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MH study guide
| Question | Answer |
|---|---|
| What is the role of the amygdala in anxiety? | Detects threat and danger, triggers fight or flight, releases stress hormones |
| What is happening in the amygdala for those with anxiety disorders? | It is overactive causing hypersensitivity to stimuli |
| What is the role of the hippocampus in anxiety? | Stores emotional memories to connect current situations to past experiences to decide if threat is actually dangerous |
| What is the role of the prefrontal cortex in anxiety? | Logical thinking, decision making, emotional regulation |
| When is anxiety a normal, healthy, protective response? | When it is acute to respond to a perceived threat and adaptive SNS activation |
| When is anxiety a disorder? | Disproportional response to a level of a threat and impacts daily life |
| Why are anxiety and depression frequent comorbidities? | Shared neurotransmitters (serotonin, norepinephrine, chronic stress can cause cortisol increase leading to depression, and negative cycles |
| What are examples of anxiety disorders? | Panic episode, social anxiety, generalized anxiety, OCD, phobias, and PTSD |
| What is occurring during a panic episode? | Sudden intense fear, palpitations, SOB, chest pain, dizziness, fear of dying |
| What is social anxiety? | Fear of being embarrassed, humiliated in social settings |
| What is generalized anxiety? | Excessive worrying for most days for at least 6 months |
| What does generalized anxiety cause? | Restlessness, fatigue, poor concentration |
| What is commonly seen by individuals with generalized anxiety? | Substance abuse and need for reassurance |
| What is obsession? | Intrusive unwanted thoughts, impulses, or images |
| What is compulsion? | Repetitive behaviors to reduce anxiety |
| What is a ritual? | A patterned compulsion |
| What is a phobia? | A learned fear with SNS activation |
| What coping mechanism is used with phobias? | Avoidance |
| What are the four symptoms of PTSD? | Hyperarousal, intrusive thoughts, avoidance, emotional/cognitive decline (numbing) |
| What is activated during PTSD? | SNS |
| What are the risk factors for anxiety? | Genetic (women dx more), environmental factors (mostly aged 0-2yrs), brain chemistry imbalances (rewired for anxiety response), and other medical conditions |
| What are screening tools for anxiety? | Self-report, Hamilton anxiety scale, GAD-7anxiety scale |
| What are the stages of anxiety? | Mild, moderate, sever, and panic level |
| What occurs during mild anxiety? | Alert, increased learning/focus |
| What occurs during moderate anxiety? | Narrowed attention, difficulty concentrating |
| What occurs during severe anxiety? | Limited perception, poor problem solving |
| What occurs during panic level anxiety? | Inability to function, loss of control, and terror lasting less than 10 minutes |
| What is the difference between state and trait anxiety? | State anxiety is a temporary state of mind due to a trigger (situational) Trait anxiety is a genetic factor (personality) |
| What occurs when trait anxiety is met with state anxiety? | Severe symptoms such as poor sleep, avoidance, feelings of failure, low mood, ect |
| What are non-pharmaceutical strategies to prevent anxiety? | CBT, exposure therapy, systematic desensitization, mindfulness, stress management techniques, regular exercise, adequate sleep, education, OCD care |
| What is CBT? | Therapy that focuses on recognizing negative thought patterns and self-talk to lean healthy coping strategies |
| What is exposure therapy? | Direct exposure to the feared stimuli |
| What is systematic desensitization? | Gradual exposure to feared stimuli while incorporating relaxation techniques |
| What is OCD care? | Do not abruptly interrupt rituals; gradually limit with CBT/exposure response prevention |
| What are pharmaceutical strategies to prevent anxiety? | First line meds: SSRI/SNRIs Beta blockers: reduce physical symptoms Do not give benzos are first line for chronic use due to dependence |
| What is the importance of GABA? | Brains main inhibitory neurotransmitter to slow brain activity down Low GABA= more anxiety |
| How is a panic attack treated? | Breathing exercises (reduce number of large gulps being taken) Reality orientation (5 things you can hear, see, smell, feel) Reduce stimuli |
| What is the S&S of depression? | Anergia, anhedonia, poor sleep/appetite, slow speech, hopelessness, impaired concentration |
| What is anergia? | Persistent and profound lack of energy |
| What is anhedonia? | Lack of interest, enjoyment, or pleasure |
| What is the S&S of mania? | Euphoria/irritability, decreased need for sleep, grandiosity, pressured speech, impulsivity |
| What are the risk factors for mood disorder? | Genetics, chronic illness, neurotransmitter imbalance (serotonin, norepinephrine, dopamine, glutamate, and GABA), and stress model |
| What is a stress model? | Explains why some people develop a mood disorder while others don't |
| What are the risk factors for suicide attemp? | Prior attempt, hopelessness, major loss, substance abuse, chronic/terminal illness, psychosis, access to lethal means |
| What is passive suicidal ideation? | "I wish I wouldn't wake up" |
| What is active suicidal ideation? | Plan, intent, preparation |
| When is someone at a higher risk of suicide attempt? | Starting antidepressants, post discharge, sudden calm after severe depression |
| How do you assess a patient for suicide risk? | Ask directly if they have a plan, access to means, lethality of their plan, and their support |
| What is difference between safety plan and no suicide contract? | Safety plan is evidence based while no suicide contracts are not |
| What is the therapeutic range for lithium? | 0.6-1.2 |
| What does lithium toxicity look like? | Tremors, diarrhea, confusion, seizures |
| How is lithium toxicity avoided? | Maintain sodium/fluid intake and monitoring levels Decreased sodium causes increased lithium |
| What is type 1 bipolar? | Full mania and psychosis |
| What is type II bipolar? | Hypomania, major depression, no full mania |
| What is a red flag sign for suicide risk? | Sudden mood lift Occurs because they have relief after planning |
| What are antidepressant classes? | SSRIs, SNRIs, TCAs, and MAOIs |
| What is first line antidepressants and why? | SSRIs because it's safer to overdose but take weeks to show improvements |
| What neurotransmitter does SNRIs increase? | Norepinephrine May also increase BP |
| What do TCAs do? | Sedation Lethal overdose risk |
| What needs to be avoided with MAOIs and why? | Tryamine because it can cause hypertensive crisis |
| What is used for resistant cases of depression? | Ketamine |
| What are the criteria for involuntary hospitalization? | Danger to self/others or gross inability to care for self |
| What are the signs of psychosis? | Delusions, hallucinations, disorganized speech, inappropriate effect |
| What is secondary psychosis causes? | Drugs, steroids, sleep deprivation, electrolyte imbalance, delirium, infections |
| What is primary psychosis? | Schizophrenia |
| What type of symptoms does schizophrenia have, positive or negative? | Both |
| What percentage of the population has schizophrenia? | 1% of population |
| At what age is schizophrenia onset | Late teens |
| What condition is auditory hallucinations most common with? | Auditory |
| What is visual/tactile hallucinations most common with? | Substances/withdrawal |
| What is olfactory hallucination types most common with? | Olfactory |
| What is schizoaffective? | Meets criteria for both schizophrenia and mood disorder |
| What communication should be used with pt with psychosis? | Short, concrete, calm, frequence contacts; build trust |
| What does antipsychotics do? | Decrease dopamine in mesolimbic pathway to reduce positive symptoms Atypical helps negative symptoms also |
| What is EPS? | Akathisia, dystonia, parkinsonism |
| What is parkinsonism treated with? | Benztropine or diphenhydramine |
| What is akathiasia? | Inability to remain skill |
| What is dystonia? | Uncontrollable muscle contraction |
| What is parkinsonism? | Slowed movement, rigidity, and tremors |
| What is tardive dyskinesia? | Long term involuntary movements |
Created by:
emilychaltraw