[Artigo] Anxiety: Adolescent Patients Skill COVID-19 toolkit
Anxiety: Adolescent Patients Skill COVID-19 toolkit
ALERT
Anxiety can lead to challenging and dangerous behaviors (e.g., throwing objects, destroying property, self-injury, assault, suicide). Unresolved anxiety, as well as ineffective coping with anxiety, can lead to depression. Regularly occurring anxiety in an adolescent patient may be a sign of depression or another underlying mental health issue.
OVERVIEW
Anxiety disorders in children and adolescents are often precursors to psychiatric disorders in later adolescence and adulthood. These disorders may include additional subsequent anxiety disorders, major depression, substance abuse, self injurious behaviors, and suicide attempts.
Anxiety is different than fear. The two conditions share some similarities but have many differences. Fear is typically a healthy, natural emotional reaction to an impending threat; it has a direct cause and promotes safety. Anxiety is the expectation of an imagined or potential threat; it tends to be vague and unfocused. Fear is commonly combined with an acute arousal of the autonomic system needed for fight or flight and thoughts and behaviors associated with immediate danger and escape. Anxiety can affect emotions, thought processes, bodily sensations, and behaviors. With anxiety, vigilance, preparation for future threats, caution, and avoidant behaviors are more common.
An adolescent patient’s memories, experiences, and social situations play intricate roles in the experience of stress and the development of anxiety. The adolescent may experience vague anxiety stemming from past pain and suffering or fear. Because these experiences are unique to each person, understanding or relating to the adolescent’s stress and anxiety may be difficult.
Anxiety is characterized by:
• Physical complaints (e.g., chest tightness, dizziness, nausea, headache)
• Cognitive symptoms (e.g., impaired judgment, confusion, inability to make decisions)
• Behavioral issues (e.g., avoidance, impulsiveness, isolation, arguing, refusal to cooperate, attempts to control others)
• Emotional symptoms (e.g., worry, irritability, sense of dread, a feeling of being overwhelmed, frustration)
An anxiety disorder often occurs concomitantly with physical, emotional, or mental illnesses or substance abuse. These other issues can also hide or aggravate anxiety symptoms. Assessment for an anxiety disorder must be part of a comprehensive examination that includes a detailed history, physical assessment, a review of symptoms, and assessments of associated functional impairments, current psychosocial issues, and other contributing factors.
Adolescent patients may experience anxiety differently than adult patients. Adolescents typically have more anxiety regarding social relationships and may avoid social activities, such as talking in groups or school. Adolescents with an anxiety disorder are more likely to demonstrate irritability and difficulty coping and functioning than adolescents who do not have an anxiety disorder. Agitation may develop more quickly and result in aberrant behaviors. Interactions that may increase the adolescent’s anxiety, such as confrontation, should be avoided.
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