anxiety and ocd Flashcards
what is anxiety?
a universal experience that consists of feelings of apprehension, uneasiness, uncertainty, or dread to an unknown threat
“fight or flight”
what is the difference between fear and anxiety?
fear is the reaction to a specific danger, where as anxiety is apprehension,
uneasiness,
uncertainty, or dread
from real or
perceived threat
what is the etiology of anxiety?
-genetics
-neurobiology (serotonin, GABA)
-psychological factors(harsh parents, ACE, abuse, disapproval)
-cultural considerations
-enviornmental factors (caffeine, or stressful event)
what are some cultural considerations for anxiety disorder?
-express through somatic symptoms
e.g. LA and norther europeans involve sensation of choking, smothering, numbness and fear of death
what are the four different levels of anxiety?
-mild
-moderate
-severe
-panic
what are the s/s of mild anxiety?
occurs in the normal experience of everyday living
-heightened perceptual field
-observations are sharper
-ABLE to work effectively
-slight discomfort
-attention seeking behaviors
-restlessness
-easily startled
-irritability
-MILD tension relieving activity
-aware of their anxiety
s/s of moderate anxiety
-SNS symptoms
-may experience tension, a pounding heart, tachy, and mild somatic symptoms
- voice tremors, poor concentration
-narrowed preceptual field
-less able to pay attention
-less able to solve problems
s/s of severe anxiety
-distorted perceptual field
-can’t problem solve
-dazed or confused
-behavior is aimed at reducing anxiety
-feeling of dreas
-confusion
-purposeless activity
-more intense somatic
-withdrawal
-diaphoresis
-loud and rapid speech
s/s of panic
-unable to process environment
-focus is lost
-completely unable to process what is happening
-disorganized or irrational
-terror
-immobility or hyperactivity
-inability to speak or speak clearly
-somatic complaints increase
-severe withdrawal
-hallucinations or delusions
-out of touch with reality
what are some defense mechanisms against anxiety?
-altruism
-compensation
-conversion
-denial
-displacement
-dissociation
-identification
-intellectualization
-projection
-rationalization
-reaction formation
-repression
-splitting
-sublimation
-suppression
-undoing
what are adaptive defense mechanisms?
those that are beneficial and productive behaviors
e.g. problem solving, talking, crying, sleeping, exercising, etc
what are maladaptive defense mechanisms?
behaviors that are NOT beneficial or productive
e.g. blaming, negative self talk, obsessive behaviors, agression, excessive eating, drinking, spending, etc.
what commonly differentiates adaptive from maladaptive?
their frequency, intensity, and duration of use
how do we treat mild-moderate anxiety?
a lot of talking to determine cause and level of anxiety
-provide a calm presence
-explore behaviors to alleviate anxiety
how to treat severe/panic anxiety?
-SAFETY
-assess risk for suicide
-provide a low stimulating environment
-ALWAYS stay with the person
-assess need for medication
what are the 10 anxiety orders?
- Generalized (GAD)
- Separation
- Social (SAD)
- Phobias
- Panic Disorder
- OCD
- Body Dysmorphic
- Hoarding
- Trichotillomania
- Excoriation Disorder
what do all anxiety disorders have in common?
they all experience excessive irrational fear and dread
describe separation anxiety
a normal part of development in an infant and should decline after 18 months
becomes a problem when adults or older children expereince this
describe GAD
-excessive and persistent worry for MORE THAN 6 MONTHS
-aware that they are being irrational
-accompanied with some somatic symptoms
r/f of GAD
-unresolved conflict
-cognitive misinterpretations
-life stressors
-GENETICS
-behavioral inhibition
what are some comorbididties of GAD?
-MDD or other anxiety disorders
-alcoholism
-one concurrent psychiatric diagnosis
what are common worries for children/adolescents with GAD?
-future events
-past behaviors
-social acceptance
-personal abilities
-school
-natural disasters
what medications are used to treat GAD?
-antidepressants (SSRI, SNRI, MAOI)
-anti anxiety drugs (buspirone, benzos)
-beta blockers, antihistamines (hydroxizine), anticonvulsants, and anti-psychotics
what teaching needs to go along with benzos?
-use lowest dose necessary
-avoid caffeine
-monitor for sedative effects
-take with food
-do NOT quit abruptly (seizures)
-avoid alcohol can be fatal
what are some nonpharmalogical treatments for GAD?
-psychotherapy
-CBT
-systematic desensitization
-meditation
-exercise
what is gradual systemic desensitization?
introduce fear through a series of tests from least scary to most scary
what is flooding desensitization?
exposure to a large amount of an undesirable stimulus to extinguish anxiety
what is agoraphobia?
fear about being in places or situations from which escape may be difficult or embarrassing. feared places are avoided sometimes to the extreme of not leaving the house
r/f for agoraphobia
female, ACE, stressful life events, overprotective and emotionally cool families, genetics
usually begins in late adolescence/early adulthood
what situations are commonly avoided with agoraphobia?
-being alone outside
-being alone at home
-traveling in a car, bus, or airplane
-being on a bridge
-riding in an elevator
-being in a crowd
what is social anxiety disorder “social phobia”
severe anxiety or fear of a social or performance situation that could be seen as negatively by others
can worry for days or weeks before a situation
r/f for social anxiety disorder
-childhood mistreatment
-shyness
-having shy parents
-genetics?
those who have SAD are at risk for what?
MDD and SUD
what is panic disorder?
a chronic condition characterized by panic attacks
what is a panic attack?
an “out of the blue” feeling of terror so severe that normal function is suspended, perceptual field is severely limited, and disrupted reality
what is anticipatory anxiety?
the fearful expectation of panic anxiety onset
what is avoidance anxiety?
personal strategies used to increase feeling of control and decrease the risk of panic attack
what are some risks with panic disorder?
-depression
-HTN
-smoking
-marijuana use
what is the treatment of panic disorder?
-CBT
-positive self talk
-flooding therapy
-relaxation therapy
-anti depressants
-benzos (second line)
how do you care for someone having a panic attack?
-rule out medical problem (cardiac)
-stay with the patient
-reassure them
-give clear directions
-assist patient to an environment with minimal stimulation
-walk with the patient
-administer PRN antianxiety
what is an obsession?
unwanted, intrusive, and persistent thoughts that persist and recur even when the individual tries to stop them
what is a compulsion?
behaviors that are performed repeatedly in a ritualistic fashion with the goal of preventing or relieving anxiety and distress caused by obsession
why are compulsive acts repeated?
because it only relieves the anxiety temporarily
s/s of OCD
-onset is gradual
-repetitive unwanted thoughts (obsessions)
-repeated activities/ rituals (compulsions)
-time consuming and may be distressing
what is the treatment of OCD?
-SSRI
-CBT
-Exposure therapy
-Deep brain stimulation
-Transcranial Magnetic Stimulation
What is Body Dysmorphic Disorder?
intrusive and unwanted preoccupation with one or more perceived defects in physical appearance that are not observed by others
what is the treatment of Body Dysmorphic Disorder?
-CBT
-SSRI
-biofeedback
-meditation
-relaxation strategies
what is hoarding disorder?
persistent difficulty discarding with possessions regardless of their value
most have MDD
what is the main priority with hoarding
Safety
what is trichotillomania?
recurrent hair pulling that can occur on any region of the body
treated with CBT and SSRI
what is excoriation disorder?
recurrent skin picking resulting in skin lesions usually in the face, arm, and hands. may be to relieve anxiety but not all. often seen with OCD and trichotillomania
treated with SSRI and CBT
