Anxiety

Front 1

how many symptoms must you have to be able to classify a panic attack

Back 1

4

Front 2

Symptoms most days for at least 6 months
-Unrealistic worry/anxiousness about a number of events
-Symptoms: poor concentration, restlessness, irritability, sleep disturbances, fatigue, muscle tension

Back 2

GAD

Front 3

Unexpected, sudden panic attacks
-Attacks followed by 1 month or more of: (A) persistent worry about more attacks, (B) worry about implications or consequences of attack, OR (C) significant change in behavior related to attack
-Symptoms of panic attack as above
-With or without agoraphobia (fear or avoidance of open spaces or any place outside of ones home or other safe zone where escape might be difficult in case of panic attack)

Back 3

panic attack

Front 4

Individual fears that he/she might act in a humiliating or embarrassing manner
-Exposure to situation provokes panic attack
-Leads to avoidance of feared situation or location
-Individual is able to recognize, but not control irrational fear
-Symptoms: blushing, “butterflies”, diarrhea, diaphoresis, tachycardia, trembling

Back 4

SAD

Front 5

Marked and specific fear that is excessive or unreasonable set off by a specific stimulus
-Exposure to stimulus triggers anxiety or panic attack
-Avoidance of stimulus disrupts normal routine
-Stimuli include: animals, environmental (heights, weather, water, fire), blood, injections, injury, situational (airplanes, elevators, enclosed places), other (numbers, clowns, sounds)

Back 5

specific phobias

Front 6

-Exposure to a traumatic event in which (A) individual experienced, witnessed, or was confronted with an actual or threatened death, serious injury or loss of physical integrity AND (B) individual’s response was fear, helplessness, or horror
-The event is persistently re-experienced in one or more of the following ways: (A) recurrent, intrusive recollections, (B) recurrent, distressing dreams, (C) acting of feeling as if the event were reoccurring (hallucinations, flashbacks), (D) intense psychological distress or reaction at exposure to internal or external stimulus that resembles or symbolizes an aspect of event
-Avoidance behavior indicated by 3 or more of the following: (A) avoiding thoughts, feelings or conversations about the event, (B) avoiding activities, places or people related to the event, (C) inability or recall specifics of the event, (D) diminished interest or participation in significant events, (E) feelings of detachment or estrangement, (F) restricted affect, (G) sense of foreshortened future
-Two or more hyperarousal symptoms (A) difficulty falling or staying asleep, (B) irritability or outbursts, (C) difficulty concentrating, (D) hypervigilance, (E) exaggerated startle response
-Subtypes: acute (<3 months of symptoms), chronic (>3 months of symptoms), delayed onset (symptoms start >6 months post-event)

Back 6

PTSD

Front 7

Either (A) obsessions defined as (1) recurrent and persistent thoughts, impulses or images that are intrusive, inappropriate and marked by anxiety or distress, (2) thoughts, impulses images are not simply excessive worries about real problems, (3) individual attempts to ignore, suppress or neutralize above AND (4) individual recognizes that above are a product of his/her own mind AND/OR (B) compulsions defined as (1) repetitive behaviors or mental acts performed in response to obsession or other rigid rules and (2) behaviors or mental acts are aimed at preventing or reducing exposure to distress or dreaded event but are not realistically connected with what they are meant to prevent or are clearly excessive
-Individual recognizes at some point that O/C are excessive
-O/C cause distress or are time consuming

Back 7

OCD

Front 8

PTSD with symptoms that last less than 4 weeks
-No treatment indicated

Back 8

acute stress disorder

Front 9

medical confounding factors for anxiety

Back 9

arrhythmias, hypoglycemia, thyroid disorder, depression, bipolar, schizophrenia, alzheimers, asthma, COPD

Front 10

medication confounding factors for anxiety

Back 10

SSRI's, TCA's, serotonin syndrome, caffeine, cocaine, pseudoephedrine, amphetamines, ma huang, ephedra, PCP, alcohool, sedatives

Front 11

prefered nonpharm tx for GAD

Back 11

alcohol and stimulant avoidance, CBT, psychoeducation, stress management, meditation, and exercise

Front 12

prefered non-pharm tx for panic disorders

Back 12

Avoidance of stimulants and other precipitating substances, CBT, psychoeducation

Front 13

prefered non-pharm tx for generalized SAD

Back 13

support groups, CBT, and psychoeducation

Front 14

prefered non-pharm tx for phobias

Back 14

CBT, psychoeducation

Front 15

prefered non-pharm tx for PTSD

Back 15

CBT, group therapy, relaxation training, psychoeducation

Front 16

preferred non-pharm tx for OCD

Back 16

CBT, psychoeducation

Front 17

first line tx for GAD

Back 17

Venlafaxine, Paroxetine, citalopram

Front 18

second line tx for GAD

Back 18

Benzodiazepines, imipramine, buspirone

Front 19

first line tx for Panic disorders

Back 19

SSRIs, venlafaxine

Front 20

second line tx for panic disorders

Back 20

SSRIs, venlafaxine
Imipramine, clomipramine, alprazolam, clonazepam

Front 21

Fist line tx for generalized panic disorders

Back 21

Paroxetine, sertraline, venlafaxine

Front 22

2nd line tx for generalized panic disorders

Back 22

Citalopram, fluvoxamine, clonazepam

Front 23

1st line tx for specific social anxiety disorders

Back 23

propranolol

Front 24

2nd line tx for specific anxiety disorders

Back 24

atenolol

Front 25

1st line tx for phobias

Back 25

CBT

Front 26

1st line tx for PTSD

Back 26

paroxetine and other SSRI's

Front 27

2nd line tx for PTSD

Back 27

TCA's, MAOI's

Front 28

1st line tx for OCD

Back 28

CBT, SSRI's

Front 29

2nd line tx for OCD

Back 29

TCA's

Front 30

Taper BZD's generally by ______ until at lowest dosage x 1 week, then discontinue

Back 30

25% per week

Front 31

Taper SSRI's generally by _____ until at lowest dosage x 1 week, then discontinue

Back 31

25% per week