ATI Chapter 14
Anxiety and Anxiety Disorders
ANXIETY
- Definition: Dread, apprehension, uneasiness, or excessive nervousness
o Expected and considered normal when appropriate to the situation
o Should resolve when situation resolves
o Emotion, behavioral, conatal, or physical symptoms
o At end of life it is at a much higher level
o Can serve as a motivation!
- Different from fear: fear is being afraid of being threatened by a clearly defined
“something” like a bear or a dog.
- Anxiety disorders: group of conditions sharing key features of excessive anxiety
o Panic without reason or an overwhelming worry
o Everyone will respond differently
- Stress: mental or emotional strain/ tension
o Everyone will respond differently
GENERAL ADAPTATION SYNDROME (How our bodies respond to stress)
- Alarm reaction stage: Fight or flight response
o Sympathetic nervous system
- Resistance stage: Blood gets sent to the essential bodily organs
o Our heart begins to beat fast & the lungs begin to take in deeper breaths
(more o2)
o Parasympathetic system
- Exhaustion stage: Body stores are depleted and have nothing left in reserve
o Parasympathetic system
LEVELS OF ANXIETY
- Mild: Something feels “different”
o Sensory stimulation increases
o Can make the person focus and can be motivational
o No direct interventions are needed
- Moderate: Disturbing feeling that something is definitely wrong
o Can still solve problems and process information
o Issues concentrating and need redirected
o Use short simple sentences
o 1 command at a time
o When teaching, make them teach it back to you
- Severe: Trouble thinking and reasoning
o Muscles become tighter
o Vital signs go crazy
High BP
High HR
o Restless, irritable, and angry
o Cannot pay attention
o Pacing is possible, so walk with to keep up
o Decrease anxiety to mild or moderate so we can proceed accordingly
Focus them in on taking deep breaths
o Do not leave them alone (someone needs to be with them at all times)
, o Take them to a non-stimulating environment
o Reassure them that they are safe and anxiety will pass (up to 30 min)
o Talking down techniques:
Talking to them like a little child and slowly to calm them down
- Panic: She did not say…
ANXIETY DISORDERS
- Stress-related illness: present or made worse by chronic unresolved stress
o Eating disorders
o Somatic symptom disorder
- Agoraphobia: When people will not leave the house
- Panic disorder:
o Most common!
- Specific phobia: being afraid of specific things
- Social anxiety disorder: also called social phobia and don’t want to be in party or
social areas.
o Fear of speaking in public
o Issues performing in front of others
o Excessive fear of embarrassment or poor performance
- Generalized anxiety disorder:
o Highest rates of all mental disorders for all kids and adults
o Most common in women and those under the age of 45
RELATED ANXIETY DISORDERS
- Selective mutism: Kids fail to speak in social situations
o They’re able to speak, but they wont talk with friends or extended family
o They will talk at home
o Can be seen in abusive situations esp. if abuser threatens to harm the child’s
family if they talk
o Occurs due to high level of social anxiety
- Anxiety disorder due to another medical condition: Endocrine dysfunction,
COPD and anxious over breathing, or with anything like that
o When its due to another medical condition, they can sill experience pain,
panic attacks, GAD, or have obsessions/convulsions
- Substance/medication-induced anxiety disorder: Direct result of using drugs or
certain medication
o Or exposure to toxins
o Would not occur if they have had no medications running through their system
- Separation anxiety disorder: Excessive anxiety when they are separated from
their home, people, or whoever they are attached to
o Some separation anxiety is normal with little kids or toddlers
o Once past that childhood developmental stage and then clinically
inappropriate
o Diagnosed before turning 18, but after that developmental stage
ANXIETY DISORDERS: ETIOLOGY
- Genetic: Likely to suffer from anxiety if a first degree relative has it
- Neurochemical: Thought that GABA is a neurotransmitter than is dysfunctional for
patients who have anxiety disorders
- Psychodynamic
Anxiety and Anxiety Disorders
ANXIETY
- Definition: Dread, apprehension, uneasiness, or excessive nervousness
o Expected and considered normal when appropriate to the situation
o Should resolve when situation resolves
o Emotion, behavioral, conatal, or physical symptoms
o At end of life it is at a much higher level
o Can serve as a motivation!
- Different from fear: fear is being afraid of being threatened by a clearly defined
“something” like a bear or a dog.
- Anxiety disorders: group of conditions sharing key features of excessive anxiety
o Panic without reason or an overwhelming worry
o Everyone will respond differently
- Stress: mental or emotional strain/ tension
o Everyone will respond differently
GENERAL ADAPTATION SYNDROME (How our bodies respond to stress)
- Alarm reaction stage: Fight or flight response
o Sympathetic nervous system
- Resistance stage: Blood gets sent to the essential bodily organs
o Our heart begins to beat fast & the lungs begin to take in deeper breaths
(more o2)
o Parasympathetic system
- Exhaustion stage: Body stores are depleted and have nothing left in reserve
o Parasympathetic system
LEVELS OF ANXIETY
- Mild: Something feels “different”
o Sensory stimulation increases
o Can make the person focus and can be motivational
o No direct interventions are needed
- Moderate: Disturbing feeling that something is definitely wrong
o Can still solve problems and process information
o Issues concentrating and need redirected
o Use short simple sentences
o 1 command at a time
o When teaching, make them teach it back to you
- Severe: Trouble thinking and reasoning
o Muscles become tighter
o Vital signs go crazy
High BP
High HR
o Restless, irritable, and angry
o Cannot pay attention
o Pacing is possible, so walk with to keep up
o Decrease anxiety to mild or moderate so we can proceed accordingly
Focus them in on taking deep breaths
o Do not leave them alone (someone needs to be with them at all times)
, o Take them to a non-stimulating environment
o Reassure them that they are safe and anxiety will pass (up to 30 min)
o Talking down techniques:
Talking to them like a little child and slowly to calm them down
- Panic: She did not say…
ANXIETY DISORDERS
- Stress-related illness: present or made worse by chronic unresolved stress
o Eating disorders
o Somatic symptom disorder
- Agoraphobia: When people will not leave the house
- Panic disorder:
o Most common!
- Specific phobia: being afraid of specific things
- Social anxiety disorder: also called social phobia and don’t want to be in party or
social areas.
o Fear of speaking in public
o Issues performing in front of others
o Excessive fear of embarrassment or poor performance
- Generalized anxiety disorder:
o Highest rates of all mental disorders for all kids and adults
o Most common in women and those under the age of 45
RELATED ANXIETY DISORDERS
- Selective mutism: Kids fail to speak in social situations
o They’re able to speak, but they wont talk with friends or extended family
o They will talk at home
o Can be seen in abusive situations esp. if abuser threatens to harm the child’s
family if they talk
o Occurs due to high level of social anxiety
- Anxiety disorder due to another medical condition: Endocrine dysfunction,
COPD and anxious over breathing, or with anything like that
o When its due to another medical condition, they can sill experience pain,
panic attacks, GAD, or have obsessions/convulsions
- Substance/medication-induced anxiety disorder: Direct result of using drugs or
certain medication
o Or exposure to toxins
o Would not occur if they have had no medications running through their system
- Separation anxiety disorder: Excessive anxiety when they are separated from
their home, people, or whoever they are attached to
o Some separation anxiety is normal with little kids or toddlers
o Once past that childhood developmental stage and then clinically
inappropriate
o Diagnosed before turning 18, but after that developmental stage
ANXIETY DISORDERS: ETIOLOGY
- Genetic: Likely to suffer from anxiety if a first degree relative has it
- Neurochemical: Thought that GABA is a neurotransmitter than is dysfunctional for
patients who have anxiety disorders
- Psychodynamic
