Question

Natasha is a 44-year-old who came from Bosnia as a war refugee 20 years ago. She is having anxiety attacks and she isn’t sleeping more than 3 hours a night. She also has stomach pain and severe headaches almost every day. She has two young children, and she’s worried that she’ll lose her job if she takes off any more time.

1. What is the primary concern with Natasha and her cultural background and her clinical symptoms?

2. Design a plan for Natasha that is culturally sensitive and focused on refugees. The plan should ensure that she has social and financial resources, as well as a primary care provider. Discuss the rationale and evidence for effectiveness.

Answer 1

1. The primary Concern With Natasha are-

• She is Worried about losing Her Job due to her problems
• She is certain Medical problems almost Every day.

The Cultural Background of Natasha is she is a war Refugee as she came from the Adjacent Country 20 years back

Clinical Symptoms of Natasha are-

• She is Having stomach pain and severe Headaches almost Everyday.
• She also Has Anxiety Due due to which she has Insomnia and gets sleep only for 3 hours in a night.

2. Plan For Natasha that is Culturally Sensitive and Focussed on Refugees are-

Learning about anxiety

Learning about her problems and the cause for her anxiety can aid in Better Treatment and therapy for the Natasha

Mindfulness

When feeling anxious, a person can spend a significant amount of time caught up in anxiety-provoking thoughts. Mindfulness guides us to bring our attention back to the present moment and unhook from thoughts that may be unhelpful.

Mindfulness is becoming more and more popular as people start to realise how beneficial it is for a number of issues. There are many resources available to support you to develop a mindfulness practice.

Relaxation techniques

A person who feels anxious most of the time has trouble relaxing, but knowing how to release muscle tension can be a helpful strategy. Relaxation techniques include:

• progressive muscle relaxation
• abdominal breathing
• isometric relaxation exercises.

Cognitive therapy

Cognitive therapy focuses on changing patterns of thinking and beliefs that are associated with, and trigger, anxiety.

Cognitive therapy strategies include rational ‘self-talk’, reality testing, attention training, cognitive challenging and cognitive restructuring. This includes monitoring your self-talk, challenging unhelpful fears and beliefs, and testing out the reality of negative thoughts.

Dietary adjustments

The mineral magnesium helps muscle tissue to relax, and a magnesium deficiency can contribute to anxiety, depression and insomnia. Inadequate intake of vitamin B and calcium can also exacerbate anxiety symptoms. Make sure your daily diet includes foods such as wholegrain cereals, leafy green vegetables and low-fat dairy products.

Nicotine, caffeine and stimulant drugs (such as those that contain caffeine) trigger your adrenal glands to release adrenaline, which is one of the main stress chemicals. These are best avoided. Other foods to avoid include salt and artificial additives, such as preservatives. Choose fresh, unprocessed foods whenever possible.

Exercise

The physical symptoms of anxiety are caused by the ‘flight-or-fight’ response, which floods the body with adrenaline and other stress chemicals. Exercise burns up stress chemicals and promotes relaxation. Physical activity is another helpful way to manage anxiety. Aim to do some physical activity at least three to four times every week, and vary your activities to avoid boredom.

Learning to be assertive

Being assertive means communicating your needs, wants, feelings, beliefs and opinions to others in a direct and honest manner without intentionally hurting anyone’s feelings. A person with an anxiety disorder may have trouble being assertive because they are afraid of conflict or believe they have no right to speak up. However, relating passively to others lowers self-confidence and reinforces anxiety. Learning to behave assertively is central to developing a stronger self-esteem.

Building self-esteem

People with anxiety disorder often have low self-esteem. Feeling worthless can make the anxiety worse in many ways. It can trigger a passive style of interacting with others and foster a fear of being judged harshly. Low self-esteem may also be related to the impact of the anxiety disorder on your life. These problems may include:

• isolation
• feelings of shame and guilt
• depressed mood
• difficulties in functioning at school, work or in social situations.

Community support organisations and counselling may help you to cope with these problems.

Structured problem solving

Some people with anxiety disorders are ‘worriers’, who fret about a problem rather than actively solve it. Learning how to break down a problem into its various components – and then decide on a course of action – is a valuable skill that can help manage generalised anxiety and depression. This is known as structured problem solving.

Medication

It is important that medications are seen as a short-term measure, rather than the solution to anxiety disorders.

Research studies have shown that psychological therapies, such as cognitive behaviour therapy, are much more effective than medications in managing anxiety disorders in the long term.

Support groups and education

Support groups allow people with anxiety to meet in comfort and safety, and give and receive support. They also provide the opportunity to learn more about anxiety and to develop social networks.