Anxiety Flashcards
emotional response to stressor which may be unknown
-provides motivation for achievement and necessary for survival
Most common psychiatric illness
anxiety
Mild
Moderate
Severe
Panic
Levels of Anxiety
Reduced perception Reduced alertness Learning, but not at optimal level Decrease attention and concentration **Increased Heart Rate, Respirations, Perspiration, Restlessness, Muscle tension
Moderate Anxiety
Heightened perception
Learning is enhanced
Restless, irritable
Rarely distressed
Mild level of Anxiety
Greatly diminished perception
May not notice events
Extremely limited attention span; No learning
Headaches, dizziness, nausea, insomnia, hyperventilation
**Feeling of Dread; Focus on self
Severe Anxiety
Misperceptions common
No Learning; concentration or ability to comprehend
Dilated pupils, labored breathing, severe trembling, diaphoresis, pallor
**Sense of impending doom, terror, bizarre behavior, Hallucinations, delusions
PANIC Anxiety
Recurrent attacks with unpredictable onset Manifested by intense apprehension, fear or terror with physical discomfort Must include at least 4: *Palpations *Sweating *Shaking *SOB *Choking feeling *Chest pain/discomfort *Nausea *Dizziness *Chills *Paresthesia-tingling down the arms *Derealization *Fear of "going crazy" *Fear of dying
Panic disorder
*Most severe form of anxiety
can last mins or hrs
starts in 20’s
Persistent, unrealistic and excessive anxiety and worry for at least **6 Months!
- excessive anxiety difficult to control
- restlessness
- easily fatigued
- difficulty concentrating
- irritability
- muscle tension
- sleep disturbances
Generalized Anxiety Disorder (GAD)
Fear of being in situation where escape is difficult or help not available in event attack may occur. Phobias *Social anxiety disorder -acrophobia-heights -algophobia-pain -arachnophobia-spiders belonephobia-needles dementophobia-insanity ophidiophobia-snakes pyrophobia-fire triskaidekaphobia-number 13 xenophobia-strangers zoophobia-animals
Agoraphobia; afraid of being in public
Recurrent obsessions or compulsions that are severe to be time consuming or cause significant impairment
Obsessive-Compulsive Disorder OCD
Obsessions vs. Compulsions -Related disorders *Body Dysmorphic Disorder; *Trichotillomania (hair pulling disoder) *Somatic Symptoms & Dissociative Disorders Somatic Symptom Disorder Illness Anxiety Disorder Conversion Disorder Factitious Disorder Dissociative Identity Disorder
OCD disorders
- Preoccupation with one or more defects or flaws in physical apperance not observable to others
- Performed repetitive behaviors or mental acts in response to appearance concerns
Body Dysmorphic Disorder
- Recurrent pulling out of one’s hair that results in hair loss
- Preceded by increasing sense of tension and results in sense of release or gratification
Trichotillomania * hair pulling disorder
provides relief so they don’t have anxiety
compulsion
intrusive, unwanted; trying to ignore or suppress compulsion, repetitive behavior response to obsession
obsession
excessive thoughts of something physical that impairs life
somatic symptom disorder
common for military, loss or change in body function that cant be explained Usually short term
Conversion Disorder
Munchhausen
falsifying symptoms/injure self; to get emotional care and support- to be the “patient”
Facititous Disorder
DID; multiple personality disorder
Dominant personalilty doesnt have awareness of other personalities; subpersonalities are aware of the others.
transition sudden or gradual
Dissociative Identity Disorder
Buspar; own class-up to 2 weeks to be effective; Chronic GAD; having effects on serotonin & dopamine
Benzodiazepine;
Antihistamines; Vistaril, hydroxazine; drowsiness, dizziness, dry mouth, good for people with addictions and kids
Anti-anxiety (Anxiolytics)
Psychopharmocology
SSRI’s; Antidepressants; Used for OCD, anxiety disorder
Antihypertensives; bringing heart rate down. social anxiety
Psychopharmocology for anxiety
Xanax, Ativan, Klonopin; PRN Benzo’s, can be abused-drowsiness, dizziness can occur
Paxil, Prozac, Zoloft
Meds for Panic disorder
Buspar
Paxil, Lexapro, Cymbalta, Effexor XR
GAD Meds
Xanax, klonopin
Paxil, Zoloft
Phobic Disorders Meds
Prozac, Paxil, Zoloft, Luvox
OCD Meds
For the last year, a college student, continually and unrealistically worries about academic performance and love life performance. The student is irritable and suffers from severe insomnia. This behavior is assoc. with which Axis I diagnosis:
GAD
When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented?
Communicate with simple words and brief messages
Which statement is true about patients who have somatoform disorders? They..
Are difficult to convince to seek psychiatric help
What should the nurse plan to teach a client who is taking alprazolam (Xanax) three times a day?
That there is a potential for dependence and tolerance
A newly admitted client, diagnosed with OCD, spends one hour packing and unpacking, folding and refolding personal belongings. What is the most likely reason for this behavior?
It relieves anxiety
- C=Communicate
- H=Health (nurtition, exercise)
- I=Image
- L=Lighten up (relaxation techniques)
- L=Little by little (time management)
Chill
limbic system-stimulation to this area of brain produces anxiety and fear
Neuroanatomical Considerations
norepinephrine; hyperarousal & anxiety
serotonin; OCD
GABA; inhibits post synaptic excitation
Neurotransmitter assoc. with anxiety
stimulates alpha-adrenergic receptors; slow heart rate down
Clonidine meds
excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others
Social Anxiety Disorder (Social Phobia)
norepinephrine; hyper arousal and anxiety
serotonin; OCD
Gaba; inhibits post synaptic excitation
-Elevated levels of norepinephrine; Panic disorder
-Serotonin; OCD relief with SSRI’s , fluoxetine and clomipramine
GABA; enchancement of the GABA system is the mechanism of action by which benzo’s produce calming effects
Neurotransmitter assoc. with anxiety
apprehension, tension or uneasiness from anticipation of danger, the source of which is largely unknown or unrecognized. Maybe regarded as pathological when it interfers with social and occupational functioning, achievement of desired goals, or emotional comfort.
Anxiety
promotes the motivation for achievement, is a necessary force for survival.
-used interchangeably with the word Stress
-Stressor; “external pressor brought on to bear with the individual.
The subjective response to that stressor
Anxiety
Stimulates alpha-adrenergic receptors; slows the heart rate down.
Clonidine
usually considered a normal reaction to a realistic danger or threat to biological integrity or self-concept.
-Normality considered by societal standards.
Anxiety
Characterized by recurrent panic attacks; onset of which is unpredictable and manifested by intense apprehension, fear or terror; often assoc with feeling of impending doom and accompanied by intense physical discomfort.
-comes on unexpectedly
(focus of others attention as social anxiety disorder)
Panic disorder
Ind. avoids activities or events that may result in neg. outcomes, or spends considerable time and effort preparing for such activities.
-Result in procrastination in behavior or decision-making, and the ind. repeatedly seeks reassurance from others.
-Can begin in childhood/adolescenseonset not uncommon after age 20
depressive symptoms and somatic complaints common
Generalized anxiety disorder GAD
Fear cued by the presence or anticipation of a specific object or situation, exposure to which almost invariably provokes an immediate anxiety response or panic attack even though he subject recognizes that the fear is excessive or unreasonable. The phobic stimulus is avoided or endured with marked distress
Phobia
“fear of the marketplace”
Agoraphobia
excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others.
`usually results in feelings of panic anxiety, with sweating, tachycardia, and dyspnea.
Social Anxiety Disorders (Social Phobia)
`alcohol `amphetamines `cocaine `hallucinogens `sedative-hypnotics `caffeine `cannabis `other substances
medication-induced anxiety
learns to engage in behaviors that provide relief from anxiety and discomfort assoc. with traumatic events.
active avoidance
client must imagine situations or participate in real life situations that is frightening for a prolonged time.
`trigger anxiety
-This technique works best for Phobias
Implosion Therapy (Flooding)
does not depress the CNS, it produces effects through interactions with serotonin, dopamine, and other neurotransmitter receptors
Buspirone; wellbutrion
effective in blocking the acute anxiety effects in conditions such as opioid and nicotine withdrawal.
Clonidine (betablockers, alpha-receptor)
agoraphobia and social anxiety
MAOI’s
treatment (1st line) in social anxiety disorders
SSRI’s
reducing symptoms of stage fright
Beta blockers
OCD relief
SSRI’s
clomipramine (anafranil) and Prozac (fluoxetine)
Body Dymorphic Dysorder
chlorpromazine, amitriptyline, lithium carbonate
Trichotillomania (hair pulling)
the splitting off of clusters of mental contents from conscious awareness, a mechanism central to hysterical conversion and dissociative disorder
`a type of repression
Dissociation
fabricating symptoms for emotional gain
`fabricated stories and fanciful exaggerations about ones self.
Munchausen Syndrome
aka hypochodriasis (fear of having a disease)attention seeking through medical care. Often more doctors than 1 seen for treatment
dramatized, exaggerated
-anxiety and depression common; suicidal thoughts and attempts
-overmedicating/drug abuse and dependence
`heightened emotions, impressionistic thought and speech, seductiveness, strong dependency needs, preoccupation with symptoms and oneself.
Illness anxiety disorder
involves conscious, intentional feigning of physical or psychological symptoms. Ind. with factitious disorder pretend to be ill in order to receive emotional care and support commonly assoc. with the role of the “patient”
Somatic Syndrome disorder
unrealistic or inaccurate interpretation of physical symptoms or sensations, leading to preoccupation and fear of having a serious disease.
`becomes disabling and persists despite appropriate reassurance that no pathology detection.
Illness Anxiety Disorder
inability to produce voice
aphonia
inability to perceive smell
anosmia
false pregnancy
pseudocyesis
a disturbance in the perception of oneself
Depersonalization
An alteration in the perception of the external environment.
derealization
