Anxiety disorders - Diagnosis and treatment (2023)

Diagnosis

You may start by seeing your primary care provider to find out if your anxiety could be related to your physical health. He or she can check for signs of an underlying medical condition that may need treatment.

However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).

To help diagnose an anxiety disorder, your mental health provider may:

  • Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
  • Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.

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Treatment

The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

Psychotherapy

Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.

Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety.

(Video) Generalized anxiety disorder (GAD) - causes, symptoms & treatment

CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms.

Medications

Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example:

  • Certain antidepressants are also used to treat anxiety disorders.
  • An anti-anxiety medication called buspirone may be prescribed.
  • In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta blockers. These medications are for short-term relief of anxiety symptoms and are not intended to be used long term.

Talk with your doctor about benefits, risks and possible side effects of medications.

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(Video) Generalized Anxiety Disorder | Diagnosis and Treatment

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:

  • Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
  • Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you.
  • Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety.
  • Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
  • Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.
  • Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed.

Alternative medicine

Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the Food and Drug Administration (FDA) the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions.

Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

Coping and support

To cope with an anxiety disorder, here's what you can do:

  • Learn about your disorder. Talk to your doctor or mental health provider. Find out what might be causing your specific condition and what treatments might be best for you. Involve your family and friends and ask for their support.
  • Stick to your treatment plan. Take medications as directed. Keep therapy appointments and complete any assignments your therapist may give you. Consistency can make a big difference, especially when it comes to taking your medication.
  • Take action. Learn what triggers your anxiety or causes you stress. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.
  • Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
  • Join an anxiety support group. Remember that you aren't alone. Support groups offer compassion, understanding and shared experiences. The National Alliance on Mental Illness and the Anxiety and Depression Association of America provide information on finding support.
  • Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
  • Socialize. Don't let worries isolate you from loved ones or activities.
  • Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.

Preparing for your appointment

You may start by seeing your primary care provider. He or she may refer you to a mental health professional.

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What you can do

Before your appointment, make a list of:

  • Your anxiety symptoms. Note when they occur, whether anything seems to make them better or worse, and how much they affect your day-to-day activities and interactions.
  • What causes you stress. Include any major life changes or stressful events you've dealt with recently. Also note any traumatic experiences you've had in the past or as a child.
  • Any family history of mental health problems. Note if your parents, grandparents, siblings or children have struggled with any mental health problems.
  • Any other health problems you have. Include both physical conditions and mental health issues.
  • All medications you're taking. Include any medications, vitamins, herbs or other supplements, and the doses.
  • Questions to ask your doctor to make the most of your appointment.

Some basic questions to ask your doctor include:

  • What's the most likely cause of my anxiety?
  • Are there other possible situations, psychological issues or physical health problems that could be causing or worsening my anxiety?
  • Do I need any tests?
  • Should I see a psychiatrist, psychologist or other mental health provider?
  • What type of therapy might help me?
  • Would medication help? If so, is there a generic alternative to the medicine you're prescribing?
  • In addition to treatment, are there any steps I can take at home that might help?
  • Do you have any educational materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you several questions, such as:

  • What are your symptoms, and how severe are they? How do they impact your ability to function?
  • Have you ever had a panic attack?
  • Do you avoid certain things or situations because they make you anxious?
  • Have your feelings of anxiety been occasional or continuous?
  • When did you first begin noticing your feelings of anxiety?
  • Does anything in particular seem to trigger your anxiety or make it worse?
  • What, if anything, seems to improve your feelings of anxiety?
  • What traumatic experiences have you had recently or in the past?
  • What, if any, physical or mental health conditions do you have?
  • Do you take any prescription drugs?
  • Do you regularly drink alcohol or use recreational drugs?
  • Do you have any blood relatives who have anxiety or other mental health conditions, such as depression?

Preparing and anticipating questions will help you make the most of your time.

By Mayo Clinic Staff

FAQs

How is anxiety disorder diagnosed? ›

To diagnose an anxiety disorder, a doctor performs a physical exam, asks about your symptoms, and recommends a blood test, which helps the doctor determine if another condition, such as hypothyroidism, may be causing your symptoms. The doctor may also ask about any medications you are taking.

What are 5 treatments for anxiety? ›

Some ways to manage anxiety disorders include learning about anxiety, mindfulness, relaxation techniques, correct breathing techniques, dietary adjustments, exercise, learning to be assertive, building self-esteem, cognitive therapy, exposure therapy, structured problem solving, medication and support groups.

When is anxiety usually diagnosed? ›

You may have GAD if: your worrying significantly affects your daily life, including your job and social life. your worries are extremely stressful and upsetting. you worry about all sorts of things and have a tendency to think the worst.

What are the 4 treatment options for anxiety disorders? ›

Four major classes of medications are used to treat anxiety disorders: SSRI (selective serotonin reuptake inhibitor), SNRI (serotonin-norepinephrine reuptake inhibitor), tricyclic antidepressant, and benzodiazepine.

What happens if you get diagnosed with anxiety? ›

An anxiety disorder is a type of mental health condition. If you have an anxiety disorder, you may respond to certain things and situations with fear and dread. You may also experience physical signs of anxiety, such as a pounding heart and sweating. It's normal to have some anxiety.

Can diagnosed anxiety be cured? ›

There is no cure for anxiety disorders, but they are treatable. Treatment for anxiety disorders can include medication, therapy, or a combination of both. It's important to work with a healthcare provider to find the treatment that best suits your concerns.

What is the most extreme form of anxiety? ›

Panic disorder

Panic attacks are intense, overwhelming and often uncontrollable feelings of anxiety. Physical symptoms can include trouble breathing, chest pain, dizziness and sweating. If someone has repeated panic attacks they may have a panic disorder.

Is anxiety a form of mental illness? ›

Anxiety disorders are the most common of mental disorders and affect nearly 30% of adults at some point in their lives. But anxiety disorders are treatable and a number of effective treatments are available. Treatment helps most people lead normal productive lives.

What are the 2 main symptoms of anxiety disorders? ›

Common anxiety signs and symptoms include: Feeling nervous, restless or tense. Having a sense of impending danger, panic or doom.

What is the rarest anxiety disorder? ›

Illness anxiety disorder (hypochondria) is extremely rare. It affects about 0.1% of Americans. It typically appears during early adulthood. Illness anxiety disorder can affect all ages and genders.

What is the first drug of choice for anxiety? ›

Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) SSRIs and SNRIs are often the first-line treatment for anxiety. Common SSRI brands are Celexa, Lexapro, Luvox, Paxil, and Zoloft.

What is the most common drug used for anxiety? ›

Benzodiazepines (also known as tranquilizers) are the most widely prescribed type of medication for anxiety. Drugs such as Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam) work quickly, typically bringing relief within 30 minutes to an hour.

What is the best long term treatment for anxiety? ›

Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are widely used to treat and prevent a variety of anxiety disorders.

Can anxiety show up in blood test? ›

After reviewing the psychiatric history of 461 volunteers, researchers found that by checking for high levels of acetylcholinesterase (AChE), a blood protein people release when under stress, they could identify anxiety disorders 90% of the time.

What is the best test for anxiety? ›

This questionnaire called the GAD-7 screening tool can help you find out if you might have an anxiety disorder that needs treatment. It calculates how many common symptoms you have and based on your answers suggests where you might be on a scale, from mild to severe anxiety.

How long does an anxiety diagnosis last? ›

From the time of diagnosis, an anxiety disorder can last from a few months to many years. Most people will have symptoms of an anxiety disorder for a long time before seeking professional help, sometimes up to 15 years³.

How is anxiety disorder best managed? ›

Quit smoking, and cut back or quit drinking caffeinated beverages. Nicotine and caffeine can worsen anxiety. Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.

What are 2 treatments for someone dealing with anxiety? ›

Guided self-help and cognitive behavioural therapy (CBT) Your GP or talking therapies service may suggest trying a self-help course to see if it can help you learn to cope with your anxiety. Self-help courses for GAD are usually based on the principles of cognitive behavioural therapy (CBT).

How serious is anxiety disorder? ›

Anxiety disorders are real, serious medical conditions - just as real and serious as physical disorders such as heart disease or diabetes. Anxiety disorders are the most common and pervasive mental disorders in the United States.

Do regular doctors diagnose anxiety? ›

Diagnosis of anxiety disorders

An anxiety disorder can be diagnosed by a primary care doctor. In severe cases, you will be referred to a mental health specialist (psychiatrist) for follow-up and treatment.

What chemical in the brain causes anxiety? ›

Epinephrine is just one chemical involved in your body's response to anxiety. Other chemicals may also play a role. For example, a serotonin imbalance¹ may contribute to anxiety, as can high cortisol levels. However, epinephrine is the primary chemical because it is directly involved in your anxiety symptoms.

Is having anxiety a disability? ›

Anxiety disorders like OCD, panic disorders, phobias, or PTSD are considered a disability. Therefore, they can qualify for Social Security disability benefits. Individuals must prove that it is so debilitating that it prevents them from working.

What causes anxiety in the brain? ›

Anxiety happens when a part of the brain, the amygdala, senses trouble. When it senses threat, real or imagined, it surges the body with hormones (including cortisol, the stress hormone) and adrenaline to make the body strong, fast and powerful.

What does a person with anxiety feel like? ›

feeling tense, nervous or unable to relax. having a sense of dread, or fearing the worst. feeling like the world is speeding up or slowing down. feeling like other people can see you're anxious and are looking at you.

When anxiety becomes too much? ›

Are you always waiting for disaster to strike or excessively worried about things such as health, money, family, work, or school? If so, you may have a type of anxiety disorder called generalized anxiety disorder (GAD). GAD can make daily life feel like a constant state of worry, fear, and dread.

What anxiety feels like? ›

"Symptoms of a panic attack include a racing heartbeat, trembling or shaking, shortness of breath and chest pain."

What is crippling anxiety? ›

Rather than being a clinical term, crippling anxiety is a common expression used to describe severe anxiety or an anxiety disorder. And in order to understand anxiety disorders, it's essential to differentiate them from the everyday pressures and stressors people experience in their daily lives.

What is a nervous breakdown? ›

The term "nervous breakdown" is sometimes used by people to describe a stressful situation in which they're temporarily unable to function normally in day-to-day life. It's commonly understood to occur when life's demands become physically and emotionally overwhelming.

How do I know when I need anxiety meds? ›

If you feel edgy almost every day, it's a good idea to seek help. Talk therapy will sometimes do the trick. However, if you often feel like you're standing at the edge of a cliff—heart racing, palms sweating, feeling like you might faint—you could be having panic attacks.

Is anxiety emotional or mental? ›

Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry.

What is difference between anxiety and anxiety disorder? ›

Anxiety is a problem when it becomes overwhelming or unmanageable and it comes up unexpectedly. Anxiety disorders are mental illnesses that have a big impact your life. People may avoid going about their daily lives in order to avoid anxiety.

What is the most dominant symptom of anxiety disorders? ›

Symptoms. Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening.

What is the difference between feeling anxiety and having an anxiety disorder? ›

Normal anxiety is usually short-term and related to a stressor. It doesn't cause significant distress, and is resolved in a short time. But an anxiety disorder isn't something that simply goes away and it persists over time. Treatment is necessary in order to manage it and minimize its impact on your life.

What is false anxiety? ›

Unwanted thoughts are one of the most common examples of false anxiety. Often time we as humans tend to be cynical, thinking about worst case scenarios, 'what if' thoughts so to speak. We tend to get so caught up in our thoughts that we end up getting trapped by them.

Can anxiety disorders get worse with age? ›

Anxiety disorders don't necessarily get worse with age, but the number of people suffering from anxiety changes across the lifespan. Anxiety becomes more common with older age and is most common among middle-aged adults.

Which anxiety disorder is most common later in life? ›

Generalized Anxiety Disorder

After phobias, generalized anxiety disorders (GADs) are the most common anxiety disorder of older adults, occurring in 1.2% to 4.6% of those in a community-based sample. Among those with the disorder, onset occurs in late life (after age 55) for about 25% (1).

What are 3 treatment options that are available for anxiety disorders? ›

Anxiety disorders should be treated with psychological therapy, pharmacotherapy, or a combination of both. Cognitive behavioral therapy can be regarded as the psychotherapy with the highest level of evidence.

What is the most diagnosed anxiety disorder? ›

Generalized anxiety disorder (GAD) is the most common anxiety disorder among older adults, though anxiety disorders in this population are frequently associated with traumatic events such as a fall or acute illness.

What is the first step in treating anxiety disorders? ›

Self-management is the first step toward addressing anxious feelings and often involves relaxation techniques, an active lifestyle, and effective time management. If these measures do not bring anxious reactions under control, a person should consider speaking with a doctor and seek other avenues of treatment.

What is the number one thing that causes anxiety? ›

Difficult experiences in childhood, adolescence or adulthood are a common trigger for anxiety problems. Going through stress and trauma when you're very young is likely to have a particularly big impact. Experiences which can trigger anxiety problems include things like: physical or emotional abuse.

Who can diagnose severe anxiety? ›

Psychiatrist. A psychiatrist is a medical doctor with specialized training in the diagnosis and treatment of mental illnesses. A psychiatrist can provide both psychotherapy and medication to treat your anxiety disorder.

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