History taking -- Anxiety.
Introduction:
Find out about: tension; agitation; trembling; impending doom; collapse;
insomnia; poor concentration.
Hyperventilation; chest pains; tinnitus; tingling; tetany.
Headaches; sweating; palpitations; poor appetite; nausea; lump in the throat (globus hystericus).
Excessive concern about self and bodily functions; repetitive thoughts and activities like: thumb sucking, nail biting, bed wetting, food fads and stammering in children. Find out about phobias?
Causes of anxiety: stress,
Life events: death of spouse, losing a job.
Intrapsychic theories.
Management: symptom control: simple listening, explain that the headaches are not due to brain tumour and palpitations are harmless.
Graded exposure to anxiety provoking stimulus.
Progressive relaxation training; teach to relax and tense groups of muscles in an orderly way.
Deep breathing exercises.
Anxiolytics: Diazepam.