Anxiety Diagnosis
Diagnosing anxiety requires a comprehensive approach, including a physical examination and a thorough review of your personal history to rule out other medical conditions that may mimic anxiety symptoms.
Various self-assessment questionnaires and clinical assessments, such as the Zung Self-Rating Anxiety Scale and the Hamilton Anxiety Scale, are used to evaluate the level and severity of anxiety.
Effective management of anxiety involves a combination of medication, therapy, lifestyle adjustments, and open communication with family and friends.
Read on to learn more about the process of diagnosing anxiety.
During the physical examination
You should be completely honest with your doctor. Many things can contribute to or be affected by anxiety, including:
certain illnesses
medications
alcohol consumption
coffee consumption
hormones
Other medical conditions can cause symptoms that resemble anxiety. Many anxiety symptoms are physical, including:
racing heart
shortness of breath
shaking
sweating
chills
hot flashes
chest pain
twitching
dry mouth
nausea
vomiting
diarrhea
frequent urination
Your doctor may perform a physical exam and order a variety of tests to rule out medical conditions that mimic anxiety symptoms. Medical conditions with similar symptoms include:
heart attack
angina
mitral valve prolapse
tachycardia
asthma
hyperthyroidism
adrenal gland tumors
menopause
side effects of certain drugs, such as drugs for high blood pressure, diabetes, and thyroid disorders
withdrawal from certain drugs, such as those used to treat anxiety and sleep disorders
substance abuse or withdrawal
Diagnostic tests
It's suggested that you complete a self-assessment questionnaire before other testing. This can help you decide whether you may have an anxiety disorder or if you may be reacting to a certain situation or event. If your self-assessments lead you to believe that you may have an anxiety disorder, your doctor may then ask you to take a clinical assessment or conduct a structured interview with you.
Your doctor may use one or more of the following tests to assess your level of anxiety.
Zung Self-Rating Anxiety Scale
The Zung test is a 20-item questionnaire. It asks you to rate your anxiety from 'a little of the time' to 'most of the time' on subjects such as:
nervousness
anxiety
shaking
rapid heartbeat
fainting
frequent urination
nightmares
Once you complete this test, a trained professional assesses your responses.
Hamilton Anxiety Scale (HAM-A)
Developed in 1959, the Hamilton test was one of the first rating scales for anxiety. It's still widely used in clinical and research settings. It involves 14 questions that rate moods, fears, and tension, as well as physical, mental, and behavioral traits. A professional must administer the Hamilton test.
Beck Anxiety Inventory (BAI)
The BAI helps measure the severity of your anxiety. You can take the test by yourself. It may also be given orally by a professional or paraprofessional.
There are 21 multiple-choice questions that ask you to rate your experience of symptoms during the past week. These symptoms include tingling, numbness, and fear. Answer options include 'not at all,' 'mildly,' 'moderately,' or 'severely.'
Social Phobia Inventory (SPIN)
This 17-question self-assessment measures your level of social phobia. You rate your anxiety in relation to various social situations on a scale from zero to four. Zero indicates no anxiety. Four indicates extreme anxiety.
Penn State Worry Questionnaire
This test is the most widely used measure of worry. It distinguishes between social anxiety disorder and generalized anxiety disorder. The test uses 16 questions to measure your worry's generality, excessiveness, and uncontrollability.
Generalized Anxiety Disorder Scale
This seven-question test is a screening tool for generalized anxiety disorder. You're asked how often in the past two weeks you've been bothered by feelings of irritability, nervousness, or fear. Options include 'not at all,' 'several days,' 'more than half the days,' or 'nearly every day.'
Yale-Brown Obsessive-Compulsive Scale (YBOCS)
The YBOCS is used to measure levels of OCD. It's conducted as a one-on-one interview between you and a mental health professional. You choose three items from a symptom checklist that are the most disturbing and then rate how severe they are. Then, you're asked whether you've had certain other obsessions or compulsions in the past. Based on your answers, the mental health professional grades your OCD as subclinical, mild, moderate, severe, or extreme.
Mental health disorders that feature anxiety
Anxiety is a symptom in several disorders. Some of these include:
Disorder Symptoms
Panic disorder High amounts of anxiety as well as physical stress for a short amount of time; physical stress can come in the form of dizziness, a high heart rate, sweating, numbness, and other similar symptoms
Obsessive-compulsive disorder (OCD) Anxiety expressed as obsessive thoughts or as compulsive behavior that's acted upon repeatedly to relieve stress
Phobias Anxiety triggered because of a specific thing or situation that isn't necessarily harmful or dangerous, including animals, heights, or riding in vehicles
Social phobias Anxiety that's experienced in interpersonal situations, such as during conversations, in large social groups, or when speaking in front of a crowd
The broadest anxiety disorder, generalized anxiety disorder (GAD), is different from these other disorders because it doesn't necessarily relate to a specific cause or behavior. With GAD, you may worry about many different things at once or over time, and the worries are often constant.
Diagnostic criteria
An anxiety diagnosis depends a lot on your description of the symptoms you're experiencing. Mental health professionals use the 'Diagnostic and Statistical Manual of Mental Disorders' (often called the DSM) to diagnose anxiety and other mental disorders based on symptoms. The criteria differ for each anxiety disorder.
The DSM lists the following criteria for generalized anxiety disorder (GAD):
excessive anxiety and worry most days about many things for at least six months
difficulty controlling your worry
appearance of three of the following six symptoms: restlessness, fatigue, irritability, muscle tension, sleep disturbance, and difficulty concentrating
symptoms significantly interfering with your life
symptoms not being caused by direct psychological effects of medications or medical conditions
symptoms aren't due to another mental disorder (e.g. anxiety about oncoming panic attacks with panic disorder, anxiety due to a social disorder, etc.)
Anxiety diagnosis in children
Childhood and the teenage years are full of new, frightening experiences and events. Some children learn to confront and accept these fears. However, an anxiety disorder can make it difficult or impossible for a child to cope.
The same diagnostic criteria and assessments that are used for adults apply to children, too. In the Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5), your doctor interviews both you and your child about their symptoms.
Symptoms in children are similar to those in adults. If you notice anxiety symptoms or any anxious or worrying behaviors that last for more than two weeks, take your child to the doctor. There, they can be checked for an anxiety disorder.
Some research suggests that anxiety can have a genetic component. If anyone in your family has ever been diagnosed with anxiety or a depressive disorder, get your child evaluated as soon as you notice symptoms. A proper diagnosis can lead to interventions to help them manage anxiety at a young age.
What to do if you're diagnosed with anxiety
Focus on managing your anxiety rather than on ending or curing it. Learning how best to control your anxiety can help you live a more fulfilled life. You can work on stopping your anxiety symptoms from getting in the way of reaching your goals or aspirations.
To help manage your anxiety, you have several options.
Medication
If you or your child is diagnosed with anxiety, your doctor will likely refer you to a psychiatrist who can decide what anxiety medications will work best. Sticking to the recommended treatment plan is crucial for the medications to work effectively. Try not to delay your treatment. The earlier you begin, the more effective it will be.
Therapy
You might also consider seeing a therapist or joining a support group for people with anxiety so that you can talk openly about your anxiety. This can help you control your worries and get to the bottom of what triggers your anxiety.
Lifestyle choices
Find active ways to relieve your stress. This can lessen the impact that anxiety may have on you. Some things you can do include:
Get regular exercise.
Find hobbies that engage or occupy your mind.
Participate in activities that you enjoy.
Keep a daily journal of thoughts and activities.
Create short-term or long-term schedules.
Socialize with friends.
Also, avoid alcohol, nicotine, and other similar drugs. The effects of these substances can make your anxiety worse.
Communication
Be open with your family and close friends about your diagnosis, if possible. It's not easy to talk about any mental disorder. However, the more the people around you understand your anxiety, the easier it becomes to communicate your thoughts and needs to them.
Anxiety relief tips
Stick to the treatment plan recommended by your psychiatrist.
Consider seeing a therapist or joining a support group for people with anxiety.
Find active ways to relieve your stress, such as getting regular exercise or keeping a daily journal.
Be open with your family and close friends about your diagnosis, if possible.
Avoid alcohol, nicotine, and other similar drugs.
Focus on managing your anxiety rather than on ending or curing it.
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