Anxiety is the most common mental illness

Running head: Mental Health 1
Mental Health Nursing
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Mental Health 2
Anxiety Among Adults aged 25-65 years
PART A
Introduction
Anxiety is the most common mental illness in the general population and affects both the old and
the young. The disorder is characterized by the emotional state of tension and thoughts of worry.
It is a usual experience in life, but if it rises to the level at which it hampers normal life
functioning, then it is classified as a disorder. Anxiety disorder consists of a group of mental
illnesses with varying symptoms. It has severe effects on both physical health and mental health
(Bandelow & Michaelis, 2015). Studies have indicated that adults aged 25-65 years are more
vulnerable to anxiety disorders. A survey was conducted in Australia on the prevalence of
anxiety disorders among adults, and the findings indicated that 20% of the mental disorders were
experienced in adults (Australian Bureau of Statistics, 2009). Its prevalence in Australia can be
attributed to multiple factors such as the growing population of older adults. Other frequent
negative experiences in life such as the loss and bereavement of loved ones are significant risks
for developing anxiety in adults (Australian Psychological Society, 2015). This essay aims at
providing comprehensive detail on the prevalence, causes and therapeutic approach to anxiety.
Prevalence of Anxiety
Global statistics indicated that approximately 272.2 million people have been diagnosed with
anxiety at any one given time in 2010 (Baxter et al., 2014). The females were doubly affected
(5.2%) compared to males (2.8%). Additionally, an adult age group of 20-64 years were the most
affected than other age groups. According to the 2010 study by the Global Burden of Disease
which comprised of 21 regions globally, the point prevalence of disorders related to anxiety was
6.1% in North Africa and 2.1% in Asia. The study concluded that countries experiencing
conflicts, developed countries and Latin America were the most affected with anxiety disorders.
The survey conducted by Wittchen et al. (2011) on the prevalence of mental disorders in Europe
found out that 28.2% of the population were affected by mental disorders with anxiety being the
most common (14.0%) followed by phobia (6.4%), and the least prevalent being panic disorder
(1.8%). A more comprehensive and extensive community survey was conducted across
seventeen countries by the World Health Organization’s (WHO) World Mental Health (WMH)

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Survey Initiative. The survey found out that anxiety had a 12-month prevalence of 8.3% and an
average lifetime prevalence of 14.3% (Kessler et al., 2009). A 12-month prevalence study on
anxiety disorders among adults was also conducted by the Australian National Survey of Mental
Health and Wellbeing (NSMHWB). The findings indicated that there was a lifetime prevalence
of 20.0% and 12-month prevalence of 11.8% (McEvoy, Grove, & Slade, 2011). The above
studies show that anxiety disorders are a national public health problem that is affecting all
adults in all countries but more prevalent in developed countries. There is, therefore, need for
more research on the disorder concerning its causes, effects among adults and the most effective
approach in addressing it.
Causes of Anxiety among Adults
The biopsychosocial model suggests the existence of multiple and inter-related causes of
pathological anxiety. These causes have generally been grouped into three namely biological
causes, social/environmental causes and psychological causes. The biological causes in the
biopsychosocial framework consist of the physiological adaptive reactions of the body to fear
(Schetter, & Tanner, 2012). It can also include genetic characters and the functionality of the
brain that we inherit. Bourne (2011) observed that it is the genetic susceptibility articulated as a
personality type that is inherited. It is this personality that explains one’s response to stress such
as being more sensitive, reactive or both. The individuals born with these more sensitive
temperaments that are more prone to developing anxiety disorders in their adulthood because
their nervous system is aroused easily.
A biological vulnerability to stress is not sufficient to develop an anxiety disorder, however, the
risk of developing the disorder increases when there is a psychological vulnerability. Studies
have found four significant psychological factors that predict a psychological risk of anxiety.
These include perceived control, cognitive appraisals, beliefs and distortions van (Santen et al.,
2011). Gulliver, Griffiths, Christensen, and Brewer (2011) observed that psychological
susceptibilities to anxiety are caused by later life experiences. An example of such susceptibility
is the inability to exercise self-control over distressing events. An individuals’ perceived control
can significantly be influenced by childhood experiences especially when they lack self-control

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from a tender age. Cognitive appraisals refer to how we asses and evaluate a given
environmental situation or circumstance.
The primary cause of the different responses to stressors is how individuals appraise events.
Cognitive beliefs determine one’s responses to stressors and these can include belief about the
stressor, about one’s ability to manage or endure negative events. Regarding cognitive
distortions, an individual’s thoughts will lead to distressing emotions and maladaptive conduct.
The social aspect of the biopsychosocial model accounts for several types of anxiety disorders.
According to the social learning theory (SLT), people learn new ways of thinking and acting
through the observation of the behaviours of others. the rewarding of behaviour is a motivation
for others to learn to improve on the conduct or if punished people fear and develop mechanisms
to discontinue that conduct (Reed et al., 2010).
Effects of Anxiety on Normal Life
Anxiety disorders have been associated with the impairment of the general functioning of life
including behaviour, physical functioning, communication and mood. The quality of life among
adults with anxiety disorders is more impaired than that of adults diagnosed with cardiovascular
disease (Barrera & Norton, 2009). Anxiety leads to low work productivity because it also affects
one’s health. Wu, Luo, Broster, Gu, and Luo, (2013) found out that absenteeism due to anxiety
and depression account for one trillion dollars loss in productivity annually. The disorder has
also been found to impair family and social functioning. Anxiety results in social isolation thus
affecting social interaction which is fundamental to normal life functioning. A study conducted
by McKnight et al. (2016) found out that anxiety disorders had a significant association with
social seclusion and social phobia. Generally, social functioning in individuals with anxiety
disorders shows that effective indicators are more insistently influenced than behavioural
indicators. Long-term anxiety is associated with an increased risk of mental health sickness and
physical impairment. Anxiety affects the cognitive function of the body because it affects the
brain section called amygdala which is responsible for deep emotional responses. As a result, the
neurotransmitter transports the impulse to the sympathetic nervous system which increases the
heartbeat and breathing rate, the tension in muscles and diversion of blood to the brain from the

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abdominal body parts. This might lead to nausea, excessive urination, headache and diarrhoea
(Saris, Aghajani, van der Werff, van der Wee, & Penninx, 2017).
PART B
Cognitive Behavior Therapy for Anxiety
Cognitive-behavioural therapy (CBT) is a typically conceptualized approach that works to alter
maladaptive emotional responses by altering the thoughts, conducts or both of the patients. The
therapy is premised on the fact that altering behaviours results in alterations in emotions and
cognitions such as appraisals. CBT can be implemented in multiple forms depending on the
needs of the patient. Some of the commonly used approaches include interpersonal therapy,
exposure therapies among others. however, the underlying principle of CBT is that it focuses on
the thoughts and not external circumstances. In other words, an individual’s feeling towards a
given situation is determined by his/her perception of the situation and not the situation itself
(Otte, 2011). The exposure therapies are commonly used for various types of anxiety disorders
such as obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder among
others. For instance, OCD patients are treated using Exposure and response prevention (EX/RP)
therapy which makes use of both in vivo and imaginal exposures. In vivo exposures involve
activities with the therapist during the therapy session and outside the session. Compulsive
behaviours should be avoided because compulsions work as safety behaviours that preserve the
relationship between obsessions and feared repercussions. CBT for panic disorder constitutes
interoceptive exposure in which the heart rate is increased through exercising to discourage the
thought that physical sensations will result into destructive events such as myocardial infarction
or public embarrassment (Kaczkurkin & Foa, 2015).
Effectiveness of the CBT Approach
Several studies have been carried out on the effectiveness of the different forms of CBT on
different anxiety disorders (Hans & Hiller, 2013; Watts, Turnell, Kladnitski, Newby, &
Andrews, 2015). The therapy has also been found to result in the improvements in quality of life
in adults diagnosed with anxiety. For instance, a review of the effectiveness of EX/RP showed
that the patients had significant improvements than the control approach or waiting list (Rosa-
Alcázar, Sánchez-Meca, Gómez-Conesa, & Marín-Martínez, 2008). The study by Foa (2010)

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showed that the variants of EX/RP showed that the exposure therapy for OCD was much more
effective when conducted by an expert than when self-guided. CBT has also been found to be
effective in the treatment of the panic disorder. The use of exposure therapy alongside CBT or
without was found to be effective than no treatment (Hofmann, Asnaani, Vonk, Sawyer, & Fang,
2012). Twomey, O’Reilly, and Byrne (2014) conducted a meta-analysis to ascertain the
effectiveness of CBT for anxiety and depression and found out that the approach was more
effective than no treatment (d=0.59) for the symptoms of the disorder. The current state of
evidence also shows that CBT is effective in different forms of the disorder such as panic
disorder, generalized anxiety disorder among others. CBT treatment of panic disorder had an
effect size of 0.35 (95% CI 0.04-0.65) and 1.01 (95% CI 0.77-1.25) according to the study by
Kaczkurkin and Foa (2015).
Nursing Practice and Anxiety Patients
How the nurse manages his/her emotions have a significant effect on the anxiety patient.
However, a nurse can help reduce or aggravate the situation based on the patient is handled. The
nurse should exercise listening skills and show concern to the patient for example by inquiring of
any positive progress in the treatment. Such an approach will help avoid patients from transiting
to relief-behaviour mode. The nurse can also reduce anxiety in the patient by making a formal
introduction and responsibility to the patients and families and an outline of the intended
treatment services. This can be in addition to asking the patients about their individual lives,
work, family etc. It is also imperative that the nurse is calm, responding to questions, obtaining
information about their needs and constantly assuring them of positive results (Sauls, & Warise,
2010).
Conclusion
Anxiety is the most common mental illness in the general population and affects both the old and
the young. The disorder is characterized by the emotional state of tension and thoughts of worry.
The disorder is more common among adults in Australia and globally. Developing countries are
the most affected with the disease due to the various factors such as the poor economy forcing
people to develop anxiety for fear of meeting life needs. The biopsychosocial model proposes

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three major causes of anxiety namely biological causes, social/environmental causes and
psychological causes. Furthermore, the disorder is critical because it affects normal life
functioning such as behaviour, physical functioning, communication and mood. The disorder
impairs social functioning leading social isolation and family breakdown. It may also result in
negative physical experiences such as nausea, excessive urination, headache and diarrhoea.
Despite the high prevalence of the disorder, CBT is effective in the treatment of several forms of
the disease. Since the disorder is associated with emotions and feelings, nurses must manage
their emotions and feelings, improve communication skills, and create a rapport with the patient
and family for them to be successive in handling adult anxiety patients

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