Agitation (restlessness or anxiety) is a form of interference that show excessive motor activity and not intended or fatigue, usually associated with a state of tension and anxiety.
In some literature says that the agitation is psychomotor disorders that are characterized by an increase in motor activity and psychology in patients (their irritability). Movement goes back and forth in the room for no reason, the movement of wringing hands, took off the shirt and wear it again in the reverse condition, and unwarranted actions and other motor. In severe circumstances, the movement generated could endanger others, such as tearing, biting fingernails and biting own lips that give rise to the potential for bleeding due to trauma. Psychomotor agitation is a typical symptom that can be found in major depressive disorder or abnormal obsession and sometimes found in bipolar disorder, although this disorder is the result of excess stimulus received. Middle age (decade to 2 and 3) and old age is an age filled with risk of this disorder.
These symptoms may arise alone or accompanied by other mental disorders such as severe anxiety and delirium. Most agitation is a sign of brain dysfunction or acute cerebral insufficiency. This situation is common in cases of emergency, usually in adults, and is caused by various factors, of which can be due to a disease (metabolic disorders, sepsis-associated encephalopathy, treatment) and external factors (noise, discomfort, pain). Agitation is a serious problem with morbidity and mortality are quite large (connected causes metabolic disorders). The presence of accompanying symptoms that usually accompany these symptoms such as delirium worsens the prognosis of patients. Agitation can be caused by a variety of causes including a side effect of antipsychotic drug use.
Etiology
Here is the cause of agitation:
- Excess alcohol: Drinking alcohol is more than 15 glasses, (5 / day) per week for men and women as much as 8 glasses, (4 / day). Alcohol containing toxic material damage the nervous system and cause severe agitation.
- Caffeine.
- Cocaine, hallucinogenic drug, ephedrine.
- Cocaine dependence.
- Hyperthyroidism.
- Nicotine withdrawal.
- Opiate withdrawal.
- Theophylline or other treatment.
- Deficiency of vitamin B6; neurological effects.
Accompanying Symptoms of Acute Agitation
Besides agitation, some mental disorders can be observed, such as anxiety and delirium. Until now not known how the pattern of variation can lead to brain dysfunction mental disorders difference between the patients with other patients. Some patients only showed agitation, while others may be accompanied by two accompanying symptoms. Delirium (confusion), anxiety, extreme hyperactivity, and hostile to other people can be on the accompanying symptoms of extreme agitation.
Agitation can come suddenly or at a specific time. These symptoms could end up in a few minutes, a couple of weeks and even months. Pain, stress, and fever can increase the symptoms of agitation. Keep in mind that the agitation itself is not a sign of health problems. Nevertheless, if there is one other symptom occurs, the agitation could be a sign of the disease. When the agitation resulted in a change of consciousness and alertness in a couple of hours, the doctors said it was delirium (to be treated). The cause is generally in the form of alcohol abuse and infection (usually the parents).
Agitation is usually associated with the onset of the following symptoms:
a. Bipolar Disorder
This disorder usually occurs at age 15-25 years. This disorder is characterized by mood or condition that is passionate that can suddenly become depressed. Changes in mood between them can take place very quickly on one conversation. The main cause is interference on the part of the brain regulating mood.
b. Dementia (such as Alzheimer's disease)
The disease is usually about the age of 60 years. Alzheimer's is one of the rapidly deteriorating condition of dementia that gradually. Cause a disturbance in memory, thinking, and behavior. Memory loss as a problem to forget the language itself, the inability to decide something, fair and personality is part of the diagnosis.
c. Depression
Disorder characterized by feelings of sadness, not happy, feeling guilty, and aloof. These symptoms usually occur within a relatively short time. Agitation is one of the symptoms of depression symptoms are usually caused by stress and unpleasant environment. Symptoms of depression are:
- Problems in sleeping or excessive sleeping.
- Dramatic changes in appetite, often accompanied by weight loss.
- Fatigue and lack of energy.
- Feeling self-worthlessness, self-loathing, and self-blame that does not fit the actual situation.
- Extreme concentration problems.
- Agitation, irritability, and restlessness.
- Did not want to move and silent.
- Despair.
- Feeling of wanting to die and suicide.
- Major depression if five or more of the above symptoms for 2 weeks while if only 2-4 that appears so-called minor depression.
- Atypical depression takes place in 1/3 patients with symptoms of oversleeping and overeating.
- Dysthymia - lasted for 2 years.
Anxiety is a diffuse sensation of fear, which is not related to the actual danger. This sensation often occurs in patients due to stressful situations such as pain, noise, and loss of body control. Anxiety can be regarded as a normal phenomenon in patients. However, the incidence of anxiety that looks disproportionate to the cause or excessive anxiety can be considered pathological. Anxiety can also be associated with symptoms of ballast, dysautonomia or severe loss of self-control. The patient is relatively difficult to treat due to in-cooperative patients.
e. Delirium
Delirium is an acute change in mental status or mood fluctuation, which is associated with disorganized thinking, confusion, and changes in the level of consciousness. This phenomenon is often associated with acute confusion and symptoms that were encountered in the ICU in the form of an acute condition. Cognitive changes occur vary from day to day and reached its peak during the night. These symptoms are usually reversible which lasts a few days or a few weeks although some patients may occur permanent brain failure. Illusions and hallucinations also occur in patients. Florid delirium with severe agitation in patients with active delirium very easily identified. However, delirium may show symptoms of silent and quiet (hypoactive delirium). Both of them almost the same frequency of the discovery of the ICU.
Management
Much remains to be known about the prevention and treatment of agitation. First, it is unknown whether the time is detected and treatment of the patient's condition can affect the health of the next patient. Indications and type of therapy depends on whether the disorder is agitation accompanied by delirium that causes damage to the brain (brain as a passive victim of other organ abnormalities) or abnormalities in the brain (brain as active trigger) which causes the extracerebral organ dysfunction. Both questions are important to determine the therapeutic action. There are two governance can be done at home and in the hospital.
Home care
Quiet environment, sufficient lighting, quality sleep, and stress reduction can reduce the symptoms of agitation. Do not hold the patient's willingness excessive agitation as it may worsen the situation, for example, if he wants to move to run, let alone as long as it is still within normal limits (do not want to jump). Moreover, in the face of patient agitation act wisely and reasonable because in this way the patient will be easy to express feelings, improve mood and severity of agitation.