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Examines the clinical presentation and etiology of generalized anxiety, panic, and phobic disorders.
Imagine your body's fire alarm goes off every time you toast bread—or worse, when there is no toast at all. Why does the brain sometimes fail to distinguish a minor worry from a life-threatening predator?
Anxiety is a natural response, but it becomes a disorder when it is disproportionate or persistent. Generalized Anxiety Disorder (GAD) is characterized by 'free-floating' anxiety—a chronic, pervasive worry about multiple events for at least 6 months. In contrast, Panic Disorder involves sudden, intense spikes of terror known as panic attacks, often accompanied by physical symptoms like palpitations. Finally, Specific Phobias involve an irrational, intense fear of a particular object or situation (e.g., heights or spiders). While GAD is a constant low-level 'hum' of worry, Panic Disorder is an acute 'explosion' of fear, and phobias are 'triggered' by specific stimuli.
Consider three students before an exam: 1. Student A feels a sudden, overwhelming sense of doom and can't breathe (Panic Attack). 2. Student B has spent six months worrying about school, health, and family safety constantly (GAD). 3. Student C is terrified only when they see the classroom's pet tarantula (Specific Phobia).
Quick Check
What is the primary difference in duration and focus between GAD and a Specific Phobia?
Answer
GAD is chronic and pervasive (lasting 6+ months with no single focus), while a Specific Phobia is acute and triggered only by a specific object or situation.
When a person encounters a bear: 1. The Amygdala signals 'Danger!' 2. The Hypothalamus releases Corticotropin-releasing hormone (). 3. The Pituitary responds by sending Adrenocorticotropic hormone () through the blood. 4. The Adrenal glands release cortisol, increasing blood sugar for a 'fight or flight' response.
Quick Check
Which gland in the HPA axis is responsible for the final release of cortisol into the bloodstream?
Answer
The Adrenal glands.
Post-Traumatic Stress Disorder (PTSD) occurs after exposure to a traumatic event. It is unique because it involves both cognitive symptoms (intrusive memories, flashbacks, and distorted guilt) and behavioral symptoms (avoidance of reminders and hypervigilance). Biologically, individuals with PTSD often show an overactive amygdala and an underactive prefrontal cortex, meaning the 'brakes' of the brain cannot successfully shut down the 'alarm.' This leads to a state of constant high arousal, where the person remains in a permanent 'fight or flight' mode even in safe environments.
A veteran returns from combat. He avoids crowded places (behavioral avoidance), experiences vivid nightmares (cognitive intrusion), and startles at loud noises (hypervigilance). To diagnose PTSD, clinicians look for symptoms across four clusters: Intrusion, Avoidance, Negative Alterations in Cognition, and Alterations in Arousal/Reactivity. If symptoms persist for more than one month and cause significant distress, the diagnosis is confirmed.
Which disorder is characterized by at least 6 months of persistent, 'free-floating' anxiety?
In the HPA axis, what hormone does the Pituitary gland release to signal the Adrenal glands?
Hypervigilance is considered a behavioral/arousal symptom of PTSD.
Review Tomorrow
In 24 hours, try to sketch the HPA axis flow from memory and list the three main differences between GAD and Panic Disorder.
Practice Activity
Find a news article or case study about a stressful event and try to categorize the observed symptoms into 'Cognitive' or 'Behavioral' categories.