Stress, Anxiety, Coping & Crisis Intervention - Cheat Sheet
Your last-minute revision companion for the psychiatric nursing chapter on stress, anxiety, and crisis management. This rapid-fire reference covers Selye's GAS, anxiety levels, coping mechanisms, crisis types, and intervention priorities — all organized for exam speed and accuracy.
Selye's General Adaptation Syndrome (GAS)
Important facts
- Stage 1: Alarm Reaction — 'fight-or-flight' activates; sympathetic NS + HPA axis increase; catecholamines and cortisol rise; ↑ HR, BP, RR, blood glucose.
- Stage 2: Resistance (Adaptation) — Body adapts and attempts to return to homeostasis while managing the stressor; if coping succeeds, recovery occurs.
- Stage 3: Exhaustion — Prolonged stressor depletes adaptive reserves; physiologic reserves fail; stress-related illness or death may result.
- Local Adaptation Syndrome (LAS) — Local counterpart to GAS; example: inflammatory response at an injury site.
- Selye's model is foundational to understanding why prolonged stress exhausts the body and why early intervention is critical.
Key definitions
Stress
Example
Exam stress triggers sympathetic activation; grief after a death; workplace deadline.
The body's nonspecific physiologic response to any demand (stressor) — physical, psychological, social, developmental, or situational.
Stressor
Example
Job loss, illness diagnosis, exam, traffic, interpersonal conflict.
Any stimulus or demand that triggers a stress response.
Diagrams to know
- Three-stage progression of GAS with physiologic changes at each stage
- Alarm reaction cascade: stressor → HPA axis/sympathetic NS → hormonal release → physical symptoms
Anxiety: Definition & Distinction from Fear
Important facts
- Anxiety is interpersonally communicated — it spreads from one person to another (contagious effect).
- Mild anxiety is normal and adaptive — it motivates learning, problem-solving, and growth.
- Anxiety becomes pathologic when it is excessive, irrational, persistent, interferes with functioning, or occurs without a clear trigger.
- The source of anxiety is often vague, nonspecific, or internal (worry about the future, generalized dread), whereas fear is directed toward a known external object or event.
- Both anxiety and fear activate the same physiologic systems (sympathetic NS, HPA axis) but anxiety is psychological in origin and fear is more situational.
Key definitions
Anxiety
Example
Feeling uneasy before a presentation (unclear threat); 'butterflies' before a test; generalized sense of worry without a clear cause.
A vague, diffuse feeling of apprehension or dread in response to a threat whose source is often nonspecific or unknown; a normal part of life at mild levels.
Fear
Example
Fear of a dog approaching; fear of a car accident; fear of a known diagnosis.
A response to a specific, identifiable, external threat that is concrete and present.
Diagrams to know
- Spectrum showing anxiety (vague threat) vs. fear (specific threat)
- Triggers and characteristics of each
The Four Levels of Anxiety — MOST CRITICAL FOR NLE
Important facts
- Mild = ↑ Perceptual Field — Alert, aware, optimal for learning; use this window for teaching and problem-solving.
- Moderate = Narrowed Perceptual Field (Selective Inattention) — Can still learn and problem-solve WITH GUIDANCE; use clear, short sentences; may need redirection.
- Severe = Greatly Reduced Perceptual Field — DO NOT TEACH or problem-solve; provide calm, quiet, low-stimulus environment; stay with client; short, simple, firm directions; consider PRN medication.
- Panic = Distorted Perceptual Field — NEVER LEAVE ALONE; ensure safety above all; firm, low, reassuring voice; minimize stimuli; one simple direction at a time; do NOT touch without permission; administer prescribed medication immediately; psychiatric emergency — prolonged panic incompatible with life.
- The perceptual field determines the nursing approach. Attempting to teach or reason with a severe/panic client is a trap and can worsen anxiety.
- As anxiety ↑, the ability to perceive, learn, problem-solve, and process information ↓ exponentially.
- Physical manifestations escalate with level: mild (slight restlessness) → moderate (↑ HR, RR, tremor, sweating, shakiness) → severe (tachycardia, hyperventilation, headache, nausea, trembling) → panic (terror, possible hallucinations, loss of rational thought).
Key definitions
Mild Anxiety
Example
Student alert before an exam; employee focused on an important project; person preparing for a presentation.
Perceptual field is heightened/increased; alert, takes in more environment; learning and problem-solving optimal; minor physical signs (restlessness, mild tension).
Moderate Anxiety
Example
During a job interview — attends to the interviewer's questions but may not notice the office décor; a patient focused on their illness but can listen to education if redirected.
Perceptual field narrows; exhibits selective inattention (focuses on immediate concerns, misses periphery but can attend if directed); learning/problem-solving possible with assistance.
Severe Anxiety
Example
A panicking patient during a procedure; someone hyperventilating after bad news; intense trembling, nausea, headache, dizziness.
Perceptual field greatly reduced; focuses on one small or scattered detail; cannot attend to more even when directed; cannot learn or solve problems; marked somatic distress.
Panic
Example
A person experiencing hallucinations during panic; someone unable to speak or move; severe dread, sense of impending doom; risk of exhaustion, harm.
Most extreme level; perceptual field is distorted; loss of rational thought, loss of contact with reality, unable to function or communicate coherently; psychiatric emergency.
Diagrams to know
- Four-level anxiety spectrum with perceptual field changes
- Comparison of physical symptoms at each level
- Nursing approach decision tree by anxiety level
Nursing Approach by Anxiety Level — DIRECT CLINICAL APPLICATION
Important facts
- MILD: Teach, problem-solve, encourage use of anxiety productively, support learning and growth.
- MODERATE: Assist refocus; use clear, short sentences; guide problem-solving; allow limited learning.
- SEVERE: Reduce stimuli, stay with client, short simple firm directions, ensure safety/comfort, consider PRN medication — DO NOT TEACH.
- PANIC: Stay with client (never leave), ensure safety, firm low reassuring voice, minimize stimuli, one direction at a time, no touch without permission, administer medication, assess suicidality/homicidality.
- The rule: Match approach to perceptual field. High anxiety = simple, directive, protective response. Low anxiety = collaborative, educational, growth-focused response.
- A calm, unhurried nurse who stays present reduces client anxiety through modeling and reassurance.
- Avoid escalating anxiety by attempting complex communication, multiple stimuli, or reasoning at high anxiety levels.
Diagrams to know
- Anxiety level → Perceptual field → Nursing approach decision matrix
Coping & Defense Mechanisms
Important facts
- Adaptive coping resolves the stressor and promotes growth. Examples: problem-solving, seeking support, exercise, relaxation, verbalization, humor, spirituality.
- Maladaptive coping provides temporary relief but does NOT resolve the problem and may cause harm. Examples: substance abuse, aggression, avoidance, denial, rumination.
- Defense mechanisms are unconscious (person is unaware they are using them), whereas coping is often conscious.
- Suppression is unique — it is the only conscious defense mechanism; all others are unconscious.
- In the working phase of therapeutic relationship, the nurse helps the client identify maladaptive coping and replace it with adaptive strategies.
- Assessment of coping is part of NANDA nursing diagnosis and informs interventions (e.g., 'Ineffective coping,' 'Denial').
- Healthy coping is a sign of psychological resilience and adaptation; identifying and strengthening adaptive coping is therapeutic.
Key definitions
Coping Mechanism
Example
Adaptive: problem-solving, seeking support, exercise, relaxation, talking through feelings. Maladaptive: substance use, aggression, withdrawal, denial.
Conscious and unconscious efforts to manage stress and anxiety; may be adaptive (resolving the stressor, promoting growth) or maladaptive (temporary relief without resolution, potential harm).
Defense Mechanism
Example
Repression (forgetting trauma), denial (refusing to accept diagnosis), projection (blaming others), displacement (anger at family after work stress), rationalisation, reaction formation, regression, sublimation.
Unconscious ego strategies to reduce anxiety and protect the psyche; become problematic when overused or replacing realistic problem-solving.
Suppression
Example
A nurse thinking about a personal problem during a shift, then addressing it after work.
The only conscious defense mechanism — deliberately postponing anxiety-producing thoughts or feelings until appropriate time.
Diagrams to know
- Spectrum of coping: adaptive ↔ maladaptive with examples
- Defense mechanisms classified by intensity (mild, moderate, psychotic) and examples of each
Crisis Theory & Types
Common values
Value
4 to 6 weeks
Symbol
t
Quantity
Crisis duration
Value
3
Symbol
n
Quantity
Number of balancing factors
Important facts
- A crisis is self-limiting — resolves within 4 to 6 weeks one way or another (toward higher, same, or lower functioning).
- A crisis is NOT an illness. It can happen to any person; it is a normal response to an abnormal situation.
- A crisis is an opportunity for growth. The person is often more open to help during crisis than at other times; intervention during crisis can produce lasting positive change.
- Crisis outcome depends on three balancing factors: (1) perception, (2) supports, (3) coping. Strengthening any of these can tilt outcome toward resolution.
- Maturational crises are predictable but can still overwhelm coping if the person is unprepared or has poor supports.
- Situational and adventitious crises are unexpected — the person has no chance to prepare psychologically.
- In the Philippines, adventitious crises (typhoons, earthquakes, flooding) are common and nurses must be trained in disaster mental health and crisis response.
- The outcome of a crisis is not determined by the event itself but by the person's perception, supports, and coping resources.
Key definitions
Crisis
Example
Job loss, death of a loved one, diagnosis of serious illness, sudden injury, divorce, assault, natural disaster.
An acute state of psychological disequilibrium when usual coping mechanisms fail to resolve a stressful event; person experiences temporary inability to function.
Aguilera's Balancing Factors
Example
Same job loss: one person (good supports, adaptive coping) → growth; another (poor perception, isolated, maladaptive coping) → longer crisis or deterioration.
Three factors that determine crisis outcome: (1) perception of the event (is it seen as threat, loss, or challenge?), (2) situational supports (family, friends, community), (3) coping mechanisms (adaptive strategies available).
Maturational Crisis
Example
Adolescence, marriage, parenthood, retirement, middle age, aging.
Crisis arising from expected life transitions; occurs during predictable developmental stages.
Situational Crisis
Example
Sudden illness, job loss, accident, divorce, death of a loved one, diagnosis of serious disease.
Crisis arising from unanticipated external events outside the person's control.
Adventitious Crisis
Example
Typhoons, earthquakes, floods, fires, violent crimes, terrorist attacks, war — highly relevant in the Philippines context.
Crisis arising from large-scale unplanned events affecting many people; linked to disaster nursing.
Diagrams to know
- Three types of crisis with examples and time course
- Aguilera's balancing factors diagram showing how each influences crisis resolution
Crisis Intervention — Steps & Principles
Important facts
- Step 1: ENSURE SAFETY FIRST — Always assess for suicide and homicide risk before any other intervention. This is the absolute priority.
- Step 2: Assess the crisis — Identify the precipitating event, the client's perception of it, and the three balancing factors (perception, supports, coping).
- Step 3: Focus on the immediate problem — Work in the here-and-now, not on long-standing personality issues or past trauma. Crisis is acute and time-limited.
- Step 4: Set realistic, short-term goals collaboratively — Goals should be achievable within days or weeks, not months. Involve the client in planning.
- Step 5: Take an active, directive role — The nurse is more directive than in ordinary therapy. Help the client develop concrete plans, make decisions, and use supports.
- Step 6: Mobilise resources and support systems — Connect client with family, friends, community resources, employers, religious leaders, referrals (mental health, financial, legal).
- Step 7: Anticipatory planning — Help the client prepare for future stressors; teach coping skills; identify warning signs; plan responses to prevent future crises.
- Goal is restoration to pre-crisis functioning, NOT personality reconstruction. Crisis intervention is short-term and focused, not psychotherapy.
- The therapeutic relationship in crisis is more directive — the nurse makes suggestions, provides guidance, and is actively involved in decision-making.
Key definitions
Crisis Intervention
Example
After a suicide attempt, the nurse assesses safety, identifies the precipitating event, mobilizes supports, and develops a concrete plan to prevent future attempts.
Short-term, focused, active help aimed at restoring a person to at least the pre-crisis level of functioning.
Diagrams to know
- Seven-step crisis intervention process flow
- Crisis assessment framework: event → perception → balancing factors → intervention → outcome
Pharmacology of Anxiety & Panic
Common values
Value
2-4 weeks
Symbol
t_onset
Quantity
SSRI & buspirone onset time
Value
Minutes to 1 hour
Symbol
t_rapid
Quantity
Benzodiazepine onset time
Important facts
- Benzodiazepines = RAPID relief (minutes to hours); SHORT-TERM use. Do not prescribe for chronic anxiety.
- Buspiron & SSRIs = SLOW onset (2-4 weeks); LONG-TERM use. Useless for acute panic; must be used preventively.
- Medication complements but does NOT replace therapeutic and environmental interventions.
- Benzodiazepine cautions: Avoid alcohol (severe CNS depression, respiratory failure), do NOT stop abruptly (withdrawal seizures), avoid driving until effects known, caution in elderly (falls, confusion, delirium).
- Teach clients on benzodiazepines: Do not drink alcohol, do not stop suddenly, do not drive, take as directed, report side effects.
- SSRI onset: 2-4 weeks for partial effect; 4-8 weeks for full therapeutic effect; counsel client to continue even if no immediate benefit.
- Beta-blockers are NOT first-line anxiolytics — used only for physical symptoms of situational anxiety, not for the anxiety itself or panic disorder.
Key definitions
Benzodiazepines (e.g., lorazepam, diazepam, alprazolam)
Example
Lorazepam (Ativan) IV for acute panic; diazepam (Valium) for muscle tension; alprazolam (Xanax) for situational anxiety — but NOT for long-term chronic anxiety.
GABA-enhancing anxiolytics that provide rapid relief of severe anxiety and panic; for short-term use only due to dependence, tolerance, sedation, respiratory depression risk.
Buspirone
Example
Prescribed for generalized anxiety disorder in a patient who needs long-term relief without sedation or dependence risk.
Non-benzodiazepine, non-sedating, non-dependence-forming anxiolytic for chronic anxiety; requires 2–4 weeks for full effect; NOT useful for acute panic.
SSRIs (e.g., sertraline, fluoxetine, escitalopram)
Example
Sertraline (Zoloft) or escitalopram (Lexapro) for generalized anxiety disorder, panic disorder, social anxiety — started and continued for months.
First-line for long-term management of anxiety disorders; also treat depression; require weeks for full effect; NOT for acute panic.
Beta-blockers (e.g., propranolol)
Example
Propranolol for a musician with stage fright; a public speaker with performance anxiety.
Used to blunt the physical symptoms of situational (performance) anxiety; reduce tremor, tachycardia, sweating.
Diagrams to know
- Medication choice by anxiety type: acute panic, chronic anxiety, situational anxiety, performance anxiety
- Timeline of onset: benzodiazepines (rapid) vs. SSRIs & buspirone (slow)
Priority Nursing Interventions
Important facts
- Priority 1: Assess anxiety level accurately. It determines every subsequent action and approach.
- Priority 2: Ensure safety. ALWAYS check for suicide/homicide risk, especially in crisis and at panic level.
- Priority 3 (Severe/Panic): Reduce environmental stimuli. Quiet room, dim lights, minimal noise, remove unnecessary people, eliminate clocks/reminders.
- Priority 3 (Severe/Panic): Stay with the client. NEVER leave a panicking client alone; your presence is reassuring and ensures safety.
- Priority 4: Use calm communication. Speak in a low, even tone; short, simple, clear sentences; avoid complex explanations; give one direction at a time.
- Priority 5: Do NOT teach or problem-solve at severe/panic levels. Reserve teaching for mild-to-moderate anxiety when the perceptual field allows learning.
- Priority 6: Administer prescribed anxiolytic medication and monitor for response and side effects (especially respiratory depression).
- Priority 7: In crisis, work in the here-and-now. Focus on the immediate problem, mobilize supports, set short-term goals, ensure safety.
- General principle: A calm, unhurried nurse lowers the client's anxiety through modeling, presence, and reassurance.
Diagrams to know
- Nursing intervention hierarchy by anxiety level
Patient & Family Teaching
Important facts
- Teach recognition of personal anxiety triggers and early warning signs — enables the client to intervene early (at mild level) before anxiety escalates.
- Teach relaxation and coping skills: Deep breathing, progressive muscle relaxation, grounding techniques (5-4-3-2-1 sensory method), physical activity, mindfulness — best taught at mild-to-moderate anxiety.
- Explain that crisis is time-limited and resolves within 4-6 weeks — helps client maintain hope and perspective.
- Emphasize that seeking help is a strength, not a weakness. Counter Filipino stigma around mental health help-seeking; normalize mental health care as part of overall health.
- Provide emergency contacts: NCMH crisis hotline, local mental health services, suicide prevention numbers, trusted healthcare providers.
- Involve family as a support system. Teach family to recognize signs of crisis, support the client, access community resources.
- Reinforce medication teaching: Purpose, timing, side effects, importance of adherence, what to do if side effects occur, never stop suddenly.
- Teach anticipatory coping: Prepare for foreseeable stressors, develop action plans, identify resources, practice coping skills in advance.
- Normalize anxiety as a human experience — mild anxiety is normal, adaptive, and part of life; it is only problematic when excessive or persistent.
Diagrams to know
- Grounding technique (5-4-3-2-1 sensory method) step-by-step
- Deep breathing technique with timing
Must remember
- GAS Three Stages: Alarm (fight-or-flight, sympathetic activation) → Resistance (adaptation, homeostasis) → Exhaustion (reserves depleted, illness/death risk). Prolonged stress without resolution leads to exhaustion and illness.
- Anxiety = vague, nonspecific threat (internal); Fear = specific, identifiable threat (external). Do not confuse them; they require different interventions.
- The Four Anxiety Levels and Perceptual Fields are CRITICAL: Mild (heightened) → Moderate (narrowed, selective inattention) → Severe (greatly reduced) → Panic (distorted). Perceptual field determines nursing approach.
- MILD-TO-MODERATE anxiety is the teaching window. DO NOT attempt teaching or complex problem-solving at SEVERE or PANIC levels — the client cannot process information. Match approach to perceptual field.
- At PANIC level: NEVER leave the client alone. Ensure safety, use firm low voice, minimize stimuli, give one simple direction at a time, do NOT touch without permission, administer prescribed medication immediately. Panic is a psychiatric emergency.
- Aguilera's Three Balancing Factors determine crisis outcome: (1) Perception of the event, (2) Situational supports, (3) Coping mechanisms. Strengthen any of these to resolve crisis.
- A Crisis is self-limiting (4-6 weeks), NOT an illness, and is an OPPORTUNITY for growth. The person is more open to help during crisis than usual.
- Three Crisis Types: Maturational (expected), Situational (unexpected), Adventitious (disaster/mass trauma — relevant in Philippines). Nursing approach is the same for all: safety-first, here-and-now, short-term, active/directive.
- Medication Timing: Benzodiazepines = rapid (minutes); Buspirone & SSRIs = slow (2-4 weeks). Benzodiazepines for acute panic (short-term); SSRIs & buspirone for chronic anxiety (long-term). Never use slow-onset meds for acute panic.
- Defense mechanisms are UNCONSCIOUS; suppression is the ONLY conscious defense mechanism. Assess which mechanisms clients use and help replace maladaptive ones with adaptive coping in the working phase of the therapeutic relationship.
Last minute tips
- When you see 'anxiety level' in an NLE question, immediately ask: 'What is the perceptual field?' This tells you the correct nursing approach. If you see 'client cannot learn or focus' = severe/panic = no teaching, reduce stimuli, stay present. If 'client is alert' = mild = teach and problem-solve.
- 'Do NOT teach' at severe/panic anxiety is a trap answer that catches many students. Remember: mild anxiety → heightened perception → learning optimal; severe/panic → perceptual field shrinks/distorts → cannot learn. Teaching is ineffective and may worsen anxiety.
- Crisis intervention is SHORT-TERM and ACTIVE/DIRECTIVE. The nurse is not passive; you suggest, guide, mobilize resources, set concrete short-term goals. It is not psychotherapy — goal is restoration to pre-crisis functioning in 4-6 weeks.
- If the question involves medication for 'acute panic attack,' benzodiazepines are correct; if 'chronic anxiety disorder,' SSRIs or buspirone are correct. Know the timeline: rapid benzodiazepines (acute), slow SSRIs/buspiron (chronic). Never choose a slow-onset medication for acute panic.
- In crisis, ALWAYS assess suicide/homicide risk first. This is the absolute priority. Then assess the precipitating event, perception, and balancing factors. Focus on the here-and-now, not past issues. Mobilize supports and set concrete goals.
Comparison tables
Anxiety vs. Fear
| Characteristic | Anxiety | Fear |
|---|---|---|
| Source of threat | Vague, nonspecific, often unknown | Specific, identifiable, concrete |
| Origin | Internal, psychological | External, situational |
| Level of control | Person often cannot identify or control the threat | Person can identify and sometimes avoid the threat |
| Response | Apprehension, dread, worry, sense of doom | Specific protective or avoidance behavior |
| Communication | Interpersonally contagious; spreads from person to person | More individual; less contagious |
| Example | Feeling uneasy before an exam without specific worry; generalized dread | Fear of a dog; fear of a specific diagnosis; fear of heights |
Four Levels of Anxiety: Perceptual Field & Nursing Approach
| Anxiety Level | Perceptual Field | Cognitive/Learning Ability | Physical Signs | Nursing Approach |
|---|---|---|---|---|
| MILD | Heightened/Increased — alert, aware, takes in environment | Can learn, problem-solve, focus optimally | Slight restlessness, mild tension, alert | TEACH; help use anxiety productively; problem-solve; support growth |
| MODERATE | Narrowed (Selective Inattention) — focuses on immediate concerns, misses periphery | Can learn and problem-solve WITH GUIDANCE; can attend if redirected | Increased HR, RR, tremor, sweating, shakiness in voice, pacing | Clear, short sentences; redirect attention; assist problem-solving; limited learning possible |
| SEVERE | Greatly Reduced — focuses on one small or scattered detail only | CANNOT learn or problem-solve; cannot attend even if directed | Tachycardia, hyperventilation, headache, dizziness, nausea, marked trembling | DO NOT TEACH. Quiet, low-stimulus environment; stay with client; short, simple, firm directions; ensure safety; PRN medication |
| PANIC | Distorted — loss of rational thought, may lose contact with reality | CANNOT function or communicate coherently; irrational thinking | Terror, dread, possible hallucinations, severe physical distress, inability to move or speak | NEVER leave alone. Ensure safety first. Firm, low, reassuring voice. Minimize stimuli. One direction at a time. NO touch without permission. Administer medication. PSYCHIATRIC EMERGENCY |
Types of Crisis
| Crisis Type | Nature | Characteristics | Examples |
|---|---|---|---|
| Maturational (Developmental) | Expected, predictable life transition | Arises from normal developmental milestones; person may prepare but often unprepared emotionally | Adolescence, marriage, parenthood, menopause, retirement, aging |
| Situational | Unexpected external event outside person's control | Sudden, unanticipated; person has no chance to prepare psychologically | Job loss, sudden illness, accident, death of loved one, diagnosis, divorce, assault |
| Adventitious (Social/Disaster) | Large-scale unplanned event affecting many people | Affects entire community or population; mass trauma; linked to disaster nursing | Typhoons, earthquakes, floods, fires, violent crimes, war, terrorism — common in Philippines |
Anxiolytic Medications: Onset, Duration, & Use
| Medication Class | Examples | Onset Time | Duration of Effect | Use Case | Key Cautions |
|---|---|---|---|---|---|
| Benzodiazepines | Lorazepam, diazepam, alprazolam | Minutes to 1 hour | 4-12 hours | ACUTE panic, severe anxiety, short-term use only | Dependence, tolerance, respiratory depression with alcohol, elderly at risk (falls, confusion). Do not stop abruptly (withdrawal). No alcohol. No driving until effects known. |
| Buspirone | Non-benzodiazepine anxiolytic | 2-4 weeks | Long-term with continuous use | CHRONIC anxiety only; NOT for acute panic | No sedation, no dependence. Slower onset requires client counseling to continue use before benefit felt. Cannot use for acute episodes. |
| SSRIs | Sertraline, fluoxetine, escitalopram, paroxetine | 2-4 weeks (full effect 4-8 weeks) | Long-term with continuous use | LONG-TERM anxiety disorders, panic disorder, depression | First-line for anxiety disorders. Slow onset — counsel client to continue. NOT for acute panic. Takes weeks for full effect. |
| Beta-blockers | Propranolol | 30-60 minutes | 4-6 hours | SITUATIONAL (performance) anxiety: physical symptoms only (tremor, tachycardia) | NOT first-line anxiolytic. Used only for physical symptoms of situational anxiety, not for anxiety disorder itself or panic disorder. |
Adaptive vs. Maladaptive Coping
| Type | Mechanism | Outcome | Examples |
|---|---|---|---|
| ADAPTIVE (Constructive) | Addresses the root cause of stress | Resolves the problem, promotes growth, increases resilience, allows learning | Problem-solving, seeking support, exercise, relaxation, talking through feelings, humor, spirituality, meditation, education |
| MALADAPTIVE (Destructive) | Avoids or masks the problem without addressing it | Temporary relief only; does NOT resolve the problem; may cause harm; perpetuates cycle of stress | Substance abuse, aggression, withdrawal/isolation, denial, avoidance, overeating, self-harm, gambling, rumination |
Diagrams
Anxiety Level Assessment & Nursing Approach Decision Tree
This flowchart guides the nurse through the anxiety assessment process and directly links perceptual field to the correct nursing approach. It emphasizes that teaching is appropriate only at mild-to-moderate levels and is contraindicated at severe and panic levels.
Crisis Intervention Framework & Key Components
This mind map organizes the seven key steps and principles of crisis intervention into a visual hierarchy, emphasizing safety first, the balancing factors, active nurse role, short-term goals, and resource mobilization. It reflects the acute, time-limited nature of crisis intervention.
Selye's General Adaptation Syndrome — Three Stages & Outcomes
This state diagram illustrates the three stages of GAS and shows two possible outcomes: recovery (if coping succeeds during resistance) or exhaustion/death (if stressor persists and reserves deplete). It emphasizes that early intervention during the resistance stage is critical to prevent progression to exhaustion.
Anxiety Management: Medication Selection by Presentation & Timeframe
This flowchart guides medication selection based on the acuity of anxiety presentation (acute panic vs. chronic anxiety) and the expected timeline for symptom relief. It prevents common errors such as prescribing slow-onset medications for acute panic or benzodiazepines for long-term anxiety.
Distribution of Crisis Types in Mental Health Practice
This pie chart illustrates the relative frequency of the three crisis types in clinical practice. In the Philippines, adventitious crises (typhoons, earthquakes, floods) are notably common and represent 30% of crisis presentations, underscoring the importance of disaster nursing competence.
Timeline: Medication Onset & Effectiveness for Anxiety
This timeline visually compares the onset and duration of anxiety medications, highlighting why benzodiazepines are used for acute anxiety (minutes-to-hours onset) and SSRIs/buspirone are used for chronic anxiety (weeks-to-months onset). It prevents inappropriate medication selection based on timeframe.