PROBLEMS WITH ANXIETY

Glossary terms:
Acute stress disorder – a disorder characterized by a high level of anxiety
immediately after a traumatic event
Anxiety – an unpleasant feeling of tension, apprehension, and uneasiness or a
diffuse feeling of dread or unexplained discomfort; accompanied by physiological,
psychological, and behavioral symptoms
Fear – a reaction to specific danger
Generalized anxiety disorder – a disorder characterized by at least 6 months of
persistent and excessive anxiety and worry
Panic attack – a discrete, sudden, unpredictable, intense episode of severe
anxiety characterized by personality disorganization
Post-traumatic stress disorder – anxiety and stress symptoms that occur after a
massive traumatic event; often includes the feeling that the event is reoccurring,
lasting for weeks, months or years

A. In pairs, discuss the following questions:

1 What is the difference between anxiety and fear?
2 Have you ever found someone with anxiety?
3 How do you think you should react to someone who is in anxiety?

B. Read the following texts

Text 1. Answer the questions below
Anxiety disorders are the most common mental illness in the U.S.,
affecting 40 million adults in the United States age 18 and older, or 18% of the
population, according to the National Institute of Mental Health. In fact, anyone
from all walks of life can suffer from anxiety disorders. It affects the poor, the
rich, the young, the old, the sick, the healthy, and more. However, everyone
experiences anxiety differently. It can be a result of fear, uncertainty, circular
and racing thoughts, and the avoidance of certain behaviors. It can affect our
ability to function normally, and even convince us that we’re losing our
minds. And worst, it can even lead to related psychological conditions, like
substance abuse and personality difficulties.

The reality is that many people struggle with anxiety. Thus, it’s
important for health care providers and the patient to understand what anxiety
he or she is suffering from and how it affects him or her. Patients can and do
overcome anxiety if they stick with the cognitive strategies and practically apply
them to their lives. Here are some factors that may be related to Anxiety:
Changes in or threats to: Economic status, Environment, Health status,
Interaction patterns, Interpersonal relationships, Role function or status, Self-
concept. Maturational or situational status, Stress, Substance abuse,
Unconscious conflict about essential life goals or values, Unmet needs

1 Who are in the risk of having anxiety?

2 How can anxiety affect someone?
3 What are the causes of anxiety?

Text 2. Translate the following into Bahasa Indonesia.

Nursing interventions for Anxiety can apply to any individual with anxiety, are
among others;
• Recognize awareness of the patient’s anxiety.
• Use presence, touch (with permission), verbalization, and demeanor to remind
patients that they are not alone and to encourage expression or clarification of
needs, concerns, unknowns, and questions.
• Interact with patient in a peaceful manner.
• Accept patient’s defenses; do not dare, argue, or debate.
• Converse using a simple language and brief statements.
• Reinforce patient’s personal reaction to or expression of pain, discomfort, or
threats to well-being (e.g., talking, crying, walking, other physical or nonverbal
expressions).
• Lessen sensory stimuli by keeping a quiet and peaceful environment; keep
“threatening” equipment out of sight.
• Allow patient to talk about anxious feelings and examine anxiety-provoking
situations if they are identifiable.
• Encourage the patient to consider positive self-talk like “Anxiety won’t kill me,”
“I can do this one step at a time,” “Right now I need to breathe and stretch,” “I
don’t have to be perfect.”
• Assist the patient in developing new anxiety-reducing skills (e.g., relaxation,
deep breathing, positive visualization, and reassuring self-statements).
• Instruct the patient in the appropriate use of antianxiety medications
 .

C. Communication Focus
Below are the characteristic of anxiety level, read carefully and then make a
group of four, each group choose a level to be discussed. From your discussion:
a. Write a case of a patient with a certain level of anxiety
b. Make a dialog and practice conversations between a nurse and patient.
Student A, you are the nurse; use good communication strategies.
Student B, you are an anxious patient; talk about it to the nurse. Use the
words and phrases in this section to help you. Swap roles and practice
again.

Level Characteristic
Mild • Enhanced ability to deal with stressors
• Heightened awareness, problem-solving
activities, increased attention to details
• Curiosity increased, ask questions
• Alert, confident
• Logical thinking intact

Moderate • Hesitation and procrastination

• Change in voice pitch; speech rate accelerates
• Frequent change in topics
• Repetitive questioning
• Increased respiratory rate, heart rate, muscle
tension
• Dry mouth
• Palpitations
• Changing body positions frequently,
restlessness
• Purposeless activity

Severe • Highly distorted perceptual and cognitive

function
• Focus on small or scattered detail, inability to
see connections between events
• Selective inattention, inability to concentrate
• Fear of losing control
 • Difficult and inappropriate verbalizations
• Sweating
• Nausea, headache, dizziness
• Gross motor tremors, trembling, shaking
• Numbness or tingling sensations
• Dilated pupils

Panic • Dyspnea, choking feeling, chest pain

• Extreme discomfort, emotional pain
• Unrealistic, distorted perception of situation
• Disruption of visual field
• Inability to speak, incoherent speech
• Vomiting, incontinence
• Feeling of personality disintegration
• Fear of losing mind, fear of dying

D. Share your knowledge

In small groups, discuss the following questions and then feedback your group’s
ideas to the class
• Do you find it easy to talk to patients about their feelings and problems?
• What topics are difficult for you to talk about with patient