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 By the end of lecture the student will be able to acquire knowledge
about:-
 1- DEFINE ANXIETY AND ANXIETY DISORDER
 2- Identify PREVALENCE AND EPIDEMIOLOGY
 3- Discuss CAUSES
 4-List LEVELS OF ANXIETY
 5-Enumerate SYMPTOMS OF ANXIETY
 6-List TYPE OF ANXIETY OF ANXIETY
 7-Discuss DIAGNOSIS OF ANXIETY
 8- DISCUSS TREATMENT
 9-Discuss COMPLICATION OF ANXIETY
 10-IDENTIFY PREVENTION OF ANXIETY
 11-DISCUSS SOCIAL ANXIETY DISORDER
(DEFINITION,CAUSES,SYMPTOM,TREATMENT)
 12-DISCUSS POST TRAUMATIC STRESS DISORDER (DEFINITION,
RISK FACTOR, SYMPTOM, TREATMENT)

 -Introduction
 -Definition of
 Anxiety
 Anxiety disorder
 -Prevalence of anxiety
 -Causes of anxiety
 -Level of anxiety
 -Symptom of anxiety
 -TYPE of anxiety
 -Diagnosis of anxiety
 -Treatment of anxiety
 -Complication of anxiety
 -Prevention of anxiety
 -11- Social anxiety disorder (definition, causes, symptom, treatment)
 12- Post traumatic stress disorder (definition, Risk
factor,symptom,treatment)

 People often experience a general state of worry or
fear before confronting something challenging such
as a test, examination, recital, or interview. These
feelings are easily justified and considered normal.
Anxiety is considered a problem when symptoms
interfere with a person's ability to sleep or
otherwise function. Generally speaking, anxiety
occurs when a reaction is out of proportion with
what might be normally expected in a situation.

 abnormal and overwhelming
sense of apprehension and fear often marked
by physiological signs (as sweating, tension,
and increased pulse), by doubt concerning the
reality and nature of the threat, and by self-
doubt about one's capacity to cope with it

 A general term for several disorders that cause
nervousness, fear, apprehension, and worrying.
These disorders affect how we feel and behave,
and they can manifest real physical symptoms.

 Often begins early in life
 Reported more by women than men
 Reported more in Western countries
 Up to 15% of general population
 Onset early in life
 Female: Male 2:1

 1 - Environmental and external factors
 Environmental factors that are known to cause
several types of anxiety include:
 - Trauma from events such as abuse, victimization,
or the death of a loved one
 - Stress in a personal relationship, marriage,
friendship, and divorce
 - Stress at work
 - Stress from school
 - Stress about finances and money
 - Stress from a natural disaster
 - Lack of oxygen in high altitude areas

2-Medical factors
Anxiety is associated with medical factors such as anemia, asthma, infections,
and several heart conditions. Some medically-related causes of anxiety
include:
-Stress from a serious medical illness
-Side effects of medication
-Symptoms of a medical illness
-Lack of oxygen from emphysema, or pulmonary embolism (a blood clot in the
lung)
-Substance use and abuse

3. Severe anxiety
.Limited field of perception
• Fragmented thought processes
• It's hard to think
• Poor problem-solving
• Unable to consider the information
• Just watch the threat
• Egocentric
4- Panic Anxiety
This most intense state of anxiety,
- Individual is unable to focus on even one detail within the environment.
- Misperceptions are common,
-a loss of contact with reality may occur.
-The individual may experience hallucinations or delusions.

 - Mild, Moderate Severe, and panic
 1. Mild anxiety
 Associated with the tension of everyday life events. At this level of
perception of land to widen and individuals will be cautious and
vigilant.
 • Concentrate on the problem
 • Solve problems effectively
 • Little sense of failure
 • Be alert and pay attention to many things
 • Look calm and confident
 • Optimal learning
 • Able to accept that complex excitatory

2. Moderate anxiety
At this level of land decreases the perception of the environment, individuals
are more focused on the important thing was to the exclusion of anything else.
Field perception of declining
• No attention is selectively
• The focus of the stimulus increases
• Decreased attention span
• Decreased problem-solving
• Learning takes place by focusing

 -Trembling
 -Churning stomach
 -Nausea
 -Diarrhea
 -Headache
 -Backache
 -Heart palpitations
 -Numbness or "pins and needles" in arms, hands or legs
 -Sweating/flushing
 -Restlessness
 -Easily tired
 -Trouble concentrating
 -Irritability
 -Muscle tension
 -Frequent urination
 -Trouble falling or staying asleep
 -Being easily startled

 Anxiety disorders can be classified into several more
specific types. The most common are briefly
described below.
 1-Generalized Anxiety Disorder (GAD)
 2-Panic Disorder
 3-a Phobia
 4- Social Anxiety Disorder
 5-Obsessive-Compulsive Disorder (OCD)
 6-Post-Traumatic Stress Disorder (PTSD)
 7-Separation Anxiety Disorder

 A psychiatrist, clinical psychologist, or other mental-
health professional is usually enlisted to diagnose
anxiety and identify the causes of it. The physician will
take a careful medical and personal history, perform a
physical examination, and order laboratory tests as
needed. There is no one laboratory test that can be used
to diagnose anxiety, but tests may provide useful
information about a medical condition that may be
causing physical illness or other anxiety symptoms.
 Patients with anxiety disorder often present symptoms
similar to clinical depression and vice-versa. It is rare for
a patient to exhibit symptoms of only one of these.

 Treatments will consist of a combination of psychotherapy,
behavioral therapy, and medications.
 1-Self-treatment lady using breathing techniques
 Learn to replace "negative self-talk" with "coping self-talk." Make a
list of the negative thoughts you have, and write a list of positive,
believable thoughts to replace them. Replace negative thoughts
with positive ones.
 Picture you successfully facing and conquering a specific fear.
 Talk with a person who is supportive.
 Meditate.
 Exercise.
 Take a long, warm bath.
 Rest in a dark room.
 2-Counseling
 A standard method of treating anxiety is with psychological
counseling. This can include cognitive-behavioral therapy,
psychotherapy, or a combination of therapies.

3-Cognitive-behavioral therapy
Aims to recognize and change the patient's thinking patterns that are associated with
the anxiety and troublesome feelings. This type of therapy has two main parts: a
cognitive part designed to limit distorted thinking and a behavioral part designed to
change the way people react to the objects or situations that trigger anxiety.
4-Psychotherapy
Is another type of counseling treatment for anxiety disorders. It consists of talking with
a trained mental health professional, psychiatrist, psychologist, social worker, or other
counselor. Sessions may be used to explore the causes of anxiety and possible ways to
cope with symptoms.

5-Medicinemedication
, medicines such as antidepressants, benzodiazepines, tricyclic's, and beta-
blockers are used to control some of the physical and mental symptoms.
Benzodiazepines include:
Diazepam (Valium)
Alprazolam (Xanax)
.Anti-depressants - especially those in the class of serotonin reuptake inhibitors
(SSRI) - are also commonly used to treat anxiety even though they were
designed to treat depression. Include:
Sertraline (Zoloft)
Paroxetine (Paxil)
Tricyclic's are a class of drugs that are older than SSRIs and have been shown to
work well for most anxiety disorders include:
Imipramine (Tofranil)
Clomipramine (Anafranil)

 1-PREGNANCY
 More likely to have babies with low birth weight
 2-Children and teens
 -Depression
 -Behavioral problems e.g. aggressive
 -Substance abuse
 -Failing in school
 3-Adults
 -Suicide
 -Psychiatrically hospitalized
 -Having low paying jobs

 Although anxiety disorders cannot be prevented, there
are ways to reduce your risk and methods to control or
lessen symptoms. Recommendations include:
 -Reducing caffeine, tea, cola, and chocolate consumption.
 -Checking with a doctor or pharmacist before using over-
the-counter or herbal remedies to see if they contain
chemicals that may contribute to anxiety.
 -Exercising regularly.
 -Eating healthy foods.
 -Keeping a regular sleep pattern.
 -Seeking counseling and support after a traumatic or
disturbing experience.
 -Avoiding alcohol, cannabis.

 1-Acknoeledge awareness of patient anxiety
 2-Reassure patient and make good patient- nurse relation
ship
 3-Maintain calm while interacting with patient
 4-Use simple language
 5-Maintaining a quiet environment
 6-Encourge patient to talk about anxious feeling
 7-Assisst patient in assessing situation realistically and
recognizing factor leading to anxious feeling
 8-Assisst the patient in developing anxiety reducing skill
e.g.; relaxation, deep breathing
 9-Assisst patient in developing problem solving abilities
 10-Instruct the patient in the appropriate use of anti-
anxiety medication

 The fear of being judged and evaluated
negatively by other people, leading to Feelings
of inadequacy, inferiority, embarrassment, ,
and depression

 Emotional symptoms of social anxiety disorder
/ social phobia
 • Excessive self-consciousness and anxiety in
everyday social situations
 • Intense worry for days, weeks, or even
months before an upcoming social situation
 • Extreme fear of being watched or judged by
others, especially people you don’t know
 • Fear that you’ll act in ways that that will
embarrass yourself
 • Fear that others will notice that you’re
nervous

 • Red face, or blushing
 • Shortness of breath
 • Upset stomach, nausea
 • Racing heart or tightness in chest
 • Sweating or hot flashes
 • Feeling dizzy or faint

 • Avoiding social situations to a degree that
limits your activities or disrupts your life
 • Staying quiet or hiding in the background in
order to escape notice and embarrassment
 • A need to always bring a buddy along with
you wherever you go
 • Drinking before social situations in order to
soothe your nerves

 We don't really know what causes social anxiety
disorder, but it is likely to involve a combination of
factors. Genes may play a role.
 Also, the behavior of parents may have an influence on
whether their child will develop social anxiety disorder.
People with the disorder have described their parents
as:
 • overprotective
 • not affectionate enough
 • constantly criticizing them and worrying they may
do something wrong
 • overemphasizing the importance of manners and
grooming
 • exaggerating the danger of approaching strangers

 1-Cognitive behavioral therapy
 Usually 14 sessions over approximately four months.
 Generally, CBT works by helping you identify unhelpful
and unrealistic beliefs and behavioral patterns. You and
your therapist work together to change your behavior
and replace unhelpful beliefs with more realistic and
balanced ones.
 2-Supported self-help
 3-Antidepressants
 Usually an SSRI (selective serotonin reuptake inhibitor),
either instead of or in combination with individual CBT.
 4-Psychotherapy
 Encourage you to face feared social situations outside
therapy sessions. It is normally 25-30 sessions over six to
eight months

Develop following a traumatic event that threatens your safety or makes
you feel helpless.

 • War
 • Natural disasters
 • Car or plane
crashes
 • Sudden death of a
loved one
 • Rape
 • Terrorist attacks
 • Childhood neglect

 • Previous traumatic
experiences,
especially in early life
 • History of physical
or sexual abuse
 • History of
substance abuse
 • High level of stress
in everyday life
 • Family history of
PTSD or depression
 • Lack of coping
skills

 1-Symptoms of PTSD
 :-( Re-experiencing the traumatic event)
 • Intrusive, upsetting memories of the event
 • Flashbacks (acting or feeling like the event is
happening again)
 • Nightmares (either of the event or of other
frightening things)
 • Feelings of intense distress when reminded of
the trauma
 • Intense physical reactions to reminders of the
event (e.g. pounding heart, rapid breathing,
nausea, muscle tension, sweating)


2-Symptoms of PTSD: (Avoidance and numbing)
• Avoiding activities, places, thoughts, or feelings that remind
you of the trauma
• Inability to remember important aspects of the trauma
• Loss of interest in activities and life in general
• Feeling detached from others and emotionally numb
• Sense of a limited future (you don’t expect to live a normal life
span, get married, have a career)
3-Symptoms of PTSD: (Increased anxiety and emotional
arousal)
• Difficulty falling or staying asleep
• Irritability or outbursts of anger
• Difficulty concentrating
• Hyper vigilance (on constant “red alert”)

 • Cognitive-behavioral therapy.
 Cognitive-behavioral therapy for PTSD and trauma
involves carefully and gradually “exposing” yourself to
thoughts, feelings, and situations that remind you of the
trauma. Therapy also involves identifying upsetting
thoughts about the traumatic event–particularly thoughts
that are distorted and irrational—and replacing them
with more balanced picture.
 • Family therapy.
 • Since PTSD affects both you and those close to you,
family therapy can be especially productive. Family
therapy can help your loved ones understand what
you’re going through. It can also help everyone in the
family communicate better and work through
relationship problems caused by PTSD symptoms.

• Is sometimes prescribed to people with
PTSD to relieve secondary symptoms of
depression or anxiety. Antidepressants such as
Prozac and Zoloft are the medications most
commonly used for PTSD. While antidepressants
may help you feel less sad, worried, or on edge,
they do not treat the causes of PTSD.

•Mayo Clinic Staff, (2010). Treatments and drugs.
Mayo clinic. Retrieved October 25, 2010, from
panic-attacks/DS00338/DSECTION
treatments-and-drugs
•Autism research asd-carc. (2007). Retrieved from
http://www.asdcarc.com/index.php/publisher/articl
eview/?PHXSESSID=7361595bf597d9853f375f838eff96
d3&/1/frmArticleID/421/staticId/1253/#A9

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