Panic disorder / GAD

Panic disorder DSM criteria

- recurrent, unexpected panic attacks
- worry about another attack, or consequences of an attack
- not due to substance abuse or medical condition
- not explained by social/specific phobia
* consider comorbid diagnosis of agoraphobia

causal factors panic disorder (biological)

- genetic predisposition
- abnormal brain activity--> amygdala= more active, panic circuit (amygdala, locus Cornelius, hippocampus, central grey matter) overactive
- abnormal ntm activity--> norepinephrine=more active=greater cardiovascular activity

causal factors panic disorder
(psych)

- classical conditioning--> settings of previous panic attacks and later trigger anxiety
-panic cycle-->perceived threat, apprehension or worry, bodily physiological sensations, interpretation of sensations as catastrophic

CBT for panic disorder

- 12-15 sessions
- psychoeducation
- self monitoring of panic attack and thoughts
- exposure therapy (interceptive exposure: expose to feared sensations through caffeine--> habituate clients to feared sensations)

exposure therapy for panic/agoraphobia (CBT)

-Interoceptive exposure (e.g., caffeine ingestion exposes clients to internal sensations they fear)
- habituate clients feared situations

medications used for panic disorder

- benzodiazepines and antidepressants
- concern for long term use (rids symptoms but wont habituate to situations that produce anxiety)
- concern for how people are using benzodiazepines

best chance of lasting recovering in panic disorder=

CBT+ drug

panic cycle

perceived threat>apprehension/worry>body sensations> interpretations of sensations as catastrophic

medications for panic disorder

antidepressants
benzodiazepines

generalized anxiety disorder symptoms

chronic excessive worry about a number of events/activities with no specific threat present
- more days than not for 6 months, 3+ symptoms
- restlessness
- fatigue
- difficulty concentrating
- irritability
- muscle tension
- sleep disturbance