Hello, I’m Dr. Carlo Carandang, and I’m a psychiatrist. Today, I will talk about diagnosing anxiety disorders. Anxiety disorders are diagnosed by doctors, which include family physicians, psychiatrists, and PhD-level psychologists.
Here is a flow chart that doctors should be using when they are evaluating you for anxiety disorder:
As an example, let’s say you have significant anxiety symptoms, and it impairs your daily functioning and your life. So when we look at this flow chart, the doctor should be assessing if you also have moderate to severe depression. If the answer is yes, then the doctor should be treating your depression first.
The reason for this is that depression is an emergency, and is more of an emergency than your anxiety symptoms, as severe depression can lead to safety issues such as suicidal behaviors. Therefore, it’s important to treat the depression first.
If the answer to this question is no, then you don’t have a concurrent severe depressive episode. The doctor can then proceed and look at what particular anxiety symptoms you may have.
So let’s say you have a history of trauma and you also have flashbacks and nightmares. This could clue-in the doctor that you might have post-traumatic stress disorder, also known as PTSD. The doctor should then go on to evaluate you fully for PTSD.
On the other hand, you may have obsessions or compulsions. Obsessions are recurrent, intrusive thoughts which cause significant anxiety. Compulsions are behaviors which you repeat systematically in a ritualistic manner, and these serve to decrease the anxiety associated with the obsessions. So let’s say you have obsessions plus or minus compulsions. The doctor should then check if you have OCD, also known as obsessive compulsive disorder.
In another scenario, let’s say you have uncontrollable worry about several areas. You have generalize worries, so then the doctor should check for generalized anxiety disorder, also known as GAD.
Furthermore, let’s say you have symptoms of panic or anxiety attacks. This could be a number of things. This could be panic attacks due to feared social social situations. So you might have a fear of being embarrassed in crowds. If this is the case, then the doctor should check for social phobia, also known as social anxiety disorder.
If the anxiety or panic attacks are caused by discrete objects or situations which are highly feared, then the doctor should check for specific phobia.
If the panic and/or anxiety attacks are severe or if they occur spontaneously (such as getting panic attacks which wake you from sleep or getting a panic attack while you’re just sitting in your chair), then the doctor should check for panic disorder.
For more information and help on anxiety disorders, please visit the rest of AnxietyBoss.com. Thank you for listening I’m Dr. Carlo Carandang.
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Hi Dr. Carlo.
I found your web site by accident while searching for answers for my little one who has been in the hospital for the past 8 days. He got very sick lately with the high blood pressure. Ended up having PRES due to high blood pressure. His blood pressure is under control now and 8 days later the doctors have still not found a diagnoses. His kidneys, thyroid and brain are fine. His heart has shown that this high blood pressure has been going on for some time now. He is being tested for a rare adrenal gland tumor (has some symptoms). His urine test showed that his adrenaline levels are high! So here is the thing. On a regular bases I limit video games for my kids to few times a week, 20 mins maximum. With our nanny leaving and some major work changes, that rule went out of the window just before the Christmas brake. I noticed how agitated and upset my 7 yr old become when he plays games. He also became very addictive, irritable, could not get to bed on time etc. I actually believe he became sleep deprived due to gaming. 2.5 weeks ago he got sick and was in bed for days. He played games and watched TV a lot! His blood pressure went up and we ended in hospital and are still here. For some reason, I kept thinking that his adrenal glad and blood pressure got our of control due to gaming. I’m leaving it to the doctors to figure out what is going on but 8 days later they still don’t have answers. I hope for the best and in the meanwhile, I’m weaning him of off iPad and TV. He is less irritable now but his blood pressure is still controlled by meds. Please let me know if you can send me a link to any clinical studies so I can share them with the team of doctors trying to help my child. Also, what would you recommend I do as Mum to help him calm down (certain foods etc). Thanks much for your post. Makes perfect logical sense.
Dear Danielle,
I don’t know of any clinical studies of gaming as the cause of adrenal gland dysfunction, but gaming can certainly trigger the adrenaline response chronically: Can video games trigger an adrenaline response?. So chronic and intense playing of video games can chronically trigger the adrenaline response, and your attempts to limit the gaming should help to quell the adrenaline response. However, an adrenal gland tumor needs medical care and attention, so please continue to follow the doctors’ treatment plan.
Buspirone is an anti-anxiety medicine prescribed for the treatment of anxiety disorders. This drug provides short-term relief of anxiety symptoms such as pounding heartbeat, irritability, dizziness, fear, and tension.
Not entirely correct- buspirone addresses the excessive worrying, but not the physical symptoms of anxiety that you mention.