Anxiety

PREPARED BY:

JEANETTE J. ROJO, RN, MAN

ASST. PROF II UEP ,CNAHS

 Anxiety
 Is a vaque feeling of dread or apprehension;it
is a response to external or internal stimuli
that can have behavioral, emotional,
cognitive, and physical symptoms.

 Anxiety is distinguished from fear, which is

feeling afraid or threatened by a clearly
identifiable external stimulus that represents
danger to the person.

 Anxiety is unavoidable in life and can serve

many positive functions such as motivating
the person to take action to solve a problem
or to resolve a crisis.
General symptoms of anxiety
 Feelings of panic, fear, and uneasiness
 Problems sleeping
 Cold or sweaty hands and/or feet
 Shortness of breath
 Heart palpitations
 An inability to be still and calm
 Dry mouth
 Numbness or tingling in the hands or feet
 Nausea
 Muscle tension
 Dizziness
Levels of Anxiety
1.Mild Anxiety
 Mild Anxiety-is a sensation that something is different
and warrants special attention. Sensory stimulation
increases and helps the person focus attention to learn,
solve problems, think, act, feel, and protect himself or
herself. It helps to motivate people to make changes or
to engage in goal-directed activity.

 E.g. It helps students to focus on studying for an

examination.
a. Physiological response
 Occasional shortness of breath
 Pulse and blood pressure increase
 Mild symptoms of the stomach
 Wrinkled face and lips tremble
 Mild muscle strain
 Relaxed or less anxious

b. Cognitive response
 Able to accept that complex excitatory
 Concentrate on the problem
 Solve problems effectively
 Little sense of failure
 Be alert and pay attention to many things
 Look calm and confident
 Optimal learning rate
c. Behavioral and Emotional Response
 Unable to sit still
 Fine tremor of the hands
 Voice sometimes rising
 A little impatient
 Activity tends to be alone
2.Moderate Anxiety
 is the disturbing feeling that something is definitely wrong; the
person becomes nervous or agitated.

 The person can still process information, solve problems; and learn
new things with assistance from others

 He or she has difficulty concentrating independently but can be

redirected to the topic.

A. Physiological responses
 Intermediate muscle tension
 Vital signs improved
 Pupillary dilation, began to sweat
 Often paced, slapped hands
 Sound change: a shaky voice, high voice
 Increased alertness and tension
B. Cognitive response
 Field perception of declining
 attention is selective
 The focus of the stimulus increases
 Decreased attention span
 Decreased problem-solving
 Learning takes place by focusing

C. Behavioral and emotional responses

 uncomfortable
 sensitive
 Confidence shaken
 Unconsciousness
 excited
 3.Severe Anxiety
 is experienced when an individual believes that there is something different
and there is a threat: it shows the response of fear and distress.
 has trouble thinking and reasoning. Muscle tighten and vital signs increase.
 The person paces; is restless, irritable and angry; or uses other similar
emotional-psychomotor means to release tension.

A. Physiological responses
 Severe muscle tension
 hyperventilation
 Poor eye contact
 respiration increased
 Fast talking, high-tone
 Aimless and haphazard actions
 jaw tightened
 The need for increased space
 Pacing, yelling
 4. Panic

 the emotional-psychomotor realm predominates with accompanying

fight, flight, or freeze response.
 Pupils enlarge to let in more light, and the only cognitive process
focuses on the person’s defense.

B. Cognitive response
 Limited field of perception
 Fragmented thought processes
 hard time thinking
 Poor problem-solving
 Unable to consider information

 Preoccupation with a mind of its own

 Egocentric
C. Behavioral and emotional responses
 very anxious
 agitation
 fear
 confused
 Feeling inadequate
 withdraw
 denial
 want to be free
Ego defense Mechanism
Defense mechanism Description Example
Repression Burying a painful feeling or You can't remember your
thought from your awareness father's funeral.
though it may resurface in
symbolic form. Sometimes
considered a basis of other
defense mechanisms.
Denial Not accepting reality because it You are arrested for drunk
is too painful. driving several times but don't
believe you have a problem
with alcohol.
Regression Reverting to an older, less You and your roommate have
mature way of handling get into an argument so you
stresses and feelings stomp off into another room
and pout
Projection Attributing your own You get really mad at your
unacceptable thoughts or husband but scream that he's
feelings to someone or the one mad at you.
something else
Splitting Everything in the world is seen You think your best friend is
as all good or all bad with absolutely worthless because
nothing in between he forgot a lunch date with
you.
Isolation of affect Attempting to avoid a painful Acting aloof and indifferent
thought or feeling by toward someone when you
objectifying and emotionally really dislike that person
detaching oneself from the
feeling
Displacement Channeling a feeling or thought When you get mad at your sister, you break
from its actual source to your drinking glass by throwing it against
something or someone else. the wall.

Reaction Formation Adopting beliefs, attitudes, and When you say you're not angry when you really
feelings contrary to what you really are.
believe

Rationalization Justifying one's behaviors and I always study hard for tests and I know a lot of
motivations by substituting "good", people who cheat so it's not a big deal I cheated
acceptable reasons for these real this time.
motivations

Altruism Handling your own pain by helping After your wife dies, you keep yourself busy by
others volunteering at your church.

Humor Focusing on funny aspects of a A person's treatment for cancer makes him lose
painful situation his hair so he makes jokes about being bald.

Sublimation Redirecting unacceptable, Intense rage redirected in the form of

instinctual drives into personally participation in sports such as boxing or football
and socially acceptable channels

Suppression The effort to hide and control You are attracted to someone but say that you
unacceptable thoughts or feelings really don't like the person at all

Undoing Trying to reverse or "undo" a

thought or feeling by performing an
action that signifies an opposite
feeling than your original thought
or feeling You have feelings of dislike for someone so you buy them a
gift
Anxiety Disorder
 Anxiety Disorder

 Are diagnosed when anxiety no longer functions

as a signal of danger or a motivation for needed
change but becomes chronic and permeates
major portions of the persons life, resulting in
maladaptive behaviors and emotional disability.
Panic disorder
 Is composed of discrete episodes of panic attacks, that is, 15-30
minutes of rapid, intense, escalating anxiety in w/c the person
experiences great emotional fear as well as physiologic
discomfort
S/S:
• Palpitation
• Sweating
• Tremors
• Shortness of breath
• Sense of suffocation
• Chest pain
• Nausea
• Abdominal distress
• Dizziness
• Chills
• Hot flashes
 Phobias
 Is an illogical, intense, and persistent fear of a specific objects or a social situation that
causes extreme distress and interferes with normal functioning

 Phobias usually do not result from past negative experiences. In fact, the person may
never have had contact with objects of the phobia
TYPES:
 SIMPLE PHOBIA- circumscribed (limited) to dread of a discrete object or situation (dread
of spiders,snakes)
 SOCIAL PHOBIA- dread of public humilation,as in fear of public speaking, performing.
 ACROPHOBIA-dread of high places.
 AGORAPHOBIA-dread of open places.
 ALGOPHOBIA-dread of pain.
 CLAUSTROPHOBIA-dread of closed places
 XENOPHOBIA- dread of strangers.
 XOOPHOBIA- dread of animals.
 ASTRAPHOBIA- dread of storms,thunder, lightning.
 HEMATOPHOBIA- dread of blood.
 MONOPHOBIA- dread of alone.
 MYSOPHOBIA-dread of germs or contamination.
 NECTOPHOBIA- dread of darkness.
 OCHLOPHOBIA-dread of crowds.
 Obsessive-compulsive disorder
 Are recurrent,persistent, intrusive, and
unwanted thoughts, images, or impulses that
cause marked anxiety and interfere with
interpersonal, social, or occupational function.

 Compulsion are ritualistic or repetitive

behaviors or mental acts that a person carries
out continuously in an attempt to neutralize
anxiety
Common compulsions include the following:

 Checking rituals(repeatedly making sure the door is locked or the

coffee pot is turned off)
 Counting rituals (each step taken, ceiling tiles, concrete blocks, or
desks in a classroom)
 Washing and scrubbing until the skin is raw
 Praying or chanting
 Touching, rubbing, or tapping (feeling the texture of each material in
a clothing store; touching people, doors, or oneself)
 Hoarding items (for fear of throwing away something important)
 Ordering (arranging and rearranging furniture or items on a desk or
shelf into perfect order; vacuuming the rug pile in one direction)
 Exhibiting rigid performance (getting dressed in an unvarying pattern)
 Having aggressive urges (for instance, to throw one’s child against a
wall)
Generalized Anxiety Disorder
 A person with GAD worries exessively and feels highly
anxious at least 50 % of the time for 6 months or more.

 Unable to control this focus on worry,the person has

three or more following symptoms: uneasiness,
irritability, muscle tension, fatigue, difficulty thinking,
and sleep alterations

 Buspirone(buspar) and SSRI antidepressants are the

most effective treatments.
Post traumatic stress Disorder
 Can occur in a person when has witnessed an
extraordinarily terrifying and potentially deadly
event.

 After the traumatic event, the person reexperiences

all or some of it through dreams or waking
recollections and responds defensively to these
flashbacks

 Neww behaviors develop related to the trauma, such

as sleep difficulties, hypervigilance, thinking
difficulties, severe startle response and agitation
 Acute Stress Disorder
 Acute stress disorder is similar to post
traumatic disorder in that the person has
experienced a traumatic situation but the
response is more dissociative.

 The person has a sense that the event was

unreal, believe he or she is unreal, and forgets
some aspects of the event through amnesia,
emotional detachment, and muddled
obliviousness to the environment.
 References:
Books:
Psychiatric-Metal Health Nursing (5th edition).Lippincott Williams
& Wilkins:Author.

Internet resources:
http/mayoclinic.com
Wikipedia.com
 Prepared by:
JEANETTTE J. ROJO,MAN