Diagnosis of Anxiety

OVERVIEW

The diagnosis of anxiety is not an easy one to make. Unlike diseases that have recognizable causative organisms, anxiety presents in varying modes and may even be associated with a medical condition. For the diagnosis of anxiety to be made, a good history taking and physical examination should be conducted so as to enable the doctor to exclude other possible illnesses that may cause the symptoms seen or other possible causes that the symptoms may have over-shadowed. An individual history is particularly important to aid in making a diagnosis.

WHAT HAPPENS DURING THE PHYSICAL EXAMINATION?

When speaking to a doctor, try to be very transparent and do not omit vital information. Plenty contributors to anxiety include:

• Some diseases
• Drugs
• Alcohol intake
• Coffee intake
• Hormonal factors

Other disease conditions exist that may produce signs and symptoms suggestive of anxiety. The possible symptoms of anxiety include:

• Increased heart rate
• Shortness of breath
• Tremors
• Sweating
• Chills
• Chest pain
• Convulsions
• Dry mouth
• Nausea
• Vomiting
• Diarrhea
• Urinary frequency
• Hot flushes

The doctor handling your case may ask you to do some tests so as to exclude other possible causes or similar conditions, this is usually after a physical examination has been carried out. Disease conditions where the symptoms resemble anxiety include:

• Heart attack
• Chest pain (angina)
• Mitral valve prolapse
• Tachycardia
• Asthma
• Hyperthyroidism
• Adrenal gland cancers
• Menopause
• Side effect of some medications like anti-hypertensive drugs and anti-thyroid drugs
• Substance abuse or withdrawal

DIAGNOSTIC TESTS

It is advised that before you proceed to carry out this test, you fill a self-assessment questionnaire. The result gotten will help you to know if you may really be having an anxiety disorder or if the symptoms are due to the body’s response to a life event or circumstance.

If the results make you believe that an anxiety disorder is present, the doctor will then put you through an assessment done clinically or he performs an organized interview with you.

The following tools may be used by the doctor for the clinical assessment:

Zung self-rating anxiety scale

This is a questionnaire-based form consisting of twenty items. You are to grade your anxiety from “a little of the time” to “most of the time” on headings such as:

• Nervousness
• Anxiety
• Tremors
• Racing heartbeat
• Fainting
• Urinary frequency
• Nightmares

The answers you give are being assessed by a skilled professional.

Hamilton anxiety scale

This was introduced in 1959 and it was one of the earliest grading scales for anxiety. It is still being used globally in clinics and for research purposes. It is comprised of 14 questions that grade mood, fears and tension including some character a person demonstrates like the physical, mental and behavioral. This test is only administered by a professional.

Beck anxiety inventory

This assists in evaluating the depth of anxiety. It can be self-administered. It can be conducted orally too by a professional or near-professional.

It is comprised of 21 questions with various choices to make. These questions need you to grade the symptoms you noticed over one week. The symptoms include numbness, tingling sensation and fear. The answers are “not at all”, “mildly”, “moderately” or “severely.”

Social phobia inventory

This is self-administered. It consists of 17 questions that quantify one’s social phobia level. The anxiety is usually graded on a scale of 0 – 4 where zero represents no anxiety and 4 is for the highest form of anxiety.

Penn state worry questionnaire

This measures worry. It differentiates between social anxiety disorder and generalized anxiety disorder. It consists of 16 questions that measure some attributes of worry including its generality, excessiveness and uncontrollability. It is the commonest measure of worry globally.

Generalized anxiety disorder scale

This comprises of 7 questions that check for generalized anxiety disorder. It is a screening test where you are asked about the frequency in two weeks of your being burdened by such feelings as irritability, nervousness or fear. The answers include “not at all”, “several days”, “more than half the days”, or “nearly every day”.  

Yale-brown obsessive compulsive scale

This scale is interviewer-administered. The interviewer is likely a professional in mental health. A symptom checklist is shown to you and you select 3 symptoms that disturb the most and grade them based on how severe they are. Following the answers you give, a past history of an obsessive compulsive disorder can be elicited. The disorder is classified as being subclinical, mild, moderate, severe or extreme.

MENTAL HEALTH CONDITIONS THAT HAVE ANXIETY AS A FEATURE

Many conditions have anxiety as a feature. Examples include:

Panic disorder: is characterized by increased amounts of anxiety along with bodily stress which lasts for a short time, bodily stress may manifest as dizziness, racing heartbeat, sweating and numbness.

Obsessive compulsive disorder

Here, anxiety is shown as impulsive uncontrollable attributes that are done repeatedly to alleviate stress.

Phobias

Are anxiety conditions brought on by a particular thing or a condition may not actually be dangerous or hurtful such as the fear of heights, animals or taking a ride in vehicles.

Social phobias

They are fears encountered in relation to people such as that occurring during talks with people, in a large crowd, or even in a social gathering.

Generalized anxiety disorder which doubles as the widest type of anxiety disorder is distinguished from the others by the lack of a particular cause or behavior. Plenty things may be disturbing someone at the same time or over time in generalized anxiety disorder though this worry is always there.

DIAGNOSTIC CRITERIA

To make a diagnosis of anxiety, the bulk of information needed to make this diagnosis rests on the history of symptoms experienced. The “Diagnostic and Statistical Manual of Mental Disorders” also called DSM is being used to diagnose anxiety disorders and other conditions by mental health specialists. This DSM has specific symptoms which are different for a particular anxiety disorder.

According to DSM, a diagnosis of generalized anxiety disorder is made when the following criteria are met:

• Excessive anxiety and worry about many things on most days for at least six months
• Difficulty in controlling worry
• Having any 3 of the following 6 symptoms: restlessness, irritability, fatigue, loss or difficulty in concentrating, muscle tension and sleep disturbance
• Symptoms that intermeddle greatly with life
• Symptoms that are not as a result of intake of a drug with psychological effects or medical condition
• Symptoms not caused by another medical condition e.g. being anxious about the panic attacks that will occur in someone with panic disorder.

DIAGNOSIS OF ANXIETY IN CHILDREN

Growing years in a child’s life are filled with some novel, scary encounters and events. Certain children find ways to deal with and take the fears. The presence of an anxiety disorder makes this handling of fear hard to do and the child will almost not be able to cope.

Similarities exist between the diagnostic criteria for adults and also for children. When an interview schedule for anxiety and related disorders is being held, the child is interviewed alongside the parents by the doctor.

The symptoms experienced by adults can also be experienced by children. Take your child with you to the hospital any time you observe anxiety symptoms or if the child is worried for more than two weeks about something. The doctor will then evaluate for anxiety disorder.

Some schools of thought propose anxiety as having a genetic linkage. If you have a family history of anxiety disorder, take your child for assessment immediately when you observe symptoms. Early diagnosis can assist in the management of anxiety at that tender age.

WHAT DO I DO IF DIAGNOSED WITH ANXIETY?

Rather than attempting to cure the anxiety, try to manage the anxiety. Develop personal ways through which you can effectively control the anxiety and live a normally functional life. Try to make sure that anxiety doesn’t interfere with your daily life and productivity.

The various options for managing anxiety include:

• Drugs: when a diagnosis of anxiety has been made, the doctor refers you to a mental health specialist for expert management. It is the specialist that will determine which drug is best for the individual patient. Adherence to treatment regimen is needed for effectivity. Do not post-pone treatment as the earlier treatment begins, the better the outcome.
• Therapy: a therapy session may be indicated either as a lone therapy or a group therapy where people with similar conditions are present. This aids in controlling anxiety and getting to know the triggers for anxiety.
• Lifestyle choices: find ways to live and maintain a productive life free of worries or free of the negative impacts of anxiety. Possible lifestyle choices include: exercising regularly, getting hobbies that keep you busy, doing activities you like, having a daily record of your thoughts and deeds, prior creation of schedules and hanging out with friends.

In addition, do away with alcohol, tobacco and other drugs of abuse. The anxiety can be exacerbated by these substances.

• Communication: talk to your close friends and family about the diagnosis. This is because their knowledge and understanding of the condition makes you more relaxed to talk to them about your needs and thoughts. It is usually not easy to talk about a mental condition to people.

TIPS NEEDED FOR ANXIETY RELIEF

• Be adherent to the treatment plan approved by your psychiatrist
• Visit a therapist or join a support group with similar people
• Discover ways to relieve stress such as exercises or hanging out with friends
• Talk openly to your family and friends about the condition
• Do away with alcohol, nicotine and similar drugs
• Rather than attempting to cure the anxiety, try to manage it