Anxiety

Question 1

What are the causes of anxiety?

Answer 1

• Medical
• Drug withdrawal
  
  • Alcohol
  • Tobacco
  • Cannabi
  • Benzodiazepine
  • Opioids
  • Caffeine
  • Cocaine
• Stressful upcoming life events

Question 2

Outline the pathophysiology of anxiety

Answer 2

• Neural circuitry involving the amygdala and hippocampus
  
  • ​The amygdala regulates anxiety and fear, stimulating the HPA axis and sympathetic nervous system
  • The hippocampus regulates emotional memory along with the amygdala
• Decreased GABA level in the cortex
  
  • GABA is an inhibitory neurotransmitter

Question 3

Name the types of anxiety

Answer 3

• Generalied anxiety disorder
  
  • Excessive symptoms for most days for 6 minutes
• Panic disorders
  
  • Recurrent panic attacks
• Phobias
  
  • Irrational and intense
  • Limited to certain situations
  • Leads to avoidance and anticipatory anxiety

Question 4

What are the signs and symptoms of anxiety?

Answer 4

• Unease
• Muscular tension
• Restlessness
• Fatigue
• Lack of concentration
• Withdrawal from social situations
• Neurological - headache, vertigo, presyncope
• GI - abdo pain, nausea, diarrhoea, indigestion, dry mouth
• Resp - SOB
• Cardiac - Chest pain, palpitations
• Urinary - frequency, urgency

Question 5

How is anxiety diagnosed?

Answer 5

• DSM-5
  
  • Excessive anxiety - occurs for 6 months
  • Challenging to control
  • Accompanied with at least 3 months
• Generalized anxiety disorder questionnaire (GAD-7)
• ICD 10

Question 6

How should anxiety be managed?

Answer 6

• Education about anxiety and active monitoring
• Lifestyle
  
  • Keep active
  • Prioritise slee, relaxation, exercise, healthy eating
  • Avoid alcohol, drugs, quit smoking/coffee
• CBT
• Medication
  
  • SSRI -sertraline
  • SNRI - Duloxetine
  • GABA analogue - Pregabalin
  • Beta blockers - propanalol