Generalized Anxiety Disorder Diagnosis

Persons with Generalized Anxiety Disorder (GAD) often feel worried and anxious. These feelings are not confined to a specific time or situation, but occur throughout the day. GAD can be an intense emotional state, which interrupts a person’s day-to-day activities. It affects both women and men, without any age predilection. It is difficult to diagnose this disorder, which is often confused with  other mental conditions.

Basic Diagnostic Process

There is no specific laboratory examination for the diagnosis of GAD. The process starts with observation of the affected person. The healthcare provider draws out the medical history and elicits the symptoms to see whether they are related to other medical conditions or fit the diagnosis of GAD.

The major factor pointing to GAD is that a person is persistently worried  a variety of problems over a period of six months or more.  These worries prevent the individual from pursuing normal daily occupations by causing severe mental stress. Moreover, if the person finds difficulties in maintaining control, suffers from severe worry and anxiety, and is not able to relax, it is clearly a sign of GAD.

Primary Symptoms for Diagnosis

The mental healthcare provider should look for the baseline symptoms and classify them to identify what type of mental disorder they refer to. In this situation, it is necessary to be sure whether the person undergoes clinical distress. If any of these three symptoms occur for a period of six months at least, then the individual is identified as having GAD.

• Frequent irritation during daily activities, even though there might not be any known reasons for the irritability
• Difficulty in sleeping and suffering from unsatisfied or improper sleep
• Constant restlessness or hyperactive state
• Often distracted, not able to concentrate on activities, or the mind suddenly goes blank
• Frequent exhaustion or tiredness
• Rapid occurrence of muscle tension in the body

The symptoms of this illness remain stable over years. The basic difference between GAD in the young and old people with GAD lies in the matters they worry about. Thus children and adolescents with GAD worry about their academic performance, school, sports, and social relationships, whereas adults have worries related to their work, family, friends, and their health conditions.

The underlying cause for the emergence of GAD should also be searched for earnestly. The healthcare provider must actively look for and apply necessary tests for other disorders that could cause or contribute to GAD.

Conditions Which May be Associated with GAD

Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease (GERD) is defined as a digestive defect that develops when the acid or fluid in the stomach refluxes into the esophagus. GERD has no age predilection. Research has proved that people with acid reflux are often suffering from stress and anxiety which may act as the basic triggers. Studies are going on to find out the exact relation between stress and the quantity of acid in the esophagus.

Thyroid Disorder

Hypothyroidism is a condition in which there is an insufficient amount of thyroid hormone secreted from the thyroid gland. This leads to the occurrence of anxiety. Along with psychological treatments, replacement of the missing hormone is necessary to correct this cause of anxiety.  

Heart Disease

Clinical studies have proved that more than half the people with cardiovascular diseases report suffering from a variety of anxiety problems. Moreover, in some cases, anxiety plays a vital role in complicating the heart condition.

Menopause

During menopause, anxiety is one of the major and most difficult symptoms. Anxiety during menopause creates feelings of pressure in the minds of women. Adequate skills to overcome such anxiety must be learned to handle this period of life.

Tests Performed for Diagnosis

The healthcare provider must rule out any medical cause for the symptoms of anxiety displayed by the patient. This process may involve some medical tests, such as:

• Blood tests to detect low levels of thyroid hormone
• Urine tests to rule out substance abuse
• X-ray or an endoscopy of the digestive system to rule out GERD – the gastric reflux test
• Testing stress levels
• X-rays of the chest to rule out cardiac conditions which could cause anxiety

Difficulties in Diagnosing GAD

As mentioned earlier, GAD may be difficult to diagnose, as it does not have noticeable or dramatic symptoms as with other conditions. For instance, senseless panic attacks may be a characteristic of panic anxiety disorders).

The major problem in diagnosing GAD is the “generalized” nature of the condition. There are no traceable incidents (as is present in post-traumatic stress disorder, PTSD) to draw one towards the diagnosis.  The physical symptoms of GAD may resemble those of many other disorders like depression, panic disorder, and substance abuse. So the healthcare provider must analyze the primary factor that is responsible for the patient’s symptoms.

Patients sometimes hesitate to share their emotions and feelings with mental health professionals. It is essential for the doctor to draw out the actual symptoms, so that the proper diagnosis is made to treat GAD appropriately.

References

• http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/basics/tests-diagnosis/con-20024562
• https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
• http://www.calmclinic.com/anxiety/diagnosis
• http://www.aafp.org/afp/2015/0501/p617.html
• https://psychcentral.com/lib/how-is-generalized-anxiety-disorder-diagnosed/
• http://www.umm.edu/health/medical/reports/articles/anxiety-disorders
• https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/panic-attacks/#.WVmq6oSGPIW
• http://www.wlmht.nhs.uk/patients-and-carers/conditions/anxiety-disorder/diagnosis-of-anxiety-disorder/
• https://nihseniorhealth.gov/anxietydisorders/riskfactorsandcauses/01.html
• https://www.anxiety.org/social-anxiety-disorder-panic-attacks-specifier

Further Reading

• All Anxiety Disorder Content
• What is Generalized Anxiety Disorder?
• Anxiety Disorders in Children
• /health/Generalized-Anxiety-Disorder-Comorbidities.aspx
• Neural Mechanism of Generalized Anxiety Disorder

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.