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Symptom Management


Anxiety is a common symptom among patients with a life-threatening disease, sometimes occurring with depression.

Characteristics of anxiety include:

Feelings of fear, worry or apprehension
Additional symptoms, such as tension, restlessness, jitteriness, insomnia, fatigue, distractibility, shortness of breath, numbness or muscle tension
Long duration (generalized anxiety) or short, intense bouts (panic attacks)

Causes of anxiety can include:

Difficulty adjusting to the illness
Common fears about death, including isolation and separation
Poorly-controlled pain
Side effects of medication
Withdrawal from benzodiazepines or opioids, if these are decreased abruptly
Medical conditions, such as dehydration, electrolyte imbalance, or withdrawal from drugs such as nicotine or alcohol.

Some anxiety is a normal response to the frightening situation facing patients with a life-threatening illness. However, if anxiety begins to cause the patient distress, there are several treatment options.

Treatment of anxiety can include:

Stress management techniques, such as progressive relaxation, guided imagery and hypnosis
Support from family, friends, spiritual leaders and peers
Control of pain, side effects from medication and other medical conditions, where possible

Medication can include:

Other tranquilizers, such as the phenothiazines and haloperidol
Antihistamines, especially hydroxyzine

Counseling for Anxiety

Counseling can help patients with a life-threatening disease by:

Establishing a bond to decrease the patient's sense of isolation
Fostering a sense of self-worth
Correcting misconceptions about the past and present
Integrating the present illness into a continuum of life experience
Emphasizing past strengths
Supporting ways of coping that the patient has used successfully in the past
Helping the patient meet interpersonal goals, such as reconciling differences with a family member or maintaining relationships with friends
Exploring issues of separation, loss and the unknown that arise when facing death
Addressing practical concerns
Addressing needs of the family and other caregivers.


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