1. Mental Health 2.1 Stress, Anxiety, Coping, Abuse, and Neglect. Judith Wikel RN BSN Med Practical Nursing Instructor

2. Chapter 18 Managing Anxiety Anxiety is a feeling of uneasiness, uncertainty, and helplessness. Anxiety is a state of tension sometimes associated with feelings of dread or doom.

3. Managing Anxiety Anxiety can be a warning of impending danger. Mild anxiety can increase learning by helping with concentration and focus. Anxiety can also provide motivation.

4. Managing Anxiety Types of Anxiety – Signal anxiety – a learned response to an anticipated event.

5. Managing Anxiety Anxiety state – Occurs when an individual’s coping abilities become overwhelmed and emotional control is lost.

6. Managing Anxiety Anxiety trait – A learned component of the personality. Persons with anxiety traits react with anxiety in relatively low stress situations.

7. Managing Anxiety Uncontrolled anxiety often leads to ineffective and maladaptive behaviors. Anxiety is a NORMAL part of survival and growth. How individuals use and control anxiety is one of the measures of mental health and illness.

8. Managing Anxiety Levels of Anxiety – Mild – Moderate – Severe – Panic Please refer to Table 18-1 on page 192.

9. Common Defense Mechanisms Compensation Conversion Identification Rationalization Regression Substitution – These are only a few Defense Mechanism please refer to Table 18-2 page 193.

10. Defense Mechanisms Examples of Defense Mechanisms – – Substitution – A person who is attracted to pornography campaigns to ban adult book stores in his community. – Regression – A 4 year old boy whose parents are going through a divorce starts to suck his thumb and wet his pants.

11. Anxiety in Childhood Separation anxiety disorder – the child experiences severe anxiety that can develop into panic when separated form significant others.

12. Anxiety in Childhood Overanxious disorder – unrealistic levels of anxiety. – This could lead to avoidance behaviors in which the child refuses to cope with the anxiety- producing situation by ignoring it.

13. Anxiety in Older Adulthood Somatize – Expressing feelings physically.

14. Panic Disorders Agoraphobia is anxiety about possible situations in which a panic attack may occur. Individuals with agoraphobia avoid people, places, or events from which escape would be difficult or embarrassing.

15. Posttraumatic stress disorder PTSD is intense fear, horror, or helplessness experienced by being exposed to a traumatic experience that was outside the realm of normal life experiences at some time in ones life. Flashbacks are common.

16. Chapter 22: Clients with Psychological Problems Cultural influences – The nurse must understand the problem within the client’s cultural framework.

17. Chapter 22: Clients with Psychological Problems Somatization Disorder – Individuals with Somatization disorder often possess a long history of vague complaints. – Complaints usually are described in colorful and exaggerated terms, but offer few facts. – Individuals with Somatization disorder seek treatment from several physicians at the same time.

18. Chapter 22: Clients with Psychological Problems Conversion disorder – A somatoform disorder in which the individual presents problems related to the sensory or motor functions.

19. Chapter 22: Clients with Psychological Problems Body Dysmorphic Disorder – Is characterized by a preoccupation with a physical difference or defect in one’s body. – Usually related to face or head.

20. Chapter 22: Clients with Psychological Problems Malingering – Producing symptoms to avoid work, military service, the police, jury duty, or social obligations, are all examples of malingering.

21. Chapter 22: Clients with Psychological Problems Hypochondriasis – A somatoform disorder in which one has an intense fear of or preoccupation with having a serious disease or medical condition based in a misinterpretation of body signs and symptoms.

22. Chapter 26: Outward-Focused Emotions: Violence Exploitation – Refers to the use of an individual for selfish purposes, profit, or gain.

23. Chapter 26: Outward-Focused Emotions: Violence Machismo – A word to describe violence against women. – Compulsive masculinity.

24. Chapter 26: Outward-Focused Emotions: Violence Batter – A term that describes repeated physical abuse of someone.

25. Chapter 26: Outward-Focused Emotions: Violence Elderly abuse – deliberate efforts to cause emotional distress, such as threatening harm or withholding important information.

26. Chapter 26: Outward-Focused Emotions: Violence Stages of recovery from violent acts – Disorganization – Adjustment – Integration of experience into life

27. Chapter 26: Outward-Focused Emotions: Violence Cycle of Domestic Violence - refer to page 285. – Tension Building – Serious Battering Incident – Honeymoon

28. Chapter 26: Outward-Focused Emotions: Violence Signs and Symptoms of Child Abuse and Neglect - refer to table 26-3 page 292 – Three categories of child abuse and neglect Physical abuse Neglect Sexual abuse Emotional maltreatment

29. Q & A Question: On the first morning of every trail, an experienced lawyer becomes extremely anxious and nauseated. Often, she fears throwing up on the drive to the courthouse. However, once the trial begins, her nausea subsides, and she is able to perform admirably. Why do people experience anxiety? What are the three types of anxiety, and which one is this lawyer experiencing?

30. Q & A Answer: Normally, anxiety occurs when people are exposed to events that they cannot control or predict, or events that seem threatening or dangerous. The tree types of anxiety include signal anxiety ( a learned response to an anticipated event), an anxiety state (occurs when an individual is overwhelmed and emotional control is lost), and an anxiety trait (a learned component of the personality). The lawyer is likely experiencing signal anxiety because she is exhibiting a learned response to an anticipated event.

31. Q & A Question: Every time he attempts to give blood, an otherwise healthy young man starts to feel light-headed and his heart rate and blood pressure increase to the point that the blood bank does not allow him to give blood. He argues that these symptoms are the result of his anxiety and do not indicate any other underlying conditions. Is anxiety associated with physical and emotional signs and symptoms, or is it only “in his head”? Hint: look up Somatize!

32. Q & A Answer: Anxiety is accompanied by physical and emotional signs and symptoms. Physical signs and symptoms often include sweating, dizziness, and elevated heart rate and blood pressure. In this case, the young man’s elevated heart rate and blood pressure are likely the result of his anxiety over giving blood. He is experiencing Somatization.

33. Study Tips Power pts are to assist in areas of focus, but remember all material must be read and understood. Clarify objectives with instructor prn. Have fun and Good luck Judith Wikel RN Practical Nursing Instructor