Anxiety disorders are a common type of psychiatric disorder characterized by anxiety or fear that does not go away over time.
Symptoms of anxiety disorders vary depending on the specific condition and may include:
- Excessive anxiety and worry that is difficult to control
- Feeling restless or on edge
- Being easily fatigued
- Difficulty concentrating
- Irritability
- Muscle tension
- Sleep problems
- Fears
- Of social situations and exposure to possible scrutiny by others
- Of humiliation or embarrassment
- Of being trapped without escape
- Irrational and out of proportion fear to specific situations (e.g., animals, insects, blood, needles, flying, heights)
- Chest pain
- Shortness of breath
- Feeling as if you’re having a heart attack (patients with panic disorder often come to a hospital’s emergency department because they fear a heart attack is occurring)
How Are Anxiety Disorders Diagnosed?
Anxiety disorders are usually diagnosed with a psychological evaluation. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, provides diagnostic criteria for an anxiety disorder.
Lab studies to diagnose or exclude medical conditions that may cause anxiety disorders include:
- Blood tests
- Complete blood cell (CBC) count
- Chemistry profile
- Thyroid function tests
- Urine tests
- Urinalysis
- Urine drug screen
Tests to rule out central nervous system (CNS) disorders that can cause anxiety include:
- Neurologic consultation
- Brain computed tomography (CT) scan
- Magnetic resonance imaging (MRI) of the brain
- Positron emission tomography (PET) scan
- Electroencephalography (EEG)
- Lumbar puncture
Tests to rule out heart conditions that can cause anxiety include:
- Electrocardiography (ECG)
- Treadmill ECG
Tests to rule out infectious causes of anxiety include:
- Rapid plasma reagin test
- HIV testing
- Lumbar puncture (CNS infections)
Other tests to rule out other physical causes of anxiety include:
- Chest X-ray
- Arterial blood gas analysis
What Is the Treatment for Anxiety Disorders?
Treatment for anxiety disorders often involves a combination of medication and/or psychotherapy.
Medications used to treat anxiety disorders include:
- Antidepressants
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Atypical antidepressants
- Tricyclic antidepressants
- Monoamine oxidase inhibitors (MAOIs)
- Benzodiazepines, especially in emergency situations
- Anti-anxiety drugs
- Anticonvulsants
- Antihypertensive drugs
Types of therapy used to treat anxiety disorders include:
- Behavioral therapy and cognitive-behavioral therapy (CBT)
- Computerized CBT (FearFighter)
- Interpersonal psychotherapy
- Relaxation therapy
- Supportive psychotherapy
- Mindfulness therapy
- Psychodynamic therapy (or insight-oriented therapy)
Other treatments used for anxiety disorders include:
- Cranial electrotherapy stimulator (CES) for treatment of anxiety, depression, and insomnia
Hospitalization may be needed to treat severe anxiety disorders in cases such as:
- Severe functional impairment (cannot meet own daily needs)
- Suicide or homicide risk
- Deficits in social skills
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https://www.ncbi.nlm.nih.gov/books/NBK262332/