Anxiety pathophysiology: Difference between revisions

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== Overview==
The [[pathophysiology]] of [[anxiety]] is attributed to various theories that have been proposed which constitute: [[Biologic]], [[psychoanalytic]], [[learning]], and  [[genetic]] component. There is increased [[sympathetic]] tone, decreased levels of inhibitory neurotransmitter [[Gamma-aminobutyric acid|GABA]], and alterations in [[neurotransmitters]] such as [[dopamine]] and [[serotonin]]. A [[gene]] coding for [[serotonin]] transport has also been implicated.


==Pathophysiology==
==Pathophysiology==
The cognitive component entails expectation of a diffuse and uncertain danger. Somatically the body prepares the organism to deal with threat (known as an emergency reaction): [[blood pressure]] and [[heart rate]] are increased, sweating is increased, bloodflow to the major muscle groups is increased, and [[immune system|immune]] and [[Digestion|digestive]] system functions are inhibited. Externally, somatic signs of anxiety may include pale skin, sweating, trembling, and[[mydriasis|pupillary dilation]]. Emotionally, anxiety causes a sense of dread or panic and physically causes nausea, and chills. Behaviorally, both voluntary and involuntary behaviors may arise directed at escaping or avoiding the source of anxiety and often maladaptive, being most extreme in [[anxiety disorder]]s. However, anxiety is not always pathological or maladaptive: it is a common emotion along with fear, anger, sadness, and happiness, and it has a very important function in relation to survival.  
Various theories have been implicated in the [[pathogenesis]] of [[anxiety]] which are as follows:
 
=== Biologic component===
 
*There is an increased [[Sympathetic nervous system|sympathetic]] tone.
* There is a surge of [[catecholamines]]<nowiki/>.
*Decreased levels of gamma - aminobutyric acid ([[Gamma-aminobutyric acid|GABA]]).
*Alterations in [[serotonergic]] and [[dopaminergic]] system.
* In anxiety states like [[panic]] attacks, the [[locus ceruleus]] is [[hyperactive]].
* [[Hyperactivity]] of [[amygdala]] has been implicated in [[social anxiety]]. <ref name="pmid26791511">{{cite journal |vauthors=Baslet G, Seshadri A, Bermeo-Ovalle A, Willment K, Myers L |title=Psychogenic Non-epileptic Seizures: An Updated Primer |journal=Psychosomatics |volume=57 |issue=1 |pages=1–17 |year=2016 |pmid=26791511 |doi=10.1016/j.psym.2015.10.004 |url=}}</ref>


Neural circuitry involving the [[amygdala]] and [[hippocampus]] is thought to underlie anxiety.
=== Psychoanalytic component===
* [[Freud]] described that [[anxiety]] is developmentally related to childhood fears of disintegration that derived from the fear of actual or imagined loss of a love object or fear of bodily harm.
* He used the term "signal anxiety" to describe anxiety that triggers [[defense mechanisms]] used by the person to cope with the potential threat, but anxiety in fact, is not consciously experienced.
 
=== Learning theory===
* [[Anxiety]] is produced due to continued [[Stress (medicine)|stress]].
* The anxiety eventually becomes a [[Conditioned place preference|conditioned]] response to stressful situations of less severity.
 
===Genetic studies===
* About 5% individuals with [[anxiety]] have [[polymorphic]] variant of the [[gene]] associated with [[serotonin]] [[transporter]] [[metabolism]].<ref name="pmid28413930">{{cite journal |vauthors=Ersig AL, Schutte DL, Standley J, Leslie E, Zimmerman B, Kleiber C, Hanrahan K, Murray JC, McCarthy AM |title=Relationship of Genetic Variants With Procedural Pain, Anxiety, and Distress in Children |journal=Biol Res Nurs |volume=19 |issue=3 |pages=339–349 |year=2017 |pmid=28413930 |doi=10.1177/1099800417692878 |url=}}</ref>


==References==
==References==
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[[Category:primary care]]
[[Category:Psychiatry]]
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Latest revision as of 20:26, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

The pathophysiology of anxiety is attributed to various theories that have been proposed which constitute: Biologic, psychoanalytic, learning, and genetic component. There is increased sympathetic tone, decreased levels of inhibitory neurotransmitter GABA, and alterations in neurotransmitters such as dopamine and serotonin. A gene coding for serotonin transport has also been implicated.

Pathophysiology

Various theories have been implicated in the pathogenesis of anxiety which are as follows:

Biologic component

Psychoanalytic component

  • Freud described that anxiety is developmentally related to childhood fears of disintegration that derived from the fear of actual or imagined loss of a love object or fear of bodily harm.
  • He used the term "signal anxiety" to describe anxiety that triggers defense mechanisms used by the person to cope with the potential threat, but anxiety in fact, is not consciously experienced.

Learning theory

  • Anxiety is produced due to continued stress.
  • The anxiety eventually becomes a conditioned response to stressful situations of less severity.

Genetic studies

References

  1. Baslet G, Seshadri A, Bermeo-Ovalle A, Willment K, Myers L (2016). "Psychogenic Non-epileptic Seizures: An Updated Primer". Psychosomatics. 57 (1): 1–17. doi:10.1016/j.psym.2015.10.004. PMID 26791511.
  2. Ersig AL, Schutte DL, Standley J, Leslie E, Zimmerman B, Kleiber C, Hanrahan K, Murray JC, McCarthy AM (2017). "Relationship of Genetic Variants With Procedural Pain, Anxiety, and Distress in Children". Biol Res Nurs. 19 (3): 339–349. doi:10.1177/1099800417692878. PMID 28413930.

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