Diagnosis of Anxiety Neurosis
The diagnosis of anxiety disorders is made on the basis of clinical presentation. It is often complicated by a large number of causes and types of anxiety and also by the range of disorders that may include anxiety as a part of their symptoms. Many patients who suffer from anxiety disorders have features or symptoms of more than one disorder giving a mixed picture.
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A doctor examining an anxious patient will usually begin by ruling out diseases that are known to cause anxiety and then proceed to take the patient's medication history, in order to exclude side effects of prescription drugs. Most doctors will ask about caffeine consumption to see if the patient's dietary habits are a factor. The patient's work and family situation will also be discussed.
Anxiety neurosis and related anxiety disorders are mostly diagnosed clinically by trained doctors. Some of the following symptoms are to be considered in the diagnosis of anxiety disorders:
- Sudden episodes and anxiety or mental discomfort, stressed feeling
- Worries - Out of proportion. Over-worrying, prolonged worrying, and brooding over matters which do not need much worrying
- Tendency to get disturbed, upset, and unrestful, with small, trivial matters
- Anticipating negative outcomes, 'something wrong will happen', 'what if things will not go right?' kind of thoughts
- Negative thoughts - Thinking of failure, unfavourable outcomes, etc.
- Anxiety or worries or stress make one restless, exhausted, weak, and sleepless, and some physical symptoms such as aches, pain, headache, and the like
- Fear or phobias - Fear of loss, fear of the future, fear of disease, fear of infection, and fear of loss of loved ones, are among the most common fears
- Trigger factor: Episodes of anxiety may get triggered by some of the following points: Illness, loss of business, loss of job, financial loss, sex, accidents, loss of relatives, etc.
- Panic attacks: Panic attacks are those experiences where the patients feel sudden, intense fear or anxiety, with exhaustion, weakness, fatigue, sinking feeling, sense of insecurity, chest discomfort, chest pain, palpitation, sweat, etc. Panic attacks could be recurring and may often affect one's sleep in form of nightmares
- Anxiety-related to space: Anxiety in closed places like bathrooms, and lifts, is called Claustrophobia. Such fears are due to the sense of an inability to escape in case of some problem, Similarly, fear or discomfort in open spaces is called Agoraphobia.
- Anxiety disorder could often present with Irritability, anger, and frustration. A tendency to get annoyed easily, show irritability, and throw into a rage could be a part of the presentation of Anxiety disorder which may help the physician diagnose the disease.
The severity of Anxiety disorders
Diagnosis of the severity of Anxiety is made on the basis of frequency, severity, and duration of episodes of anxiety; as well as on the response to medicines. Patients who are dependent on chemical-based medicines for a longer time may be considered more severe and resistant to treatment.
Laboratory tests
Lab tests for blood sugar (for diabetes) and thyroid function (for Hyperthyroid or Underactive thyroid (Hypothyroid) are also commonly done. There are no laboratory tests that can diagnose anxiety, although the doctor may order some specific tests to rule out disease conditions. Although there is no psychiatric test that can provide definite diagnoses of anxiety disorders, there are several short-answer interviews or symptom inventories that doctors can use to evaluate the intensity of a patient's anxiety and some of its associated features. These measures include the Hamilton Anxiety Scale and the Anxiety Disorders Interview Schedule (ADIS).
Diagnosis by a detailed Clinical evaluation
A clear diagnosis of anxiety neurosis or anxiety-related disorders is concluded only through a detailed clinical evaluation. A physician should spend quality time with the patient to evaluate the cause of the problem, A detailed questionnaire also helps in case the patient needs to be treated remotely or online. The empathetic approach in the case evaluation helps understand the diagnosis, the causes, and in turn, that helps to determine the treatment.
Written & Approved by-
Dr. Rajesh Shah
M.D. (Hom.)