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Anxiety Disorders.pptx
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- 2. Define anxiety andanxiety disorders. List levels of anxiety. List etiological factors of anxiety disorders Identify types of anxiety disorders. Discuss nursing care plan for anxious patient.
- 3. Anxiety Anxiety is afeeling of apprehension or fear. o It is normal reaction to stressors in daily life and can help people to more effectively deal with everyday stressful situations, such as starting a new job or passing an exam.
- 5. o If anxietyrises to excessive levels or becomes recurring or continuous, it can develop into a mental health condition, called anxiety disorder which involve excessive anxiety or anxiety without any stressful stimulus.
- 6. Anxiety Anxiety Disorders affectabout 40 million American adults age 18 years and older (about 18%). Anxiety is highly treatable (up to 90% of cases) Women are affected more frequently than men. The female-to-male ratio for any lifetime anxiety disorder is 3:2. Depression often accompanies anxiety disorders
- 7. 1- Mild anxiety:is associated with the tension of daily living. 2- Moderate anxiety: in which the person focuses only on immediate concerns involves the narrowing of the perceptual field 3- Severe anxiety: is marked by a significant reduction in perceptual field. 4- Panic: associated with dread and terror and the person is unable to do things even with direction.
- 8. Genetic theory Biochemical factors Psychoanalyticaltheory Socieocultural theory Learning theory Cognitive theory
- 9. Genetic factors significantlyinfluence risk for many anxiety disorders. It is well established that the tendency to develop anxiety disorders runs in families. This is similar to a predisposition to other illnesses, such as diabetes and heart disease. About 25% of the first degree relatives with GAD are affected.
- 10. Brain chemical imbalancemay increase the anxiety response. Example: Noradrenaline and Gamma aminobutyric acid (GABA).
- 11. This theory hasexplained anxiety as a conflict between the id and ego. These drives may produce automatic anxiety.
- 12. Some people maylearn responses that can be unlearned e.g. a mother may transmit anxiety to her children, who will continue to adopt her behavior even into adult life.
- 13. Stressful life experiencese.g. societies with high technology, urban area and changes places are associated with the development of some anxiety disorders, particularly post traumatic stress disorder.
- 14. They believe thatanxiety disorders are caused by distortions in the way that individual thinks and perceives e.g. people with social phobia believe that they must be approved of all the time by every one. They must never make a mistake when they do, they respond to embarrassment with acute anxiety.
- 15. Cont Anxiety disorders takemany forms: Phobias Panic disorder. Posttraumatic stress disorder. Acute stress disorder. General anxiety disorder. Obsessive-compulsive disorder. Substances induced anxiety disorders Anxiety disorders due to medical causes
- 17. Social phobia Marked andpersistent fear of social or performance situations. Specific phobia Marked and persistent fear; excessive and unreasonable; cued by presence or anticipation of object. Agoraphobia Anxiety about being in places or situations where escape may be difficult or embarrassing, and a panic attack may occur.
- 18. Agoraphobia: involves intense fearand anxiety of any place or situation where escape might be difficult such as shopping malls, or public transportation, leading to avoidance of situations such as being alone outside of the home.
- 19. Social phobia Social phobia:is an anxiety disorder characterized by overwhelming anxiety and excessive self consciousness in everyday social situations and it can be limited to only one type of situation. The DSM-5 define social phobia as "a marked and persistent fear of social or performance situations in which embarrassment may occur".
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- 21. Signs and symptoms 1.Racingheart. 2.Turning red. 3.Dry mouth and throat. 4.Dysphagia. 5.Trembling. 6.Nausea. 7.Sweating. 8. Muscle twitches.
- 22. Cont Social phobia iscommon in females, and appears in childhood and adolescent ages, and decreased gradually with aging.
- 23. Specific phobia Specific phobia:is an intense, irrational fear of something that poses little or no actual danger. It is also defined as a marked and persistent fear of a particular object, place, or situation (phobic stimulus) which interfere with daily occupational function and social life or cause marked personal distress.
- 24. Specific phobia It twiceas common in women as men.
- 26. Panic attacks—alone arenot psychiatric illnesses A discrete period of intense fear or in which 4 or more of the following sx develop abruptly and reach a peak within 10 minutes: Palpitations, pounding heart, accelerated heart rate Sweating Trembling or shaking Sensations of SOB or choking Chest pain or discomfort Nausea or abdominal distress Dizziness, lightheadedness, unsteadiness Derealization, depersonalization Fear of losing control or going crazy Fear of dying Chills
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- 29. Cont Panic disorder: isdiagnosed in people who experience panic attacks and are preoccupied with the fear of a recurring attack.
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- 31. is asevere anxiety disorder that can develop after someone exposure to extremely traumatic event and reacted to the event with intense fear, horror or helplessness. PTSD
- 32. Exampleortraumatic events: Learning events Witnessing events Personal experienceby the client Events experienced by family members of close friends Injury or death experienced by another persons seen by the client Military fight Sever auto accident, Diagnosed with life threatening illness
- 33. Classification Acute if the durationof the symptoms less than 3 months Chronic If the symptoms last 3 months of longer Delayed onset 6 months passed between the traumatic event the onset symptoms
- 34. Diagnostic Criteria ofPTSD Exposureand Response Experienced the traumatic events, witnessing or learning then response in fear hopelessness and horror Re-experiencing Recurrent image, thoughts and perception about the events or distress dreaming, and flashback Avoidance Avoid thought, activities, places involved in traumatic event Inability to recall important aspect of the event Inability to act in some activities
- 35. Diagnostic Criteria ofPTSD -Hyper arousal -Irritable -Sleeplessness -Difficult concentration Significant Impairment Duration More than 1 month
- 37. Cognitive-behavioral therapy forPTSD Systemic desensitization involves carefully and gradually “exposing” to thoughts, feelings, and situations that remind person of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational and replacing them with more balanced picture.
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- 39. Acute stress disorder Anxietysymptoms that occur within one month after exposure to traumatic events. Last two days but no more than one month. ( if more it considers PTSD)
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- 41. Obsessive Compulsive Disorder Ananxiety disorder characterized by - Obsession (repetitive thought that make little sense). - Compulsive behaviors (repetitive behaviors that strive to neutralize the anxiety related to obsession).
- 42. Obsessive compulsive disorder Commonobsessions – violence, sex, contamination, order Common compulsions – washing, cleaning, checking, seeking reassurance, ordering or arranging objects
- 43. Clinical features OCD mustmarked distress, be time consuming (take more than 1 hour per day) and significantly interfere with socio-occupational functions. Person with obsession of contamination may avoid public restroom or shaking hand.
- 44. Diagnostic criteria -Recurrent thoughtsthat are inappropriate and caused marked anxiety or distress. -The person attempts to ignore these thought. -The person recognize that these thought are product of his mind.
- 45. -Repetitive behaviors suchas washing, checking or ordering are developed. -These behaviors induced to reduce the distress and the anxiety. -The person should recognize that these behaviors are excessive and not appropriate. -The obsession and compulsion should cause marked distress with time consuming. Diagnostic criteria
- 46. Psychological Treatment ofOCD Exposure with response prevention Person is gradually and systematically exposed to the feared thought or situation Promotes habituation to the feared stimulus
- 47. Nursing intervention Gradually limitthe time to neutralizing the obsessive thought Provide patients with positive reinforcements Help the client learn more coping technique such as relaxation, thought stopping, or physical activities
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- 49. Generalized anxiety disorder GADis characterized by persistent and excessive worry about a number of different things. People with GAD may anticipate disaster and may be overly concerned about money, health, family, work, or other issues. An excessive anxiety or worry occurring most days over at least 6 months.
- 50. Clinical feature Muscle tension. Fatigueand difficult concentration. Restlessness, irritability, sleep disturbance. Somatic symptom such as nausea or diarrhea. Increase heart rate, S.O.B and dizziness.
- 51. Nursing intervention Provide thepatient with reassurance of safety and security Provide patient with calm environments Help the client to identify area that can control Provide patient positive feedback
- 52. It is characterizedby symptoms of anxiety which develop during the use of substance or after stopping using. The evidence needs to be obtained through the history, physical examination or laboratory finding. Substances like alcohol, cocaine, heroin and hallucinogens.
- 53. Anxiety may occurdue to medical causes such as hyperthyroidism, pulmonary embolism, or cardiac dysrthythmias so a careful and comprehensive assessment of multiple factors is necessary through history, physical examination or laboratory findings.
- 54. 1- Ineffective individualcoping Related to anxiety. Evidenced by increased muscles tension and restlessness, report feeling apprehensive, sweating, frequent urination, pulse elevated, skin pale.
- 55. The client willrecognize his own anxiety and care effectively with symptoms associated with anxiety.
- 56. - Stay withthe client and listen. - Acknowledge the client anxiety. - Speak slowly and calmly. - Have the client use positive, self-talk e.g. I can handle this or I can come. - Administer anti-anxiety drugs as indicated.
- 57. -The nurse mustmonitor and control own feeling because anxiety is transmissible. - Use short simple sentences. - Give brief directions. - Decrease excessive stimuli and provide quite environment. -Walk with pacing client to give him support.
- 58. - Related tophysiologic disturbances caused by anxiety. - Evidenced by difficulty getting in sleep. - The goal - client will achieve adequate sleep.
- 59. Provide measures appropriateto reduce insomnia, if indicated:- Quite, secure environment. Relaxation techniques. Night light. Decreased number of distraction. e.g. .taking temperature during night.
- 60. Structured bedtime routine for the client e.g. bath, reading, warm milk, music…….etc Maximum measures for comfort of bed, clothing,……..etc. Discourages napping.