ADVANCED PATHOPHYSIOLOGY
EDAPT ANXIETY DISORDERS
Introduction bto bAnxiety bDisorders b- bcorrect banswer✔✔- bAnxiety bis bthe bmost
bcommon bmental bdisorder bin bthe bUnited bStates, baffecting b19.1% bor b40 bmillion
badults bover bthe bage bof b18 b(Anxiety b& bDepression bAssociation bof bAmerica
b[ADAA], b2022). bAnxiety boccurs bwhen bthe bamygdala bsenses btrouble. bThis b"trouble"
bappears bas ba breal bor bimagined bthreat, bactivating bneurotransmitters, bflooding bthe
bbody bwith bstress bhormones, band bactivating bthe bfight-or-flight bresponse. b
- bWhile ba bstate bof barousal bis bnormal bin bthe bpresence bof ba bperceived bthreat,
bwhen bsymptoms bof banxiety bpersist bin bthe babsence bof bthreatening bstimuli bor
bbecome boverwhelming bto bthe bpoint bof bimpacting ban bindividual's bdaily bfunctioning,
ban banxiety bdisorder bmay bdevelop. b
Pathophysiology bof bAnxiety bDisorders b- bcorrect banswer✔✔- bClients bwith banxiety
bdisorders, bcompared bto bthose bwithout banxiety bdisorders, bdisplay bsignificantly
bdecreased bspontaneous bbrain bactivities bin bthe bright bputamen, bthe bright borbital
binferior bfrontal bgyrus, band bthe bright btemporal bpole b(Wang bet bal., b2022). bThese
bareas bin bthe bbrain bare bassociated bwith bemotional bprocessing. bActivation bof bthe
blimbic bsystem balso boccurs bin bresponse bto bstress, bwhich bcan blead bto banxiety
b(when bthe bamygdala btriggers bthe bfight-or-flight bresponse).
- bAnxiety bdisorders bhave bmany bcauses, bincluding bneurohormonal bimbalances,
bpost-traumatic bstress bsyndrome b(PTSD), bor bhead binjuries. b
Neurohormonal bimbalances binclude bthe bfollowing: b
- bNorepinephrine b(noradrenaline): bThis bneurotransmitter bis binvolved bin bthe bfight-or-
flight bresponse. bStressors btrigger ban bincrease bin bnorepinephrine, bwhich bleads bto
bthe bphysical bmanifestations bassociated bwith banxiety, bincluding btachycardia,
bincreased bblood bpressure, btremors, band bdiaphoresis.
- bSerotonin b(5-HT): bThis bneurotransmitter bmodulates bseveral banxiety-related
bfactors, bincluding breleasing bnorepinephrine band bcorticotropin-releasing bhormones.
- bCorticotropin-releasing bhormone: bThrough bthe bmechanism bof bthe bhypothalamic-
pituitary-adrenal baxis, bthis bhormone bis breleased, bcontributing bto banxiety.
, Normal bPhysiology bof bGamma-Aminobutyric bAcid b- bcorrect banswer✔✔- bGamma-
aminobutyric bacid b(GABA) bis bthe bmajor binhibitory bneurotransmitter bthat bregulates
bserotonin, bnorepinephrine, band bdopamine blevels. bGABA breceptors blocated bin bthe
bneural bsynapses bof bthe bcentral bnervous bsystem b(CNS) bplay ba bkey brole bin
bneuronal bfiring b(e.g., bseizure bdisorders), bregulating bemotion, band bcontrolling
bcognition, bpain, bsleep, band bmotor bfunction. bGABA bdecreases bneuroexcitability
bacross bthe bbrain. bWhen btriggers bincrease bthe butilization bof bGABA, bGABA blevels
bdecrease, bcausing banxiolysis band banxiety. bThe brole bof bGABA bhas blong bbeen
bregarded bas bcentral bto bthe bregulation bof banxiety, band bthis bneurotransmitter bis bthe
btarget bof bbenzodiazepines bused bto btreat banxiety bdisorders.
- bWhen balterations baffect bGABA, bserotonin balso bacts bas ban binhibitory
bneurotransmitter b(found bin bthe braphe bnuclei). bAlterations bin bserotonin bwill baffect
bthe bserotonin-reuptake btransporter band bthe bpost-synaptic bserotonin breceptors. bThis
balteration bresults bin bthe bclient bexperiencing ban bincreased bsensitivity bto bstress,
bleading bto banxiety.
- bReductions bof bglutamate bactivity bin bthe bhippocampus bcan balso bcontribute bto
bincreased bstress band banxiety. bGlutamate bregulation bis bimportant bfor bmemory,
bcognition, band bmood bregulation.
Types bof bAnxiety bDisorders b- bcorrect banswer✔✔- bGeneralized b
- bSocial
- bPanic
Generalized bAnxiety bDisorder b- bcorrect banswer✔✔Generalized banxiety bdisorder
b(GAD) bis bcharacterized bby bincreased, bpersistent, bunreasonable banxiety babout
beveryday bsituations binvolving bmoney, bwork, bfamily, band brelationships. bNormal bday-
to-day bactivities bcan bprovoke banxiety.
Social bAnxiety bDisorder b- bcorrect banswer✔✔Social banxiety bdisorder b(SAD) binvolves
bthe bfear bof bbeing bnegatively bjudged bby bothers, baffecting ban bindividual's bability bto
bperform bdaily bactivities. bFear bof bjudgment bmay bprevent bthe bperson bfrom battending
bcertain bevents bor bparticipating bin bsocial bactivities.
Panic bDisorder b- bcorrect banswer✔✔Panic bdisorder bis bcharacterized bby ba b"panic
battack" bin bwhich ban bindividual bexperiences bstress band bintense bfear bthat
bsomething bbad bwill bhappen. bAn bimminent bthreat bor bdanger bis balso bperceived.
bThese bfeelings bare boften baccompanied bby bphysiological bsymptoms bsuch bas bheart
bpalpitations, bdizziness, bor bshortness bof bbreath. bThe bsymptoms btypically bpeak
bwithin bthe bfirst bten bto btwenty bminutes, bbut bsome bmay blast bfor bhours. bThe
bindividual bwill bsometimes bdescribe bthe bfeeling bof bhaving ba bheart battack bor bsome
bother blife-threatening billness. bA bpanic battack bcan bbe bunpredictable bbecause bclients
bcan bexperience bit bin bfamiliar bplaces bwhere bthere bare bno breal bthreats. bThis bcan
bfurther bincrease banxiety bas bthe bindividual bbegins bto banticipate bwhen bthe bnext
EDAPT ANXIETY DISORDERS
Introduction bto bAnxiety bDisorders b- bcorrect banswer✔✔- bAnxiety bis bthe bmost
bcommon bmental bdisorder bin bthe bUnited bStates, baffecting b19.1% bor b40 bmillion
badults bover bthe bage bof b18 b(Anxiety b& bDepression bAssociation bof bAmerica
b[ADAA], b2022). bAnxiety boccurs bwhen bthe bamygdala bsenses btrouble. bThis b"trouble"
bappears bas ba breal bor bimagined bthreat, bactivating bneurotransmitters, bflooding bthe
bbody bwith bstress bhormones, band bactivating bthe bfight-or-flight bresponse. b
- bWhile ba bstate bof barousal bis bnormal bin bthe bpresence bof ba bperceived bthreat,
bwhen bsymptoms bof banxiety bpersist bin bthe babsence bof bthreatening bstimuli bor
bbecome boverwhelming bto bthe bpoint bof bimpacting ban bindividual's bdaily bfunctioning,
ban banxiety bdisorder bmay bdevelop. b
Pathophysiology bof bAnxiety bDisorders b- bcorrect banswer✔✔- bClients bwith banxiety
bdisorders, bcompared bto bthose bwithout banxiety bdisorders, bdisplay bsignificantly
bdecreased bspontaneous bbrain bactivities bin bthe bright bputamen, bthe bright borbital
binferior bfrontal bgyrus, band bthe bright btemporal bpole b(Wang bet bal., b2022). bThese
bareas bin bthe bbrain bare bassociated bwith bemotional bprocessing. bActivation bof bthe
blimbic bsystem balso boccurs bin bresponse bto bstress, bwhich bcan blead bto banxiety
b(when bthe bamygdala btriggers bthe bfight-or-flight bresponse).
- bAnxiety bdisorders bhave bmany bcauses, bincluding bneurohormonal bimbalances,
bpost-traumatic bstress bsyndrome b(PTSD), bor bhead binjuries. b
Neurohormonal bimbalances binclude bthe bfollowing: b
- bNorepinephrine b(noradrenaline): bThis bneurotransmitter bis binvolved bin bthe bfight-or-
flight bresponse. bStressors btrigger ban bincrease bin bnorepinephrine, bwhich bleads bto
bthe bphysical bmanifestations bassociated bwith banxiety, bincluding btachycardia,
bincreased bblood bpressure, btremors, band bdiaphoresis.
- bSerotonin b(5-HT): bThis bneurotransmitter bmodulates bseveral banxiety-related
bfactors, bincluding breleasing bnorepinephrine band bcorticotropin-releasing bhormones.
- bCorticotropin-releasing bhormone: bThrough bthe bmechanism bof bthe bhypothalamic-
pituitary-adrenal baxis, bthis bhormone bis breleased, bcontributing bto banxiety.
, Normal bPhysiology bof bGamma-Aminobutyric bAcid b- bcorrect banswer✔✔- bGamma-
aminobutyric bacid b(GABA) bis bthe bmajor binhibitory bneurotransmitter bthat bregulates
bserotonin, bnorepinephrine, band bdopamine blevels. bGABA breceptors blocated bin bthe
bneural bsynapses bof bthe bcentral bnervous bsystem b(CNS) bplay ba bkey brole bin
bneuronal bfiring b(e.g., bseizure bdisorders), bregulating bemotion, band bcontrolling
bcognition, bpain, bsleep, band bmotor bfunction. bGABA bdecreases bneuroexcitability
bacross bthe bbrain. bWhen btriggers bincrease bthe butilization bof bGABA, bGABA blevels
bdecrease, bcausing banxiolysis band banxiety. bThe brole bof bGABA bhas blong bbeen
bregarded bas bcentral bto bthe bregulation bof banxiety, band bthis bneurotransmitter bis bthe
btarget bof bbenzodiazepines bused bto btreat banxiety bdisorders.
- bWhen balterations baffect bGABA, bserotonin balso bacts bas ban binhibitory
bneurotransmitter b(found bin bthe braphe bnuclei). bAlterations bin bserotonin bwill baffect
bthe bserotonin-reuptake btransporter band bthe bpost-synaptic bserotonin breceptors. bThis
balteration bresults bin bthe bclient bexperiencing ban bincreased bsensitivity bto bstress,
bleading bto banxiety.
- bReductions bof bglutamate bactivity bin bthe bhippocampus bcan balso bcontribute bto
bincreased bstress band banxiety. bGlutamate bregulation bis bimportant bfor bmemory,
bcognition, band bmood bregulation.
Types bof bAnxiety bDisorders b- bcorrect banswer✔✔- bGeneralized b
- bSocial
- bPanic
Generalized bAnxiety bDisorder b- bcorrect banswer✔✔Generalized banxiety bdisorder
b(GAD) bis bcharacterized bby bincreased, bpersistent, bunreasonable banxiety babout
beveryday bsituations binvolving bmoney, bwork, bfamily, band brelationships. bNormal bday-
to-day bactivities bcan bprovoke banxiety.
Social bAnxiety bDisorder b- bcorrect banswer✔✔Social banxiety bdisorder b(SAD) binvolves
bthe bfear bof bbeing bnegatively bjudged bby bothers, baffecting ban bindividual's bability bto
bperform bdaily bactivities. bFear bof bjudgment bmay bprevent bthe bperson bfrom battending
bcertain bevents bor bparticipating bin bsocial bactivities.
Panic bDisorder b- bcorrect banswer✔✔Panic bdisorder bis bcharacterized bby ba b"panic
battack" bin bwhich ban bindividual bexperiences bstress band bintense bfear bthat
bsomething bbad bwill bhappen. bAn bimminent bthreat bor bdanger bis balso bperceived.
bThese bfeelings bare boften baccompanied bby bphysiological bsymptoms bsuch bas bheart
bpalpitations, bdizziness, bor bshortness bof bbreath. bThe bsymptoms btypically bpeak
bwithin bthe bfirst bten bto btwenty bminutes, bbut bsome bmay blast bfor bhours. bThe
bindividual bwill bsometimes bdescribe bthe bfeeling bof bhaving ba bheart battack bor bsome
bother blife-threatening billness. bA bpanic battack bcan bbe bunpredictable bbecause bclients
bcan bexperience bit bin bfamiliar bplaces bwhere bthere bare bno breal bthreats. bThis bcan
bfurther bincrease banxiety bas bthe bindividual bbegins bto banticipate bwhen bthe bnext
