Anxiety Disorders: Understanding Stress and Eustress

Anxiety Disorders

• Stress produces anxiety, and it can come from both positive and negative experiences.
• Eustress is a type of stress that comes from positive experiences, such as weddings or job promotions.
• A stressor is any person or situation that produces anxiety responses.
• Anxiety can be described as an uncomfortable feeling of dread that is a response to extreme or prolonged periods of stress.
• There are four commonly accepted levels of anxiety: mild, moderate, severe, and panic.

Types of Anxiety

• Free-floating anxiety is a feeling of impending doom without knowing when or where the event might occur.
• Signal anxiety is an uncomfortable response to a known stressor.
• Both types of anxiety are involved in various anxiety disorders.

Etiology of Anxiety and Stress

• Psychoanalytic theory suggests that conflict between the id and the superego causes anxiety.
• Biologically, the fight-or-flight response contributes to feelings of anxiety.
• The release of epinephrine and norepinephrine constricts blood vessels and raises blood pressure.
• If the body adapts to the stress, hormone levels adjust to compensate for the epinephrine-norepinephrine release.

General Adaptation Syndrome (GAS) Model of Stress

• Crisis: the "fight or flight" response, where blood vessels constrict, and norepinephrine and epinephrine are released, raising blood pressure.
• Adaptation: hormone levels adjust, and body functions return to homeostasis.
• Exhaustion: the immune system becomes challenged, and there is a potential for cardiac and renal failure, or even death.

Differential Diagnosis

• Differentiating normal anxiety from an anxiety disorder can be challenging.
• A complete physical workup is necessary before diagnosing anxiety disorders.
• Symptoms of anxiety disorders can mimic those seen in other conditions, such as diabetes or cardiac problems.

Adaptation Responses to Stress and the Outcome of Stress on the Body

• Lowered Immunity: the body's adaptation to stress interferes with the effectiveness of antibodies, making it susceptible to illnesses.
• Burnout: associated with stress-related depression, leading to emotional detachment.
• Migraine, Cluster, and Tension Headaches: tightening skeletal muscles and dilating cranial arteries, leading to nausea, vomiting, and other symptoms.
• Hypertension: stress contributes to hypertension by interacting with the kidneys and endocrine system, leading to resistance to blood flow and increased pressure on the arteries.
• Coronary Artery Disease: stress increases the amount of epinephrine and norepinephrine, leading to constricted coronary vessels and increased pulse and respirations.
• Asthma: the automatic nervous system stimulates mucus, increases blood flow, and constricts bronchial tubes, leading to wheezing, coughing, and other symptoms.

Symptoms of Anxiety

• Muscle aches
• Shakes
• Palpitations
• Dry mouth
• Nausea
• Vomiting
• Diarrhea
• Hot flashes
• Chills
• Polyuria
• Insomnia
• Difficulty swallowing

Types of Anxiety and Anxiety-Related Disorders

• Generalized Anxiety Disorder (GAD): excessive worry or severe stress, characterized by restlessness, easily being fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances.
• Panic Disorder: a recurrent condition characterized by fear of dying, losing control, or "going crazy," accompanied by physical symptoms such as nausea, diaphoresis, and chest pain.
• Phobia: an irrational fear of a specific object or situation, often directed towards snakes, spiders, enclosed spaces, or other stimuli.
• Obsessive-Compulsive Disorder (OCD): reoccurring thoughts, ideas, and actions that interfere with daily life, characterized by repetition of thoughts and behaviors.
• Post-Traumatic Stress Disorder (PTSD): a disorder that can appear immediately or be repressed until later, characterized by flashbacks, social withdrawal, nightmares, insomnia, and other symptoms.

Threats to Mental Health

• Obsessive-Compulsive Disorder: a neurological short circuit that causes repetitive behaviors, often linked to a genetic component.
• Social Phobias: fears of social situations, leading to avoidance of situations due to fear of humiliation or being judged negatively.
• Specific Phobias: irrational fears of specific objects or situations, such as acrophobia (fear of heights) or odontophobia (fear of teeth or dental surgery).
• Self-medicating with alcohol and substances: a concern for patients with anxiety disorders, as it can lead to substance abuse.
• Trust and Communication: important for nurses to build trust with patients and encourage expression of thoughts and feelings.
• Family Members: family members and significant others can also suffer from the effects of PTSD, known as vicarious trauma.
• Survivor Guilt: a feeling of guilt expressed by survivors of traumatic events, often accompanied by suicidal thoughts.

Learn about the concept of stress, eustress, and their impact on anxiety. Discover how both positive and negative experiences can produce anxiety.