Jeremiah 17:7

"But blessed is the man who

trusts in the LORD, whose
confidence is in him."

NURSING FACTS IN BRIEF

Anxiety, Anxiety Disorders, Psychosomatic

and Mood disorders
ANXIETY AND ANXIETY DISORDERS
ANXIETY
Amxiety is the feelings of uncertainty,
uneasiness and tension to an unknown object.
Fear is bodys physiologic response to a known
danger.
Signal anxiety- anticipated event
Anxiety trait- component of personality
Anxiety state- result of stressful situation
Free-floating anxiety- always present
Phases: normal, acute, chronic and panic
Level 1 (Mild): increase alertness, ability to
learn and challenged
Level 2 (Moderate): narrowing of perception
occurs. Pacing, tremors, increase verbalization
Level 3 (Severe):
perception reduces.
Inappropriate
verbalization,
lack
of
determination
Level 4 (Panic): Disintegration of personality
occurs. Individual loses control
Physiologic
symptoms:
elevated
VS,
diaphoresis, vertigo, sweaty palms, dilated
pupils
Psychologic symptoms: withdrawal, irritability,
anger feelings of worthlessness, helplessness
and apprehension
Behavioral symptoms: pacing, inability to sit
still, nervous habits
Intellectual symptoms: decreased interest and
productivity,
nonresponsive,
forgetful,
rumination
ANXIETY DISORDERS
Panic Disorders: out of the blue, experiences
frightening and uncomfortable symptoms.
Lasts 1 minuite to I hour, onset begins late
teens or early twenties, more seen in women.
Symptoms of panic attack: palpitations
diaphoresis, tremors choking, vertigo, SOB
Phobic disorders: most common form of
anxiety disorder.
Phobia is the irrational fear of an object.
A person unconsciously displaces the source of
anxiety from an unpleasant childhood
experience.
Avoidance of the object allows the person to
be free from anxiety.
Agoraphobia (fear of public places); Social
phobia (avoid situations); Specific phobia 5
subtypes: animal, natural environment, bloodinjection injuries, situational, others such as
sound, space and costumed characters.

Generalized Anxiety disorders: unrealistic or

excessive anxiety or worrying in a 6 month
period.
Associated restlessness, fatigue, irritability,
impaired concentration, muscle tension and
sleep disturbances
Obssessive-Complusive
Disorder:
characterized by obsessions and compulsions
Common obsessive thought involve religion,
violence, symmetry and contamination
Post-traumatic Stress Disorder: exposure to
traumatic experiences such as rape, combat,
crimes, violence, etc.
Symptoms of PTSD: recollections, flashbacks,
nightmares, avoidance, insomnia, exaggerated
response, labile emotion
Acute onset refers to symptoms less than 3
months; chronic if more than 3 months.
Acute Stress Disorder: lasts for 2 days and
either resolve within 4 weeks.
Avoids stimuli that causes recollections of the
trauma.

MOOD DISORDERS
Bipolar I: presence of one manic episode with
or without depression.
Bipolar II: presence of one hypomanic episode
and major depression
Cyclothymic Disorder: numerous episodes of
hypomania and depression for 2 years
Dysthymic Disorder: depressed mood for at
least 2 years for more days than not
MANIA
Manic Episode: abnormal, persistent elevated
mood for 1 week.
Hypomanic episode: elevated mood for 4 days
Affective symptoms: elation, humorous, lack
of shame or guilt
Physiological symptoms: dehydrartion, poor
nutrition, little sleep time, weight loss
Cognitive symptoms: ambitious, deny danger,
illusions, lack judgment
Behavioral symptoms: aggressive, excessive
spending
of
money,
hyperactive,
argumentative
Nursing management: provide safety, reduce
external stimuli, avoid competitive activities,
allow verbalization of feelings, limit setting,
be firm and consistent.

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250

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DEPRESSION
Depression:
lowered or saddened mood;
feeling of multiplied unhappiness for at least 1
week
Major depression: symptoms that persist over
a minimum period of 2 weeks.
Symptoms:
apathy,
sadness,
sleep
disturbances, guilt, anger, hopelessness,
helplessness, worthlessness, withdrawal, selfblame, ruminations, destructive thoughts,
suicidal thoughts
Women are more prone than men
Average onset is mid-20s
Occurrence of depression in children and
adolescents can be more devastating than in
adults.
Nursing
management:
Provide
safe
environment, structured activities, listen to
verbalization of feelings, divert attention,
help build self-esteem.
SUICIDE
Suicide is the outcome of a persons inability
to cope with catastrophic stress.
Ideation- persons thought regarding suicide
Gestures- non-lethal acts to get attention
Threats- verbal statements to declare suicide
Attempt- actual implementation of ending
ones life
Causes of suicide: mental disorder, personality
abnormalities,
family history, physical
disorders
Suicide risk factors:anhedonia, hopeless, male,
over 60 years old, adolescents (15-24), living
alone, unemployed, prior suicide attempts,
family history, substance abusers
Nursing Management: recognize level of
depression, observe behavioral cues, listen to
verbalization, provide safe environment,
supportive relationships, increase self-esteem,
emotional and professional support.
SOMATOFORM DISORDERS
Somatization disorder: Briquets syndrome
Various physical complains over several years
usually appear before age 30.
Involves 4 different body functions: 2
gastrointestinal, 1 sexual symptom and 1
neurologic symptoms other than pain.
Conversion disorder: one or more symptoms
or deficits ( numbness or paralysis)
Characterized by La Belle Indifference (little
or no concern about disorder)
Not intentionally produced Malingering
Causes distress or impairment in social,
occupational or other important areas of
functioning
Pain disorder: pain is the major complaint for
several months
Pain is usually caused by stress or unconscious
conflict.
Body Dysmorphic Disorder: excessive concern
of a perceived defect involving body image.

Symptoms: compulsive mirror checking or

inability to look at ones reflection or image.
Excessive grooming behaviors: combing hair,
plucking eyebrows, shaving, etc.
Obssession with plastic surgery. In obscure
cases, patient perform surgeries themselves.
Hypochondriasis: preoccupation of having a
serious disease.
Doctor-shopping or hospital-hopping
Doctors reassurance does not calm the fears.
Might have had a serious illness as a child.

DISSOCIATIVE DISORDERS
Dissociative disorder is a disruption of the
functions of consciousness, identity, momery
or perception of the environment.
Dissociative Amnesia: lossof memory in
regards to important events.
Classified as: Retrograde ( inability to recall
remote past) Anterograde ( inability to recall
immediate past)
Dissociative Fugue: sudden, unexpected
travel away from home and unable to recall
the past.
Client is unaware of the travel to another
location.
Dissociative Identity Disorder: formerly
known as multiple personality disorder
A person is domanted by one or two or more
personalities which controls ones behavior.
Seen in adult women than men.
Depersonalizaton Disorder: strange alteration
in perception or experience of self-esteem
with sense of unreality.
Detachment from oneself, feeling of going
crazy or insane.
Cannot separate reality from fantasy
Feelings of being in a dream-like or movie-like
state, mechanical or bizarre appearance
Nursing management: Present reality, use
grounding techniques, reduce external stimuli,
redirect attention away from self, avoid
sympathizing with the client, increase
socialization activites, provide therapies (
hypnosis, abreaction, cognitive and behavioral
therapy). Administer drugs (anxiolytics and
anti-depressants).
Notes:
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DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250

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