ANXIETY DISORDERS

I. INTRODUCTION
o Everyone feels anxious now and then. It’s a normal emotion. For
example, you may feel nervous when faced with a problem at work,
before taking a test, or before making an important decision.
o Anxiety disorders are different, though. They are a group of mental
illnesses, and the distress they cause can keep you from carrying on
with your life normally.
o For people who have one, worry and fear are constant and
overwhelming, and can be disabling. But with treatment, many
people can manage those feelings and get back to a fulfilling life.

II. DEFENITION OF TERMS

Anxiety
 is defined as an emotion characterized by feelings of tension,
worried thoughts and physical changes.
American Psychological Association (APA) 
Anxiety
 is defined as an exaggerated feeling of apprehension, uncertainty
and fear. It is an unpleasant state of tension with
an anticipation of imminent danger.
Anxiety disorders
 share features of excessive fear and anxiety and related
behavioral disturbances.
Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition (DSM-V)
 III. ANATOMY and PATHOPHYSIOLOGY

Thalamus
 is the central
hub for sight
and sounds.
The
thalamus
breaks down
incoming
visual cues
by size,
shape and
color and
auditory
cues by volume and dissonance and then signals the cortex.
Cortex
 gives raw sights and sounds meaning enabling you to be
conscious of what you are seeing and hearing.
Prefrontal Cortex
 is vital to turning off the anxiety response once the threat
has passed.
Amygdala
 appears key in modulating fear and anxiety.
 is an almond-shaped structure deep in the brain that is believed to be a
communications hub between the parts of the brain that process
incoming sensory signals and the parts that interpret these signals. 
 The emotional core of the brain whose primary role is to trigger the fear
response. Information passing through the amygdala is associated with an
emotional significance.
  It can alert the rest of the brain that a threat is present and trigger a fear
or anxiety response. 
 The emotional memories stored in the central part of the amygdala may
play a role in anxiety disorders involving very distinct fears, such as fears
of dogs, spiders, or flying.

Locus Ceruleus
 Receives signals from the amygdala and initiates the classic anxiety
response: rapid heartbeat, increased blood pressure, sweating and pupil
dilation.

Hippocampus
 is the part of the brain that encodes threatening events into memories. 
 The memory centre storing raw information from the senses, along with
emotional baggage attached to the data by the amygdala.

o Our fight or flight response is triggered, and your system is flooded

with norephinephrine and cortisol.

o Anxiety, stress and fear are triggered primarily through our senses.
o Hypothalamus and Pituitary Gland will cause the ADRENAL GLAND Cortisol.
SIGHT AND SOUND THALAMUS AMYGDALA OR CORTEX
o Neurotransmitter will be released and alert the sympathetic nervous system
SMELL AND TOUCH AMYGDALA

Blood pressure
Heart rate
Perspiration
Hyperventilate, Goosebumps

NOREPINEPHRINE: Excitatory neurotransmitter. Associated with the fight-or-

flight response.  It's what makes your heart rate and blood pressure soar
during a "fight or flight" reaction. A sudden, rapid rise of norepinephrine can
cause panic attacks. A somewhat high level makes you happy, and a really
high level makes you euphoric.
 GABA: The role of the inhibitory neurotransmitter GABA has long been
regarded as central to the regulation of anxiety and this neurotransmitter
system is the target of benzodiazepines and related drugs used to treat
anxiety disorders.

SEROTONIN: Inhibitory neurotransmitter

It appears to play a key role in maintaining mood balance, in sleep, appetite,
memory, impulsivity, sexual behavior, motor functions.

IV. EPIDEMIOLOGY

o The Philippines has the highest number of depressed people in

Southeast Asia. The National Statistics Office reported that mental
illness is the third most common form of disability in the country.
Records show a high number of cases among the youth.
o The study conducted by the Global Burden of Disease in 2015
reported that 3.3. million Filipinos suffer from depressive disorders,
with suicide rates in 2.5 males and 1.7 females per 100,000 of the
Filipino population according to the National Center for Mental
Health. Most suicides are among males in their 20s.

 Is Anxiety Hereditary?
The tendency to develop an anxiety disorder might stem from your genes
but your life experiences and environment play a role, too. -
https://www.everydayhealth.com

For most people, genetic risk for anxiety is less likely to be an on/off switch
than a complicated mix of genes that can put you at risk for developing
anxiety. Even then your anxiety disorder might be different from your
relative’s in important ways.

“Individuals inherit a predisposition to being an anxious person, and about

30 to 40 percent of the variability is related to genetic factors,”