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Anxiety Diagnosis

Anxiety Disorders are diagnosed by psychiatrists and psychologists in the USA with the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision). The purpose of the DSM-IV is to define criteria as guidelines for use by clinicians and researchers. A diagnosis should always be done with a competent health professional.

The anxiety disorders are divided into the following types:
Generalized Anxiety Disorder
Panic Disorder (with and without Agoraphobia)
Panic Attack
Post Traumatic Stress Disorder (PTSD)
Social Anxiety Disorder or Social Phobia
Obsessive Compulsive Disorder (OCD)

Generalized Anxiety Disorder (GAD)

A. Excessive anxiety and worry (apprehensive expectation), occurring most days for at least 6 months, about a number of events or activities (such as work or school performance).

B. The person finds it difficult to control the worry.

C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for most days over the past 6 months). Only one item is required in children.

1. restlessness or feeling keyed up or on edge

2. being easily fatigued

3. difficulty concentrating or mind going blank

4. irritability

5. muscle tension

6. sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

D. The focus of the anxiety and worry is not confined to features of a disorder, e.g., the anxiety or worry is not about having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder.

E. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

F. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.

Panic Disorder (with and without Agoraphobia)

Note: The DSM-IV distinguishes Panic Disorder with Agoraphobia from Panic Disorder Without Agoraphobia. In the summary below, see criterion B.

A. Both (1) and (2):

1. Recurrent unexpected Panic Attacks.

2. At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:

a. Persistent concern about having additional attacks.

b. Worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, “going crazy”).

c. A significant change in behaviour related to the attacks.

B. Absence of Agoraphobia / Presence of Agoraphobia.

C. The Panic attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

D. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Post-Traumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

Panic Attack

A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

  • Palpitations, pounding heart, or accelerated heart rate.
  • Sweating.
  • Trembling or shaking.
  • Feelings of shortness of breath or smothering.
  • Feeling of choking.
  • Chest pain or discomfort.
  • Nausea or abdominal distress.
  • Feeling dizzy, unsteady, light-headed, or faint.
  • Sense of unreality or depersonalization.
  • Fear of losing control or going crazy.
  • Fear of dying.
  • Numbing or tingling sensations.
  • Chills or hot flushes.

Anxiety disorders continues with Post Traumatic Stress Disorder (PTSD).

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