Anger is an emotion characterized by a strong feeling of annoyance, displeasure, or hostility toward someone or something you feel has deliberately done wrong. According to Berger “Anger is an emotional state that varies in intensity from mild irritation to intense fury and rage”. Sometime anger can be a good thing because it gives us a way to express negative feelings until it get worst. Intensity of anger depends on the situation. For anger people most commonly says that “Anger deprives a sage of his wisdom, a prophet of his vision”(Talmud).Situation in which anger is appropriate, then it has normal behavior but if anyone get angry more easily on minor incidents or situations and more intensely than the average person then, it is bad for health.
Angry person shows some physical signs which are clenching of jaws, teeth grinding, flushed (red and hot, typically as the result of illness or strong emotion), filling hot in the neck and face, trembling,goose bumps, headache, increase and rapid heart rate, dizziness, and person becoming hyperactive (Mills, 2005). Excessive anger can cause problem and harm to physical health (Weakened immune system,decrease GI mortality, imbalance reproductive hormones, cause cardio vascular disease, Disturbed nervous system) and mental health (Lowered mood, increased pessimism, anxiety and irritability) (Efron, p. 6).Recently It was observed in karwan -e- hayat that, all students were engaged in activities with patients suddenly the nurse came n went at with a patient, and the patient started to shout and show verbal gestures and abused to nurse continuously. So nurse decided to restrain. At this situation patient is trying to hide their mistake but it doesn’t mean that we have to punish her. This situation is very sorrowful for us. As a nurse first we need to calm down the patient’s frustration and peacefully solve the misunderstanding, on this situation no need of restrain. According to American nurses association restrain should be the last option when no practical option is available. Another scenario was seen in clinical area. A 26 year old patient was planned for diagnostic procedure. He and his son arrived on time suddenly they were told that the surgery was delayed until late afternoon but at midafternoon they were told that due to many emergency surgeries, the surgery would be postponed for one day. Already patient was anxious about procedure and then surgery was cancelled so patient become angry and got frustrated on nurses and doctors. But his behavior was unnoticed by nurses and doctors. On this situation nurse should need to calm the patient, keeping him well-informed of relevant information and offering support and comfort.
Mangment of anger varies according to the situation but the goal of anger management is same, to reduce both emotional feelings and the physiological arousal that anger causes. Generaly we need to teach the client how to control their anger and distract the mind.There are many strategies which help in managing the anger but some of them are appropriate for patient. Firstly we asked patient try to identify when and where they feel angry, identify the triggers, because if patient don’t know why they are getting angry, it’s very difficult to control anger. After knowing the reason patient should learn and understand about relaxation techniques such as deep breathing exercise, relaxing imaginary etc. Encourage patient to change their thinking, identify positive approaches, reflect your behavior and start thinking logically about the situation. Once patient thinks in a positive manner then need to focusing on problem solving and try to neglecting your frustration and perceiving the situation positively. That is the way, by which patient can control and manage the anger. According to Neil (2010) some more anger management techniques which helpful when triggers in front of you, try to distract yourself for the single moment e.g. start counting, changing place etc., then calm down yourself. After some space talk to your family members and friends and share your feelings and try to resolve the situation because suppression is also not good for health it can show worst effect after few years.
Depression is another most common negative emotion seen in patients. We also often use the expression “I’m feeling depressed” when we were feeling sad or distress. Depression is happen to all patients due to disease. According to Lexicon (2009) “Depression is a mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation (or less frequently agitation), with drawal from social contact, and vegetative states such as loss of appetite and insomnia”. Patent donot able to understand what is happening with them because due to depression they have physical problem rather than mental. They only think because of tiredness they are depressed, nothing to worried about it But if the person shows five or more of the following physical symptoms, it’s likely you are depressed these symptoms are, patient being restless, agitated, irritated, sleep disturbance, loss of energy, loss of appetite, weight loss, wants to cry, feel pain without any physical cause, distress spirituality, low self- esteem, losing interest in your pleasures activity, feeling helpless, most dangerous is self-harming (patient try to harm his/her self, suicidal ideation occur and may be attempt suicide). Causes of depression vary from person to person and can occur through a combination of inter-related factors. Some of us are more prone to get depression than others. Most common causes are biochemical imbalance, neurotransmitters do not function normally which interferes in signal transmit ion and cause depression and stress, some stressful events such as relationship break-up, persist and lead to depression.
It was noticed that A 18 yr. old female patient was not participated in activity, her social interaction was impaired, when I am trying to talk to her she refused to talk, when nurse called her for occupational therapies they did not response and went away. When I was asked doctor about her, doctor told me that she is depressed due to family problem. No one tried to communicate her. Isolation makes depression worst, on that situation we need to involve patient in social interaction and should maintain close relationship with them. Encourage patient for sharing their problems with his/her loved ones or whom they trust, and ask patient to trusting their family members because they help and support you. However, support plays a big role in lifting the fog of depression and keeping it away. Teaching for depression is must, we should teach the patient in such a way, we ask patient to express your feelings rather than suppress. Being envolve in such activities and keep yourself around other peoples more and more, social activities is very important like sports, running, dancing, cycling and walking, join a support group which help you how to deal with depression and reducing your isolation and give advice how to cope. You need to do things that will improve the way you feel about yourself. Allow your mind to understand positive aspects and reinforce the idea that you deserve good things. Pay attention to your personal appearance. Set yourself goals that you can achieve and that will give you a sense of satisfaction. These all are the psychological treatment while depression also treated with medication called antidepressant. This medication regulates the neurotransmitters and balances the chemicals in the brain to improve mood.
Another emotion which is universal expirienced emotion is anxiety. It is also a negative emotion that is a strange to no one. Anxiety is an emotion that arises in response to how we interpret or appraise a situation. According to oxford dictionary “anxiety is a feeling of worry, nervousness, or unease about something with an uncertain outcome. Anxiety is experienced on four levels according to intensity: mild, moderate, severe and panic anxiety. Basically anxiety gives allerting signals and warn of an internal or external threat, it has life saving qualities. In other words, we says that the way the body responds to danger it is due to anxiety. The fight or flight response prepares the body for action and your body become ready to fight. Anxious patient show variety of physical symtoms, most common are sweating, change in appetite, insomnia, chest pain, shortness of breath etc. and also shown cognitive symtoms which are lack of concentration, distractibility, decreased problem solving, negative thinking.
When I was assigned in OR. It was seen that A 72 yr old male schedualed for hand surgery, patients responses and facial epressions indicated that patient was anxious.when nurse asked him whats your feeling about surgery? He won,t be replied. Then nurse quitly move to next patients. At that time nurse need to assess patients anxiety. When patients is on Preopreative area the anxiety must be on peak due to surgery process and outcome. On that situation we need to work on decrease anxiety level rather than neglect. According to Bailey (2010). Preoperative education and musical therapy successfully reduce the preoperative anxiety. Actualy anxiety is short particully for situation, and goes away and the causes can be redused by own but in some circumstances we have to relieve it by such actions as these: picturing yourself successfully facing the specific fear, talking with sopportive person such as familt, friends etc. listening music, resting in a dark rum, deep breathing exercises etc. high levels of anxiety can cause physical tention in the jaw, neck and back as well as an emotional somatic feelings in the pit of the stomach, which will manage according to causative factors of anxiety.
According to Suls & Bunde (2005) all of these emotions evaluated in a single study; risks factors for cardiovascular disease are anger, anxiety and depression. Due to the outburst of chronic and intense negative emotions activate the sympathetic nervous system, which increase blood pressure, heart rate and myocardial oxygen demand which can lesd to cardiovascular disease.