By Spilios Argyropolous;Adrian Feeney;David Nutt
In scientific perform, complicated sufferers with comorbidity of temper and nervousness problems are arguably the norm. those volumes specialize in this quarter, delivering up to date experiences of the conceptual matters that confront the clinician while comparing those sufferers Concise and easy-to-read, additionally they current a pragmatic method of the administration and remedy of sufferers with comorbid temper and nervousness problems.
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Additional resources for Anxiety Disorders Comorbid with Depression: Pocketbook: Panic Disorder and Agoraphobia
The first, the serotonin excess theory, suggests that panic results from either excess levels of serotonin or excess postsynaptic sensitivity to serotonin. If this is the case, the acute exacerbation of anxiety seen with selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants may be caused by the initial rise in synaptic serotonin concentration, and the subsequent reduction in anxiety symptoms may be the result of gradual postsynaptic downregulation of these receptors with time.
Neurophysiological vulnerability Inborn neurophysiological irritability Frightening parental behaviours Psychological vulnerability Dependence/independence conflicts Disturbed object relations Suboptimal defence mechanisms Heightened frequency and intensity of negative affects Further neurophysiological sensitivity Biologically or psychologically meaningful life stress Neurophysiological activation Erosion of a sense of safety Neurophysiological changes associated with sense of loss control Intrusive negative affect Initial panic episode Figure 5 Psychodynamic model of panic disorder.
CCK-4 induces similar respiratory symptoms to inhalation of 35% carbon dioxide. It also acts as a respiratory stimulant in normal controls. The CCK-4 antagonist, L-365,250, has been shown to alleviate panic symptoms precipitated by CCK-4, but unfortunately it proved less effective in naturally occurring panic disorder itself (Bradwejn et al 1994). Respiratory control as a common pathway in the aetiology of panic disorder As noted above, lactate, carbon dioxide and CCK-4 all have the ability to provoke panic attacks and have been implicated in alterations in respiratory control.