Anxiety (Panic Disorder (GAD (Anxiety ( worry
- perspirations :sweat_drops:
- :female_sign:Women suffer more than men
- Onset in teens/early 20s
- Pt gets uncomfortable and develops mood disorders (± MDD, ± EtOH :beer_mugs:)
Path: Chronic, insidious, low level of anxiety all the time
- Constant state of worry
- about most things
- on most days
- ≥ 6mo
- & ≥3 somatic complaints (sleep change :bed:, Weight change :pregnant_woman::skin-tone-2:, irritability :angry:, lack of concentration)
Tx: Psychotherapy >> Rx
- teach person to deal w/ anxiety
Rx: SSRI, buspirone
:pencil2:GAD often comorbid w/ panic attacks (tx w/ benzo's). :warning: Don't prescribe for GAD alone, develops dependence.
:pencil2:There are no specific triggers, they just worry. So if there is an external stressor, r/o GAD.
Instead, look for there person who makes mountains out of molehills, and stresses.
Path: Acute, overt, catastrophic
- out of the blue.
Fear: Irrational, Exaggerated :ghost:
- against a specific object or situation
Indiana Jones is hindered by his occupation which usually brings him in contact w/ snakes, but he has an exaggerated response that is irrational
- heights, flying :airplane:
- spiders :spider:, clowns, snakes :snake:
- flooding: quick, doesn't last. Overload of the stimulus.
- desensitization: Lasts, takes longer. Slowly incrementing the severity of the offending stimulus.
- public speaking
- public peeing
Tx: Nonselective beta blockers :trumpet:
- propranolol or nadolol (tremors & voice crack)
- evolutionary response to stay alive
- getting triggered after a trauma (lion attack, now fears kittens) is not pathologic.
- Pathologic: learned or new fear against something that you know you should not be afraid of, + loss of control.
- eg fear of clowns, small spiders
- Vague sensation that something is wrong.
- Anxiety might be driven by stimulus, or relieved by an action
- Will introduce the concept here then show 2 diseases: Chronic vs. Acute, then introduce phobias
- Anxiety is difficult to pinpoint: one persons anxiety may be different from another.
- But 1 person's anxiety is felt by that person the same way every time they feel anxiety.