ANXIETY DISORDERS Flashcards
Diagnosed when anxiety becomes chronic and permeates major portions of a person’s life
Anxiety Disorders
Most cases appear in childhood and adolescence
Anxiety Disorders
Anxiety that is chronic, excessive, and unreasonable and may concern everyday events, such as work or school.
Generalized Anxiety Disorder (GAD)
Often co-exists with other mental disorders
Generalized Anxiety Disorder (GAD)
High risk for suicide
Generalized Anxiety Disorder (GAD)
What’s the exact cause of Generalized Anxiety Disorder?
unknown
Predisposing Factors of Generalized Anxiety Disorder
-Genetic
-Increased activity in the amygdala
-Dysregulation in the GABA- Norepinephrine, Serotonin- Glutamate system
Diagnostic Criteria of Generalized Anxiety Disorder
Excessive worry and anxiety at least 50% of the time for 6 months or more.
Accompanying Manifestations of Generalized Anxiety Disorders
-Uneasiness
-Irritability
-Muscle tension
-Fatigue
-Difficulty thinking
-Sleep alteration
Medical Management for Generalized Anxiety Disorder (GAD)
-Escitalopram (Lexapro)
-A primary treatment for GAD
-Buspirone (BuSpar)
Escitalopram (Lexapro) Classification and its side effects
-Class: Selective Serotonin Reuptake (SSRI)
-S/E: dizziness, somnolence, insomnia, confusion, seizures
Buspirone (BuSpar) class and its side effects
-Class: Non-benzodiazepine anxiolytic
-S/E: nausea, headache, dizziness, nervousness/excitement
-Caution: -Emphasize avoidance of alcohol intake
- Inform patient that it may take up to 2-4 weeks before effects are seen.
Management- Milieu of Generalized Anxiety Disorder (GAD)
-Cognitive therapy
-Recreational activities - to help reduce tension and anxiety
-Relaxation exercises and tapes, meditation, and biofeedback - these decreases tension and promote relaxation and comfort
-Group therapy - Focuses on stress management, problem solving, self- esteem, assertiveness, and goal setting
Management- Nursing of Generalized Anxiety Disorder (GAD)
-Provide a calm and quiet environment
-Ask patient to identify what and how they feel
-Encourage patient to describe and discuss their feelings
-Help patient identify possible cause of feelings
-Listen carefully for patients’ expression of helplessness and hopelessness
-Directly ask patient whether they feel suicidal or have plans to hurt themselves
-Plan and involve patients in activities such as going for walks or playing recreational games
Recurrent panic attacks and persistent worry about having more attacks
Panic Disorder
It occurs even without a life-threatening situation
Panic Disorder
Predisposing factor of panic disorders
Genetics
Precipitating Factor of Panic Disorder
Life Stressors
Diagnostic Criteria of Panic Disorder
-Panic attacks of 15 to 30 minutes, followed by at least one (1) month of persistent concern about future attacks
-Somatic symptoms (Fight- or- flight response)
-Avoidance behavior
Fear of being outside
Agoraphobia
Causes the person to be homebound
Agoraphobia
Management of Panic Disorder
-Cognitive- Behavioral Therapy (CBT)
(First- line treatment for panic disorder with agoraphobia)
-Gross motor activities
(used when anxiety levels has moved down to further decreased tension and anxiety)
Medical Management of Panic Disorder
-Benzodiazepines for immediate relief of panic
Alprazolam (Xanax), Lorazepam (Ativan), Diazepam (Valium)
-S/E: Sedation, psychomotor impairment, depression, amnesia, agitation, dependence
A drug that is commonly used for the long-term treatment of panic symptoms
-SSRs
- Escitalopram (Lexapro), Sertraline (Zoloft)
Management-Nursing of Panic Disorder
-Stay with the patient who is having a panic attack, and acknowledge patient’s discomfort
-Maintain -a calm style and demeanor
-Speak in short, simple sentences, and give one direction at a time in a calm tone of voice
-If hyperventilating, provide a brown paper bag and focus on breathing with patient
-Allow the patient to pace or cry
-Communicate to patients that you are in control and will not let anything happen to them
-Move or direct patients to a quieter, less- stimulating environment
-Do not touch patient - touching can increase feelings of panic
-Ask patient to express their perceptions or fears about what is happening to them
an illogical, intense, and persistent fear of a specific object or a social situation that causes extreme distress and interferes with normal functioning.
Phobia
Predisposing factor of Phobia
Genetics
Precipitating factor of Phobia
Environmental (bad first encounter with fear object)
Without history of panic disorder
Agoraphobia
Fear of being humiliated, scrutinized, or embarrassed in public
Social Phobia
Irrational fear of an object or situation
Specific Phobia
What are the types of phobias?
-Agoraphobia
-Social Phobia
-Specific Phobia
Fear of heights
Acrophobia
Fear of flying
Aerophobia
fear of enclosed places
claustrophobia
fear of spiders
Arachnophobia
Fear of dogs
Cynophobia
Fear of blood
Hematophobia
Fear of snakes
Ophidiophobia
Fear of being buried alive
Taphophobia
Fear of injections
Trypanophobia
Fear of strangers
Xenophobia
Patient Characteristics of Phobic Disorders (Phobia)
-Awareness of having unusual and irrational fear
-Powerlessness to stop fear
-Anticipatory anxiety
-Avoidance behavior
Management of Phobic Disorders (Phobia)
-Cognitive-Behavioral Therapy
Most successful treatment for phobic patients
-Systematic desensitization- progressive exposure to feared object in a controlled environment until anxiety decreases
-Flooding- Therapist abruptly confronts patient with phobic object until it no longer produces anxiety
Medical Management of Phobic Disorders (Phobia) Drugs
-SSRIs
-Paroxetine (Paxil), Sertraline (Zooloft)
-Used to reduce anxiety and depression, and back panic attacks, if present
Management-Nursing of Phobic Disorders (Phobia)
-Accept patient and their fears with a non-judgmental attitude
-Provide and involve patients in activities that do not increase anxiety but rather increase involvement
-Help patients with physical safety and comfort needs
-Help patients recognize that their behavior is a method of avoiding anxiety
