ANXIETY AND

ANXIETY DISORDERS
 Concepts of
Anxiety
1. Anxiety motivates a person to take action, to
solve a problem or to resolve a crisis.
2. Anxiety is considered normal when it is
appropriate to the situation.
3. Anxiety becomes a disorder when it is exccesive
and shows unusual behaviors.
• Panic without reason, irrational fear of
objects, uncontrollable repetitive actions, re-
experiencing traumatic events and
unexplainable or overwhelming worry
LEVELS OF ANXIETY
LEVELS OF ANXIETY:
MILD ANXIETY
PERCEPTION:
• Increased/widens
• Enlarged perceptual field
BEHAVIORAL CHANGES:
• Alert/aware • Enhance learning
• Energetic • Can solved problems
• Confident • Learning id effective
• Attention increased
LEVELS OF ANXIETY:
MILD ANXIETY
PHYSIOLOGIC CHANGES:
• Slight discomfort • GI butterflies
• Restlessness • Difficulty sleeping
NURSING MANAGEMENT
• Help client focus attention to learn and solve
problem
• Motivate client to make changes or engage in
goal directed activity
LEVELS OF ANXIETY:
MODERATE ANXIETY
PERCEPTION:
• Decreased/narrowed
• Selective inattention
BEHAVIORAL CHANGES:
• Difficulty in • Attention span
concentration decreased
• Easily distracted • Cannot connect
thoughts or events
• Pacing/restlessness independently
• Increased rate in speech
LEVELS OF ANXIETY:
MODERATE ANXIETY
PHYSIOLOGIC CHANGES:
• Perspiration • Dry mouth
• Moderate muscle tension • Nervous mannerisms
• Increased heart and • Diaphoresis
respiratory rate • Clammy hands
• GI distress
• Headache
• Dry mouth
• Frequent urination
• High pitch voice
LEVELS OF ANXIETY:
MODERATE ANXIETY
NURSING MANAGEMENT:
• Redirect person to topics because he/she has
difficulty concentrating
• Speak in short, simple and easy to understand
sentence.
• Supervise the person in solving problems and
learning new things
• Administering oral anxiolytic as prescribed.
LEVELS OF ANXIETY:
SEVERE ANXIETY
PERCEPTION:
• Distorted perception
• If prolong, may experience presence of
hallucinations and delusions
BEHAVIORAL CHANGES:
• Difficulty focusing even with assistance
• Ineffective reasoning and problem solving
• Crying • Impaired judgement,
• Disorientation decision making and
problem sloving
• Loud and rapid speech • Absence of abstract
• Confused communication reasoning
LEVELS OF ANXIETY:
SEVERE ANXIETY
SIGN AND SYMPTOMS BECOMES THE FOCUS OF
ATTENTION:
• Increased BP, RR, CR
• Chest pain
• Severe headache/vertigo
• Tremors • Trembling
• Pale/faint • Diarrhea
• Dilated pupils
• Tachycardia
• Nausea
LEVELS OF ANXIETY:
SEVERE ANXIETY
NURSING MANAGEMENT
• Decrease the patient’s anxiety level
• Stay with person because anxiety is likely to
worsen if he/she is left alone
• Talk in low, calm and soothing voice
• Walk with the person while talking if he/she can’t
sit still
• Relaxation techniques
• Reduce environment stimuli
• Administer IM anxiolytics
LEVELS OF ANXIETY:
PANIC ANXIETY
PERCEPTION:
• Disorganized
BEHAVIORAL CHANGES:
• Disorganized thinking
• Irrational reasoning
• Feeling overwhelmed and out of control
• Suicidal
• May become hysterical or mute
• May bolt and run
• Out of contact with reality
LEVELS OF ANXIETY:
PANIC ANXIETY
PHYSIOLOGICAL CHANGES:
• Totally immobile and mute
• Dilated pupils
• Increased BP and pulse rate
• Flight/fright or freeze
• Same with severe anxiety
• Shortness of breathing
• Hyperventilation
• Hallucination/delusion
LEVELS OF ANXIETY:
PANIC ANXIETY
NURSING MANAGEMENT:
• Provide safety because the person cannot perceive
potential harm
• Continuously talk with the person in a comforting
manner even though the client cannot process what
you are saying
• Provide non-stimulating environment to decrease
anxiety
• Remain with the person until panic subsides (Panic
can last from 15-30 minutes)
• Reduce environmental stimuli
LEVELS OF ANXIETY:
PANIC ANXIETY
COPING DYSFUNCTIONAL:
• Defense mechanisms fail
UNDERLYING CAUSES OF ANXIETY
BIOLOGICAL FACTORS
a. Genetic
b. Neurochemical
• GABA – anti-anxiety disorders
• Norephinephrine – panic disorder, GAD, PTSD
• Serotonin – panic disorder, GAD, OCD
GABA believed to be dysfunctional in anxiety disorder
GABA reduces anxiety and norepinephrine increases
it, researches believe that problem with the
regulation of their neurotransmitters occur in anxiety
disorder
UNDERLYING CAUSES OF ANXIETY
PSYCHODYNAMIC
a. PSYCHOANALYTIC/
INTRAPSYCHIC THEORY
- Defense mechanisms are
cognitive distortions that a
person uses unconsciously
to maintain a sense of
being in control of a
situation to lessen
discomfort to deal with
stress
b. INTERPERSONAL
THEORY
- The higher the level of
anxiety to communicate
and solve the lower the
ability of the individual to
solve problems and the
greater chance for anxiety
disorder to develop