Anxiety vs Fear
Anxiety: anticipation of threat
Fear: emotions to danger
Abnormal anxiety
Out of proportion or prolonged
Symptom of children
Abdominal pain
NT involved in anxiety
NE, Serotonin, Dopamine, GABA
Separation Anxiety
Abnormal after 2.5 years.
Often with another anxiety disorder.
Etiology: Parent (modeling, styles, anxiety), External stress
Tx: CBT, Family psychosocial therapy, SSRI
Specific phobia
Cued by specific object or situation
Greater than 6 months.
Etiology: Modeling (runs in the family), Substance abuse common
Tx: Anti-anxiety meds, Desensitization
Social anxiety
Fear of embarrassment (not actual situation)
Sx: blushing & muscle twitching
Etiology: Parent with panic disorder, overcritical, not caring
Tx: SSRI, SNRI, Buspar, Benzo
BB for performance.
CBT, Exposure therapy
Panic disorder
Etiology: Greater life events/loss Hyperventilation: paper bag to avoid resp alkalosis May vasovagal & lose consciousness Course: Chronic, late adolescence Tx: CBT, SSRI, Benzos. 6-12 mo.
Agoraphobia
Fear of places can’t escape from.
1st line=SSRI
Benzo, TCA, Pyschotherapy
GAD
Worry about everyday things, constant
More days than not for >6 mo.
Presentation: may be due to somatic sx, “as long as can remember”
Course: lifelong
Tx: lifelong-SSRI, SNRI, Benzo, Buspirone
Drug therapy often needed for CBT to work
Does not CURE.
Due to other medical condition
- MCC: Cardiomyopathy & waiting transplant
- Sjogrens & Graves ds
Course: wax & wane with medical condition
Tx: Tx underlying condition
If still–SSRI, Benzo, therapy
Substance-induced
Sympathomimetics (amphet, cocaine, caffiene)
Serotenergic (LSD, MDMA)
Other
Alcohol
Sx: Memory & cognition may be impaired
other specified
- Limited sx attack
- GAD but occurs on less than more days than not
- Kayal cap
- Ataque de nervious
Communicated why ds doesn’t meet full criteria
