Anxiety
Name the disorders assoc, with anxiety
GAD
Panic
Specific Phobias
Social Anxiety (aka Social phobia)
Agoraphobia
Anxiety & fear lead to the _________ physiological response
The difference between anxiety & fear is.......
same
Anxiety can occur WITHOUT (defined or anticipated) a stimulus, fear occurs with a stimulus.
Hypothalamic levels of Corticotrophin Releasing hormone (CRH) are increased by _________ which activated the HPA Axis to release more cortisol
stress
cortisol
Approx_____% of ppl with anxiety disorder have a family with anxiety
Which variant is this assoc. with?
50%
Serotonin transport gene
Which decreased sleep cycles are assoc with GAD
delta
stage 1
reduced REM
Anxiety is a ________ emotional response and not always assoc. with a ________
normal
disorder
1. The __________ helps processes stimuli to identify threats to mount a response out of fear
2. What other brain areas help to regulate fear?
3. Fear circuity plays a role in_________ memory
1. Amygdala
2. Hypothalamus & periductal grey matter
3. fear
This NTs causes
increased noradrenergic fxn
when the noradrenergic system is poorly regulated hyperactivity can cause periods of anxiety (panic sx)
it is located in the locus ceruleus and involved in fear response
NE
GAD DSM 5 TR definition pg 250
A. excessive anxiety & worry (apprehensive expectation) occurring more days then not for at least 6 months about a number of events or activities( such as work or school performance)
B. individual finds it difficult to control worry
C. anxiety/worry assoc with 3 (or more) of the following sxms ( with at least some sxms being present more days then not for 6 months
1. restlessness, feeling keyed up, or on edge
2. easily fatigued
3. difficulty concentrating or mind going blank
4. Irritability
5. muscle tension
6. sleep disturbances(difficulty falling asleep, staying asleep, restless, or unsatisfying sleep
D, must cause impairment in at least some area of fxing.
E, Not assoc with SUD or medical condition
F,Not better explained
Panic attacks
Anxiety can some times be __________
Anxiety helps to mount a ______,______, or _______
response
adaptive (ex. testing, running from a threat)
fight, flight, or freeze
Anxiety is one of the most _______ disorder classes
______% of the population could be dx'd with anxiety disorder which is more common in ________ then ______
Still common in _________ in comparison to other psychiatric disorders
common
25%.females then males
males
This NTS role
increased or decreased levels cause panic disorder
LSD cause a rapid release of this NT and causes anxiety
******Balance is needed with this NT
SSRI can be helpful
____________ is an anxiolytic 5HT1A receptor agonist
5HT
Buspirone
GAD is the ________ common anxiety disorder and may occur with _________ sxms
occurs more often in __________
onset is _______ adolescence or _________ adulthood
common, panic
women
late, early
All of the following are?
worry is out of proportion and excessive
interferes with fxning in life
physical sxms are present : h/a, muscle tension, GI issues, TMJ/teeth grinding, SOB, tachycardia
Tips for dxing GAD
(usually PCP 1st for physical sxms
stressful events may prompt treatment)
Anxiety becomes a problem with it becomes _____________
Anxiety becomes a problem when it becomes _______ __________
maladaptive
long term
1. extends beyond when the stimulus has passed
2. associated with benign stimuli (ex. opening up ur door)
3. contributes to over all health concerns (pain, GI issues)
****** anxiety presents in children and elderly through increased pain or GI sx
The role of the Autonomic Nervous System in anxiety is..........
increases sympathetic nervous system
&
responsible for physical sxm w/ anxiety
This NT is........
inhibitory
decrease in GABA
________ are primary anxiolytics that work to enhance GABA at the __________ receptors
GABA
Benzos, GABA A
Common morbidities of GAD include (4)
Depression
Panic Disorder
Social phobia
SUD
True or False
Having panic attacks mean one has panic disorder
False
One has to have a MALADAPTIVE pastern of avoidance & persistent significant worry about having another attack
(ex. driving 20 mins out of the way to take the kids to school to avaid
Anxiety is a __________ assoc. with other psychiatric disorders.
what other disorders is anxiety assoc. with?
symptom
depression with anxious features
Anxiety from psychotic symptoms
The role of the Hypothalamic Pituitary Adrenal (HPA) Axis in anxiety is..........
Corticotrophin releasing hormone (CRH) is released by the ________ & __________ a stress response
HPA axis asso. w/ increased synthesis (making) and release of cortisol(INCREASED HR, breathing, and B/P). & mobilizes energy
hypothalamus. medicates(brings out) a stress response
name the 3 Anxiety theories and explain
1. Psychoanalytic: presence of danger in subconscious
2. Behavioral: conditioned response
3. Existential: response to perceived personal void, purposelessness (world and life)
Patho of GAD is ________
Which NTs are involved
unknown
5HT and GABA
Explain Panic Attack and specifiers
DSM 5 TR pg 235
A. abrupt surge of intense fear or intense discomfort that reaches a peak in minute during which 4 (or more) of the follower sx occur
1. palpitations
2. sweating
3. trembling/shaking
4 sensation of SOB or smothering
5 feeling of choking
6 CP or discomfort
7 Nausea or abdominal distress
8 feeling dizzy, unsteady. light headed or faint
9 chills or heat sensations
10 paresthesia( numbness or tingling)
11 derealization( feelings of unreality) or depersonalization(being detached from one's self)
12. fear of losing control or going crazy
B. at least one of the attacks has been followed by 1 month (or more) of the following
1. persistent or worry about additional panic attacks or their consequences (losing control, having a MI, or going crazy
2.signifigant maladaptive change in behavior r/t attacks( behaviors designed to avoid attacks such as avoiding exercise and unfamiliar situation)
C. not attributed to SUD or medical ( hyperthyroidism or cardiopulmonary disorders)
D. not better explained by another psychiatric disorder