside medications.
84
What are some supplements possibly beneficial for anxiety?
• Vitamin B (linked to panic disorder)
• Inositol (from cruciferous veggies, may help with OCD/panic)
• 5-HTP (precursor for serotonin/melatonin)
• St. John’s Wort (herbal mood enhancer)
• Kava (kava kava) (fast-acting relaxant)
• Valerian (promotes sleep)
• Bach flower remedies/aromatherapy (some efficacy)
• L-theanine (calming amino acid)
85
What are effective self-care practices for anxiety management?
1. Meditation, visualization, relaxation
2. Regular exercise (adjust if linked to panic)
3. Good diet, sleep, time with friends
4. Yoga, tai chi, diaphragmatic breathing
5. Warm baths or nurturing practices
6. Journaling
7. Avoid caffeine, chocolate, ginseng, recreational drugs
8. Avoid OTC meds with anxiety side effects
9. Don’t use alcohol as a sedative
10. Assertion and interpersonal skills training
11. Self-help or support groups
12. Educating family and friends
13. Massage therapy
86
What causes PTSD?
• Experiences of trauma, abuse, horror, war, captivity
• Frightening accidents/near-death experiences
• Severe injury or risk of injury
• Exposure to non age-appropriate materials/events (esp. children)
• Witnessing abuse, injury, or death of others
• Chronic exposure to stressors beyond one’s coping tolerance (e.g., bullying, domestic abuse, repeated war battles)
87
Who can develop PTSD and when do symptoms appear?
• PTSD can happen to anyone
• Susceptible/predisposed individuals develop PTSD more readily
• Symptoms usually develop within 3 months of the trauma
• Onset can be delayed
• Sometimes activated by buried memories being triggered
88
What general anxiety symptoms are associated with PTSD?
• Hypervigilance
• Exaggerated startle reactions
• Irritability
• Poor concentration
• Persistent, non-specific anxiety
89
What emotional and psychological features often accompany PTSD?
• Feelings of inadequacy or failure
• Loss of trust in self and others
• Survival guilt
• Depression
90
What are common experiential symptoms in PTSD?
• Flashbacks and reliving the event
• Triggered by sounds, smells, etc.
• Avoidance of people, places, situations associated with the trauma
• Distress around anniversaries or similar associations
91
What other symptoms are common in PTSD?
• Panic attacks
• Disordered sleep and nightmares
• Anger/rage problems
• Emotional numbness
• Indifference to loved ones
• Avoidance of intimacy and self-isolation
• High rates of alcohol and medication abuse
• Risk of violence to self and others
• High suicide rate
92
When do PTSD symptoms become considered a disorder?
• If symptoms last longer than 3 months
• If symptoms are recurrent
93
Is there a male or female predominance in PTSD?
Yes, the predominance reflects the scenarios:
• More males with war-related PTSD
• More females with sexual abuse-related PTSD
94
What characterizes OCD?
• Persistent, intrusive, anxiety-driven thoughts/images (obsessions)
• Obsessions often relate to domestic activities, contamination fears, or fear of inappropriate impulses
95
How does a person with OCD typically respond to obsessions?
• Develops precise ritualistic tasks to counteract or avoid anxiety source
• Examples: hand washing, locking doors, arranging objects, walking in patterns
• Rituals often have a superstition-like logic (e.g., “If X is done, Y won’t happen”)
96
What is the “thought avoidance paradox” in OCD?
• Trying not to think a thought (e.g., “don’t think of pink elephants”) makes it more persistent
• This is especially strong in OCD
97
What emotional experience accompanies OCD rituals?
• Driven, uncontrollable quality
• Helplessness, despair, inability to cope with the idea of not performing the ritual
• Relief/satisfaction after ritual, but no pleasure is derived from doing it
98
How do OCD rituals affect daily life?
• Time-consuming
• Distressing
• Interfere with daily functioning
• Tend to worsen over time, becoming more public and humiliating
99
Is the person aware their OCD thoughts and rituals are irrational?
Usually yes, although they may struggle to accept how irrational they are
100
What other disorders or symptoms are often associated with OCD?
• General anxiety symptoms (not the focus)
• Panic attacks
• Depression
• Anorexia nervosa
• Drug addiction
• Body dysmorphic disorder
• Compulsive skin/hair picking
101
What biological factors are linked to OCD?
• Altered brain wave patterns and neurochemistry
• Genetic components: serotonin transporter gene, gene for striatal action processing
• Environmental factors also likely involved
102
When does OCD typically begin?
In childhood or adolescence
103
What is a phobia?
• Intense, irrational fear of things that pose little or no real threat
• Occur twice as often in females
• More likely in predisposed individuals and often run in families
• Can be triggered by events or occur without a specific trigger
104
What are examples of common specific phobias?
Spiders, heights, flying, water, elevators, bridges, tunnels, snakes, dogs, insects, blood, needles
105
How are specific phobias experienced?
• Highly imaginative mental images of the feared object
• May understand the fear is irrational
• Intense anxiety or panic attacks can be triggered just by thinking about the phobic object
• Avoidance is often the primary coping strategy
• Can interfere with daily life if avoidance isn’t possible
106
What did the spider drawing study show about phobias?
• People with arachnophobia drew spiders 7x larger than controls
• Added features like evil faces or horn-like structures
107
What is agoraphobia?
• Fear of public spaces or situations
• Primary fear: being unable to escape or get help
• Intense feelings of vulnerability and fear of being at the mercy of strangers
• Often unwilling to leave home unless with trusted person or going to a “safe” place
108
What are common causes of agoraphobia?
• Frequently a progression of panic disorder (36%)
• May also follow social phobia
• Linked to avoidance of places where panic attacks occurred previously
109
What is social phobia?
• Intense fear of doing things in front of others
• Includes performance fears (e.g., public speaking) and daily social activities (e.g., eating, talking, using public washrooms)
110
What is the person afraid of in social phobia?
• Being judged, scrutinized, or humiliated
• Fixation on what could go wrong
• Negative self-evaluation and fear of being watched
111
What are physical and behavioral signs of social phobia?
• Inability to speak
• Avoids eye contact
• Blushing, sweating, trembling, nausea
• May experience panic attacks
• Avoidance behaviors can develop, sometimes leading to agoraphobia
112
How does social phobia affect daily life?
• Can be very disabling at work or in daily activities
• Affects women twice as often as men
• Person knows their anxiety is irrational but cannot easily control it
113
What conditions and traits are associated with social phobia?
• Amygdala hyperactivity
• Low self-esteem
• Depression, bipolar disorder
• Frequently occurs with other anxiety disorders
• Runs in families and may appear as early as infancy
• Important: Social phobia is not the same as shyness
114
What is the key differentiation in handling stress and managing problem anxiety?
The key differentiation is coping versus not coping.
115
Who developed the cognitive-mediational theory and what does it propose?
Psychologist Richard Lazarus developed it. He asserts that our emotional responses are determined by our appraisal of a stimulus, which is often immediate and unconscious.
116
What are the two types of appraisal in Lazarus' theory?
• Primary appraisal: Assesses the significance of a situation in terms of threat level or potential negative outcomes.
• Secondary appraisal: Evaluates the person’s ability to cope with the situation.
117
What combination leads to the feeling of being "stressed" according to Lazarus?
A threatening primary appraisal combined with a lack of effective coping strategies.
118
What is a common outcome of poor coping in anxiety-prone individuals?
Panic and avoidance behaviors due to perceived threats and lack of coping resilience.
119
What is a measure of successful anxiety treatment?
Improved self-efficacy, both subjectively and objectively (coping capacity).
120
What therapy has been shown to help improve coping in anxiety?
Massage therapy, though the exact mechanisms are not always clear.
121
What is central sensitization?
A state of heightened sensitivity or hyper-reactivity in the central nervous system.
122
What triggers central sensitization and what is its normal purpose?
It is triggered by intense sympathetic activation during physical or emotional threat. Its purpose is to promote awareness, pain perception, and safeguarding behavior for protection and recovery.
123
What happens if the central sensitization state becomes prolonged?
The person may become "stuck" in undifferentiated hyperarousal, leading to chronic pain and behavioral issues.
124
List five manifestations of prolonged central sensitization.
• Intense, prolonged, or stimulus-free pain
• Allodynia (pain from non-nociceptive stimuli)
• Hyperalgesia (exaggerated pain response)
• Insomnia and poor digestion
• Chronic anxiety/depression cycle, hypervigilance, and risk aversion
125
What type of relationship exists between anxiety and central sensitization?
A chicken-and-egg relationship—each can reinforce the other.
126
What role does sympathetic activation play in anxiety and central sensitization?
Persistent sympathetic activation reinforces fear states, distress, and suffering, making it harder to restore emotional homeostasis.
127
What can neuroplasticity do in the context of central sensitization?
It can reinforce the hyperaroused state as the new “normal.”
128
What are the best predictors of successful anxiety disorder treatment?
Early diagnosis, commitment to treatment, and a multi-therapeutic approach.
129
What must be treated first if an anxiety disorder co-exists with another condition (e.g., substance abuse)?
The co-existing physical or mental health disease must often be treated or managed first.
130
What are common goals of psychotherapy for anxiety?
• Processing triggering events
• Understanding family and contributing factors
• Accepting predisposition, need for meds
• Addressing low self-esteem and avoidance
• Reducing overreaction to external threats
• Promoting assertiveness and support system development
131
What is interoceptive desensitization and what are its two approaches?
A form of CBT that involves:
1. Intentional exposure to feared items/situations for desensitization and confidence building.
2. Intentional symptom provocation (e.g., panic attack symptoms) to reduce fear and improve control.
132
How do medications support anxiety treatment?
By counteracting, balancing, or restoring depleted neurochemicals such as serotonin or norepinephrine; most effective when combined with psychotherapy.
133
Why should massage therapists check for medication side effects?
Some side effects can affect treatment or mimic physical complaints (e.g., muscle weakness, dizziness, headaches).
134
How long do anxiety medications typically take to show effect?
2–8 weeks, with side effects often diminishing gradually.
135
Name some anti-anxiety drugs and their uses.
• Benzodiazepines (Klonopin, Ativan, Xanax, Diazepam): short-term use; powerful but can be addictive
• Buspar: used for GAD
• MAOIs (Nardil, Parnate): older, dietary restrictions, not used with SSRIs or birth control
136
Name some antidepressants used for anxiety.
• SSRIs (Prozac, Zoloft, Paxil, Celexa, Lexapro)
• Tricyclics (Tofranil, Anafranil): effective for panic disorder and SAD
• Beta-blockers (e.g., Inderal): blood pressure meds that help with anxiety symptoms
137
What supplements may support anxiety management?
• Vitamin B: May help with panic disorder
• Inositol: May help with OCD and panic attacks
• 5-HTP: Supports serotonin/melatonin; for mood/sleep
• St. John’s Wort: Herbal antidepressant
• Kava: Fast-acting natural relaxant
• Valerian: Promotes sleep
• Bach flower remedies/aromatherapy: Possible mild benefits
• L-theanine: Calming amino acid
Note: Always use supplements under expert guidance, especially with meds.
138
List 13 self-care or lifestyle practices beneficial for anxiety management.
1. Meditation, visualization, relaxation
2. Regular exercise (adjust if panic-linked)
3. Good nutrition, sleep, social time
4. Yoga, tai chi, diaphragmatic breathing
5. Warm baths, nurturing habits
6. Journaling
7. Avoid caffeine, chocolate, ginseng, recreational drugs
8. Avoid anxiety-triggering OTC/prescription meds
9. Avoid using alcohol as a sedative
10. Assertion and interpersonal skills training
11. Self-help or support groups
12. Family/friend education
13. Massage therapy
