Anxiety Disorders Flashcards
Anxiety
A vague feeling of dread or apprehension in response to internal or external stimuli
- Anxiety is unavoidable in life and can serve many positive functions
Stress
The wear and tear that life causes on the body
- It occurs when a person has difficulty dealing with life situations, problems, and goals
Stages of Reaction to Stress
Alarm reaction stage
Resistance stage
Exhaustion stage
Levels of Anxiety: Mild
Sensation that something is different and warrants special attention; sensory stimulation increases; attention is focused to learn; solve problems, think, act, feel, and protect self; motivated
Levels of Anxiety: Moderate
Feeling that something is definitely wrong; nervousness or agitation; can still process information, solve problems, and learn new things with assistance from others; concentration difficult but can be redirected
Levels of Anxiety: Severe
Trouble thinking and reasoning; muscles tighten, vital signs increase, pacing, restlessness, irritability, and anger; use of other emotional - psychomotor means to release tension
Levels of Anxiety: Panic
Fight, flight, or freeze responses; cognitive process focus on the person’s defense
Working with Anxious Clients
Be aware of nurse’s own anxiety level
Assess the person’s anxiety level
Speak in short, simple, easy to understand sentences
Lower the person’s anxiety level to mild or moderate before proceeding anything else
Talk to the client in a low, calm, and soothing voice
Walk while talking if the patient cannot sit still
Ensure safety during panic level anxiety
Remain with the client until the panic recedes
Short term use of anxiolytics
Anxiety Disorders
Agoraphobia with or without panic disorder Panic disorder Specific phobia Social phobia Obsessive Compulsive Disorder (OCD) Generalized anxiety disorder (GAD) Acute stress disorder Post traumatic stress disorder (PTSD)
Incidence of anxiety disorders
Anxiety disorders are the most common psychiatric disorders in the US, affecting 25% of adults
More prevalent in women
Prevalent in people younger than 45 years of age
More common in separated or divorced people
More common in people of lower socioeconomic status
Onset and clinical course are variable
Related Disorders
Anxiety disorder due to a general medical condition
Substance-induced anxiety disorder
Separation anxiety disorder
Adjustment disorder
Etiologies
Biologic Theories
- Genetic theories: anxiety may have an inherited component
- Neurochemical theories: neurotransmitters may be dysfunctional in persons with anxiety disorders
Psychodynamic Theories
- Intrapsychic/ psychoanalytic theories: overuse of defense mechanisms
- Interpersonal theory: results from problems in interpersonal relationships
- Behavioural theory: “learned” behavioural response
Cultural Considerations
Asian cultures often express anxiety through somatic symptoms such as headaches, backaches, fatigue, dizziness, and stomach problems
Hispanics experience high anxiety as weakness, sadness, agitation, weight loss, and heart rate changes; the symptoms are believed to occur because supernatural spirits or bad air from dangerous places and cemeteries invades the body
Treatment
Usually involves a combination of medication (anxiolytics and antidepressants) and therapy
- Cognitive - behavioural therapy:
- Positive reframing (turning negative messages into positive ones)
- Decatastrophizing (making a more realistic appraisal of the situation
- Assertiveness training (learn to negotiate interpersonal situations)
Elder Considerations
Later-life anxiety disorders are often associated with another condition, such as depression, dementia, physical illness, or medication toxicity or withdrawal
- Phobias, particularly agoraphobia and GAD, are the most common late-life anxiety disorders
The treatment of choice for anxiety disorders in the elderly is SSRI antidepressants
Community-Based Care
Treatment settings include family practitioner or advanced practice nurse, physician offices, psychiatric clinical specialists, psychologists, or other mental health counsellors
Referral to community resources such as anxiety disorder groups or self-help groups