Diagnosis

Diagnostic criteria :

To assess whether a person suffers from anxiety, it is advisable to rule out the existence of systemic disease. To do this, the doctor must take into account the following aspects:

• Physical symptoms that it presents. 
• Previous medical and psychological history of the patient and his family.
• Possibility of suffering from a disease that generates anxiety disorder.
• The influence of toxins such as caffeine, cannabis or cocaine and other synthetic drugs triggers anxiety attacks and anguish in predisposed people.

Semi-structured interview :

The clinical interview is the instrument par excellence to establish a diagnosis of anxiety disorders and reach a global understanding of the patient. It must collect the necessary information to guide the diagnosis and is usually structured in four phases:

1. Preliminary phase: the objective is to know the reason for the consultation.

2. Exploratory phase: the patient is asked about the following:

• Symptoms, location, intensity, chronology and evolution.
• Presence of organic pathologies.
• Direct triggers include life changes, grief, traumatic events, etc. 
• Personal history: manic episodes, previous depression, etc. 
• Exploration of the psychosocial sphere: beliefs and expectations, thought, affectivity and socio-family environment, personality

3. Resolution phase: the problems are summarised, the patient is informed of the nature of the problem, and his involvement is requested in developing a diagnostic-therapeutic plan.

4. Final phase: the doctor offers the patient a series of recommendations he must implement until the next appointment.

Scales :

The risk of underdiagnosis of anxiety has given rise to many structured scales that attempt to be screening instruments to detect the disorder. These scales are insufficient to establish a diagnosis, but they allow for identifying people susceptible to mental pathology, which should be subjected to a more in-depth study. Some of the most widely used scales are the Goldberg Anxiety and Depression Scale and the Hamilton Scale for Anxiety.

How to control anxiety and panic attacks

Anxiety is an emotion that everyone experiences in a situation of uncertainty and threat. Prepares the person for scenarios that may have a negative outcome. It is adaptive, and it is good. The problem occurs when it becomes pathological and manifests itself too intensely and frequently.

Cano categorically rejects medication to solve the problem and opts for cognitive behavioural therapy. “It is the one that has been most studied at a scientific level, and that has best demonstrated its effectiveness.” To understand what this therapy consists of and to give useful advice, he explains in detail the necessary steps to overcome anxiety.

1. Find out what anxiety is and what its symptoms are

“Some people are unaware that the symptoms they suffer from are caused by anxiety.” The first step to recovery is knowing what is happening to them and noticing the symptoms. “Tachycardia, sweat, increased temperature, difficulty sleeping, digestive discomfort, etc., are some of them.” Then it would be necessary to discover the causative factors and determine what emotions and anxiety are.

2. Reinterpret the problem

What anxiety does is that the person anticipates very negative consequences just in case they occur. Cano advises “to interpret the threat less seriously, to be realistic and not to magnify it “.

3. Divert attention from the problem

When there is anxiety, attention is continually focused on the problem, “we don’t stop thinking about what worries us.

To achieve this, you have to:

• Force yourself to think about something else.

• Forcing them to do something different to distract themselves.

4. Interpret problems as a challenge, not a threat

The expert adds as advice “the interpretation of difficulties as a challenge, instead of as a threat”. This allows you to face the situation with motivation, leaving aside worry.

5. Relaxation techniques

Relaxation techniques also help.

“When these skills are trained, problems begin to be solved,” says Cano. “The patient –he continues- realises his mistakes and corrects them. That’s how the problems start to ease.”

What to do in case of an anxiety or panic attack

When a person suffers a panic attack, anxiety gets out of control, loses control and is scared by that lack of control. 

They decrease by changing the focus of attention and the importance we give to panic attack symptoms.”

The best way to achieve this is:

• Do and think about something else.

• Change the topic of conversation.

• Get to work on something.

• Carry out any activity that allows you to ignore your symptoms.

• Instead of hyperventilating, breathe more slowly.