Psychosocial Maladaptions to Anxiety (Nursing)

00:01 Other anxiety related diagnoses that can cause the psychosocial maladaptation is trichotillomania.

00:09 Now trichotillomania is hair pulling.

00:13 Hair pulling, the patients I have seen who have trichotillomania.

00:19 I have seen people who I would not know they had trichotillomania until, after they feel comfortable with me, they put their hair up, and I noticed big circles of baldness, or they may not have any eyebrows and they have just pulled all the eyebrows out and they will put a pencil mark or I might notice on their arms, that there are patches circles where there is no hair.

00:52 These are anxiety related diagnosis because when the person is pulling their hair, they actually have a momentary relief from that level of anxiety that they chronically feel.

01:08 Hoarding is another psychosocial maladaption to anxiety.

01:16 Hoarding is when people are unable to part with possessions, regardless of their worth.

01:23 And homes can become unlivable.

01:28 If you have ever been in the home of a person who hoards, there may be just a small center line that you can walk through.

01:39 I've had to visit homes, where young adults that I have been treating, I can't understand where their anxiety disorders are coming from.

01:51 And when I asked to do a house visit, I find out that one or both of their parents are hoarders and there is stuff everywhere, and they are not allowed to throw anything out.

02:04 And it has given rise to their own anxiety.

02:08 There's also body dysmorphic.

02:11 And if a person has anxiety related to body dysmorphic, they believe that their body is defective.

02:19 They believe that there is a true defective area or possibly the whole body and they see it as defective.

02:31 Now body dysmorphic belongs to something called the somatoform disorders.

02:38 Somatoform disorders present as physical symptoms, symptoms that would normally point to a medical disease process.

02:48 But when we investigate them, we find that there are no organic pathological processes, or any other mechanisms that would support the medical diagnosis.

03:00 All are associated with psychosocial distress, and very long term help seeking.

03:07 And it is difficult.

03:09 Because when persons who have somatoform disorders get an actual disease, oftentimes it's hard for them to find practitioners who take them seriously.

03:24 Now, their presentation might include pain, for example, maybe stomach pains, or sexual symptoms or or pseudoneurological symptoms.

03:37 For example, they might say, "I'm paralyzed, my left leg is paralyzed." And when they walk in, it's like, you really see a person who can't walk.

03:47 Or they might say, "I'm seeing double." They might actually be blind.

03:53 They tell you, they are blind, they are blind.

03:57 But when you actually go and you do all the tests, you can't find any facts that support either their GI symptoms, or the sexual symptoms, or the neurological symptoms.

04:13 Other somatoform disorders include hypochondriasis.

04:17 And hypochondriasis is when the person is telling you what's wrong with them and there is nothing that you can find wrong with them.

04:27 So if you have in your lexicon now, "Oh, that person is such a hypochondriac." You want to take that out of your lexicon, because it is a somatoform disorder.

04:37 And the person is not doing this just to make it up.

04:43 They are feeling what they're telling you even though there is no medical basis.

04:49 There is conversion disorder where the person might have a loss or change in one of their body functions.

04:57 They may have a pain disorder or they might have a somatization disorder with they come in with multiple, multiple somatic symptoms.