A 47-year-old female patient has been experiencing several anxiety-based symptoms for many years, and was previously diagnosed with generalized anxiety disorder. She describes difficulty concentrating in addition to difficulty falling asleep. Her family has recently told her that she seems to be displaying heightened anger responses toward them over minor details. Oftentimes she will cry for extended periods of time and become irritable and distant. Based on the above patient's revelations, if she were to continue to experience these stressful reactions to stimuli (i.e., excessive crying, fatigue, problems concentrating, tension, irritability), what could potentially occur?

4. Increased hippocampal volume

1. . Reduced brain-derived neurotrophic factor (BDNF) production
2. Reduced reactivity to stress
3. Decreased hippocampal volume