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In some cases, patients may be unaware that they have an anxiety disorder and will visit a physician because of physical symptoms that they experience. For example, a patient with panic disorder may visit a physician believing that symptoms such as chest discomfort, heart palpitations and shortness of breath indicate a heart problem rather than an anxiety disorder.

In such cases, a physician will have to rule out the possibility of an underlying medical illness such as heart disease before suspecting that an anxiety disorder may be causing physical symptoms. Blood tests such as a complete blood count or tests such as an echocardiogram (an image of the heart produced by ultrasound) may be used to rule out certain heart conditions.

In other cases, patients may not experience acute physical symptoms, but may instead report feelings of unease or anxiety. These patients may find that anxiety is interfering with their lives and that they require medical treatment to help alleviate the problem.

In most cases, a physician will perform a complete medical examination and compile a thorough medical history. Once other conditions have been ruled out, the physician may diagnose an anxiety disorder if certain criteria are present.

All anxiety disorders have their own, specific criteria as defined by the American Psychiatric Association (APA). For example, panic disorder is diagnosed when the patient has recurrent, unexpected panic attacks, and when for a month or more after at least one attack, the patient has one or more of the following:

• Ongoing concern about future attacks
  
  
• Concerns about the significance of future attacks and their potential consequences
  
  
• Change in behavior to reduce the likelihood of future attacks

In addition, to diagnose a panic disorder, symptoms should not be caused by a general medical condition or the use of substances, and cannot better be explained by another anxiety disorder or other mental illness.