Understanding Behavior in HD.final.8-18-05 - Huntington's Disease ...

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Many chronically ill patients hide multiple medication bottles “in case I need them” all over the house,
apartment or room. An occasional unobtrusive check while the person with HD is bathing or eating may be
wise. It is not only suicide that is problematic but a decision such as “I’m not right today—I need to take a few
of those pills.”
ANXIETY
DEFINITION
It is common for an individual with any chronic progressive illness to experience some excess anxiety, or
worries, about the future. Oftentimes, however, symptoms of anxiety can become so severe that they are
problematic. Anxiety can present in a variety of ways, including general nervousness, restlessness, repetitive
thoughts about troublesome topics, fidgeting hands, shallow breathing, sweating, rapid heart rate, fear or panic.
Typically, anxiety symptoms are worse when individuals are in new situations or perceive themselves to have
insufficient skill to handle a situation. Often, anxiety is associated with depression. Many individuals with HD
find that they worry more than they used to. Even about seemingly trivial matters, excess worry occurs. For
instance, several patients have reported that the day prior to a doctor’s appointment is particularly anxietyridden.
When anxiety symptoms become severe, other anxiety disorders can be present, such as panic disorder or
obsessive-compulsive disorder. Panic disorder is characterized by an acute onset of overwhelming anxiety and
feelings of dread often accompanied by rapid heart rate, sweating, hyperventilation, light-headedness or
numbness and tingling of fingers and toes. The symptoms typically last about 15 minutes, but residual anxiety
often remains. Obsessive-compulsive disorder is characterized by senseless recurrent intrusive thoughts or
impulses (obsessions) that are anxiety-provoking. Compulsions are repetitive behaviors that are performed over
and over, sometimes in response to an obsession or as part of a stereotyped routine that must be followed. The
most common obsessions tend to focus on cleanliness (such as washing hands) or safety (such as checking to
make sure the stove is turned off). Although true panic and obsessive-compulsive disorders are rare in HD, they
can occur. More common are components of these anxiety disorders, such as obsessive preoccupation with
particular ideas.
STRATEGIES TO AVOID ANXIETY
• Establish routines and stick to them.
• Keep the environment simple.
• Keep demands simple (one step at a time).
• Refrain from discussing future stressful events until the day before.
• Plan on changes in routine and compensate for these stressful times.