- Is a subjective, individual experience characterized by a feeling of apprehension, uneasiness, uncertainty, or dread.
- It occurs as a result of threats that may be actual or imagined, misperceived or misinterpreted, or from a threat to identity or self-esteem.
- It often precedes new experiences.
Types of Anxiety:
- A healthy type of anxiety that mobilizes a person to action.
- Precipitated by imminent loss or change that threatens the sense of security.
- Anxiety that the individual has lived with for a long time.
Levels of Anxiety:
1.Mild/ Alertness Level (+1)
- This is the type of anxiety associated with the normal tension of everyday life.
- The individual is alert
- Perceptual field is increased
- Produce growth and creativity, as it increases learning
- The person uses adaptive coping mechanisms to solve problems and alleviate anxiety.
- Recognize the anxiety by statements such as “I notice you being restless today”.
- Explore causes of anxiety and ways to solve problems that cause anxiety by statements such as “Let’s discuss ways to…”
2. Moderate/ Apprehension Level (+2)
- The response of the body to immediate danger and focus is directed to immediate concerns.
- Narrows the perceptual field to pay attention to particular details.
- Selective inattentiveness occurs
- The increased tension makes this the optimal time for learning
- The person uses palliative coping mechanisms.
- Provide outlets for anxiety such as crying or talking.
- Tell client “It’s all right to cry”.
- Encourage in motor activity to reduce tension.
- Make client be aware of his behavior and feelings by statements such as “ I know you feel scare…”
- Encourage client to move from affecting (feeling) to cognitive mode (thinking).
- Refocus attention
- Encourage the client to talk about felings and concerns.
- Help the client identify thoughts and feelings that occurred prior to the onset of anxiety.
- Provide anti-anxiety oral medications.
3. Severe/ Free-floating Level (+3)
- Creates a feeling that something bad is about to happen, or feeling of an impending doom.
- Fight and flight response sets in
- Narrow perceptual field occurs and focus is on specific details or scaterred details so that learning and problem-solving is not possible.
- All behaviors are directed at alternative the anxiety
- The individual needs direction to focus
- Dilated pupils, fixed vision
- The person uses maladaptive coping mechanisms.
- Do not focus on coping mechanisms
- Stay calm and stay with the client
- Give short and explicit direction
- Modify the environment by setting limits or seclusion, limit interaction with others, and reduce environmental stimuli to calm client.
- Provide IM antianxiety medications.
4. Panic Level (+4)
- Feelings of helplessness and terror
- The personality and behavior is disorganized
- The individual lessens perception of the environment to protect the ego from awareness and anxiety causing distorted perceptions and loss of rational thoughts.
- Is unable to communicate or function effectively
- Inability to concentrate
- If prolonged, panic can lead to exhaustion and death
- The person uses dysfunctional coping mechanisms.
- Guide patient step by step to action
- Restrain if necessary.
image courtesy of: www.nlm.nih.gov, healthpapa.com