Anxiety Disorders

Objectives of the Lecture

  • Define stress and the stress response.

  • Describe physiological and psychological responses to stress.

  • Differentiate between various types of anxiety disorders.

  • Utilize the nursing process to provide holistic care for anxiety disorder patients.

  • Discuss educational needs for patients and their families affected by anxiety disorders.

Understanding Anxiety and Stress

Stress Definition

  • Stress is the wear and tear life causes on our body.

Fear vs. Anxiety

  • Fear: Feeling afraid due to a clearly identifiable threat.

  • Anxiety: A vague feeling of dread or apprehension without a specific threat.

General Adaptation Syndrome

  • Describes the body's response to stressors

  • Alarm Phase: Activation of neurotransmitters (adrenaline, norepinephrine) leading to increased alertness.

  • Resistance Phase: Body responds to the stressor through fight, flight, or freeze, with physiological responses such as increased heart rate and mental alertness.

  • Adaptive Coping Mechanisms: Positive coping skills (e.g., walking with a dog) that reduce discomfort.

  • Negative Responses: Unhealthy coping methods (e.g., headaches, pain syndromes) when stress isn't managed.

Levels of Anxiety

  • Mild Anxiety: Related to excitement (e.g., first date, concert); increases motivation and problem-solving ability.

  • Moderate Anxiety: Beginning of distress; physical symptoms like muscle tension, dry mouth; increased use of coping mechanisms.

  • Severe Anxiety: Catastrophic; prevents task completion; physical symptoms become debilitating (e.g., GI distress).

  • Panic Anxiety: Complete collapse of coping mechanisms leading to intense panic attacks; symptoms include hyperventilation, dizziness, impending doom.

Types of Anxiety Disorders

Generalized Anxiety Disorder (GAD)

  • Persistent anxiety; symptoms include muscle tension, irritability, and fatigue.

  • Treatments: Cognitive therapy and SSRIs (e.g., Lexapro, Zoloft).

Panic Disorder

  • Characterized by recurrent panic attacks.

  • Symptoms: Hyperventilation, rapid heartbeat, nausea, intense fear of impending doom.

  • Treatments: Therapy focusing on grounding techniques and medications like benzodiazepines during panic episodes.

Phobias

  • Definition: Illogical, intense, and persistent fears of specific objects or situations; may lead to avoidance behavior.

  • Types:

    • Natural Elements Phobias: Fear of heights, tornadoes.

    • Blood-Injection Phobias: Fear related to blood or medical procedures.

    • Situational Phobias: Fear in situations like bridges or flying.

    • Animal Phobias: Commonly include fear of snakes or dogs.

    • Social Phobia: Intense fear of judgment in social settings; may prevent leaving home.

  • Agoraphobia: Fear of being in public or leaving home; may involve limited mobility.

  • Treatments: Behavioral therapy approaches such as systematic desensitization and flooding.

Treatment Approaches

Behavioral Therapy

  • Systematic Desensitization: Gradual exposure to feared stimulus paired with relaxation techniques.

  • Flooding: Immediate exposure to fear-inducing situation; not suitable for everyone.

Key Takeaways

  • Anxiety is a natural part of life; it does not always need to be debilitating.

  • Treatment can include stress reduction techniques, cognitive restructuring, behavioral therapy, and appropriate pharmacology.

  • Understanding and managing the levels of anxiety can empower both patients and healthcare providers in the healing process.