Miami Dade College Nurs 683 Week 5 discussion

Hello class,

I have chosen to explore generalized anxiety disorder, a psychiatric condition characterized by excessive worrying about daily activities (Yum, 2022). This persistent worry significantly impacts normal functioning and relationships. According to Yum (2022), it is a prevalent disorder, with approximately 3.1% of people in the US diagnosed with GAD.

While the neurobiology of GAD remains incompletely understood, research suggests potential links to alterations in brain chemistry, including disruptions in serotonin, norepinephrine, and GABA receptors (Mishra & Varma, 2023). Patients with GAD are found to have low serotonin levels, the neurotransmitter associated with mood and emotions. Additionally, elevated levels of norepinephrine and GABA contribute to increased anxiety in individuals with GAD.

GAD symptoms are overt and can vary among individuals. Persistent worry or anxiety about routine events affecting well-being is a hallmark of GAD. Other symptoms include sleep disturbances, fatigue, poor concentration, irritability, and muscle tension (NIMH, 2023). Diagnosis requires the presence of persistent anxiety or worry for at least six months, significantly impacting normal functioning.

Evidence-based treatments for GAD include a combination of psychotherapy and pharmacology, leading to improved quality of life for patients. Psychotherapy aims to identify anxiety triggers and enhance coping mechanisms, involving cognitive-behavioral therapy and exposure therapy (Mishra & Varma, 2023). Medications such as selective serotonin reuptake inhibitors (e.g., fluoxetine) and serotonin-norepinephrine reuptake inhibitors effectively manage GAD by modulating neurotransmitter levels in the brain (Stefano de Biase et al., 2018). Patients on medications require careful monitoring for potential side effects.

Post‐traumatic stress disorder (PTSD) is a mental disorder resulted from sudden, threatening, or catastrophic events. The current prevalence of the disorder worldwide is approximately 8%, increasing significantly year by year. Clinical manifestations include recurrence of traumatic events, avoidance of trauma‐related cues, high arousal, and selective forgetting and emotional numbness of traumatic experiences, causing great suffering to patient (Lai et al., 2020). A comprehensive assessment of past ex-posture to traumatic events to diagnose PTSD (American Psychiatric association, 2022)

The pathogenesis of PTSD is still not fully known and brings certain limitations for the treatment and management of the condition. Stahl, 2013 explains that pharmacologic treatments for PTSD are aimed towards treating at comorbidities such as depression, insomnia, substance abuse, and pain than at core symptoms of PTSD. SSRIs and SNRIs drugs are considered first-line treatments, however they lead to residual symptoms, including insomnia. Cognitive behavioral therapy is also recommended including Exposure therapy is also effective psychotherapy for PTSD. the central symptoms concern intrusions about, and avoidance of, memories associated with the traumatic event itself, whereas in separation anxiety disorder. As an example, Sertraline, SSRI (selective serotonin reuptake inhibitor) is classified as an antidepressant, but it is also FDA approved to treat PTSD; medication is to be continued until all symptoms are gone or significantly reduced. The onset of therapeutic effects is usually delayed in about 2–4 weeks (Stahl, 2020).

Studies report that the amygdala is key in monitoring the PTSD symptoms. It has been shown that the amygdala is activated in patients with PTSD when fear is triggered and conditional fear expression. In the central nervous system, some neurotransmitters are involved in the development and maintenance of PTSD including dopamine (DA) is a crucial catecholamine neurotransmitter in the brain that has been shown to be closely associated with fear memory; Serotonin or 5‐hydroxytryptamine (5‐HT) is an important cause of anxiety, depression, and PTSD (Lai et al., 2020).

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