N165 Final: Unit 6b

• diffuse, vague feelings of fear and apprehension
• becomes a problem when it is irrational, uncontrollable, and/or disruptive

an intense, irrational fear of a specific thing (e.g., object, event/situation, social setting) that interferes with normal behavior; may develop through classical conditioning

a set of disorders in which the normal anxiety response is inappropriately provoked by homeostatic imbalance

Associated with low levels of GABA (primary inhibitory neurotransmitter in the brain)

limbic system component that controls the fear response and processes fear-related memories and stimulus salience

adjust anxious thought patterns

• seem to be effective in many disorders in addition to depression
• many now view anxiety and depression as a spectrum of disorders. (e.g., SSRIs, NSRIs, MAOIs)

produce short-acting reduction in anxiety (e.g., Ativan, Xanax, Valium)

used to stop physical symptoms (e.g., cardiovascular medication use to slow heart rate)

• characterized by chronic anxiety, worry, and tension independent of external cause for at least 6 months.
• Patients anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work.
• Physical symptoms are also often present, including headaches, stomachaches, muscle tension/trembling, irritability.
• Possible causes: genetics and associated with childhood trauma and resulting hypervigilance

an anxiety disorder most commonly characterized by obsessive, distressing, intrusive thoughts and related compulsions which attempt to neutralize the obsessions.

• Obsession – irrational, disturbing thoughts that intrude into consciousness
• Compulsion- irresistible, repetitive actions performed to alleviate obsessions (most commonly checking and washing)

• Caudate nucleus – component of the basal ganglia associated with initiation of learned, habitual motor activities; elevated activity is seen here in OCD
• serotonin may reduce caudate nucleus activity, which is why SSRIs may help with OCD.

deep brain stimulation (in addition to the treatments listed above for anxiety in general)

• a disorder characterized by recurring panic attacks (feelings of helpless terror with high physical arousal) and fear of having them,
• Symptoms: palpitations, sweating/trembling/shaking, chest pain/feeling of chocking, nausea/dizziness, fear of losing control/dying

• is an anxiety disorder associated with panic disorder defined as a morbid fear of having a panic attack or panic-like symptoms in a situation from which it is perceived to be difficult (or embarrassing) to escape.
• These situations can include, but are not limited to, wide-open spaces, crowds, or uncontrolled social conditions.
• As a result, sufferers of agoraphobia may avoid public and/or unfamiliar places.
• Patients may attempt to self-treat with nicotine / alcohol (but these actually increase risk of panic attack)
• Possible causes: genetic plus environment; initial stressful event, possible imbalance in amygdala/limbic system, possible history of stimulant use

• an anxiety disorder in which patients have nightmares, flashbacks, increased arousal (sleeplessness, hypervigilance), depression, irritability, and avoidance of stimuli associated with a traumatic event such as war, rape, or assault.
• A new diagnosis of complex PTSD is now being used to describe PSTD symptoms that arise from an extended period of more mild/moderate stress, rather than from one very high stress event as is typically associated with PTSD.

• Alterations in baseline stress hormone levels (cortisol): initial differences in baseline cortisol levels may predispose individuals to PTSD
• Anatomical/functional differences in amygdala, hippocampus, prefrontal cortex
• Possibly maladaptive learning pathway to fear response through a hypersensitive, hyper-reactive and hyper-responsive hypothalamuspituitary-adrenal axis [= major part of the neuroendocrine system that controls reactions to stress and regulates many body processes, including mood and emotion]