Tag: Chronic Stress

This is a brief video on psych disorders related to nervousness, rumination, and related somatic complaints. I created this presentation with Google Slides. Images were created or taken from Wikimedia Commons I created this video with the YouTube Video Editor. ADDITIONAL TAGS: Generalized anxiety disorder 5-10 percent lifetime prevalence; 2:1 W:M Definition: Excessive worrying and anxiety for 6 months Worry about school/grades, job, money, relationships, events, life Pathophys: “disrupted functional connectivity of the amygdala and its processing of fear and anxiety” At least 3 of symptoms: Restlessness, Tires easily, Problems concentrating, Irritability, Muscle tension, Problems with sleep Specific phobias 10 percent lifetime prevalence; W M, approx 2:1 Definition: Irrational fear of a specific object, place, situation, or concept for 6+ months Fear out or proportion to imminent threat Fear interferes with functioning in society Exposure induces immediate fear; removal reduces anxiety Fear might have developed from related trauma Social phobia: fear of embarrassment in public situation Agoraphobia: fear of public places due to lack of ability to escape; fear of unsafe environment Treatment: Separation anxiety disorder Definition: “excessive anxiety regarding separation from home or from people to whom the individual has a strong emotional attachment” for 4w in children or 6mo in adults May include anxiety/fear/distress when separated; reluctance to be alone/leave home/school/work; worry about harm to attachment figures Symptoms cause dysfunction in society Treat with CBT, family therapy, and possibly adjunct SSRIs Similar anxiety during normal child development: Stranger anxiety at 6 months Separation anxiety at 1 year Panic attacks 4% lifetime prevalence; W:M 2:1 Definition: “sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something bad is going to happen” Occurrence of at least one attack Constant worry about recurrence Other symptoms … trembling, unsteadiness, depersonalization, palpitations, abdominal pain, chest pain Must rule out medical etiologies: hyperthyroidism, afib, pheochromocytoma, drugs (amphetamines, sympathomimetics) Obsessive compulsive disorder 2 to 3 percent lifetime prevalence; M=F Obsessions: recurrent thoughts that persist despite trying to ignore them Compulsions: explicit rituals that either reduce anxiety or that patients feel they have to perform OCD is associated/comorbid with other psychiatric disorders: other anxieties, depression/bipolar, OCPD Treatment: Psychotherapy: CBT Pharmacotherapy: SSRI clomipramine (TCA) ECT Generalized anxiety d/o Specific phobias Separation anxiety d/o Panic attacks OCD OCD-related d/o PTSD Acute stress d/o Adjustment d/o OCD-related disorders Body dysmorphic disorder WM, higher in derm and cosmetic sx pts Perceived flaws in physical appearance Excoriation disorder – compulsive skin picking Hoarding disorder Cannot discard possessions, regardless of value Typically accumulate trash Treat with specialized CBT Trichotillomania – hair pulling disorder Treat with specialized CBT: habit reversal training; SSRIs, atypical antipsychotics Post traumatic stress disorder Mental disorder occurring after exposure to trauma, such as sexual assault, warfare, violence, traffic collisions Symptoms of increased reactivity, irritability, difficulty concentrating, hypervigilance, exaggerated startle, sleep difficulties Avoidance of triggers of symptoms Symptoms lasting 1 month Acute stress disorder: PTSD-like condition with trauma occurring 1 mo ago symptoms lasting 1 mo Treatment: Psychotherapy: CBT (exposure therapy, cognitive processing therapy) Adjustment disorder Very common; up to 20 percent in outpatient clinics Patient unable to cope with stress or major life event Symptoms include loss of interest, crying, feeling of hopelessness Symptoms occur within 3 mo of stressor and should resolve by 6 mo Symptoms resolve when pt adapts to new situation “Situational depression” Treat with supportive therapy Can consider temporary medications for some symptoms (insomnia, anxiety, or depression)