Anxiety/GAD
what is anxiety?
what is excessive worry that you are unaware of why you are worried. Can overwhelm an individuals defense mechanisms and coping mechanisms
What is PTSD
What is panic disorder?
recurrent unexpected panic attacks that cause intense fear which peaks within minutes when 4 or more of the s/s occurs
What is OCD?
Compulsions: things individuals do to try and decrease anxiety
avoidance of places of situations from which there is no perceived escape and from where help may not be available
WHAT IS AGORAPHOBIA
People with anxiety may experience...
avoidance to settle the sense of discomfort or feeling of impending doom
they report feeling like they are going crazy
energy and emotional resources are drained
Symptoms of PTSD
avoidance of stimuli associated with trauma
numbing of general responsiveness
persistent hyper arousal: cant sleep, cant think, startle easy and irritable
S/S of panic disorder
-palpitations, chest pain, pounding heart, shaking, nausea, fear of dying, chills or heat, derealization, sensations of SOB, depersonalization, numbness, tingling
-recurrent and happens abruptly
What is diagnostic criteria?
obsessions and compulsions must be associated with at least 1:
-severe distress
-they take up time (more than an hour a day)
-interfere with normal routine
What is a phobia?
illogical, intense and persistent fear of a specific object, experience or social situation that causes extreme distress
-interferes with ability to function
-people are aware that fear is irrational but feel powerless
What is mild anxiety?
restlessness, fidgeting, butterflies, nail bitting, foot tapping
wide perceptual range, sharpened sense, irritability, effective problem solving and learning ability
Diagnostic criteria for panic disorder
-at least 1 panic attack has been followed by 1 month of:
-persistent concern or worry about having another panic attack
-significant maladaptive behavioural change such as avoidance techniques to avoid panic attacks
-must r/o substance, medication, medical condition or mental disorder
What are compulsions + examples
- ritualistic or repetitive behaviours or mental acts that a person will do continuously to alleviate anxiety
-repeated checking or counting, hand washing, repeating words, touching rituals, cleanliness
What is social phobia?
involves severe anxiety to panic when confronted with situations involving people, especially when meeting new people, but may be a fear of eating in public, using public bathrooms, or being the center of attention
What is GAD?
excessive worry and anxiety for more than half the days in a 6 MONTH period + 3 or more of the following:
-feelings of restlessness, tiring easily, trouble concentrating, trouble sleeping, increased muscle tension, irritability
-comorbid conditions? suicidal? family issues/therapy, stigma, trauma informed approach, self assessment
Levels of anxiety: Panic (psychological and physiological characteristics)
psychological: perception reduced to only seeing self, cannot process, cant talk, delusions, loss of rational thought , hallucinations, cant process environment
physiological: may bolt, may freeze, may be mute, dilated pupils, increased bp
Interventions
- CBT and SSRI for anti anxiety
-cognitive restructuring
-behavioural therapy such as exposure, thought stopping, response prevention
What is stress?
- causes physiological symptoms such as increased HR, BP and RR + increased muscle tension
-stress is caused by things we are aware of such as exams and finances
Nursing interventions for pt with anxiety?
stay with client, talk in low calm voice, walk with pt, encourage db, reduce environmental stimuli, safety and meds
cbt is helpful for gad
When do symptoms of PTSD show up?
3 months post event but can be delayed for years
Interventions for panic disorder
- SSRI are first line treatment not for acute episodes
-benzos will be used for acute episodes
-provide safety
People with OCD are not aware that their anxieties are irrational
TRUE OR FALSE
TX for phobias/agoraphobia
Anxiolytics: benzo and non benzos