ANXIETY DISORDERS circulate this highly oxygenated and

Anxiety highly nourished blood to the muscles

• it is a response to external or internal to defend the body by fight, flight, or
stimuli that can have behavioral, freeze behaviors.
emotional, cognitive, and physical • But if the person adapts to the stress,
symptoms. the body responses relax, and the
• is distinguished from fear, which is gland, organ, and systemic responses
feeling afraid or threatened by a clearly abate.
identifiable external stimulus that • The exhaustion stage occurs when the
represents danger to the person. person has responded negatively to
Anxiety Disorders anxiety and stress: body stores are
• comprise a group of conditions that depleted or the emotional components
share a key feature of excessive anxiety are not resolved, resulting in continual
with ensuing behavioral, emotional, arousal of the physiologic responses
cognitive, and physiologic responses. and little reserve capacity.
ANXIETY AS A RESPONSE TO STRESS What are the different theories on the cause of
Stress anxiety?
✔ Is your body’s way of responding to any Psychoanalytic Theory
kind of demand or threat. Anxiety is caused by a conflict between the
✔ It occurs when a person has difficulty Id and Super ego.
dealing with life situations, problems, Interpersonal Theory
and goals. Each person handles stress Cause of anxiety is fear of interpersonal
differently rejection.
• Hans Selye (1956, 1974), an Behavioral Theory
endocrinologist, identified the Anxiety is a product of frustration.
physiologic aspects of stress, which he Learning Theory
labeled the general adaptation Exposure to early life fearful experience
syndrome. causes anxiety.
• He determined three stages of reaction Conflict Theory
to stress: Presence of two opposing drives, causes
• In the alarm reaction stage, stress anxiety.
stimulates the body to send messages Biologic Theory
from the hypothalamus to the glands Anxiety may accompany physical
and organs to prepare for potential ailments/disease.
defense needs. Family Studies
Gland - such as the adrenal gland, to send out Anxiety can run in families
adrenaline and norepinephrine for fuel Precipitating Factors
Organs - such as the liver, to reconvert glycogen Threat to one’s biological integrity
stores to glucose for food e.g. surgery
• In the resistance stage, the digestive Threat to one’s self system
system reduces function to shunt blood e.g. insult
to areas needed for defense. Peplau’s 4 Levels of Anxiety
• The lungs take in more air, and the heart
beats faster and harder so it can
 • At the mild level, individuals employ Social phobia
various coping mechanism to deal with Obsessive–compulsive disorder
various stress. Generalized anxiety disorder
• Includes: eating, drinking, sleeping, • is characterized by at least 6 months of
physical exercise, smoking, crying, persistent and excessive worry and
laughing, and talking to persons with anxiety.
whom they feel comfortable. • Apprehensive expectations more days
• Anxiety at the moderate to severe level than not for 6 months or more about
that remains unresolved will result to a several events or activities;
number of physiological disorders – uncontrollable worrying; significant
migraine headaches, cardiac distress or impaired social or
arrhythmias occupational functioning; three of the
• Extended periods of repressed severe following symptoms: restlessness, easily
anxiety can result to psychoneurotic fatigued, difficulty concentrating or
patterns of behaving – anxiety disorders mind going blank, irritability, muscle
and somatoform disorders tension, sleep disturbance
Anxiolytic Drugs • Intervention: anti-anxiety;
Anxiety provides the motivation for psychotherapy
achievement, a necessary force for survival. Acute stress disorder
• Anxiety disorders are the most common Post-Traumatic Stress Disorder (PTSD)
of all psychiatric illnesses Post-Traumatic Stress Disorder
• More common in women than men PTSD Symptoms are generally grouped into four
• Minority children and children from low types intrusive memories; avoidance, negative
socioeconomic environments at risk changes in thinking and mood; and changes in
• A familial predisposition exists physical and emotional reactions. Symptoms
How much is too much? can vary over time or vary from person to
• When anxiety is out of proportion to person:
the situation that is creating it. Symptoms of intrusive memories may include:
• When anxiety interferes with social, • intrusive recollections or dreams,
occupational, or other important areas flashbacks, physical and psychological
of functioning. distress over reminders of the event
Anxiety Disorders Symptoms of avoidance may include:
• Agoraphobia with or without panic • avoidance of thoughts, feelings,
disorder conversations, people, places, amnesia,
• Panic disorder diminished interest or participation in
• Specific phobia life events, feeling detached or
• Social phobia estranged from others, restricted affect,
• OCD sense of foreboding
• Generalized anxiety disorder (GAD) Symptoms of changes in physical and emotional
• Acute stress disorder reactions (also called arousal symptoms) may
• Posttraumatic stress disorder. include:
Agoraphobia • sleep disturbance, irritability or angry
Panic disorder outbursts, difficulty concentrating,
Specific phobia
 hypervigilance, exaggerated startle • It teaches a person different ways of
response thinking, behaving, and reacting to
Post-Traumatic stress disorder anxiety-producing and fearful situations.
Risk Factors • CBT can also help people learn and
• a combination of factors including practice social skills, which is vital for
genetic, environmental, psychological treating social anxiety disorder.
and developmental. Self-Help or Support Groups
• Anxiety disorders can run in families, • joining a self-help or support group and
suggesting that a combination of genes sharing their problems and
and environmental stresses can produce achievements with others
the disorders. • Internet chat rooms
• Shyness, or behavioral inhibition, in • Talking with a trusted friend
childhood Stress-Management Techniques
• Having few economic resources • Stress management techniques and
• Being divorced or widowed meditation can help
• Exposure to stressful life events in B. Medication
childhood and adulthood • See Table 13.3 DRUGS USED TO TREAT
• Anxiety disorders in close biological ANXIETY DISORDERS
relatives • Medication does not cure anxiety
• Parental history of mental disorders disorders but often relieves symptoms.
• The CAUSE of anxiety disorders are - These are used as the initial treatment of an
currently unknown but likely involve anxiety disorder, or are used only if there is
• Researchers are finding that genetic and insufficient response to a course of
environmental factors, frequently in psychotherapy.
interaction with one another ❑ What are the priority NURSING
Treatments and Therapies DIAGNOSES?
• Anxiety disorders are generally treated Ineffective individual coping
with psychotherapy, medication, or Anxiety
both. ❑ What are the PRINCIPLES OF NURSING
A. Psychotherapy or Talk Therapy CARE?
• must be directed at the person’s specific BE C →alm
anxieties and tailored to his or her A →dminister medications
needs L →isten to patient’s concern
Cognitive Behavioral Therapy (CBT) M→inimize environmental stimuli