[L. anxietas, distress]
Vague uneasy feeling of discomfort or dread accompanied by an autonomic response (the source is often nonspecific or unknown to the individual); a feeling of apprehension caused by anticipation of danger. It is an alerting sign that warns of impending danger and enables the individual to take measures to deal with that threat.
SEE: anxiety disorder;
Health care providers evaluate the patient's level of anxiety and document related behavior and physical characteristics, e.g., sympathetic nervous system arousal, effects on the patient's perceptual field, and ability to learn and solve problems. Coping and defense mechanisms, a family history of similar problems, avoidance behavior, sleep history, depression, the use of alcohol, caffeine, tobacco, herbal supplements, prescription and over-the-counter drugs are reviewed. A calm, caring, quiet, and controlled atmosphere can prevent progression of the patient's anxiety and even reduce it by lessening feelings of isolation and instability. Patients with mild anxiety are helped to identify and eliminate stressors, if possible. Appropriate outlets are provided for excess energy. Health care providers establish a trusting relationship with the patient and encourage the patient to express feelings and concerns. False reassurance is never offered. Care for patients with severe anxiety focuses on reducing environmental stimuli. Clear, simple validating statements are used to communicate with the patient and are repeated as often as necessary, and reality is reinforced if distortion is evident. The patient's physical needs are addressed, and activity is encouraged to help the patient discharge excess energy and relieve stress.
If the anxiety is ongoing, the patient should be referred to a care provider who specializes in treatment of anxiety disorders. Relaxation therapy, counseling, psychotherapy, and/or pharmacologic therapies may be required. Drug types used include benzodiazepines, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and tricyclic antidepressants. Desired effects of the specific prescribed drug are explained and when the patient may expect to see these results; adverse effects to watch for and report are described. The patient is advised that, in general, antianxiety drugs should not be stopped abruptly or without the prescriber’s agreement. The patient also may benefit from referral to a support group such as the Anxiety Disorders Association of America.
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