1 / 27

Anxiety disorders

Anxiety disorders. Panic disorder PHOBIAS Generalized Anxiety Disorder “GAD” Obsessive Compulsive & Related Disorders Trauma &Stressor Related Disorders. Anxiety disorders. Anxiety: is a vague, subjective, nonspecific feeling of discomfort and apprehension.

lperson
Télécharger la présentation

Anxiety disorders

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Anxiety disorders • Panic disorder • PHOBIAS • Generalized Anxiety Disorder “GAD” • Obsessive Compulsive & Related Disorders • Trauma &Stressor Related Disorders Psychiatric and Mental Health Nursing

  2. Anxiety disorders Anxiety: is a vague, subjective, nonspecific feeling of discomfort and apprehension. - Response to external or internalstimuli that can have psychological &physical symptoms. - Fear: afraid by a clearly identifiable, external stimulus that represents danger to the person. - Anxiety is considered normal when it is appropriate to situation and dissipates after situation resolved. * As anxiety increases: • Energy become available for problem solving. • Perceptual fields narrow. • Disorganization increases. Psychiatric and Mental Health Nursing

  3. * Levels of anxiety: • Mild anxiety“Optimal”: People generally functioningwell. • Moderate anxiety: Cope with the pleasant or unpleasant stressfulsituations • Sever anxiety , Energy is focused in reducing the pain of anxiety, rather than on coping with environment. “Impaired client function, and he may be in need for help to reserve the situation. • Panic anxiety: Client is disorganized, increased motor activity, loss of rational thought, and decrease ability to relate to others Psychiatric and Mental Health Nursing

  4. Anxiety disorders • Group of conditions of excessive anxiety with behavioral, emotional, and physiologic responses. • Major symptoms of anxiety disorder: “panic, fear, stress, worry and rituals: A- panic: - Panic attack: can occur in any anxiety disorders - Panic disorder with or without agoraphobia B- Fear: • Agoraphobia, social phobia, & specific phobia Psychiatric and Mental Health Nursing

  5. Anxiety disorders.. Cont. C- Stress: • Adjustment disorder with anxiety(exogenous orsituational) • Acute stress disorder • Post-traumatic stress disorder D- worry: - Generalized anxiety disorder - Obsessions and rituals (obsessive compulsive disorder). Psychiatric and Mental Health Nursing

  6. Etiology of anxiety disorders No definitive cause, but there are some theories: 1- Stress Theory: Hans Selye * Identified three stages of stress: - Alarm reaction. - Resistance: continues as 'flight or fight' reaction&may relax. - Exhaustion: may be unable to relax & deplete his resources (physiological and emotional ) Psychiatric and Mental Health Nursing

  7. Etiology of anxiety disorders.. Cont. 2- Biological Theories: * Genetic theory: - - Increased incidence in first-degreerelatives. • Monozygotic twins are greater than dizygoticfivetimes. * Neurochemical theory: - GABA , Serotonin & noradrenaline associated with anxiety disorders. Psychiatric and Mental Health Nursing

  8. Etiology of anxiety disorders.. Cont. 3- Personality Theory: - Shy, inhibited temperament: the strongest predictor of development of anxiety disorder. 4- Psychoanalytic Theory: • Unacceptable thoughts and emotion which occupy the unconscious mind lead to anxiety disorder . Psychiatric and Mental Health Nursing

  9. Etiology of anxiety disorders.. Cont. 5- Interpersonal Theory: Sullivan • Insecure parents may transmitanxiety to their children. • Or when persons do notconform to socialnorms. 6- Behavioral Theory: - Anxiety can be learned through experience e.g.: When dog bites you, you develop a fear of dogs. • May develop fears by watching/ hearing about dangerous situations Psychiatric and Mental Health Nursing

  10. Panic attacks • Abrupt surge of intense fear /discomfort reaches a peak within minutes. Four or more) of the following symptoms occur: 1. Palpitations, pounding heart, or increased heart rate. 2. Sweating. 3. Trembling or shaking. 4. Shortness of breath (SOB). 5. Feelings of choking. 6. Chest pain or discomfort. 7. Nausea or abdominal distress. Psychiatric and Mental Health Nursing

  11. Panic attacks.. Cont. 8. Feeling dizzy, unsteady, light-headed, or faint. 9. Chilis or heat sensations. 10. Paresthesias (numbness or tingling sensations). 11. Derealization (feelings of unreality) or depersonalization (being detached from oneself). 12. Fear of losing control or “going crazy.” 13. Fear of dying. * Panic attack is not a mental disorder. - Panic attacks can occur in the context of any othermentaldisorders (e.g. phobias, PTSD, substance use disorders) and some medical conditions (e.g., cardiac, respiratory). Psychiatric and Mental Health Nursing

  12. Panic disorder • Client must have experienced at leasttwo panic attacks to be diagnosed panic disorder. ** Diagnostic criteria of panic disorder: • Recurrent unexpected panic attacks. • At least one attackfollowed by (1 month or more) of one or both of the following: 1.Worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”). 2. Maladaptive change in behaviorrelated to the attacks(designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations). Psychiatric and Mental Health Nursing

  13. Panic disorder.. cont. • The disturbance not related to physiological or medical condition. (e.g., hyperthyroidism, CPD). • The disturbance is not better explainedbyanothermentaldisorder (response to feared social situations, response to obsessions, as in OCD or as a response to PTSD. Psychiatric and Mental Health Nursing

  14. Panic disorder.. cont. * Characteristics of panic disorder are: - Fear that attacks indicate the presence of an undiagnosed, life-threateningillness • Fear of going crazyor have a weak character • Development of avoidance behaviors • Fear of havinganotherattack. * Treatment of Panic disorder : • CBT & relaxation techniques. • Medications as: as Alprazolam (Xanax), clonidine (Catapres) & propanolol (Inderal). Psychiatric and Mental Health Nursing

  15. PHOBIAS - Illogical, intense, persistentfear of a specific object or a social situation. • Extremedistress and interferes with normal functioning. • People with phobias understand their situation but cannotstop. • People develop anticipatory anxiety when thinking about phobic object or situation. • People engage in avoidance behavior which limits their lives Psychiatric and Mental Health Nursing

  16. Types of phobia A- Specific phobia: Specific phobic object or situation. * Prevalence: - Around 5% in children & older clients - Around 16% in (13-17 years). - Females more than males, 2:1. * Predisposing factors to specific phobias: • Traumatic events as biting by a dog. • Observation of others undergoing trauma. • Repeated warnings of danger e.g. by parents or the media. Psychiatric and Mental Health Nursing

  17. *Diagnostic criteria of Specific phobia: - Markedfear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). (In children, may be expressed by crying, tantrums, freezing, or clinging). • Phobic situationprovokesimmediatefear or anxiety. • Phobic object or situation is activelyavoided or endured with intensefear or anxiety. Psychiatric and Mental Health Nursing

  18. *Diagnostic criteria of Specific phobia: .. Cont. - Fear/anxiety is more than actual danger of specific object or situation. - Fear/anxiety typically lasting for 6 months or more. - Impairment in social, occupational, or other areas of functioning. - Disturbance is not directly explained by anothermentaldisorder, as panic disorder, OCD, or PTSD. Psychiatric and Mental Health Nursing

  19. * Types of specific phobia: • Animals (zoophobia) , Insects (insectophobia) • Heights (acrophobia), Water (hydrophobia). • Electrical storms (astraphobia), • Darkness or night (nyctophobia) • Seeing blood (hematophobia), receiving an injection (injection phobia) • Closed places (claustrophobia), • Bridges (Gephyrophobia) • Elevator phobia. • Flying (aviation phobia). • Fear of fire (pyrophobia). • Strangers (xenophobia). Psychiatric and Mental Health Nursing

  20. Types of phobia.. cont.. B- Agoraphobia: • Anxiety if being in open places or situations from which escape might be difficult (or embarrassing) . * Diagnostic criteria of Agoraphobia: - Marked fear about (two or more) of the 5 situations: 1. Using publictransportation (buses, trains, ships, planes). 2. Being in open spaces (e.g., parking lots, marketplaces, bridges). 3. Being in enclosed places (e.g., shops, theaters, cinemas). Psychiatric and Mental Health Nursing

  21. * Diagnostic criteria of Agoraphobia: .. Cont. 4. Standing in line or being in a crowd. 5. Being outside of the home alone. • Clientavoids these situations because of thoughts that escape is difficult or help might not be available. • Agoraphobic situations always provoke fear/anxiety. • The fear or anxiety is inappropriate to the actual danger of phobic situations. • Fear/anxiety, or avoidance lasting for 6 months or more. Psychiatric and Mental Health Nursing

  22. * Diagnostic criteria of Agoraphobia: .. Cont. • Impairment in social, occupational, or other areas of functioning. • Ifanother medical condition (e.g., inflammatory bowel disease) is present, symptoms is excessive. • Fear/anxiety, or avoidance is not better explainedby another mental or physical disorder. * Two main types:panic disorder withagoraphobia (more prevalent), & agoraphobia without panic disorder. Psychiatric and Mental Health Nursing

  23. Types of phobia.. cont.. C- Social Anxiety Disorder (Social Phobia): *Diagnostic Criteria: * Marked fear/anxiety about one or more socialsituations: Examples: - Socialinteraction (e.g. having conversation, meeting unfamiliar people) • Being observed (e.g., eating or drinking , giving a speech). * Client fears that he will act in a way or show anxiety symptoms which is embarrassing. Psychiatric and Mental Health Nursing

  24. *Diagnostic Criteria of social phobia: .. Cont. • Social situationsavoided or endured withintense anxiety. • Fear/anxiety is inappropriate to the actual social situation. • Fearing typically lasting for 6 months or more. • Impairment in social, occupational, or other areas of functioning. • Fear/anxietynotrelated to another physiological or medical condition. Psychiatric and Mental Health Nursing

  25. Features associated with social phobia • Hypersensitivity to criticism. - Fear of negative evaluation or rejection. - Difficulty in being assertive. - Low self-esteem, feelings of inferiority. • Avoiding eye contact when talking to a person. • Observable signs of anxiety tremor or shakyvoice. • Underachievement school/work & decreased social networks. Psychiatric and Mental Health Nursing

  26. Features associated with social phobia .. Cont. • In severesocialphobia client is less likely to marry, & may have suicidalideation • Social phobia begins in mid-teens and persists throughout a lifetime. • Common conditionscomorbid with socialphobia include: - Depression, substance abuse, anorexia nervosa and avoidant personality disorder. Psychiatric and Mental Health Nursing

  27. Treatment:(anxiety associated with phobias). 1. Anxiolytic drugs 2. Behavioral therapy: - (relaxation techniques) • Systematic desensitization: (progressively exposes the client to threatening object until anxiety decreases) 3. Flooding: rapid desensitization (confronts client with phobic object, picture or actual) until anxiety decreases. Psychiatric and Mental Health Nursing

More Related