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Anxiety

Anxiety.jpg

Disorders

Anxiety disorders cover a wide range of clinical conditions where the patient is in an anxiety state i.e. when anxiety dominate a person's life. Generalised anxiety disorder is the most common, and detailed below. Other types are:

Generalised Anxiety Disorder

This meercat suffers from GAD

Definition

A state of anxiety present most of the time without appropriate stressors.

Epidemiology

It affects 2% of the population and women twice as much as men.

Pathophysiology

There is no clear cut, or commonly accepted theory. It appears to run in families, so possibly has some genetic component.

Risk Factors

  • Stressful life event
  • Childhood trauma
  • Family history of anxiety
  • Family history of alcohol abuse.

Clinical Features

Anxiety

  • Severe long-lasting anxiety
  • Generally, no precipitating reason

Other features

  • Restlessness
  • Feeling of anxiety
  • Lack of sleep/low quality sleep
  • Difficulty concentrating
  • Nausea and vomitting
  • Muscle tension

There are lots of others, but these ones are key.

Investigations

Diagnosis itself is done clinically. However, other stuff needs ruling out:

  • Caffeine abuse
  • SSRI side effect
  • Hyperthyroidism
  • Illegal drugs
  • Heart conditions which cause palpitations
  • Phaeochromocytoma (very rare)

Management

  1. SSRIs.
  2. If that doesn't work, try tricyclic antidepressants.
  3. If they are really hyper, knock them down to a normal level with Benzos.
  4. Otherwise you can try cognitive behavioural therapy - which is more effective than medication.

Prognosis

Almost all patients, with treatment, will become stable. Once diagnosed, however, the condition is likely to become chronic