Anxiety is a state of apprehension and fear resulting from the perception of a current or future threat to oneself. The term describes a symptom and a variety of psychiatric disorders in which anxiety is a salient symptom.
Substantial anxiety is common in those facing life-threatening illnesses, at least 25% of cancer patients and 50% of chronic heart failure and chronic obstructive pulmonary disease patients.
- Psychiatric disorders (generalized anxiety disorder, panic disorder, adjustment disorder, acute- or post-traumatic stress disorders, and phobias)
- Acute or chronic pain, dyspnea, nausea, or cardiac arrhythmias.
- Adverse drug effects: corticosteroids, psychostimulants, and some antidepressants.
- Drug withdrawal: alcohol, opioids, benzodiazepines, nicotine, clonidine, antidepressants, and corticosteroids.
- Metabolic: hyperthyroidism and syndromes of adrenergic or serotonergic excess.
- Existential and psychosocial concerns about dying, disability, loss, legacy, family, finances, and religion/spirituality.
- Complete a detailed history and physical exam, in particular ask about:
- Prior episodes of other psychiatric disorders.
- Prior and current treatment by a mental health professional.
- Presence of specific trigger situations or thoughts leading to anxiety.
- Presence of apprehension, dread, insomnia, and hypervigilance; as well as physical symptoms such as diaphoresis, dyspnea, muscle tension, and tremulousness.
Seek help from a professional familiar with the psychiatric disorders when anxiety is a prominent and functionally impairing part of a patient’s symptoms. Symptoms that can be confused with anxiety are agitated delirium and akathisia.
See reference for more information.
Adapted from Stoklosa J et al. Anxiety in palliative care – causes and diagnosis. Palliative Care Network of Wisconsin. Fast facts and concepts #186. Internet. Accessed on May 6, 2018.