Anxiety Disorders

Trisha Economidis
Fall, 2014

Anxiety Disorders
Anxiety is a normal response to
stress
Problematic when it produces
dysfunctional behavior or becomes
intolerable.
Use behaviors to control anxiety:
rigid, repetitive, ineffective

Anxiety Facts
Most common form of psych d/o
in the U.S.
Co-morbidity occurs
simultaneously with major
depression and substance abuse
More common in women than
men

Types of Anxiety
Disorders

Phobias (specific, social)

Generalized Anxiety Disorder (GAD)
Panic Disorder
Agoraphobia
Social Anxiety Disorder
Substance/Medication Induced Anxiety
Disorder
Separation Anxiety Disorder (will cover
with children

Phobias
Irrational fear that persists even
when aware that it is irrational
Agoraphobia
Social Phobia
Specific phobia
Nursing Interventions aimed at
decreasing fear and increasing
ability to function

Generalized Anxiety
Disorder

Chronic, unrealistic & excessive

anxiety & worry
Restlessness
Fatigue
Concentration issues
Irritability
Muscle tension

Panic Disorder
Recurrent panic attacks, unpredictable
Feelings of impending doom along with
physical discomfort
Palpitations, racing heart
Sweating, shaking
Nausea, abdominal pain
De-realization or Depersonalization
Fear of going crazy or dying

GAD & Panic Disorder

Nursing Interventions
Aimed at relieving acute
symptoms
Assist client in taking control
of own life and accepting
situations over which he or she
have no control

Obsessive-Compulsive
and Related Disorders

Obsessive-Compulsive Disorder
Body Dysmorphic Disorder
Hoarding Disorder
Tricotillomania (hair-pulling)
Excoriation (skin picking)
Substance/medication-induced OCD
OCD due to another medical
condition

Obsessive-Compulsive
Disorder

Obsessions
thoughts
that
Obsessions unwanted
unwanted
thoughts
cycle
repeatedly
that cycle
repeatedly
Compulsions
ritualistic

Compulsions unwanted,
unwanted,
ritualistic
actions
actions
Usually obsessions & compulsions
Usually obsessions & compulsions
occur together
occur together
Nursing Intervention help the client
maintain
Nursing anxiety
Intervention
help the level
at a manageable
client maintain
at a
without
ritualisticanxiety
behaviors
manageable level without ritualistic
behaviors

 http://www.youtube.com/watch?v=
Rn1OYlYzgm8

Trauma and Stress-Related

Disorders:
Disorder
Post-Traumatic
Occurs after exposureStress
to an extreme
traumatic stressor
(PTSD)
Stressor involves a personal threat to
physical integrity of self or others
Symptoms:
Flashbacks
Avoidance of anything associated with the
trauma
Numbing
Hypervigilence

General Nursing
Interventions for Anxiety
OCD, and
BeDisorders,
calm
Enhance
coping
Stress-Related
D/O
Instill hope
Enhance self-esteem
Use relaxation therapy

Treatment Modalities for

Anxiety, ObsessiveCompulsive, and
Individual Psychotherapy
Trauma/Stress-Related
Cognitive Therapy
Disorders

Behavior Therapy
Group/Family Therapy
Psychopharmacology

Psychopharmacology
Antidepressants
SSRIs (Selective Serotonin
Reuptake Inibitors)
TCAs (Tricyclic Antidepressants)
MAOIs (Monoamine Oxidase
Inhibitors)
SNRIs (Serotonin- Norepinephrine
Reuptake Inhibitors

Selective Serotonin
Reuptake Inhibitors
Prozac, Paxil,
Celexa, Zoloft,
(SSRIs)

Lexapro
Newer class of meds; less side
effects
Some are sedating
DO NOT MIX WITH ALCOHOL

Tricyclic Antidepressants
(TCAs)

Elavil, Tofranil, Pamelor

One of oldest classes, but
effective
Side effects: sedating,
orthostatic hypotension,
anticholinergic effect, weight
gain, sexual dysfunction

Monoamine oxidase
inhibitors (MAOIs)

Nardil, EMSAM patch

Serious side effect when taken with
tyramine can cause hypertensive crisis
Other side effects: orthostatic hypotension,
tachycardia, sleep disturbances, impotence
**Must be at least a 2 week washout
period between MAOIs and any other
antidepressant or any tyramine-rich
foods

Anxiolytics
Benzodiazepines 1st line
medications
Buspar
Kava
Antihistamines
Beta Blockers
Anticonvulsants