Feeling anxious is a normal state to be in when in hospital – just being in hospital whether as an in or out patient can make you feel anxious for lots of reasons such as ‘What’s going to happen to me?’; ‘Will staff be understanding. Can they help me?’; ‘All my embarrassing relatives will want to visit – what will the staff think, will they judge me?’; ‘I’m going to have to have an endoscopy. I hate them’; ‘I’ll miss my dog so much’. The list is endless. What people don’t always remember is how horrible anxiety is if it lasts (even for a short time it’s awful. Who can forget their driving test?) Also how much it affects the body.
Physical effects of anxiety can include: palpitations, chest pain, rapid heartbeat, flushing, hyperventilation, shortness of breath, dizziness, headache, sweating, tingling and numbness, choking, dry mouth, nausea, vomiting, diarrhoea, muscle aches and pains – especially neck, shoulders and back, restlessness, tremor and shaking.
Mind racing or going blank, decreased concentration and memory, difficulty making decisions, irritability, impatience, anger, confusion, restlessness or feeling on edge, tiredness, sleep disturbances, vivid dreams, excessive fear and worry.
Source: Handbook – Mental Health First Aid England).
You can see how anxiety can not only effect your body but your thinking as well, so we need to have an understanding of this and frequently check that the patient has understood us, give them space to make decisions, encourage them to use relaxation techniques (many people find music soothing) and generally be aware that being anxious makes you feel awful. So we don’t assume that people can ‘snap out of it’, it’s not a choice they’re making, no one would choose to be anxious. You’re never going to solve all their problems but listening to them can make a huge difference – just let them tell their story. Sometimes simply explaining to the patient the effects of adrenaline on the body and how awful it makes us feel can help them understand why they feel so unlike themselves and helps them understand struggle less, becomes slightly less anxious.
If you see a patient showing these signs it is easy to misinterpret anxiety for aggression. Obviously if the person’s saying ‘Get out of my way or I’ll thump you’ it’s most likely they’re feeling angry and aggressive but if restless with staring eyes and shaking hands it may be anxiety. Often it is raw anxiety, or terror, that is fuelling the anger.
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