Chapter 09  Anxiety Disorders

1. Chapter 09Anxiety Disorders

2. Anxiety Defined • Vague, uneasy, emotional feeling normally experienced in response to perceived threat or danger

3. Anxiety as a Symptom • Free-floating anxiety • Thoughts, feelings, behaviors • Automatic relief behaviors • Unrelieved anxiety over time leads to disorder

4. Anxiety Disorders • Uncontrolled, overwhelming anxiety • Impaired functioning • Personal • Social • Work

5. Panic Disorder • Panic attack • Rapid heartbeat • Increased perspiration • Chilling/numbness • Nausea • Feeling of suffocation • Chest pain/fear of heart attack • Fear of being out of control

6. Agoraphobia • Avoid places or situations that trigger panic attack • Restrict activities to avoid recurrence of symptoms • Often homebound or restricted to home environment • Unemployment or school dropout common

7. Phobias • Specific phobia • Excessive, persistent fear of object or situation • Anxiety with contact • Social phobia, also called social anxiety disorder • Excessive fear of social situations in which embarrassment is possible • Discomfort being watched or at risk of being judged by others • Anticipatory anxiety

8. Obsessive-Compulsive Disorder • Obsession • Recurrent, persistent, unwanted thoughts or images causing intense anxiety • Compulsion • Repetitive behavior engaged in to reduce high level of anxiety

9. Posttraumatic Stress Disorder (PTSD) • Response to a situation involving actual death or threat of injury • Intense feeling or fear following an event • Mental reruns of an event • Emotional numbness • Avoidance of people and places associated with an event • Insomnia, inability to concentrate, impaired social or work functioning

10. Generalized Anxiety Disorder • Chronic worry/anxiety • Negative self-talk • Fatigue • Difficulty falling/staying asleep • Tension • Anticipating the “worst” • Irritability, headaches, tremors • Physical symptoms

11. Treatment of Anxiety Disorders • Focus is to reduce the anxiety level • Medications • Antianxiety drugs • Greatest success in combination with psychotherapy • Psychotherapy • Cognitive-behavioral therapy • Anxiety support groups

12. Nursing Process Applied • Take steps to lower the anxiety level; encourage the client’s trust • Assessment • Current feelings • What happened immediately prior to the onset of symptoms • Client’s perspective on the situation • Thought processes • Communication ability, thought blocking • Affect, expression, nonverbal behaviors

13. Nursing Process Applied (Cont.) • Nursing diagnoses • Expected outcomes

14. Nursing Process Applied (Cont.) • Interventions • Consider how your own anxiety may affect nursing care • Should be timely, client centered, and realistic (small steps) • Help the client try more adaptive coping strategies

15. Nursing Process Applied (Cont.) • Evaluation • Client’s ability to recognize and deal with the anxiety-producing factors

16. Question • Tell whether the following statement is true or false. The obsession aspect of obsessive-compulsive disorder refers to repetitive behavior.

17. Answer • False • Rationale: Obsession refers to recurrent, persistent, unwanted thoughts or images that cause intense anxiety.

18. Question • Which disorder is characterized by mental reruns of an event, emotional numbness, and/or avoidance of people and places associated with the event? A. Agoraphobia B. Obsessive-compulsive disorder C. Generalized anxiety disorder D. Posttraumatic stress disorder E. Panic disorder

19. Answer • D. Posttraumatic stress disorder • Rationale: A person with posttraumatic stress disorder experiences mental reruns, numbness, and avoidance of people and places associated with an event; the disorder usually occurs following a situation that involves a death or a threat of a severe injury.

20. Question • Tell whether the following statement is true or false. A person suffering from agoraphobia is often homebound.

21. Answer • True • Rationale: A person with agoraphobia often chooses to remain in familiar home surroundings.