How Psychiatrists Diagnose Anxiety Disorders

Treating an anxiety disorder starts with getting the right diagnosis. However, diagnosing these disorders can be challenging. Therefore, it is crucial to see a professional with the tools and experience needed to identify anxiety disorders and aid people in getting the help they need.

Why see a psychiatrist?

A psychiatrist is a mental health professional and a medical doctor. They have years of education and training in diagnosing and treating a range of mental health disorders. Because they are medical doctors, they can prescribe medication to treat anxiety. Though they may also recommend talk therapy, medication is often an important component of treating anxiety disorders. However, before deciding on treatment, a psychiatrist must find the right diagnosis by looking at certain criteria and performing a physical and psychological exam.

Diagnostic criteria

Everyone has some level of anxiety at times, and a certain amount is normal. Therefore, it is important to have a guide on what constitutes an anxiety disorder. When diagnosing anxiety disorders, a psychiatrist will use specific criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Here is a look at the DSM-5 criteria for generalized anxiety disorder (GAD), the most common of these disorders:

• Excessive anxiety and worry most days about many things for at least six months.
• Difficulty controlling worry.
• Appearance of three of the following six symptoms: restlessness, fatigue, irritability, muscle tension, sleep disturbance, and difficulty concentrating.
• Symptoms significantly interfering with a patient’s life
• Symptoms not being caused by direct psychological effects of medications or medical conditions
• Symptoms are not due to another mental disorder (e.g., anxiety about oncoming panic attacks with panic disorder, anxiety due to a social disorder, etc.)

The other major types of anxiety disorders include panic disorder, social anxiety disorder, and phobia-related disorders. Each has its own separate set of criteria psychiatrists use as a guide.

Physical exam

A physical exam is an important part of a psychiatrist's evaluation. The psychiatrist will ask the patient about their health history and current health issues. The patient must be open and honest about all health and lifestyle matters, including any drug or alcohol use, as this may contribute to anxiety.

In addition, many physical issues present as anxiety disorders. For example, anxiety symptoms can indicate diabetes, heart disease, thyroid troubles, hormone imbalance, or drug withdrawal. Trying to treat these conditions with anti-anxiety medications could be dangerous and ineffective. Therefore, a psychiatrist will need to rule these out. This may include ordering additional diagnostic tests and labs.

Psychological exam

During the psychological exam, the psychiatrist will ask for further elaboration and specifics on the patient's symptoms and anything in their present or past that could impact their mental health. The psychiatrist will want to know when the symptoms started and how frequent and intense they are. They will also ask about a patient’s family history of mental health issues, as anxiety disorders tend to run in families. This information will help the doctor determine the nature of the anxiety disorder and help them get the patient started on the appropriate treatment plan.