Assessing and Treating Anxiety

This article explores what anxiety is, how to identify its symptoms and diagnose it in your clients, and what some of the common treatment approaches are.

Overview of anxiety

Anxiety is a normal response to stress or danger, but anxiety disorders involve persistent, excessive, and irrational worry and fear about everyday situations. These disorders can interfere with daily functioning and can be debilitating. There are several different types of anxiety disorders, including generalised anxiety disorder, panic disorder, phobias, social anxiety disorder, and separation anxiety disorder.

Symptoms of anxiety disorders may include racing thoughts, difficulty concentrating, restlessness, irritability, muscle tension, and sleep disturbance. Anxiety disorders are often treated with a combination of therapy and medication, and can be effectively managed with proper treatment.

What is anxiety?

The DSM-5-TR defines anxiety as “excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).”

Anxiety is characterised by feelings of worry, nervousness, or fear that can be mild or severe and that can interfere with a person’s ability to function normally. It may also manifest as physical symptoms such as a racing heart, difficulty breathing, or sweating. Anxiety can be a normal and healthy reaction to stress, but when it becomes excessive or persistent, it may be a sign of an anxiety disorder.

There are several different types of anxiety disorders recognised in the DSM-5-TR, including generalised anxiety disorder, social anxiety disorder, specific phobias, panic disorder, and agoraphobia. Each of these disorders has specific diagnostic criteria that must be met in order for a diagnosis to be made.

What are the symptoms of anxiety?

Anxiety is a normal and often healthy emotion. However, when a person regularly feels disproportionate levels of anxiety, it might become a medical disorder. Anxiety disorders form a category of mental illnesses and the symptoms can vary depending on the specific type of anxiety disorder.

• Common physical symptoms of anxiety include: Muscle tension or shakiness; rapid heartbeat or palpitations; shortness of breath or feeling smothered; dry mouth; sweating or chills; nausea or upset stomach; dizziness or light-headedness; fatigue; insomnia or trouble falling asleep; headaches.
• Emotional symptoms can include: A sense of impending danger, panic, or doom; irritability; restlessness; feelings of being on edge; fear; worry.
• Behavioural symptoms can include: Avoidance of things that trigger anxiety; substance abuse; difficulty concentrating; irritability or anger outbursts; changes in eating habits; changes in sleeping habits; social withdrawal.
• Cognitive symptoms can include: Negative self-talk or negative thoughts about the future; racing thoughts; difficulty making decisions; impairment in concentration and memory; intrusive thoughts or images.

It is important to remember that everyone experiences anxiety differently and the symptoms may present themselves in a variety of ways. If someone is experiencing symptoms of anxiety, it is important to speak to a mental health professional for an accurate diagnosis and appropriate treatment.

How to diagnose anxiety

A variety of clinical assessments can be used to help diagnose and treat anxiety. Some commonly used clinical assessments for anxiety may include:

• Structured clinical interviews: Structured clinical interviews, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD), are standardised assessments that psychologists use to diagnose anxiety disorders and other mental health conditions.
• Self-report measures: Self-report measures are questionnaires that individuals complete on their own to provide information about their symptoms, thoughts, and behaviours. Some commonly used self-report measures for anxiety include the Generalised Anxiety Disorder 7 (GAD-7) and the Beck Anxiety Inventory (BAI).
• Observation: Psychologists may observe an individual’s behaviour and body language during an assessment to gather information about their anxiety symptoms.
• Physical examination: In some cases, psychologists may conduct a physical examination or order laboratory tests to rule out physical causes of anxiety symptoms.

It’s important to note that psychologists may use a combination of different assessments to accurately diagnose and treat anxiety, and the specific assessments used may depend on the individual’s specific needs and concerns.

Common treatment approaches for anxiety

Several different treatment approaches are commonly used to help individuals manage anxiety disorders. These approaches may include:

• Cognitive-behavioural therapy (CBT): CBT is a type of therapy that helps individuals identify and change negative thought patterns and behaviours that contribute to anxiety.
• Exposure therapy: Exposure therapy involves gradually exposing an individual to the things they fear or avoid in a controlled and safe environment, with the goal of helping them learn to cope with their anxiety.
• Mindfulness-based therapies: Mindfulness-based therapies help individuals become more aware of their thoughts and feelings in the present moment, and learn to accept them without judgement.
• Medication: Several types of medications, including selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines, are commonly used to treat anxiety disorders.
• Relaxation techniques: Relaxation techniques, such as deep breathing, progressive muscle relaxation, and meditation, can help individuals manage anxiety by reducing physical and emotional tension.
• Lifestyle changes: Making changes to diet, exercise, and sleep habits can also be helpful in managing anxiety.

It’s important to note that different treatment approaches may be more or less effective for different individuals, and a combination of treatments may be necessary to effectively manage anxiety. It’s important to work with a mental health professional to determine the best course of treatment.

Key takeaways

• Anxiety is a normal response to stress or danger, but anxiety disorders involve persistent, excessive, and irrational worry and fear about everyday situations.
• Symptoms of anxiety disorders may include racing thoughts, difficulty concentrating, restlessness, irritability, muscle tension, and sleep disturbance.
• Anxiety disorders are often treated with a combination of therapy and medication, and can be effectively managed with proper treatment.
• Clinical assessments such as structured clinical interviews, self-report measures, observation, and physical examination are used to diagnose anxiety.
• Common treatment approaches for anxiety include cognitive-behavioural therapy, exposure therapy, mindfulness-based therapies, medication, relaxation techniques, and lifestyle changes.