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Anxiety Disorders Class 3 Part II Fall 2014. Anxiety Disorders.

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Presentation on theme: "Anxiety Disorders Class 3 Part II Fall 2014. Anxiety Disorders."— Presentation transcript:

1 Anxiety Disorders Class 3 Part II Fall 2014

2 Anxiety Disorders

3 What is… Anxiety Subjective Emotional Response to a stressor vs. Stress Multi-faceted Response to a stressor vs. Fear Cognitive Response to a stressor

4 Anxiety Disorders When does anxiety go from normal to abnormal? How do we decide what’s normal? Is it out of proportion? Dys-function Junction

5 Types of Anxiety Disorders It’s a GAD (Generalized Anxiety D/O)! Panic Disorder Agorophobia Phobias (Specific) Social Anxiety Disorder (Social Phobia) Substance/Medication Induces Anxiety D/O OCD and Related Disorders Separation Anxiety D/O (Covered with children)

6 Trauma and Stress-Related Disorders Post-traumatic Stress Disorder In the DSN 5 PTSD is now in this new category of disorders, but we will include it with the anxiety disorders.

7 Just the Facts Anxiety is the most common form of psych disorder in US Co-morbidity-occurs simultaneously with major depression or substance use Women >2X more than men

8 Phobias Persistent Irrational Fear Response – Exposure/ Thinking about Phobic stimulus Agoraphobia Social Phobia Specific Phobia – A (acrophobia) to Z (zoophobia) Goals of Nursing Interventions – Decrease fear – Increase ability to function

9 Obsessive-Compulsive and Related Disorders OCD Body Dysmorphic D/O Hoarding D/O Tricotillomania D/O (hair pulling) Excoriation D/O (skin picking) Substance/Medication Induced OCD OCD due to another medical condition

10 Oh say can you see the OCD Obsessions Compulsions Usually in it together Neurobiological Disturbances Nursing Interventions 8

11 Patient Goals Manageable level of Anxiety Perform ADLs Understands relationship between anxiety/ compulsions IDs situations that provoked anxiety Adaptive coping strategies Role-related responsibilities

12 It’s a GAD! Generalized anxiety disorder Chronic & Unrealistic What’s in Excess? Signs & Symptoms Can also be related to Medical Conditions

13 I’m so Panicked! (Panic Disorder) Unpredictable & Recurrent Attacks Feelings Intense Physical Symptoms Derealization Depersonalization Fears of …..?

14 Nursing Interventions for GAD and Panic Disorder Relieve acute symptoms Assist client – ID S/S of escalating anxiety – Skills to manage anxiety – Setting realistic goals – Exercising control over own life – ID and accept situations where they have no control

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

16 PTSD Estimated 8% of Adult population in US have PTSD – First recognized in Vietnam War Veterans tjI

17 How do we assist our patients with anxiety disorders? Remain calm Reassure client R/T safety & security Enhance coping & self-esteem Provide hope Nonpharmacologic Measures – Relaxation therapy

18 Treatment Modalities for Anxiety Disorders Individual Psychotherapy Cognitive Therapy Behavior Therapy Group/ Family Therapy Psychopharmacology

19 Antidepressants – SSRIs – TCAs – MAOIs – SNRIs Anxiolytics – Benzos are the Best BUT… And then there are the other medications


21 Anxiolytics A void abrupt D/C after prolonged use N ot given if B/P is elevated, renal/ hepatic dysfunction or drug abuse X anax, Ativan are examples Increases the 3 D’s Drowsy, Dizzy, Decreased B/P E nhanced action of GABA (Inhibitory transmitter) T each to rise slowly from supine Y es Avoid Alcohol!

22 Pharmacotherapy GAD & Panic D/Os and Phobic D/Os Anxiolytics, Antidepressants, Anti-hypertensive agents OCD & PTSD OCD- Antidepressants PTSD- Antidepressants, Anxiolytics, Other drugs for severe symptoms

23 Coming in Class 4 Bipolar & Related Disorders Depressive Disorders Schizophrenia Spectrum Non-pharmacological & Pharmacological Management of these Disorders

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