Transcript Anxiety disorders - landman

ANXIETY DISORDERS
Definition
 A feeling of uneasiness that activates the
autonomic nervous system in response to a
vague, nonspecific threat
 Differs from fear because fear is a response to
a known threat.
4 Degrees of Anxiety
 MILD
 Perceptual field widens slightly. Increased
ability to see relationships among data.
 Person is alert, more perceptive, able to recognize the
anxiety.
 MODERATE
 Perceptual field narrows slightly. Can change
attention if directed.
 Person is able to sustain attention on a focal point. May
talk faster, V/S begin to increase, able to recognize and
express anxiety.
 SEVERE
 Perceptual field is greatly reduced. Does not
notice external events. Unable to redirect
attention even with direction.
 Attention is focused on a small part of a specific area.
May be unaware of anxiety, V/S increasing, coping relief
measures are used.
 PANIC
 Perception is distorted, may jump from one
detail to another (flight of ideas) Person feels
dread or terror.
 Feeling of unreality, confusion, terror, self-absorption.
Mat be expressed with violence toward self or others.
Loss of control. Can result in exhaustion if prolonged.
Signs & Symptoms
 Increased heart rate
 Increased blood pressure
 Dilated pupils
 Cool skin
 Piloerection (hair “standing on end”)
 Decreased GI motility
Coping with anxiety
 Coping behaviors are:
 ADAPTIVE ~
 A student receives a bad grade on an exam. The
student goes to the instructor to see what her faults
are (problem solving).
 MALADAPTIVE~
 A student receives a bad grade on an exam. The
student does not seek advice or help, keeps studying
the way he always does, hoping it will pay off
(avoidance)
Task Oriented Reactions
 Reactions to anxiety that are conscious ways to cope
with problems or to meet needs.
 Attack Behavior~ actively removing obstacles through
problem solving while considering the rights of others
 Withdrawal Behavior~ removing self either physically
or emotionally from a stressful situation
 Compromise~ changing the usual ways of behaving,
substituting goals, or giving up aspects of person needs.
Attack Behavior
 Adaptive attack behavior:
 Example~ A nurse asking another nurse to help
figure out why a client’s condition is changing
 Maladaptive attack behavior:
 Example~ A nurse shouting at a nursing assistant
that made a mistake.
Withdrawal Behavior
 Adaptive Withdrawal behavior:
 Example~ Person with asthma leaves a smoke-
filled room
 Maladaptive Withdrawal behavior:
 Example~ Avoiding visiting family or friends to
avoid arguments
Compromise
 Compromise is usually adaptive
 Example~ Nursing student wanted to go on
vacation to Disney World a week during school
but would be penalized for it. She compromised
by still going to Disney World, but on break from
school.
Types of Anxiety Disorders
 Generalized Anxiety Disorder
 Panic Disorder (with or without Agoraphobia)
 Agoraphobia (with out Panic Disorder)
 Obsessive-Compulsive Disorder (OCD)
 Acute Stress Disorder
 Posttraumatic Stress Disorder (PTSD)
Generalized Anxiety Disorder
 Characterized by excessive anxiety and worry
occurring on most days for at least 6 months.
Anxiety can be for a number of different events
or activities, and the individual finds it difficult to
control.
 Must have at least 3 of the following:






Restlessness
Fatigue
Difficulty Concentrating
Irritability
Muscle Tension
Disturbed Sleep
Generalized Anxiety Disorder
 Persons with GAD report they feel:
 Significant stress
 Difficulty controlling the worry
 Impairment in social occupational functioning
Physical Symptoms of GAD
 Fatigue
 Sweating
 Headaches
 Nausea/Vomiting
 Muscle tension
 Difficulty
 Muscle pain
 Irritability
breathing/swallowing
 Trembling
 Hot flashes
Panic Disorder
 Panic Attack:
 Characterized by an episode of intense fear or discomfort

People with Panic Disorder have recurrent, unexpected panic attacks
followed by at least one month of persistent concern about having
another one.

May occur without warning, or are associated with stressor(s)

Can occur at anytime (even sleep)

Peaks in severity within 10 minutes

Can severely limit an individual’s ability to function
Panic Disorder
 During a panic attack, four or more of the following are present:













Palpitations, pounding heart, or increased heart rate
Sweating
Trembling/shaking
Sensations of shortness of breath or smothering
Feeling of choking
Chest pain or discomfort
Nausea of abdominal distress
Feeling dizzy, unsteady, lightheaded or faint
Derealization (feeling of unreality) o depersonalization (feeling detached
from oneself)
Fear of losing control or going crazy
Fear of dying
Paresthesias (numbness or tingling)
Chills or hot flashes
Agoraphobia
 Agoraphobia:
 Characterized by anxiety about being in places or
situations where escape may be difficult (or embarrassing)
or when help might not be available in the case of a panic
attack
 Commonly associated with Panic Disorder
 More likely to occur in females than in males
 Often include situation that involve being
alone away from home in a crowd or
standing in line; on a bridge; or traveling in a
plane, train, bus, or automobile.
Post-traumatic Stress Disorder
(PTSD)
 PTSD:
 Debilitating condition that follows an extreme traumatic
stressor
 Stressor may be and even that threatens the
individual’s life, serious injury, or personal
integrity.
Characteristics of PTSD
 Persistent re-
experiencing the
traumatic event
 Numbing of general
responsiveness (“psychic
numbing” or “emotional
anesthesia”)
 Increased arousal
(difficulty sleeping,
nightmares, exaggerated
startle response, and
hypervigilance or
alertness for danger)
 Avoidance of stimuli
associated with the
trauma
Types of Phobias
 Acrophobia
 Iatrophobia
 Agoraphobia
 Hydrophobia
 Ailurophobia
 Microphobia
 Apiphobia
 Monophobia
 Aviophobia
 Claustrophobia

 Cynophobia

 Entomophobia

 Hematophobia

(autophobia)
Mysophobia
Nyctophobia
Pyrophobia
Xenophobia