Mental Health Nursing: Anxiety, Stress, and Defense Mechanisms PDF

Mental Health Nursing (Chapters 11 and 12) Chapter 4 – Stress and Defense Mechanisms Defense Mechanisms: Adaptive vs. Maladaptive Use 1. Altruism ​ ​ Definition: Helping others to reduce personal anxiety. ​ ​ Adaptive Example: A nurse volunteers after losing a family member in a f...

Mental Health Nursing (Chapters 11 and 12) Chapter 4 – Stress and Defense Mechanisms Defense Mechanisms: Adaptive vs. Maladaptive Use 1. Altruism ​ ​ Definition: Helping others to reduce personal anxiety. ​ ​ Adaptive Example: A nurse volunteers after losing a family member in a fire. ​ ​ Maladaptive Example: N/A (Always adaptive). 2. Sublimation ​ ​ Definition: Replacing unacceptable impulses with acceptable ones. ​ ​ Adaptive Example: A person channels anger into exercise. ​ ​ Maladaptive Example: N/A (Always adaptive). 3. Suppression ​ ​ Definition: Voluntarily pushing away unpleasant thoughts. ​ ​ Adaptive Example: A student ignores a breakup to focus on a test. ​ ​ Maladaptive Example: A person avoids worrying about losing their job. 4. Repression ​ ​ Definition: Unconsciously forgetting distressing thoughts. ​ ​ Adaptive Example: A person forgets about a childhood bullying incident before a speech. ​ ​ Maladaptive Example: A person continually avoids going to the dentist due to past trauma. 5. Regression ​ ​ Definition: Returning to childlike behaviors. ​ ​ Adaptive Example: A child temporarily wets the bed after losing a pet. ​ ​ Maladaptive Example: An adult throws things when upset at work. 6. Displacement ​ ​ Definition: Redirecting emotions toward something else. ​ ​ Adaptive Example: A teenager punches a pillow after an argument. ​ ​ Maladaptive Example: A parent destroys their child’s toy after losing a job. 7. Reaction Formation ​ ​ Definition: Overcompensating by behaving in the opposite way of one’s true feelings. ​ ​ Adaptive Example: A person trying to quit smoking warns others about its dangers. ​ ​ Maladaptive Example: A resentful caregiver becomes overprotective of an aging parent. 8. Undoing ​ ​ Definition: Making up for an unacceptable action. ​ ​ Adaptive Example: A teenager does chores after arguing with a parent. ​ ​ Maladaptive Example: A partner buys flowers after an abusive incident. 9. Rationalization ​ ​ Definition: Justifying behaviors with logical-sounding reasons. ​ ​ Adaptive Example: A rejected adolescent assumes their crush must be taken. ​ ​ Maladaptive Example: A drunk driver claims they only drove to avoid inconvenience. 10. Dissociation ​ ​ Definition: Disconnecting from reality to avoid stress. ​ ​ Adaptive Example: A parent tunes out distractions while driving. ​ ​ Maladaptive Example: A sexual assault victim forgets who they are. 11. Denial ​ ​ Definition: Refusing to accept reality. ​ ​ Adaptive Example: A person reacts with disbelief to a cancer diagnosis. ​ ​ Maladaptive Example: A grieving parent insists their deceased child is still alive. 12. Compensation ​ ​ Definition: Strengthening a skill to make up for a weakness. ​ ​ Adaptive Example: A student who struggles academically excels in sports. ​ ​ Maladaptive Example: A shy person avoids social interactions by focusing on computers. 13. Identification ​ ​ Definition: Adopting traits of another person or group. ​ ​ Adaptive Example: A sick child pretends to be a nurse for their dolls. ​ ​ Maladaptive Example: A child of abusive parents becomes a bully. 14. Intellectualization ​ ​ Definition: Using logic instead of emotions to cope. ​ ​ Adaptive Example: A detective focuses on facts rather than emotions. ​ ​ Maladaptive Example: A terminally ill person focuses only on finances instead of grief. 15. Conversion ​ ​ Definition: Stress manifests as physical symptoms. ​ ​ Adaptive Example: N/A ​ ​ Maladaptive Example: A person experiences blindness after receiving bad news. 16. Splitting ​ ​ Definition: Viewing things as entirely good or bad. ​ ​ Adaptive Example: N/A ​ ​ Maladaptive Example: A patient praises a nurse one day and ignores them the next. 17. Projection ​ ​ Definition: Attributing one’s own negative thoughts onto others. ​ ​ Adaptive Example: N/A ​ ​ Maladaptive Example: A cheating spouse accuses their partner of cheating. 3. Anxiety Levels and Nursing Interventions 1. Mild Anxiety ​ ​ Symptoms: ​ ​ Normal anxiety level ​ ​ Enhances perception ​ ​ Mild tension (e.g., fidgeting, lip-chewing) ​ ​ Nursing Interventions: ​ ​ Use active listening ​ ​ Ask open-ended questions 2. Moderate Anxiety ​ ​ Symptoms: ​ ​ Reduced perception ​ ​ Increased heart rate ​ ​ Headaches ​ ​ Urinary urgency ​ ​ Nursing Interventions: ​ ​ Stay calm ​ ​ Use clear communication ​ ​ Encourage problem-solving 3. Severe Anxiety ​ ​ Symptoms: ​ ​ Distorted perception ​ ​ Confusion ​ ​ Rapid speech ​ ​ Hyperventilation ​ ​ Nursing Interventions: ​ ​ Provide a quiet environment ​ ​ Set limits ​ ​ Focus on reality 4. Panic Anxiety ​ ​ Symptoms: ​ ​ Extreme fright ​ ​ Hallucinations ​ ​ Immobility ​ ​ Disorganized speech ​ ​ Nursing Interventions: ​ ​ Stay with the patient ​ ​ Speak in a calm voice ​ ​ Use simple directions Chapter 9 – Stress Management 1. Understanding Stress ​ ​ Stress: The brain’s response to demands. ​ ​ Types of Responses: ​ ​ Fight: Facing the stressor head-on. ​ ​ Flight: Avoiding the stressor. ​ ​ Freeze: Feeling stuck or unable to act. ​ ​ Fawn: Submissively trying to please others. 2. Effects of Stress Type​ Effects Acute Stress (Short-term): Increased heart rate, insomnia, decreased appetite, suppressed immunity. Chronic Stress (Long-term): Anxiety, weight changes, hypertension, fatigue, risk for infections. 3. Nursing Care: Stress Management Techniques Cognitive Techniques ​ ​ Cognitive Reframing: Restructuring negative thoughts into positive ones. ​ ​ Example: A parent thinks, “I’m a terrible parent” → “I’ve made mistakes but learned from them.” ​ ​ Priority Restructuring: Adjusting priorities to reduce stress. ​ ​ Example: A busy person delegates tasks instead of handling everything alone. Primary Techniques: ​ 1.​ Meditation – Focuses the mind for relaxation. ​ 2.​ Guided Imagery – Uses visualization to create a sense of calm. ​ 3.​ Breathing Exercises – Controls breathing to lower stress. ​ 4.​ Progressive Muscle Relaxation – Involves tensing and relaxing muscles to reduce tension. ​ 5.​ Physical Exercise – Releases endorphins, reducing anxiety and stress. Additional Techniques: ​ 1.​ Biofeedback – Uses devices to monitor physiological responses to stress. ​ 2.​ Mindfulness – Encourages staying present and aware. ​ 3.​ Assertiveness Training – Helps individuals express needs and set boundaries. ​ 4.​ Journal Writing – A therapeutic way to process stress. Other Individual Stress-Reduction Strategies ​ ​ Engaging in hobbies (e.g., music, fishing, pet therapy). ​ ​ Getting enough sleep and massage therapy. 4. Nursing Assessment for Stress ​ ​ Protective Factors: ​ ​ Strong social support ​ ​ Religious/spiritual beliefs ​ ​ Optimism and humor ​ ​ Standardized Stress Screening Tools: ​ ​ Holmes and Rahe Stress Scale (Measures life stressors) ​ ​ Perceived Stress Scale ​ ​ Lazarus’s Cognitive Appraisal (Assesses coping) Key Takeaways for the Exam ​ 1.​ Defense Mechanisms: Understand which are adaptive, which are maladaptive, and how they function. ​ 2.​ Anxiety Levels: Recognize symptoms and appropriate nursing interventions for mild to panic-level anxiety. ​ 3.​ Stress Management: Know various cognitive and behavioral stress-reduction techniques. ​ 4.​ Nursing Interventions: Focus on effective communication, calming techniques, and patient education