Anxiety Disorders Overview

Anxiety

• Characterized by excessive worry, difficulty controlling worry, and physical symptoms like restlessness, fatigue, difficulty concentrating, and poor sleep.
• Hyperalertness and anticipation of perceived threats are common.
• Anxiety disorders can impact daily functioning in areas like work, social interactions, school attendance, and leaving the house.
• Loss of control over anxiety is a significant indicator of a problem.
• Anxiety disorders are the most common mental disorder globally.
• Women are more likely to experience anxiety disorders than men.
• Symptoms often appear in childhood or adolescence.
• Only 25% of people with anxiety disorders receive treatment.

Generalized Anxiety Disorder (GAD)

• Involves persistent and excessive worry about various aspects of life.
• Can manifest as withdrawal from social support networks, pacing, fidgeting, irritability, sweating, sleep disturbances, difficulty maintaining eye contact, and fixation on specific events or scenarios.

Panic Attacks

• Sudden, intense episodes of fear or anxiety.
• Symptoms include shortness of breath, heart palpitations, chest tightness, trembling, sweating, nausea, and feeling lightheaded.

Agoraphobia

• Characterized by fear of being in situations where escape might be difficult, embarrassing, or help might not be readily available if panic attacks occur.
• Individuals often become housebound due to their fear.

Social Anxiety Disorder

• Involves anxiety and fear in social situations, particularly those involving potential judgment from others.
• Symptoms include social withdrawal, panic around large social events, avoidance of crowds, fear of being judged, and difficulty forming or maintaining relationships.

Obsessive-Compulsive Disorder (OCD)

• Characterized by repetitive, intrusive thoughts (obsessions) and urges to perform specific behaviors or rituals (compulsions) to alleviate those thoughts.
• Checking behaviors and rituals are common, driven by a fear of negative consequences if they are not completed.
• Significantly disrupts a person’s daily life.

Treatments for Anxiety

• Medications: Benzodiazepines can manage symptoms but are highly addictive and not recommended long-term.
• Talking Therapies: Used for long-term management, exploring causes of anxiety, developing coping mechanisms, identifying personal triggers, and fostering active engagement in treatment.
• Exposure Therapy: Gradual exposure to feared situations or objects (spiders, crowds) to reduce anxiety. Often undertaken once a person feels ready.

Nursing Interventions for Anxiety

• Provide emotional support and reassurance.
• Administer PRN medications to manage increased anxiety.
• Participate in rituals and checks with patients with OCD, reassuring them of their safety.
• Empower patients to recognize their own triggers.

Contemporary Mental Health Nursing

• Focuses on person-centered, recovery-oriented, and evidence-based care
• Emphasizes therapeutic relationships and patient autonomy
• Utilizes models like strengths-based approach, trauma-informed care, and collaborative care
• Aims to promote deinstitutionalization and community-based care
• Addresses stigma associated with mental illness and promotes mental health awareness

Past Mental Health Care

• Focused on symptom management and containment
• Often institutionalized, emphasizing custodial care
• Treatments were coercive, with limited attention to patient autonomy
• Practices such as lobotomies and non-consensual ECT were common

Communication with Trauma Survivors

• Use a calm, gentle tone and speak slowly
• Be an active and empathetic listener, avoiding judgment
• Encourage control and choice by offering options
• Mindful of non-verbal communication, maintaining open body language and respecting personal space
• Validate and reassure the person they are safe and supported

Long-Lasting Effects of Trauma

• Hypervigilance: Heightened alertness and difficulty relaxing, leading to exhaustion and anxiety
• Emotional Numbing or Detachment: Withdrawing from others, struggling to connect emotionally

Interventions for Trauma Survivors

• Establish a safe and stable environment
• Teach grounding techniques and mindfulness practices

Harm Minimization

• Public health approach to reducing negative impacts of risky behaviors
• Focuses preventing or minimizing harm rather than solely on stopping the behavior
• Examples include needle exchange programs and safe alcohol consumption initiatives

Anxiety in Patients

• Symptoms: Difficulty breathing, chest tightness, nausea, weight loss
• Strategies: Promote relaxation techniques, encourage social support and familiar activities

Caring for Patients with Alzheimer's Dementia

• Focus: Person-centered care, tailoring interventions to individual needs
• Communication: Use simple, clear sentences, non-verbal techniques, patience
• Routine: Establish consistent daily routine for security and reduced confusion

Evaluation of Care for Alzheimer's Dementia

• Observe behavioral changes for positive or negative responses
• Seek feedback from the patient's family members

Contemporary Mental Health Nursing

• Focuses on patient-centered, recovery-oriented, and evidence-based care.
• Recognizes the interconnectedness of physical, emotional, and social well-being.
• Emphasizes therapeutic relationships.
• Uses various models such as the strengths-based approach, trauma-informed care (TIC), and collaborative care.
• Promotes deinstitutionalization and community-based care.
• Aims to address the stigma associated with mental illness and promote mental health awareness.

Past Mental Health Care

• Focused on symptom management and containment rather than recovery.
• Often relied on institutionalized and custodial care.
• Employed treatments lacking in evidence base and often coercive.
• Practices like lobotomies and non-consensual ECT were commonplace.

Trauma-Informed Communication

• Use a calm and gentle tone of voice.
• Engage in non-judgmental and empathetic listening.
• Offer control and choice to the patient.
• Maintain open and non-threatening body language.
• Regularly validate and reassure the patient.

Trauma and Long-Lasting Effects

• Hypervigilance: heightened alertness, constant scanning for threats, difficulty relaxing, and sleep disturbances
• Emotional Numbing or Detachment: withdrawal from others, difficulty connecting with emotions, and potential for feelings of isolation

Trauma Interventions

• Establish a safe and stable environment: provide a safe, quiet, and predictable environment.
• Grounding techniques and mindfulness: use deep breathing, progressive muscle relaxation, or mindfulness practices.

Harm Minimization

• Public health approach that reduces the negative impacts of risky behaviors.
• Aims to prevent or minimize harm rather than focusing on cessation.
• Examples include needle exchange programs and safe alcohol consumption initiatives.

Anxiety Symptoms and Strategies

• Difficulty breathing and chest tightness: feeling breathless, sensation of pressure or tightness in the chest.
• Nausea and weight loss: feeling nauseous, potential changes in appetite and weight.
• Strategies: promote relaxation techniques like deep breathing and encourage social support and familiar activities.

Alzheimer's Dementia Care

• Person-centered care: tailor interventions to the individual's history, preferences, and cultural background.
• Simple Communication Strategies: use short,clear sentences, non-verbal communication, and allow extra time for the patient to respond.
• Consistent routine: establish predictable daily routines for the patient.

Evaluating Effectiveness

• Behavioral observations: look for reduced agitation, improved sleep, and increased calmness and engagement.
• Family Feedback: consult with family members for insights into the patient's emotional well-being.