Anxiety Diagnosis: How Does Anxiety Get Diagnosed?

It’s normal to occasionally experience feelings of anxiety or fear. However, if you have severe or persistent anxiety or excessive anxiety that interferes with your daily life and doesn’t go away on its own, you may be affected by an anxiety disorder. 

Anxiety disorders are a common form of mental illness, with 40 million adults (approximately 18 percent of the US adult population) affected every year.

Common anxiety disorders include generalized anxiety disorder (GAD), social anxiety disorder, panic disorder and specific phobias, such as anxiety related to heights, flying or spiders. 

If you’re concerned that you might have an anxiety disorder, it’s important to talk to a healthcare professional and get an accurate diagnosis. 

Below, we’ve explained how mental health professionals diagnose people with anxiety disorders, common symptoms and other criteria.

We’ve also discussed what you should know before you visit a healthcare provider for help with anxiety or other common mental disorders.

Anxiety comes in several forms, each with different signs and symptoms. The five major types of anxiety disorders are:

• Generalized anxiety disorder (GAD)

• Panic disorder

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD)

• Social anxiety disorder

Anxiety can also take the form of a specific phobia, which may occur only in certain situations or around specific objects. 

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder is one of the most common mental health conditions. According to data from the National Comorbidity Survey Replication (NCS-R), an estimated 5.7 percent of US adults will develop generalized anxiety disorder at some point in life.

If you have generalized anxiety disorder, you may experience the following symptoms:

• Worrying excessively about normal, everyday tasks and events

• Headaches, muscle aches and other forms of pain without an obvious cause

• Difficulty falling asleep or staying asleep throughout the night

• Persistent, difficult-to-control feelings of nervousness

• Finding it difficult to concentrate on specific tasks

• Trembling, twitching and persistent sweating

• Feelings of lightheadedness or being out of breath

• A persistent need to use the bathroom

These psychological and physical symptoms often relate to everyday things, such as careers, finances, personal health or relationships. 

If you have generalized anxiety disorder, you may be aware that you worry more than you need to, but still find it difficult to control your thoughts and feelings.

Panic Disorder

Panic disorder is an anxiety disorder that involves recurrent panic attacks — sudden moments of intense fear that can occur in certain situations. 

These attacks may involve severe physical and mental symptoms.

If you have panic disorder, you may experience the following symptoms during a panic attack:

• Sweating, trembling and/or shaking

• Heart palpitations (a rapid, pounding heartbeat)

• A choking sensation or shortness of breath

• Feeling that you’re losing control or intense feelings of dread or terror

While some people with panic disorder experience attacks randomly and unexpectedly, others have specific triggers that may bring on panic attack symptoms.

To learn more, check out our blog on Panic Disorder vs Generalized Anxiety Disorder.

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder is a mental disorder involving certain obsessive thoughts and behaviors. These obsessive thoughts can cause anxiety and result in repetitive behaviors.

If you have obsessive-compulsive disorder, you may experience the following symptoms:

• Obsessive fears or feelings of anxiety about certain things, such as germs, losing control in a public setting, sexual activity or that something isn’t “perfect”

• Compulsive behaviors, such as excessively cleaning yourself or other objects, arranging items in a certain way or constantly checking on things|

The symptoms of obsessive-compulsive disorder can come and go over time. Some people with OCD also display tics, such as blinking, moving their limbs or certain vocal sounds.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder is a type of anxiety disorder that can develop after exposure to a harmful, shocking, traumatic or intensely stressful event. 

Events that can cause PTSD to develop include losing a loved one suddenly or being exposed to violence or abuse.

If you have post-traumatic stress disorder, you may experience flashbacks or worrying thoughts related to the traumatic event. It can sometimes go hand in hand with climate anxiety.

Many people with PTSD also develop symptoms that affect their cognition (e.g. ability to remember certain events), arousal (e.g difficulty controlling temper, easily being scared or surprised, etc.) and behavior.

We have an article on anxiety and PTSD if you'd like to learn about the distinction.

Social Anxiety Disorder

Social anxiety disorder involves a fear of social situations or performances, especially those that could cause embarrassment or a negative evaluation by others. 

Situations that can trigger this form of anxiety include meeting new people, talking to strangers or performing in public.

If you have social anxiety disorder, you may experience the following symptoms when you are around other people:

• Feelings of nausea or general physical sickness

• Trembling, sweating, flushing and a rapid heartbeat

• Severe self-consciousness and embarrassment

• Difficulty making eye contact, a soft voice and/or rigid posture

• General discomfort and fear around other people

A form of anxiety that’s closely related to social anxiety disorder is performance anxiety, which can occur before public performances, job interviews and other stressful events. 

Specific Phobias

Also referred to as simple phobias, specific phobias are unreasonable and intense fears that are related to specific objects or situations. 

Common specific phobias include intense fears related to animals, situational phobias such as a fear of flying, swimming in deep water or heights, and sexual phobias.

If you have a specific phobia, you may feel excessively worried in situations that involve the object of your fear. For example, seeing a spider (arachnophobia) or being in a confined space (claustrophobia). 

People with specific phobias often change their habits or behaviors to avoid situations that could trigger their fears.

If you think you might have an anxiety disorder, the first step in seeking treatment is contacting a mental health professional for a diagnosis.

You can do this by talking to your primary care provider, contacting a mental health provider in your area, or using online mental health services.

Because anxiety can take many forms, it’s not always a straightforward diagnosis. To provide a complete, accurate diagnosis, your healthcare provider may:

• Ask you about your symptoms

• Perform a physical examination

• Discuss any medications you currently use

• Ask you to complete a clinical assessment or other diagnostic tests

During your physical exam, your healthcare provider will check for medical conditions that could cause anxiety or anxiety-like symptoms. 

If they suspect that your anxiety could be caused by an underlying medical condition, they may order a blood or urine test. 

It’s important to give your healthcare provider complete, honest answers about your symptoms, medical history and any medications you currently use or have recently used.

If you have anxiety symptoms, your healthcare provider may ask you to fill out a questionnaire or complete a diagnostic test. Several different tests are used to assess and diagnose anxiety, including the following:

• Hamilton Rating Scale for Anxiety (HAM-A). Developed in 1959, this is a rating scale that’s used to measure the severity of anxiety symptoms. It’s one of the most common rating scales for anxiety in use today. The Hamilton Rating Scale for Anxiety consists of 14 criteria and takes around 12 to 15 minutes to complete.
  

• Zung’s Self-Rating Anxiety Scale. This 20-item clinical assessment is used to measure anxiety. It consists of 20 different items related to anxiety, which are rated from “a little of the time” to “most of the time” based on how frequently they affect you.Based on your score, your healthcare provider may assess your anxiety as normal, mild to moderate, marked to severe or extreme.

• Generalized Anxiety Disorder Scale-7 (GAD-7). This seven-item scale is used to test for generalized anxiety disorder. It asks how frequently you’ve experienced a variety of anxiety symptoms during the last two weeks.

• Beck Anxiety Inventory (BAI). This 21-question assessment is designed to quickly yet accurately measure the severity of different anxiety symptoms. You may complete it by yourself or by answering questions from your healthcare provider.

• Social Phobia Inventory (SPIN). This 17-item questionnaire

  is used to evaluate social anxiety symptoms. As part of the questionnaire, you’ll need to rate how anxious certain situations and environments make you feel.
  

• Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). This 10-question test is used to identify and measure the symptoms of OCD.

  Your healthcare provider may interview you using this scale if they suspect that you have obsessive-compulsive disorder.
  

• Penn State Worry Questionnaire (PSWQ). This 16-item questionnaire is designed to measure the trait of worry.

  Your healthcare provider may use this test to identify and diagnose specific anxiety disorders, such as generalized anxiety disorder (GAD).

Your mental health provider may use information from your physical exam, interview and clinical assessment to diagnose you with an anxiety disorder.

You can get anxiety treatment online using our telepsychiatry services. 

If you’re diagnosed with an anxiety disorder, your healthcare provider will likely recommend one or several different approaches to treatment.

Since anxiety can vary in type and severity, there’s no one-size-fits-all approach that’s used to treat every anxiety disorder. 

Based on your symptoms and needs, your mental health provider may recommend medication, therapy, lifestyle changes or a combination of approaches.

Medications for Anxiety

Several medications are commonly used to treat anxiety disorders, including benzodiazepines, antidepressants and, for the physical symptoms of anxiety, beta-blockers.

Benzodiazepines work by reducing activity in certain parts of your brain. They work quickly and can provide almost immediate relief from certain anxiety symptoms. 

However, they can cause side effects, dependence and withdrawal symptoms when stopped abruptly.

Antidepressants work by increasing levels of chemicals in your brain that regulate your moods, thoughts and feelings. 

They may take several weeks to start working. Antidepressants called selective serotonin reuptake inhibitors (SSRIs) are often used to treat anxiety disorders.

Beta-blockers work by reducing the effects of the hormone epinephrine on your heart. They’re typically used to treat cardiovascular health issues, but may be used to control certain physical anxiety symptoms, such as sweating, trembling or a rapid heartbeat. 

Our guide to medications for anxiety provides more information about how common anti-anxiety medications work. 

Therapy

Psychotherapy, or talk therapy, is one of a few common effective treatments for anxiety disorders. It involves working with a therapist to identify the factors that contribute to your anxiety and taking action to reduce the severity of your symptoms.

Several different forms of therapy are used to treat anxiety, such as cognitive behavioral therapy (CBT) and exposure therapy.

We offer online therapy and online group therapy for anxiety, both of which provide you with the opportunity to discuss your symptoms with others and learn effective tools and strategies for making progress.

Our guide to therapy for treating anxiety goes into greater detail about the types of therapy used for anxiety disorders, as well as what you’ll need to know before starting therapy. 

Lifestyle Changes

Simple changes to your lifestyle, such as reducing your caffeine consumption, avoiding alcohol and exercising regularly, may help to lower anxiety and improve your control over feelings such as fear and worry.

Techniques such as mindfulness, guided imagery and breathing exercises may also help you to gain control over anxiety in certain situations.

Our guide to calming down anxiety shares science-based techniques and lifestyle changes that may help you to improve anxiety, either on your own or in combination with therapy and anxiety medication. 

Anxiety disorders are some of the most common psychiatric disorders. They can affect people of all ages and backgrounds and produce a diverse range of symptoms, some of which may be severe.

If you think that you may have an anxiety disorder, it’s important to contact a mental healthcare provider for a psychiatric evaluation. Self-diagnosing yourself with anxiety is not recommended

If you’re diagnosed with anxiety, your healthcare provider may prescribe medication to help you control your symptoms and suggest treatment options such as therapy. 

You can learn more about identifying and treating anxiety with our overview of anxiety disorders, or by using our collection of free online mental health resources.