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Anxiety Disorders - Coggle Diagram

- - - - Sense of resistance - may be lost with time
      - Tries to suppress or ignore obsession or to neutralize them by performing compulsions - can be successful initially but cannot prevent their repetition
      - Preservation of insight - recognised as one's thoughts but unwanted and anxiogenic (egodystonic)
    - - Simple
        
        Eg a song
      - Complicated
        
        Eg a sequence of words reiterated inside a persons head
  - - - Simple
        
        Eg checking door is locked when leaving house
      - Complex
        
        Needing to shower, dress and undress in a particular way before leaving house and needing to start over if failing to do so precisely
  - - - Fear of contamination
      - Concerns regarding threat of illness or feeling of being physically unclean or mentally polluted
      - Avoid situations associated with feared contaminations (public bathrooms)
      - Protective rituals - excessive washing or cleaning / designating clean areas that are off limits to others
    - - Preoccupation with symmetry, arranging, counting and exactness
      - Feeling of incompleteness
      - Magical thinking (eg belief that a thought can cause an event to happen or not)
      - Repetitive organising or arranging
      - Following rigid rules
      - Mental arranging or counting
      - Tapping and touching behaviours
    - - Intrusive images, impulses and fears related to the possibility f unintentionally harming themselves or others
      - Excessive doubt or uncertainty
      - Heightened feeling or responsibility
      - Repetitive checking behaviours to prevent dangerous outcomes
    - - Unwanted obsessions that violate morals or values, often of a religious, violent or sexual nature
      - Can present as pure obsessional
      - Mental ritualisation (arguing)
      - Mental neutralizatoin
      - Reassurance-seeking or avoidance of known triggers
- - - - Agoraphobia
      - Social phobia
      - Animal phobias
    - - Illness phobias
      - Obsessive phobias
      - Miscellaneous specific phobias
  - - - Animals
      - Heights
      - Flying
      - Closed spaces
      - Blood-injury-illness
        
        Particular propensity to vasovagal symptoms
  - - - Public speaking
      - Eating in public
      - Signing a document under scrutiny
      - Urinating in public toilet (men)
    - - Specific / performance type
      - Generalized type
  - - - Public transport
      - Open or enclosed spaces
      - Standing in lne
      - Crowds
- - - - Initiated by HPA axis and sympathetic nervous system- fight or flight response
      - Universal emotion - necessary and adaptive reponse of the organism to stress in response to immediate threats
    - - Disabling conditions marked as abnormal severity, prolonged duration, trivial nature of the triggering events, or the disabling effect of anxiety
    - - The quality of being anxious now, at this particular time, probably as a reaction to provoking circumstances
    - - The tendency over a long time, perhaps through life, to meet all vicissitudes of life with a habitually excessive degree of anxiety
    - - A diffuse, chronic sense of uneasiness, uncertainty and apprehension not related to a specificl event, object or situation
      - Often seen in generalised anxiety disorder
    - - When there is a particular target for feeling anxious, as in phobic states (specific obejcts), health anxiety, obsessive-compulsive disorder (recurring and unwanted thoughts), or social anxiety (particular situation)
  - - - Cardiovascular
        
        Palpitations
        
        Increased HR / BP
        
        Chest pain
      - Respiratory
        
        Breathlessness
        
        Hyperventilation
      - Neuromuscular
        
        Tension
        
        Tremor
        
        Light-headedness
        
        Dizziness
        
        Tingling sensation
      - Gastrointestinal
        
        Nausea
        
        Butterflies
        
        Diarrhoea
      - Feelings of choking
      - Cutaneous mucosal
        
        Dry mouth
        
        Cold skin
        
        Sweating
        
        Chilling
        
        Flushing
    - - Sense of apprehension
      - Anxious anticipation
      - Worrying over trivia
      - Pointless rumination
      - Psychis terror - fear of losing control, going crazy, imminent death
      - Depersonalization / derealization experiences
    - - Association of specific situations with anxiety and avoiding them
- - - - Phaeochromacytoma
      - Hypoglycaemia
      - Hyperthyroidism
- - - - Used in all anxiety disorders
      - Serotinergic agents
        
        1️⃣ 1st line SSRI
        SNRI or mirtazapine have been used
      - Benzodiazepines
        
        Anti-anxiety
        
        High risk of dependance
        
        Short term, low dose
  - - - Graded exposure to phobias
      - Exposure fear hierarchy - objects, activities or situations ranked and faced according to difficulty
- - - - Sertraline
    - - Clomipramine
- - - - Development of a transient and rapid response to a significantly stressfull situation
        Response to the stressor is considered to be normal, given the severity of the stressor, and is not considerd a mental health disorder
    - - Emotional symptoms
        
        Afflicted
        
        Anxious
        
        Sad
        
        Angry
        
        Numbed
      - Cognitive symptoms
        
        Dazed
        
        Unable to recall
        
        Confused
        
        Dissociative symptoms
      - Behavioural symptoms
        
        Overactivity
        
        Agitation
        
        Aggression
        
        Isolation
      - Somatic Symptoms
    - - No treatment need
      - Usually resolved within days / weeks of stressful event
      - Understand cause of symptoms and discussion may help
  - - - A maladaptive reaction to one or more psychosocial stressors
        Eg divorce, illness, disability, economic problems
      - Characterised by excessive worry, constant rumination or distressing thouhgts and preoccupation withstressor or its consequences which cause significant impairment in functioning
    - - Emerges within 1 months of stressor - does not last more than 6months usually
    - - According to predominant symptom
      - Anxiety
      - Depression
      - Conduc
    - - 3/4 recover fully
      - 1/5 have persistent problems
    - - Psychoeducation
      - Psychological support
      - Practical help to resolve stressor
      - CBT
      - Medication - SSRI/ benzoz
  - - - Pre-disposing development of PTSD
      - Poor self esteem
      - Poor social support
      - Hx mental illness
      - Previous trauma
    - - Hyperarousal
        
        Hypervigilance
        
        Increased startle response
        
        Sleep difficulty
        
        Irritability
      - Reliving
        
        Flashbacks
        
        Nightmares
        
        Intrusive imagery
      - Avoidance
        
        Emotional numbing
        
        Avoidance of reminders of event
        
        Feeling detached from others
        
        Difficulty recalling event
    - - 50% recover50% chronic
    - - Drug treatment
        
        SSRIs
      - CBT
      - EMDR - Eye movement desensitisation and reprocessing
      - Psychotherapy
        
        PTSD relatig to childhood typically require longer-term psychotherpy
- - - - 4-12%
      - 3:1 female
      - Onset early teens
    - - 2.5-3%
      - 1:1 male female
      - Onset early teens / later in life
    - - 3-6%
      - 3:1 female
      - Onset 20s-30s
    - - 1.5-5%
      - 2:1 female
      - Onset mid teens - mid 20s
        Mid 40s- mid 50s
    - - 2-6%
      - 2:1 female
      - Onset early teens / later life
  - - - Neurotransmitter / receptor hypothesis
      - HPA axis dysregulation leading to exaggereated autonomic response
    - - Negative affectivity
      - Anxiety sensitivity
      - Behavioural inhibition
      - Fear of negative evaluation
      - Harm avoidance
      - Neuroticism
    - - Parental modeling (overprotectiveness)
      - Stressful events (abuse / loss / seperation)
      - Actings
      - Predisposing, precipitating or perpetuating factors