PSYCHIATRIC NURSING MENTAL HEALTH DISORDERS

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 MENTAL HEALTH DISORDERS

1. ANXIETY  :-

                 It is normal response to stress  or it is a subjective experience that includes feeling of apprehension , uneasiness or dread .  it occurs as result of a threat that may bw misperceived or of a threat to identity or self esteem 

TYPES OF ANXIETY :-

1. NORMAL :-  A healthy type of anxiety 
 
2. ACUTE :-  precipited by imminent loss or change that threatens one`s sense of security 
 
3. CHRONIC :-  Anxiety that persisits as a characteristics response to daily life 
 
 

LEVELS OF ANXIETY :- 

SYMPTOMS OF ANXIETY 
 
1. MILD ANXIETY  :- It is associated with tension of everyday life 
  • Mild anxiety  can be motivated ,produce growth ,enhance creativity and increase learning 
  • example : You have constant worries but you can generally ignore them
 
 
2. MODERATE ANXIETY :-  Moderate anxiety narrows perceptual concerns 
  • Learning and problem solving still occurs 
 
3. SEVERE ANXIETY :-  Severe anxiety is a feeling that somethiong bad is about to happen 
  • A significant narrowing in perceptual field occurs 
  • All behaviour of a person is aimed at relieving anxiety 
  • Learning and problem solving are impossible 
  • Individual needs direction to focus 
 
4. PANIC ANXIETY :-  panic anxiety is associated with dread and terror and a sense of impending doom
  • The personality is disorganized 
  • The individual is unable to communicate or function effectively
  • Inability to concentrate occurs 
  • If prolonged panic can lead to exhaustion and death 
 

INTERVENTION :-

  • Recognise  the anxiety 
  • Establish trust 
  • Do not criticize the coping mechanism ( Used to Decrease anxiety )
  • Modify environmental by setting limits 
  • promote relaxation techniques such as breathing exercise or guided imaginary 
  • ***The immediate nursing action for anxiety to decrease stimuli in the environment provide a calm and quite environment 
INERVENTION FOR MILD TO MODERATE ANXIETY :-
 
  • Help the patient to identify anxiety 
  • Encourage patient to talk about feelings and concerns 
  • Encourage problem solving
  • ***Encourage gross motor exercise 
 
 
 

2. POSTTRAUMATIC STRESS DISORDER :-

                 After experiencing a psychologically traumatic event , individual is prone to reexperience the event and have recurrent and intrusive dreams and flashbacks .
 
 

STRESSORS OF POSTTRAUMATIC DISORDER :-

  • Natural disaster
  • terrorist attack 
  • Accidents
  • Rape 
  • Crime or violence 
  • sexual , physical and emotional abuse 
  • Reexperiencing the event as flashbacks
 
SYMPTOMS  OF POSTTRAUMATIC DISORDERS : –
 
  • Emotional numbness
  • Depression
  • Detachment
  • anxiety
  • sleep disturbances and nightmares 
  • Flashbacks of event 
  • Guilt abt surviving the event 

INERVENTION  :

  • Be nonjudgemental and supportive
  • Assure patient that hs feelings and behaviour are normal reaction 
  • Encourage use of support groups’
  • ****Hypnotharapy and systematic desensitization is used

 

3. PHOBIAS :- 

                                      Phobia is irrational fear of objects or situation that persisits although the person recognixe it as unreasonable . It is associated with panic level anxiety .
  

TYPES OF PHOBIAS :-

1. ACROPHOBIA  :-  fear of height 
 
2. AGORAPHOBIA  :- Fear of open places 
 
3. ASTRAPHOBIA :- Fear of electric stroms
 
4. CLAUSTROPHOBIA :- Fear of closed space 
 
5.  HEMATOPHOBIA :- Fear of blood 
 
6. HYDROPHOBIA :- Fear of water 
 
7. ZOOPHOBIA :- Fear of animals 
 
8. MONOPHOBIA :- Fear of being alone 
 
9. MYSOPHOBIA :- Fear of dirt or girms 
 
10.  NYCTOPHOBIA :- Fear of darkness 
11. PYROPHOBIA :- Fear of fires 
 
12. XENOPHOBIA :- Fear of strangers 
 
13. SOCIAL PHOBIA : – Fear of situation in which one might be embarrased or critisized , fear of making a fool of oneself ‘
 
 

INTERVENTION OF PHOBIA :-

  • Identify the basis of the anxiety 
  • Allow the patient to verbalize feeling abt anxiety producing objects or situation 
  • Frequently talking about the feared object is the first step in desensitization 
  • Teach relaxation technique
  • **SYSTEMATIC DESENSITIZATION  behavioural technique is used for treatment of phobia
  • Defence mechanism used by patient is repression and displacement 
 
 
 
 
 

4. OBSESSIVE COMPULSIVE DISORDER ( OCD )  :- 

OBSESSIONS :  Preoccupation with persistently intrusive thoughts and ideas 
COMPULSION :- Repiative behaviour desired to prevent some event , divert unacceptable thoughts and decrease anxiety
 
ocd

 

  • Defence mechanism used is repression , displacement and undoing 
 

INTERVENTIONS :- Ensure that basic needs are met 

  • Identify situations that precipitate compulsive behaviour 
  • Donot interrupt compulsive behaviour unless they harm the patient or to others 
  • Set limits
 
 
 

5. SOMATOFORM DISORDERS :-

                                           Somatoform disorders are characerized by persistent worry or complaints regarding physical illness without physicl findings . The patient may unconciously use somatization for secondory gains such as increased attention and decreased responsibilities 

A. CONVERSION DISORDERS :- 

                                                         The sudden onset of a physical symptom or a deficit suggesting loss of or altered function related to psychological conflicts or a neurological disorder.

  • conversion disorder is an expression of a psychological conflict or need 
  • conversion disorder has no organic cause 
  • The development of physical symptoms reduces anxiety 

 

 symptoms of conversion disorder :

  • La belle indifference : means unconcerned with symptoms 
  • physical limitaion or disabilities 
  • Feeling of guilt , anxiety or frustration
  • Low self esteem
  • unexpressed anger or conflict
  • Secondory gain
 

B. HYPOCHONDRIASIS :- 

                                                      Hypochondriasis means preoccupation of having a serious disease  . No evidence of physical illness exists. 

 

SYMPTOMS OF HYPOCHONDRIASIS : –

  • preoccupation with physical functioning 
  • Frequent somatic complaints 
  • Complaints of fatigue and insomnia
  • Anxiety
  • Difficulty expressing feelings
  • Reepeatedly visiting a  doctor despite repeated reassurance and normal test results 
 
 

INTERVENTION FOR SOMATOFORM DISORDERS :-

  • Asssit the patient to relate feelings and conflicts to the physical symptoms 
  • Assure the patient that physical illness has been ruleout 
  • Explore the source of anxiety and stimulate verbalization of anxiety 
  • provide positive feedback 
  • Allow specific time period for the patient to discuss physical complaints bcz patient feels less threatened if this behaviour is limited rather than stopped completely
  • Avoid rsponding with positive reinforcement abt the physical complaints