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The Stress of Cancer: When to Seek Help
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Overcoming Anxiety
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When Worries Surface at Night: Sleep and Anxiety
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Treating Anxiety
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Diagnosis
The diagnosis of anxiety is difficult and complex because of the variety of causes and the highly personalized and individualized nature of its symptom formation. When a doctor examines an anxious patient, he or she will first rule out physical conditions and diseases that have anxiety as a symptom. Apart from these exclusions, the physical examination is usually inconclusive. Some anxious patients may have their blood pressure or pulse rate affected by anxiety, or may look pale or perspire heavily, but others may appear physically normal. The doctor will then take the patient's medication, dietary, and occupational history to determine if they are taking prescription drugs that may cause anxiety; if they are abusing alcohol or mood-altering drugs; if they are consuming large amounts of caffeine; or if their workplace is noisy or dangerous. In most cases, patient history is the most important source of diagnostic information. The doctor may administer a brief psychological test to help evaluate the intensity of the patient's anxiety and some of its features. Some tests that are often performed include the Hamilton Anxiety Scale and the Anxiety Disorders Interview Schedule (ADIS). Many doctors will check a number of chemical factors in the blood, such as the level of thyroid hormone and blood sugar.
The diagnosis of GAD is made when a person experiences anxiety coupled with physical symptoms that exists a majority of the time over a six-month period. The following conditions must be ruled out to confirm the GAD diagnosis:
- cardiovascular disease
- pulmonary disease
- myasthenia gravis
- alcohol and substance abuse
Treatment
Not all patients with anxiety require treatment, but for more severe cases, treatment is recommended. Because anxiety often has more than one cause and is experienced in highly individual ways, its treatment usually requires more than one type of therapy. In addition, there is no way to predict how patients will respond to a specific drug or therapy. Sometimes, the doctor will need to try different medications or methods of treatment before finding the best combination for the particular patient. It usually takes about six to eight weeks for a doctor to evaluate the effectiveness of a treatment regimen.
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Author Info: Mark A. Mitchell M.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002 |
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