Summary Anxiety and depression notes

Anxiety and depression

Prevalence
 Women (~twice) more likely to suffer from mental health disorder than men
e.g. depression (1 in 4 women, 1 in 10 men), anxiety
o Women more likely to report symptoms
o Men may be underdiagnosed  present with different symptoms
 Children + young people
o 1 in 10 children (age 1-15)
o increase as they reach adolescence  affecting more boys than girls
 older people
o 1 in 5 living in community, 2 in 5 living in care homes
o 5% over age of 65, 20% over age of 80
 if depression left untreated, ~16-20%  attempt suicide




Anxiety

What is anxiety?
 Physical sensations
o Palpitations, nausea, chest pain/+ shortness of breath
 Complex combination of negative emotions
o Fear, apprehension and worry


Physiology
 Described as having cognitive, somatic, emotional and behavioural
components
 Cognitive component
o Expectation of a diffuse and uncertain danger
 Somatic component
o Body prepares organism to deal with threat (emergency reaction)
o Blood pressure + heart rate increased
o Increasing sweating
o Increased blood flow to major muscle groups
o Immune digestive system functions are inhibited
o External signs  pale skin, sweating, trembling, pupillary dilation
 Emotional component
o Sense of dread or panic, nausea and ‘chills’
 Behaviourally
o Voluntary and involuntary behaviours may arise  directed at escaping
or avoiding source of anxiety
o Frequent and often maladaptive, most extreme in anxiety disorders

,  Anxiety is not always pathological or maladaptive
o It is a common emotion along with fear, anger, sadness, and
happiness, and it has a very important function in relation to survival.


Neural circuitry
 Involves amygdala and hippocampus  underlie anxiety
 Confrontation with unpleasant and potentially harmful stimuli e.g. foul odours
or tastes  (PET scans show) increased blood flow to amygdala
 Participants also reported moderate anxiety
 Might indicated anxiety is  protective mechanismprevent organism from
engaging in potentially harmful behaviours e.g. eating rotten food


Neurochemical causes
 Not clear
 Important role for noradrenaline, 5-HT and GABA
o Increased noradrenaline activity  increased anxiety
o Increased GABAA receptor activity  decreased anxiety
o 5-HT very complex many subtypes of 5-HT receptors in CNS
o 5-HT actions at postsynaptic 5-HT1A  decreased anxiety
o 5-HT actions at 5-HT2C  increased anxiety



Types of anxiety disorders

 Generalised anxiety disorder
o Common chronic disorder
o Affects 2x women as men
o Can lead to considerable impairment
o Long-lasting anxiety, not focused on any object/situation
(unspecific/free-floating)
o People feel afraid of something  unable to articulate specific fear
o Fret constantly + hard time controlling their worries
o May develop headaches, heart palpitations, dizziness and insomnia 
due to persistent muscle tension and autonomic fear reactions
o Difficult to cope with normal daily activities


 Panic disorder
o Brief attacks of intense terror and apprehension  trembling, shaking,
dizziness and difficulty breathing
o Fear/discomfort arises abruptly + peaks in 10 mins or less
o May develop intense anxiety between episodes, worrying when/where
next episode will strike
o Generally, happen after frightening experiences, prolonged stress or
exercise
o Can be mistaken for heart attack