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Original Question

A 50-year-old woman with generalized anxiety disorder has been experiencing prolonged stress due to personal and professional challenges. She complains of poor sleep, chronic muscle tension, and feeling “on edge” most of the time. Labs reveal elevated cortisol levels. Which of the following best explains the physiological effect of chronic cortisol elevation in anxiety disorders? • Decreased dopamine in the mesolimbic pathway • Enhanced GABAergic transmission, promoting relaxation • Reduced excitatory neurotransmission in the prefrontal cortex • Atrophy of the hippocampus, impairing memory and emotional regulation

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