Recovery Oriented Approach In Mental Health Nursing

Sound Analysis of Anxiety Disorder

Discuss about the Recovery Oriented Approach in Mental Health Nursing.

Occasional anxiety problems are very common. People often feel fear and anxious while facing problem in studies, at work or some other areas of life. But, Anxiety disorder is different. It is a continuous or more than a temporary state of having fear, stress or anxiousness. Such feeling of fear or distress can arise any time, during exams, during tests, or before making a significant decision. Anxiety disorder is a mental illness that can get worse over time. The feeling aroused by anxiety can be a barrier in daily life activities like, studies, workplace performance, relationships and socializing.

The essay is based on the given case study of the 22 years old girl Georgia. She studies in University and currently she is unable to cope with the stresses in her life. According to her personal explanations, she finds difficulty in concentrating and feels panicky when her assignments are due. She lives alone in a flat, near her University and do not have much social support. This essay aims towards discussing the comprehensive understanding of the anxiety disorder and will provide interventions that could respond to the mental health needs of Georgia. The essay will also discuss the role of a health professional for quality practice towards mental illness.

Sound Analysis of Anxiety Disorder

According to the given case study, Georgia is suffering with Anxiety disorder. The subjective data offered in the case study shows that Georgia is facing problems in her life due to distress and anxious mood. The information provided by her informs that she is suffering with Generalized Anxiety Disorder. According to Lader (2015) “Generalized anxiety disorder (GAD) is characterized by an excessive and inappropriate worrying that is persistent and not restricted to particular circumstances” (p. 699). Generalized anxiety disorder is a psychological disorder that can result in disproportionate level of anxiety in various aspects of life. Patient often display various physical and psychological symptoms of GAD.  Physical symptoms could be excessive sweating, tremors, shortness of breath, while the psychological symptoms may include fatigue, difficulty in concentrating, irritability, feeling of panic and feeling worried every time (Behar et al, 2009, p. 146).

Georgia is also suffering with these physical and psychological symptoms. She finds difficulty in concentrating and often experience shortness of breath. She is not able to get her driving license, as she feels panicky and distressed, while giving the driving test. Her situation is characterized by the fact that she is not able to control her worries and could not cope with her situation. The biggest risk factor associated with generalized anxiety disorder, is having a family history of anxiety disorder. According to the Georgia, her mother has also suffered from anxiety. The risk of anxiety disorder is also associated with smoking, however in the case of Georgia; she is a non-smoker and drinks alcohol occasionally.

Personal Recovery

For the diagnosis of the generalized anxiety disorder, health care professionals are required to evaluate the family history and physical assessment of the patient (Townsend, 2014, p. 51). People having the family history of anxiety disorder are more likely to suffer from this mental illness. Laboratory tests are also performed for the clinical presentation of the disorder (Behar et al, 2009, p.1112). According to the epidemiological studies of the anxiety disorder, this disorder is mainly prevalent in the older adults, but can also be found in adolescents and young adults (Cuijpers et al, 2014, p. 143).

According to the study of Leamy et al (2011), personal recovery is a “a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles… a way of living a satisfying, hopeful and contributing life even with the limitations caused by illness” (p. 445). Personal recovery is very important for the patients suffering with any kind of mental disorders. The process of recovery is a personal experience for the patients. This concept has emerged from the personal experiences of the people suffering with mental disorders. According to Slade (2009, p 41), the process of personal recovery has changed from the traditional concept of clinical preoccupation, which involves managing the disorder and avoiding any kind of future relapses. Personal recovery procedure is the “new priorities of supporting the person in working towards their own goals and taking responsibility for their own life” (Slade, 2009, p. 49).

The process of personal recovery can be viewed as measurable dimension, which is focused on the overall well-being of the patients. According to the case study of Georgia, she has a lack of support and family history of anxiety. Recovery model is mainly refers to the way of thinking. It aims towards supporting the patient to recover from anxiety and distress and develop resilience and coping (A national framework for recovery-oriented mental health services, 2013). It not focuses only on treating the symptoms and managing the disorder, but it focuses on changing the attitude and thinking of the patients. Personal recovery process is the holistic view of mental disorder and focus on the person. This kind of recovery process is based on the belief that recovery from even the most severe mental disorder is possible (Bonney and Stickley, 2008, p. 148).

Georgia requires support and assistance in recovery and developing coping skills to fight her anxiety and distress. The process of recovery will work as a journey and not just as reaching the outcome. According to Leamy et al (2011), personal recovery will work as a framework that will give priority to the individual and not to the illness (p. 452). It also focuses on identifying the contribution of the social and personal identity towards recovery. Anxiety disorder is caused due to the association of various autonomic nervous system components (Fricchione, 2004, p. 675). These components could be related to the phobias and panic disorders occurred in childhood. Georgia’s mother suffered from anxiety disorder, which may have resulted in occurrence of this illness in her case. She does not smoke and have never been into substance abuse, which explains that her problem is genetic. Recovery approaches for every individual are different depending upon their personal attitudes and journey (Hanna, 2015, p. 141). Thus, personal recovery framework for Georgia is very important to make her life meaningful and make her able to contribute towards community without any symptoms of mental illness. According to Glover (2012) personal recovery is viewed as “living, loving, working and playing in their community”. This kind of attitude by the health professional is important to support patients in their journey of recovery.

Nexus between Physical and Mental Health

The relationship between mental health and physical health is very significant. According to the study of Kolappa, Henderson, and Kishore (2013), mental health and physical health are intimately linked with each other. The author states that without having a proper mental health, there can be no appropriate physical health. There are various evidence based studies that display the important and relationship between both health. There is a “bidirectional relationship between mental illnesses – specifically depression and anxiety – and physical health outcomes” (Kolappa, Henderson, and Kishore, 2013, p. 3). People suffering with anxiety and other mental disorder often have adverse physical condition that hampers their daily routine and daily activities related to work, studies and socialization (Friedman, Furst, and Williams, 2010, p. 17).

In case of Georgia, her problem of anxiety has deteriorated her physical and psychological health, due to which she finds difficulty in concentrating, studying and socializing. The combination of mental illness and physical problems can result in co-morbidities, such as cardiovascular diseases or high rate of depression that can further lead to suicidal tendency. According to Suls & Bunde, (2005), “people with depression and anxiety are at increased risk for developing cardiovascular disease” (p. 260).

. Georgia is suffering with generalized anxiety disorder, which is the first stage of anxiety disorder and can be controlled with appropriate interventions and recovery framework. Due to mental illness, psychological and emotional process of the body changes, which is also affected by social isolation and lack of support. This in turn increases the risk of chronic physical problems. People suffering with mental disorder, face many physical changes and symptoms. These changes could be due to psychological distress or due to treatment. Mental illness results in causing hormonal imbalance and change in sleeping pattern (Gallop, and O’Brien, 2009, p. 8).

In case of Georgia, she is finding difficulty in sleeping and often feels tired. Due to such symptoms she could be vulnerable to various physical conditions, such as fatigue, Insomnia and impaired cognitive functioning (Moore et al, 2002, p. 338). According to the report of the Canadian Institute For Health Information “people who report symptoms of depression also report experiencing three times as many chronic physical conditions as the general population” (Canadian Mental Health Association, 2008). People who face mental illness are more likely to face poverty, unemployment, social isolation and lack of housing. Due to these social factors, the condition of people suffering with mental disorders becomes more vulnerable towards physical problems and illness. The quality of life of the people is also reduced due to mental illness. Most of the cross-sectional studies have shown that poor mental performance disturbs the cognitive functioning.

Recognizing and Responding to Needs of Georgia

Recognizing the recovery and care needs of the patients with mental illness is very important. Every patient requires different approach and care. In the case of Georgia, it is important to understand her psychological needs. She has been living alone away from her parents. The process of recovery is about reclaiming the sense of security and safety (Gallop and O’Brien, 2009, p. 9). Georgia requires support of her family and peers to develop the sense of security. As the healthcare professional, it is important to conceptualize her fears and threats and helping Georgia to develop resilience and coping skills. Family is the most important life of any individual that provides sense of safety (Boyd, 2008, p.10). Thus, involving her family in the recovery planning and procedure is very important.

Self-exposure towards fear is very important. Georgia can be asked to face her fears and during the feeling of anxiety she can use the coping skills. Coping skills in the patient can be developed through developing therapeutic relationships between healthcare professional and patient. As, a healthcare professional it is important to display warmth, understanding towards the patient’s fears, being always available for patient and answering all of their questions and queries. This intervention of developing therapeutic relationships is important for putting the patient at ease, because if the nursing professionals remain like stranger than patient may not be able to share their feelings and fears (Lenze, and Wetherell, 2011, p. 383).

Another important aspect of recognizing and responding to the needs of Georgia, communication is very important (Stuart, 2014, p. 5). With proper communication and patient-centered care, healthcare professionals can understand the physical and emotional problems of patient. It will further help in developing goal based interventions (Simonds et al, 2014). Georgia will be educated about her condition and negative effects of her problem. She will be informed that how she can develop resilience with support of healthcare professionals and her family (Stuart, 2014, p. 8). Positive communication will help Georgia to have sense of safety and will help her to cope with depressing and stressing situations.

For the future implication as the healthcare professionals, it is important to deliver services that can aid in holistic approach towards recovery of patients. I will apply the appropriate nursing conducts and approaches for the overall well-being of the patients. Mental illness can cause various mental and physical health problems in patients, for which I will provide appropriate support while maintaining the professional boundaries. Anxiety is considered as contagious and can be transferred from patient to healthcare professionals. Thus, my aim would be to provide quality of care and maintaining self safety as well as patient’s safety.

Conclusion

Essay is based on the case study of Georgia, who is a 22 years old University student. Since last six months she is facing the problem of anxiety. With the evidences and discussions presented in the essay, it is found that Georgia is suffering from generalized anxiety disorder. She has the family history of anxiety, as her mother suffers from this illness. Essay reviewed the understanding the generalized mental disorder and presented the importance of personal recovery approach. Essay also provides the information about the relationship between mental health and physical health. As a healthcare professional it is important to have holistic approach and focus on overall well-being of the patients. This approach can help to enhance and promote knowledge and skills for future implications.

A national framework for recovery-oriented mental health services. 2013. Accessed: 13^th

October 2016. https://www.mhima.org.au/pdfs/Recovery%20Framework%202013_Policy_theory.pdf

Behar, E., DiMarco, I.D., Hekler, E.B., Mohlman, J. and Staples, A.M., 2009. Current theoretical

models of generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders,23(8), pp.1011-1023.         

Bonney, S. and Stickley, T., 2008. Recovery and mental health: a review of the British literature. Journal of psychiatric and mental health nursing, 15(2), pp.140-153.

Boyd, M.A. ed., 2008. Psychiatric nursing: Contemporary practice. lippincott Williams & wilkins.

Canadian Mental Health Association, 2008. The relationship between mental health, mental

illness and chronic physical conditions. In Code of Ethics for Registered Nurses. CAN Ottawa.

Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M. and Andersson, G., 2014.

Psychological treatment of generalized anxiety disorder: a meta-analysis. Clinical Psychology Review, 34(2), pp.130-140.

Fricchione, G., 2004. Generalized anxiety disorder. New England Journal of Medicine, 351(7),

pp.675-682.

Friedman, M.B., Furst, L.M. and Williams, K.A., 2010. Physical and mental health nexus. Aging

Well, 3, pp.16-19.

Gallop, R. and O’Brien, L., 2009. Re-establishing psychodynamic theory as foundational

knowledge for psychiatric/mental health nursing. Issues in Mental Health Nursing.

Hanna, L., 2015. Generalised anxiety disorder (GAD). Psychiatry: Breaking the ICE Introductions, Common Tasks, Emergencies for Trainees, p.141.

Kolappa, K., Henderson, D.C. and Kishore, S.P., 2013. No physical health without mental

health: lessons unlearned?. Bulletin of the World Health Organization, 91(1), pp.3-3a.

Lader, M., 2015. Generalized anxiety disorder. In Encyclopedia of Psychopharmacology (pp.

699-702). Springer Berlin Heidelberg.

Leamy, M., Bird, V., Le Boutillier, C., Williams, J. and Slade, M., 2011. Conceptual framework

for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), pp.445-452.

Lenze, E.J. and Wetherell, J.L., 2011. A lifespan view of anxiety disorders.Dialogues Clin

Neurosci, 13(4), pp.381-399.

Moore, P.J., Adler, N.E., Williams, D.R. and Jackson, J.S., 2002. Socioeconomic status and

health: the role of sleep. Psychosomatic medicine, 64(2), pp.337-344.

Shepherd, G., Boardman, J. and Slade, M., 2008. Making recovery a reality(pp. 1-3). London:

Sainsbury Centre for Mental Health.

Simonds, L.M., Pons, R.A., Stone, N.J., Warren, F. and John, M., 2014. Adolescents with anxiety and depression: is social recovery relevant?.Clinical psychology & psychotherapy, 21(4), pp.289-298.

Slade, M., 2009. Personal recovery and mental illness: A guide for mental health professionals.

Cambridge University Press.

Stuart, G.W., 2014. Principles and practice of psychiatric nursing. Elsevier Health Sciences.

Suls, J. and Bunde, J., 2005. Anger, anxiety, and depression as risk factors for cardiovascular

disease: the problems and implications of overlapping affective dispositions. Psychological bulletin, 131(2), p.260.

Townsend, M.C., 2014. Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.