Telemedicine Idi Lam-Tim - True

ANXIETY IN COVID -19
KILLING or SAVING
Dr.Tendry Septa.,SpKJ(K)
Psikiater Konsultan
11/04/2020 tendrysepta@gmail.com 1
OUTLINE
oOVERVIEW
oSTRES
oSTRESS RESPONSE
oANXIETY
oANXIETY AND COVID 19
oADVANTAGES AND LOSS
oMANAGEMENT
OVERVIEW
• Fear, worry, and stress are normal responses
to perceived or real threats, and at times
when we are faced with uncertainty or the
unknown.
• Outbreaks can be stressful
• The outbreak of coronavirus disease 2019
(COVID-19) may be stressful for people.
• Fear and anxiety about a disease can be
overwhelming and cause strong emotions in
adults and children.
OVERVIEW
Stress during an infectious disease outbreak can include:
 Fear and worry about your own health and the health
of your loved ones.
 Changes in sleep or eating patterns.
 Difficulty sleeping or concentrating.
 Worsening of chronic health problems.
 Worsening of mental health conditions.
 Increased use of alcohol, tobacco, or other drugs.
STRESS
What is stress?
o Stress is a feeling of emotional
strain and pressure
o Stress affects our physical,
emotional and behavior and can
have a positive or negative
influence.
STRESS
o The body's reaction to any unpleasant
situation
o Can spur people to perform better
o Is a situation commonly found in
everyday life
o Natural processes in order to adapt to
their environment
o Affects physical, emotional and behavioral
UNDERSTANDING STRESS
FROM THE ADAPTATION

INSIDE REACTION
o PHYSICAL
PRESSURE INDIVIDUAL o PSYCHIATRIC
o BEHAVIOR
FROM THE RESOLVE

OUTSIDE
tendrysepta@gmail.com 7
IMPACT STRESS
ENERGY
PHYSICAL STRESS BEHAVIOR
PSYCHOLOGICAL
ANXIETY
• Emotional responses without specific objects,
experienced and interpersonal
communication. Anxiety is confusion, worry
that will occur with causes that are not clear
and is associated with feelings of uncertainty
and helplessness (Kaplan & Saddock)
• An emotional state that has no specific object.
Conditions experienced subjectively and
communicated in interpersonal relationships
(Stuart and Sundeen)
ANXIETY
• An unpleasant symptom, anxious sensation,
fear and sometimes panic about a
threatening and inevitable disaster that can
or is not related to external stimuli (Fracchione)
• Anxiety is different from fear, the
characteristic of fear is the presence of
objects and can be identified and can be
explained by individuals.
ANXIETY
• Anxiety is a condition characterized by worry
accompanied by somatic / physical symptoms that
indicate an excessive activity of the Autonomous
Nervous System (SSO).
• Anxiety is a common but non-specific symptom that
is often a function of emotions.
• Depression is a disruption of human function related
to the atmosphere of feelings of sadness and its
accompanying symptoms including changes in sleep
patterns and appetite, psychomotor, concentration,
fatigue, hopelessness and helplessness, and the idea
of suicide.
ANXIETY –COVID 19
Everyone reacts differently to stressful situations
• How you respond to the outbreak can depend on your
background, the things that make you different from other
people, and the community you live in.
• People who may respond more strongly to the stress of a
crisis include:
o Older people and people with chronic diseases who are at
higher risk for severe illness from COVID-19.
o Children and teens.
o People who are helping with the response to COVID-19, like
doctors, other health care providers, and first responders.
o People who have mental health conditions including
problems with substance use.
ANXIETY - COVID 19
• Anxiety can also cause the opposite
reaction: denying or refusing to believe
that the situation is serious.
• Denial is unhelpful.
• When people deny the severity of a
situation in order to avoid anxiety, they
may do nothing or they may ignore public
health orders or recommendations from
health authorities.
RISK FACTORS
These factors may increase your risk of developing an anxiety disorder
• Trauma. Children who endured abuse or trauma or witnessed traumatic events

are at higher risk of developing an anxiety disorder at some point in life. Adults
who experience a traumatic event also can develop anxiety disorders.
• Stress due to an illness. Having a health condition or serious illness can cause
significant worry about issues such as your treatment and your future.
• Stress buildup. A big event or a buildup of smaller stressful life situations may
trigger excessive anxiety — for example, a death in the family, work stress or
ongoing worry about finances.
• Personality. People with certain personality types are more prone to anxiety
disorders than others are.
• Other mental health disorders. People with other mental health disorders, such
as depression, often also have an anxiety disorder.
• Having blood relatives with an anxiety disorder. Anxiety disorders can run in
families.
• Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or
worsen anxiety.
Common anxiety signs and symptoms include:
• Feeling nervous, restless or tense
• Having a sense of impending danger, panic or doom
• Having an increased heart rate
• Breathing rapidly (hyperventilation)
• Sweating
• Trembling
• Feeling weak or tired
• Trouble concentrating or thinking about anything other than the
present worry
• Having trouble sleeping
• Experiencing gastrointestinal (GI) problems
• Having difficulty controlling worry
• Having the urge to avoid things that trigger anxiety
For People Coming Out Of Quarantine
o It can be stressful to be separated from others if 

exposed to COVID-19,  even if you do not get sick
o Everyone feels differently after coming out of
quarantine.
o Emotional reactions to coming out of quarantine
may include :
– Mixed emotions, including relief after quarantine.
– Fear and worry about your own health and the health
of your loved ones.
– Stress from the experience of monitoring yourself or
being monitored by others for signs and symptoms of
COVID-19.
• Sadness, anger, or frustration because friends
or loved ones have unfounded fears of
contracting the disease from contact with you,
even though you have been determined not to
be contagious.
• Guilt about not being able to perform normal
work or parenting duties during quarantine.
• Other emotional or mental health changes.
• Children may also feel upset or have other
strong emotions if they, or someone they
know, has been released from quarantine.
MANAGEMENT
• Thing you can do, may well be the hardest.
That is, accepting that there are events that you
cannot control.
• Thing you can do to reduce stress and worry is
actually limiting media exposure on the topic,
including social media
• Devote time to yourself, your family, your
friends, and generally unwinding.
• Analyzing the causes and effects of their own
behavior
TREATMENT
PSYCHOFARMAKA
Broadly speaking, classified into:
GABA receptor complex (c: diazepam and
clobazam)
The sympathetic (adrenergic) system (c:
clonidin and propanolol)
The serotonergic system (c: buspiron)
TREATMENT
PSYCHOTHERAPY
• Transaksional Analisis
• CBT
• REBT
• Logo Terapi
• Mindfullness
• Hipnoterapi
• Psikoanalis,ect
TERIMA KASIH

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ANXIETY IN COVID -19

FROM THE ADAPTATION

FROM THE RESOLVE

PHYSICAL STRESS BEHAVIOR

• Trauma. Children who endured abuse or trauma or witnessed traumatic events

o It can be stressful to be separated from others if 

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