The Big Picture
Some anxiety is normal. An anxiety disorder is different because the fear or worry becomes extreme enough to affect normal functioning.
Different anxiety disorders can cause different patterns of fear. A person may experience sudden panic, intense fear of a particular situation, or severe anxiety connected with social situations or separation.
Traumatic experiences can also lead to ongoing symptoms. For CCAs, gentle care, respect, awareness of possible triggers, and attention to changes in a client’s willingness to complete daily care activities are especially important.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- anxiety disorders involve fears and worries that are out of proportion to the situation and affect normal functioning.
- panic is a sudden, intense feeling of fear, anxiety, terror, or dread without an obvious reason.
- A phobic disorder involves intense fear of a particular object or situation.
- trauma and stressor-related disorders can develop after a person experiences or witnesses major trauma.
- PTSD symptoms fall into three main categories: re-experiencing the trauma, avoiding reminders, and increased anxiety or arousal.
- Changes in a client’s willingness to complete certain activities of daily living may be a clue to PTSD and should be reported to the supervisor immediately and always documented.
Jump to:
Course Notes: Key Ideas You Need to Know
Understanding Anxiety and Anxiety Disorders
anxiety is a vague, uneasy feeling that occurs in response to stress. Some anxiety is normal.
anxiety disorders are a group of mental health disorders in which extreme anxiety is the main symptom. The person’s fears and worries are so out of proportion to the situation that normal functioning is affected.
Important facts include:
- Anxiety disorders affect about 5% of Canada’s population.
- Most begin during childhood and tend to continue when they are not treated.
- They are twice as likely to affect women as men.
- A person with extreme anxiety may feel dread or a sense that danger or harm is coming.
- Some people become severely limited by anxiety.
- Other people remain able to attend work or school.
Many anxiety disorders can be treated with medication. Clients generally notice fewer symptoms as long as they continue taking their medications continuously.
Panic Disorder
panic is an intense, sudden feeling of fear, anxiety, terror, or dread without an obvious reason.
During a panic attack, physical signs of fear can increase quickly. These can include:
- shortness of breath
- a racing heart
- sweating
- chest pain
The symptoms may feel similar to those of a heart attack.
A person experiencing panic disorder may also have:
- dizziness
- stomach pain
- nausea
- a feeling of losing control
- fear of dying or losing mental control
Panic attacks can happen at any time or place and may occur without warning.
After an attack, a person may fear having another one. The person may begin avoiding places where previous attacks occurred. For some people, this fear becomes so strong that they cannot leave home.
Panic disorder:
- occurs more often in women than men
- usually begins in young adulthood
- often begins during periods of excessive stress
- may last for months or years
Treatment can include helping the client recognize and change thought patterns before they lead to a panic attack. A doctor may also prescribe medication.
Phobic Disorder
A phobia involves fear, panic, or dread. A person with a phobic disorder has an intense fear of a particular thing or situation.
A phobia may develop after an upsetting event. A person may know that the fear is exaggerated and may feel embarrassed by it.
Two examples are:
- Agoraphobia: fear of open, crowded, public places.
- Claustrophobia: fear of small, enclosed places.
Symptoms of phobic disorder can include:
- excessive worry
- sleep problems caused by worrying
- fatigue or irritability
- difficulty concentrating
- increased sweating
- heavy breathing
- irregular heartbeats called palpitations
- dizziness or faintness
- muscle pain or tension
- diarrhea caused by interference with digestion
Other Anxiety Disorders
Separation Anxiety Disorder
Separation anxiety disorder involves persistent and excessive worry about losing an important attachment figure, such as a parent or significant other.
The person may:
- resist leaving home because separation would occur
- have nightmares about losing the attachment figure
Selective Mutism
Selective mutism lasts for a month or longer.
The person consistently cannot speak, or is extremely reluctant to speak, in a particular social situation even though the person can speak in other situations.
Social Anxiety Disorder
Social anxiety disorder involves severe distress or anxiety in one or more social situations where the person may face criticism or rejection.
These feelings last for more than 6 months.
Trauma and Stressor-Related Disorders
trauma and stressor-related disorders are anxiety disorders that can develop after a person experiences or witnesses major trauma.
Traumatic experiences may overwhelm the person’s usual psychological ways of coping.
Examples of traumatic events include:
- residential schools
- war
- fires
- accidents
- burns
- torture
- kidnapping
- concentration camps
- incest
- violent crimes
Post-Traumatic Stress Disorder
Post-traumatic stress disorder, or PTSD, is a trauma and stressor-related disorder.
It can occur in people of all ages, ethnicities, cultures, and genders.
Signs and symptoms can include:
- vivid nightmares about traumatic events
- nervousness or feeling on edge
- avoiding things that bring back memories of the trauma
- difficulty concentrating
- difficulty sleeping
- feeling a loss of control
The Three PTSD Symptom Categories
People with PTSD have at least one symptom in each of these three categories:
- Reliving or re-experiencing the trauma
- Avoiding reminders of the trauma, including thoughts, situations, or people
- Increased anxiety or arousal, which may include constantly watching for danger and being easily startled
People living with PTSD are also more likely to experience:
- substance abuse
- phobias
- chronic pain
- poor concentration
- sleep disturbances
- extreme anxiety
Some people may become easily angered. Others may experience overwhelming guilt because other people died while they survived.
Supporting a Client With an Anxiety Disorder
Avoid: Keep the client away from situations known to cause anxiety. For example, if a client fears small, enclosed spaces, keep the client away from them.
Avoid conversations about subjects known to cause anxiety. Guide the conversation toward other topics.
During Extreme Anxiety or a Panic Attack
CCA action: Provide comfort and stay with a client who is extremely anxious or having a panic attack.
When appropriate:
- use touch for reassurance
- offer a small number of clear choices
- make decision making simpler so additional stress is not created
Report: Tell your supervisor about the situation.
PTSD in Children
Children who have experienced traumatic events may develop:
- fear of darkness
- fear of being alone
- separation anxiety
- nightmares
- stomach aches
- headaches
Children may also be afraid to discuss the traumatic event with their parents because they fear upsetting them.
PTSD in Older Persons
PTSD signs and symptoms in older people are often similar to those seen in children.
An older person may have experienced trauma many years earlier. Major changes later in life may trigger PTSD symptoms.
Possible triggers include:
- deaths of friends or family members
- sudden loss of regular social contact
In long-term care, rough treatment or feeling a loss of control while receiving care may also trigger PTSD symptoms.
Supporting a Client With PTSD
Clients with PTSD should be treated according to the DIPPS principles.
Personal care should be:
- gentle
- respectful of the client’s privacy
Clients should have opportunities to talk or reminisce about their experiences.
Avoid promising the client that everything will be fine.
A traumatic event may have happened long ago, and PTSD symptoms can be triggered at any time.
Watch for Changes During Activities of Daily Living
Be alert to changes in a client’s willingness to complete activities of daily living (ADLs).
A change in willingness to be:
- toileted
- dressed
- undressed
- bathed
- fed
may be a clue that the client has PTSD.
Report: Report this type of reaction to the supervisor immediately.
Document: Always document the reaction.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition gives specific ways to support clients experiencing anxiety or PTSD. Current Nova Scotia standards place this support within the CCA’s Social and Mental Well-being competency. In Nova Scotia, the CCA monitors a person’s behaviour and changing needs while providing care, reports changes when required, and responds to behavioural expressions using planned interventions and strategies.
Nova Scotia also uses the term point of care assessment for the CCA’s ongoing observations before, during, and after care. This is an observational assessment, not a nursing assessment. The CCA uses these observations to recognize changes that need to be escalated, while following the care plan and employer requirements for reporting and documentation.
Why this matters in Nova Scotia: The CCA supports and observes the person’s mental well-being, but the CCA’s assessment role remains observational and does not include the comprehensive evaluation used to make care-planning decisions.
Official source: Continuing Care Assistant Occupational Standards of Practice (novascotiacca.ca)
Last checked: October 6, 2026
Exam Clue Words
- Avoid: Known anxiety-producing situations and subjects should be avoided when supporting a client with an anxiety disorder.
- Report: An episode of extreme anxiety or a panic attack should be reported to the supervisor.
- Immediately: A change in willingness to complete certain ADLs that may be a clue to PTSD should be reported to the supervisor immediately.
- Document: A reaction involving a change in willingness to complete those ADLs should always be documented.
Fast Review
Focus on the facts that help you separate the disorders and remember the CCA’s supported actions.
- anxiety is an uneasy feeling in response to stress. Some anxiety is normal.
- anxiety disorders involve extreme fears or worries that interfere with normal functioning.
- Anxiety disorders affect about 5% of Canada’s population and are twice as likely to affect women as men.
- panic begins suddenly and can include rapid physical symptoms such as shortness of breath, a racing heart, sweating, and chest pain.
- A phobic disorder involves intense fear of a particular thing or situation.
- Separation anxiety disorder involves excessive worry about losing an important attachment figure.
- Selective mutism involves being unable or extremely reluctant to speak in a particular social situation for at least a month despite being able to speak in other situations.
- Social anxiety disorder involves severe distress or anxiety related to social situations and lasts more than 6 months.
- PTSD symptoms include re-experiencing trauma, avoiding reminders, and increased anxiety or arousal. A person with PTSD has at least one symptom in each category.
- Extreme changes in an older person’s life, rough treatment, or feeling a loss of control during care may trigger PTSD symptoms.
- During extreme anxiety or a panic attack, stay with the client, provide comfort, use touch to reassure the client if appropriate, offer limited clear choices, and report the situation to the supervisor.
- A change in willingness to complete certain ADLs may be a clue to PTSD. Report the reaction immediately and always document it.
Final Pep Talk
There are several disorders and symptom patterns in this topic, so focus first on what makes each one different. Then review the PTSD categories and the specific actions you need to remember when supporting a client.