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Easy steps to assessing anxiety |
The key is that anxiety is a normal response to a stressor. If the anxiety symptom /level is judged to be beyond a normal anxiety response, then it can be called an anxiety disorder.
During a 15 minute consultation, a patient presenting with symptoms of anxiety can be sequentially examine the following key areas.
1. Different types of anxiety disorders exist. What type of anxiety condition exists?
- An acute anxiety disorder exists when there is an overwhelming anxiety in response to a stress.
- A panic attack occurs when the anxiety symptoms are acute/intense and present with physical symptoms.
- A generalised anxiety disorder exists when the anxiety symptoms occur in the context of multiple stressors.
2. Is the patient using alcohol or drugs (including benzodiazepines), which may be a form of self-treatment or the cause?
3. What form of treatment will best suit the patient?
- Simple reassurance that anxiety will resolve as the stressor resolves.
- Panic attacks generally require a specific form of cognitive behavioural therapy called exposure therapy.
- Generalised anxiety disorder requires a specific form of cognitive behavioural therapy focusing upon stress relaxation, time management and structured problem solving.
- Medication (benzodiazepines/SSRIs) should not be first line treatment
4. Other causes of anxiety symptoms include posttraumatic stress disorder, depression, psychoses and medical conditions (diabetes, thyroid / heart conditions).
5. Management of an anxiety disorder may be a complicated situation. In the general practice setting, there may be inadequate time resources. The enlistment of a psychiatrist may be helpful. The psychiatrist’s role may be to clarify the diagnosis and to suggest treatment options (which can be undertaken by yourself and/or the psychiatrist).
Mark Scurrah is a psychiatrist with the Lismore Community Mental Health Team and also conducts a private practice in Byron Bay.
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