5. Anxiety and stress

When is anxiety considered pathological?

When they are excessive , irrational , out of proportional or WITHOUT a trigger , causes significant impairment of functioning.

Caudate nucleus has been implicated in

OCD

MRI studies have found increased activity in the — in PTSD

Amygdala

Abnormalities in — in Panic Disorder.

Parahippocampal gyrus

• Fear of losing control, dying or going crazy. • Avoid situations in which attacks may occur.

Panic disorder

Fear of situations from which escape may be difficult or help unavailable (crowds, bus, bridge etc.)

Agoraphobia

Fear of humiliation, embarrassment by others.

Social phobia

Fear of a specific object, animal or situation.

Specific phobia

Re-experiencing of trauma through flashbacks, dreams, recollections.

PTSD

When do symptoms of worry begin ?

in childhood

What is psychopharmaco-therapy for GAD?

SSRI (e.g., sertraline, citalopram) or SNRI (e.g., venlafaxine)

Pharmacotherapy for Panic disorder

CBT most efficacious

• 1st line SSRI or SNRI

• 2nd line Benzodiazepines: Only recommended for short term use due to side effects.