How are Anxiety Disorders Diagnosed?

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Many people notice their anxiety at first as physical symptoms, such as heart palpitations, chest pain, difficulty breathing and profuse sweating. While these symptoms are usually completely harmless, it is important to consider that in some cases anxiety can be caused by medical conditions, such as heart disease, thyroid problems, diabetes and anemia. Therefore the first step when dealing with anxiety symptoms is to undergo a thorough physical check-up to test for any underlying illnesses, which may have been masked by the emotional challenges.

The doctor will also inquire about other contributing factors of anxiety disorders, in particular family history, recent life changes, dietary habits, caffeine intake and alcohol and recreational drug consumption. Once physical illnesses have been ruled out, the next step is often a referral to a psychiatrist for further evaluation. Besides diagnosing the severity of the anxiety disorder, the psychiatrist also examines, whether a person is dealing with other frequently co-occurring mental illnesses, such as depression, bipolar disorder and ADHD.

There are a variety of tests and assessments psychiatrists employ to evaluate a person for an anxiety disorder. Many of these tests rely on the criteria documented in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to these diagnostic criteria someone suffers from generalized anxiety disorder if he or she experiences:

• Intense worry and anxious feelings during most days for at least six months.
• Difficulties controlling the worry.
• At least three of the following six symptoms: feeling restless or on the edge, fatigue, difficulty concentrating, irritability, muscle tension or sleep issues. One or more of these symptoms need to be present for most days of the week during the past six months.
• Significant distress or impairment of daily life activities due to worry and anxiety.
• Anxiety, which doesn’t focus predominantly on the worry of having a panic attack (as in panic disorder), getting humiliated by others (as in social anxiety disorder) or encountering a specific object or situation (as in phobias).
• Worry and anxiety, which are not related to physiological illnesses, substance abuse or other mental health conditions.

Doctors often use one of the following tests to more accurately evaluate the severity of the anxiety:

Hamilton Anxiety Scale (HAM-A)

The HAM-A test involves 14 questions, which assess moods, fears, tension, sleep, physical, intellectual and behavioral symptoms on a scale from 0 (not present) to 4 (severe prevalence).

Beck Anxiety Inventory (BAI)

This test includes 21 questions, which evaluate to what extend a person has experienced common anxiety symptoms during the last week. The symptoms, such as numbness, tingling, sweating, fear are rated as “not at all,” “mildly,” “moderately,” or “severely.”

Penn State Worry Questionnaire

With 16 questions this widely used test measures the intensity, controllability and frequency of worry. It is also utilized to discern between generalized anxiety disorder and social phobia.

For many people it is difficult to distinguish whether their anxiety is an appropriate reaction to for example difficult circumstances, or whether they are dealing with an anxiety disorder. If you have been continuously anxious for several months and find that your worries and emotions consume your energy and affect your ability to function, the first step to find relief is to visit your doctor to get an accurate diagnosis.

References:

Current Diagnosis and Treatment of Anxiety Disorders
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628173/

DSM-5: Changes to the Diagnostic and Statistical Manual of Mental Disorders
http://www.adaa.org/understanding-anxiety/DSM-5-changes