Diagnosis of generalized anxiety disorder (GAD) can be difficult, since the distinction between normal anxiety and GAD is not always apparent. Diagnosis is based on a physical exam, psychological evaluation, and the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The symptoms of GAD must be present for at least six months and cause impairment in your ability to function.
After obtaining your medical history, you may be asked about worries, anxiety, “nerves,” stress, and other symptoms. Your doctor may ask whether your anxiety is acute (brief or intermittent) or chronic (persistent).
Acute anxiety lasts from hours to weeks and usually occurs in response to a particular stressor. Persistent anxiety lasts from months to years and may be considered a part of your temperament. Persistent anxiety does not normally occur in response to stress. In susceptible people, though, stress may increase levels of persistent anxiety.
Evaluation of Medical Disorders
Before generalized anxiety disorder can be diagnosed, your doctor will look for and rule out other medical disorders that could cause your symptoms. Medical conditions commonly associated with anxiety include:
- Irritable bowel syndrome
- Chronic pain conditions
- Cushing’s disease
- Mitral valve prolapse
- Carcinoid syndrome
- Chronic obstructive pulmonary disease
- Heart failure
Your doctor should also ask what medications, herbal supplements, and vitamins you take. You may be asked to stop taking certain medications or supplements so that your doctor can more accurately pinpoint the cause of your symptoms. Medications that can contribute to or worsen anxiety include:
- Over-the-counter cold remedies and diet pills
Evaluation for Substance Abuse
Use or withdrawal from addictive substances can cause anxiety. Your healthcare provider may ask about your use of alcohol, caffeine, nicotine, addictive medications (particularly sedatives), illegal drugs, and other substances.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2012 -
- Update Date: 00/92/2012 -