Anxiety

Anxiety:  a feeling of apprehension, uncertainty, and fear without apparent stimululi, associated with physiological changes.

Anxiety related to situational crisis; this diagnosis can apply to any hospitalized patient, or a traumatic change in one’s life.  It’s used most commonly in a patients with conditions requiring surgery or use of sophisticated technologic devices or techniques.  The diagnosis also applies to patients with newly diagnosed chronic or terminal cardiovascular disorders. Also related to unmet expectations or threats to safety or security, this diagnosis may be associated with such conditions as anorexia nervosa and schizophrenia.  Because anxiety can increase myocardial oxygen consumption and exacerbate cardiac stress, helping the patient improve his coping skills is vital.

Symptoms:

• Tachycardia (increase pulse rate)

• Sweating

• Tremor

• Restlessness

• Apprehensiveness

• Worry

• Extreme silence or extreme talkativeness

Treatment:

• Allowing patient to express self

• Require no demands/ giving patient facts

• Relax therapy/meditation

• Antidepressant’s/Antianxiety medications

• Have a love one stay with the patient if in a hospital 

Anxiety disorders:   Everyone at some point in their lives, experience worry, insecurity, apprehension and foreboding.  When anxiety and inner conflict become overwhelming, a psychiatric disorder may develop.  Types of anxiety disorders include obsessive – compulsive disorder and postraumatic stress disorder (PTSD).

Obsessive-compulsive disorder: Obsessive thoughts and compulsive behaviors represent recurring efforts to control overwhelming anxiety, guilt, an or unacceptable impulses that persistently and involuntarily enter the  consciousness.

Obsession :  an persistent unwanted idea or impulse that cannot be eliminated by reasoning.

Compulsion:  an overwhelming urge to perform an irrational act or ritual, or an involuntary defensive behavior as an expression of anxiety.

Obssive-compulsive is marked by compulsion to repetitively perform certain acts, or carry out certain rituals.  Compulsive behaviors are repeated because they reduce the anxiety associated with the obsession.  This disorder occurs in both sexes, with typical onset in adolescents or young adults.  Recent studies indicate a higher incidence in upper-class people with higher intelligence.

Researchers have not uncovered a single cause for obsessive-compulsive disorder.  Some studies suggest the possibility of brain lesions, but the most useful research and clinical studies point to and explanation based on psychological theories.  Major depression, organic brain syndrome, and schizophrenia may contribute to the onset of this disorder.

Symptoms: 

Compulsive actions may be simple, mild, and uncomplicated or dramatic, elaborately complex, and ritualized.  Their meanings may be obvious or may reflect inner psychological distortions that are unraveled only through intensive psychotherapy.

Often the patient’s anxiety is so strong that he will avoid the situation or the object that evokes his compulsion.  For example:  a patient who has a recurring urge to push people down long flights of stairs may avoid going up or down any stairs in buildings.

Has a tendency to repeat acts over and over, such as; repetitive touching, repetitive hand washing, repetitive doing and undoing (opening and closing doors, drawers), repetitive checking of a certain thing.

When the obsessive-compsive phenomena are mental, no one knows that anything unusual is happening unless the patient talks about these private experiences. Commonly, the obsessive patient has repeated thoughts of violence or contamination, or constant worry about a tragic event.

Treatment:

• Treatment aims to reduce anxiety, and depression

• Tranquilizer and or antidepressants therapy

• Psychotherapy (may be long-term)

• Brief supportive psychotherapy 

• Behavior therapy

• Group therapy

Posttraumatic stress disorder:  or PTSD, involves the psychological consequences of a traumatic event that occurs outside the range of usual human experience.  PTSD can be acute, chronic, or delayed and can follow a natural disaster such as; a flood, or man-made disaster such as; war, torture, incest or car accidents, an assault, or a rape.

In most people with posttraumatic stress disorder, the stressor is a necessary but insufficient cause of the persisting symptoms.  Even the severest stressors do not produce PTSD in everyone, so psychological, physical, genetic, and social factors may  also contribute to it.

Symptoms:

• Patient may have a recurrent, intrusive recollections or nightmares

• Psychological distress at exposure to events that symbolize trauma.

• Sleep disturbance

• Chronic anxiety

• Panic attacks

• Memory impairment

• Difficulty concentrating

• Feeling of detachment or estrangement that destroy interpersonal relationships

• Headaches

• Depression

• Rage

• Use of violence to solve problems

• Suicidal thoughts

• Persistent avoidance of stimuli associated with trauma

• Diminished general responsiveness

Treatments:

Goal of treatment include reducing the target symptoms, preventing chronic disability, and promoting occupational and social rehabilitation.

• Behavioral techniques/relaxation therapy

• Antianxiety medication

• Antidepressants medications

• Psychotherapy

• Support groups

Many patients need treatment for depression, alcohol and drug abuse or medical conditions before psychological healing can take place.