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CONCEPT OF

ANXIETY&

CRISISThe Philippine Women’s University

School of Nursing

Psychiatric Nursing 105

Presentor:

Hanna Grace G. Olvido, RN

Concept of Anxiety

Objectives:

At the end of the class hour, the 3rd year students of

nursing department will be able to:

• Define the characteristics of anxiety.

• Enumerate the different levels of anxiety and

identify their manifestations.

• Recognize anxiety crisis as follows:

Definition

Stages

Categories

Intervention

Defining Characteristics

• A vague feeling of dread or apprehension;

• A response to external / intenal stimuli;

Behavioral

Emotional

Cognitive

Physical Symptoms

Concept of Anxiety

Anxiety Disorder

• Demonstrates unusual behavior and are

experiencing significant distress overtime which

significantly impairs their daily routines, social

lives, and occupational functioning.

Concept of Anxiety

Anxiety Disorders

Concept of Anxiety

Panic without reason!!

Unwarranted fear!!!Objects

life conditions

Uncontrollable repetitive

actions!!!

Reexperience of traumatic events!!!

Unexplainable or overwehelming

worry!!!

Levels of Anxiety (Mild Anxiety)

• Sensation that

something is different

and warrants special

attention. Sensory

stimulation increases

and helps the person

focus attention to

learn, solve problems,

think, act, feel, and

protect himself or

herself.

Concept of Anxiety

Levels of Anxiety (Moderate Anxiety)

• A disturbing feeling that

something is definitely

wrong; the person

becomes nervous or

agitated.

• Can still process

information, solve

problems, learn new

things with assistance

from others.

• Person has difficulty

concentrating

independently but can be

redirected to the topic. Concept of Anxiety

Levels of Anxiety (Severe Anxiety)

• Person has trouble

thinking and reasoning.

Muscles tighten, and vital

signs increase.

• Restless, irritable, and

angry; or uses similar

emotional – psychomotor

means to release tension.

Concept of Anxiety

Levels of Anxiety (Panic Anxiety)

• Emotional-psychomotor

realm predominates with

accompanying fight, flight,

or freeze responses,

adrenaline surge greatly

increases vial signs. Pupils

enlarge to let in more

light, and the only

cognitive process focuses

on the person’s defence.

Concept of Anxiety

Levels of Anxiety (MANIFESTATIONS)

MILD ANXIETY

PSYCHOLOGICAL RESPONSE PHYSIOLOGIC RESPONSE

Wide perceptual field

Sharpened senses

Increased motivation

Effective problem-solving

Increased learning ability

Restlessness

Fidgeting

GI “butterflies”

Difficulty Sleeping

Hypersensitive to noise

Concept of Anxiety

Levels of Anxiety (MANIFESTATIONS)

MODERATE ANXIETY

PSYCHOLOGICAL RESPONSE PHYSIOLOGIC RESPONSE

Perceptual field narrowed to immediate

task

Selectively attentive

Can not connect thoughts or events

independently

Increased use of automatisms

Muscle tension

Diaphoresis

Pounding pulse

Headache

Dry mouth

High voice pitch

Faster rate of speech

GI upset

Frequent urination

Concept of Anxiety

Levels of Anxiety (MANIFESTATIONS)

SEVERE ANXIETY

PSYCHOLOGICAL RESPONSE PHYSIOLOGIC RESPONSE

Perceptual field reduced to one detail

scattered details.

Cannot complete tasks

Cannot solve problems or learn

effectively

Behaviour geared toward anxiety relief

and is usually ineffective.

Doesn’t respond to redirection

Feels awe, dread, or horror

Cries

Ritualistic Behaviour

Severe headache

Nausea, vomiting, and diarrhea

Trembling

Rigid stance

Vertigo

Pale

Tachycardia

Chest pain

Concept of Anxiety

Levels of Anxiety (MANIFESTATIONS)

PANIC ANXIETY

PSYCHOLOGICAL RESPONSE PHYSIOLOGIC RESPONSE

Perceptual field reduced to focus on self

Cannot process any environmental

stimuli

Distorted perceptions

Loss of rational thought

Doesn’t recognize potential danger

Cant communicate verbally

Possible delusions and hallucinations

May be suicidal

May bolt and run

Totally immobile and mute

Dilated pupils

Increased blood pressure and pulse

Fight, flight, or freeze

Concept of Anxiety

CRISIS

CRISIS

• A turning point in an individual’s life that produces

an overwhelming emotional response. Individuals

experience a crisis when they confront some life

circumstances or stressor that they cannot effectively

manage through use of their customary coping skills

CRISIS

CRISIS

CRISIS (Stages)

CRISIS

1) The person is exposed to a stressor, experience

anxiety, and tries to cope in a customary fashion.

CRISIS (Stages)

CRISIS

2) Anxiety increases when customary coping skills are

ineffective.

CRISIS (Stages)

CRISIS

3) The person makes all possible efforts to deal with

the stressors, including attempts at new methods of

coping.

CRISIS (Stages)

CRISIS

4) When coping attempts fail, the person experiences

disequilibrium and significant distress.

CRISIS (CATEGORIES- maturational crises)

CRISIS

1) Sometimes called developmental crises, are

predictable events in the normal course of life, such

as leaving home for the first time, getting married,

having a baby, and beginning a career.

CRISIS (CATEGORIES- situational crises)

CRISIS

2) Unanticipated or sudden events that threaten the

individual’s integrity, such as death of loved one,

loss of a job, and physical or emotional illness in the

individual or family member.

CRISIS (CATEGORIES- adventitious crises)

CRISIS

3) Also called social crises which include natural

disaster like floods, earthquakes, or hurricanes; war;

terrorist attacks; riots; and violent crimes such as

rape or murder.

CRISIS (intervention)

CRISIS

1) Supportive Interventions

Aim at dealing with the person’s needs for

empathetic understanding, such as encouraging the

person to identify and discuss feelings, serving as

sounding board for the person, and affirming the

person's self-worth.

CRISIS (intervention)

CRISIS

1) Directive Interventions

Designed to assess the person’s health status and

promote problem-solving, such as offering the

person new information, knowledge, or meaning;

raising the person’s self-awareness by providing

feedback about behaviour; and directing the

person’s behaviour by offering suggestions or

courses of actions.

Concept of Anxiety