Download What is anxiety? - Worcestershire Health and Care NHS Trust

Anxiety Management Toolkit
Community Stroke Service
3rd Year Occupational Therapy / Nursing students
Dec 2013
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Introduction
Why do we need a toolkit?
 The purpose of this toolkit is to provide members of the service with
Information and resources that help identify and effectively manage
anxiety problems experienced by stroke patients.
 How patients cope with the symptoms of anxiety after a Stroke plays
a huge role in determining their current and future health and
wellbeing, and their success in the rehabilitation/recovery process.
When a patient is informed and educated about their anxiety(s) they
are often more able to manage the symptoms and keep the effects of
excessive anxiety to a minimum.
 Educating and empowering our patients by facilitating learning and
the practice of helpful coping strategies is an essential part of selfmanagement. To be successful at self-management people with an
anxiety disorder need to be able to recognize their anxiety symptoms
when they occur.
 To make self-management easier, this toolkit includes information
about the common characteristics of anxiety after a stroke, the main
types of associated anxiety disorders, effective treatment options,
and basic self-management strategies that can help reduce
symptoms of anxiety.
“Although 67% had experienced anxiety and 59% felt depressed, over half of
those who responded to our survey did not receive any information, advice or
support to help with anxiety or depression.”
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Stroke Association 2013:5
Patient Information – Anxiety
What is anxiety?
Anxiety is a feeling of unease, such as worry
or fear that can be mild or severe.
Anxiety is common after stroke; it may continue for some months. Anxiety can
affect people in different ways; physically, emotionally and behaviourally.
Learning to recognise your symptoms will allow you to be more in control of
them and understand what is happening.
Psychological Symptoms:
Anxiety can cause a change in your
behaviour and the way you think
and feel about things.
Physical Symptoms:
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restlessness
a sense of dread
feeling constantly "on edge"
difficulty concentrating
irritability
impatience
being easily distracted
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Fight or Flight Response:
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This is an automatic response we
experience when anxious, it is the
body preparing to fight or escape a
threatening situation.
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 Heart rate and blood pressure
increase
 Pupils dilate
 Muscles tense up
 Produce more sweat
 Blood-glucose levels increase
 Veins narrow
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dizziness
drowsiness and
tiredness
pins and needles
irregular heartbeat
(palpitations)
muscle aches and
tension
dry mouth
excessive sweating
shortness of breath
stomach ache
nausea
diarrhoea
headache
excessive thirst
frequent urinating
painful or missed
periods
difficulty falling or
staying asleep (insomnia)
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Self-Talk
This is being self-aware of your thoughts and
managing them.
Positive thoughts will create positive feelings
When you have a negative thought you can change it into a
positive thought.
Examples of self-talk are;
 I can deal with this
 I am in control
 My coping powers are good
 I am calm
 I am relaxed
These statements will help you see your goal more clearly and be able
to achieve that goal.
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Breathing Exercises
This exercise will work on our breathing. This can be very
relaxing. It can be helpful for those who feel dizzy or light
headed when they feel stressed.
You can use this exercise to help you relax at any time.
 Find a comfortable place.
 Work out a breathing rhythm, try to breathe in for 3
seconds, hold this breath for 2 seconds, and then breathe
out for 3 seconds.
 It can be helpful to count as you do this (e.g. IN: 1-2-3,
HOLD: 1-2, OUT: 1-2-3, HOLD: 1-2).
 Repeat this action for a few minutes. You should soon
begin to feel more relaxed.
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Cognitive Behavioral Approach
CBT will help challenge beliefs and thoughts to develop coping
strategies.
 Education about stroke as a condition
 Identifying issues and talking through these with family, friends,
and professionals
 Reflection- Analyse the situation (refer to reflective cycle)
 Goal Setting- Set yourself some small achievable goals
 Diary keeping – Keep a note of thoughts, feelings, questions and
anything that comes to mind.
 Graded exposure to fears- Take small steps within daily living
activities
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References
Anxiety UK (2013). Post-Traumatic Stress Disorder. [online] available
at <http://www.anxietyuk.org.uk> [22/11/2013]
National Institute for Health and Clinical Excellence (2013). Social
Anxiety Disorder Recognition, Assessment and Treatment. London:
The British Psychological Society and the Royal College of
Psychiatrists
NHS (2013). Conditions. [online] available at
<http://www.www.nhs.uk/conditions> [22/11/2013]
Stroke Association (2013) Feeling Overwhelmed: The emotional
impact of Stroke. London: Stroke Association
Payne, R (2000) Relaxation Techniques: A Practical Handbook for the
Health Care Professional.
Churchill Livingstone, Edinburgh
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