Mood Disorders - Anxiety Disorder

Question 1

Types of Anxiety Disorders

Answer 1

1. Separation Anxiety
2. Selective Mutism
3. Panic Disorder
4. Generalised Anxiety Disorder
5. Phobia related Anxiety: Agoraphobia, Specific Phobia, Social Anxiety Disorder (Social Phobia)

Question 2

Definition of Separation Anxiety

Answer 2

Excessive Fear and Anxiety about being away from attachment figures (Such as Parents and Home)

Question 3

Definition of Selective Mutism

Answer 3

Characterised by Restricted and Qualitatively variable speech in social situations despite capacity from normal speech

Question 4

Definition of Panic Disorder

Answer 4

A sudden overwhelming feeling of acute and disabling anxiety. It involves recurrent unexpected panic attacks and can occur in other anxiety disorders and in people who do not have a mental illness.

Question 5

Characteristics of Panic Disorder

Answer 5

• Recurrent Panic Attacks
• Abruptly developed and peaks within 10 Minutes
• Intense fear
• Palpitations / Chest Pain
• Breathlessness
• Losing control

Question 6

Definition of Agoraphobia

Answer 6

Irrational or disproportionate fear of a range of situations in which a person believes escape or access to help may be impossible, very difficult or very embarrassing if he or she /he develops panic-like symptoms or some incapacitating loss of control

Question 7

Definition of Specific Phobia

Answer 7

Irrational fear of an object or stimulus out of proportion to the danger the phobic stimulus presence, leading to avoidance and distress or impairment

• Common Subtypes: Hemophobia, Cynophobia, Arachnophobia, Claustrophobia, Astraphobia, etc.

Question 8

Definition of Specific Phobia

Answer 8

Irrational fear of an object or stimulus out of proportion to the danger the phobic stimulus presence, leading to avoidance and distress or impairment

• Common Subtypes: Hemophobia, Cynophobia, Arachnophobia, Claustrophobia, Astraphobia, etc.

Question 9

Definition & Characteristics of Social Anxiety Disorder

Answer 9

D: An intense fear of being extremely anxious and possibly humiliated in social situations

C: Physiological stress, Avoidance, Fear of Embarrassment, Humiliation and Rejection in social situations

Question 10

Predisposing factors of Anxiety Disorder

Answer 10

• Biological: Neurological Imbalance, Genetics
• Psychological: Exposure to intense fear in early life are likely to result in anxiety later in life, Parental Influences, Individual’s level of self-esteem and resilience to stress
• Behavioural: Product of frustration caused by anything that interferes with attaining a desired goal

Question 11

Characteristics of Obsessive-Compulsive Disorder (OCD)

Answer 11

It is characterised as Obsessions, which is recurrent and persistent thoughts, urges, or images that are Intrusive or Unwanted, and Compulsions, which is repetitive behaviours / mental acts that an individual feels driven to perform as a result of Obsession / according to rules must be applied regularly

Question 12

Pharmacotherapy of Anxiety Disorders & Outcomes

Answer 12

1. Selective Serotonin Reuptake Inhibitors (SSRIs) - Sertraline, Escitalopram, Paroxetine & Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) - Venlafaxine, Duloxetine

O: Reduce core symptoms, Improve functioning, Strengthen resilience, Relieve comorbid symptoms, Prevent relapse

Question 13

What is Serotonin?

Answer 13

• Neurotransmitters
• Involved numerous core physical processes such as regulation of sleep, appetite and aggression
• Key player in mood, anxiety, fear, and general sense of well-being
• Serotonin deficiency is a common contributor to mood problems

Question 14

Nursing interventions / management / strategies for anxiety disorders

Answer 14

1. Therapeutic Nurse Patient Relationship (TNPR): Calm, non-threatening and non-judgmental
2. Milieu Therapy: Modifying the Environment and Encourage Calming Measures
3. Provide Psychoeducation: Recognising trigger factors and insight into anxiety, Coping strategies, Promote relaxation response, Self-monitoring of Symptoms and Coping
4. Encourage Exercises and Health Diet: Exercise releases more Serotonin, and Healthy diet strengthens lung and heart muscles
5. Somatic Therapy: Places importance on what we experience in the body and the mind - Reduces somatic anxiety (e.g. Stomachache, Headache, Muscle tension, Hyperventilation, Shaking, Nausea), Reduces cognitive anxiety (e.g. Fear and Poor concentration); e.g. Aromatherapy, Foot or Body Massage, Healthy Sleeping Habits