Information for Patients
What is anxiety?
Anxiety is a feeling of fear, dread, and uneasiness. It might cause you to sweat, feel restless and tense, and have a rapid heartbeat. It can be a normal reaction to stress. For example, you might feel anxious when faced with a difficult problem at work, before taking a test, or before making an important decision. It can help you to cope. The anxiety may give you a boost of energy or help you focus. But for people with anxiety disorders, the fear is not temporary and can be overwhelming.
What are anxiety disorders?
Anxiety disorders are conditions in which you have anxiety that does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships.
What are the types of anxiety disorders?
There are several types of anxiety disorders, including:
- Generalized anxiety disorder (GAD).People with GAD worry about ordinary issues such as health, money, work, and family. But their worries are excessive, and they have them almost every day for at least 6 months.
- Panic disorder. People with panic disorder have panic attacks. These are sudden, repeated periods of intense fear when there is no danger. The attacks come on quickly and can last several minutes or more.
- Phobias. People with phobias have an intense fear of something that poses little or no actual danger. Their fear may be about spiders, flying, going to crowded places, or being in social situations (known as social anxiety).
What causes anxiety disorders?
The cause of anxiety is unknown. Factors such as genetics, brain biology and chemistry, stress, and your environment may play a role.
Who is at risk for anxiety disorders?
The risk factors for the different types of anxiety disorders can vary. For example, GAD and phobias are more common in women, but social anxiety affects men and women equally. There are some general risk factors for all types of anxiety disorders, including:
- Certain personality traits, such as being shy or withdrawn when you are in new situations or meeting new people
- Traumatic events in early childhood or adulthood
- Family history of anxiety or other mental disorders
- Some physical health conditions, such as thyroid problems or arrhythmia
What are the symptoms of anxiety disorders?
The different types of anxiety disorders can have different symptoms. But they all have a combination of:
- Anxious thoughts or beliefs that are hard to control. They make you feel restless and tense and interfere with your daily life. They do not go away and can get worse over time.
- Physical symptoms, such as a pounding or rapid heartbeat, unexplained aches and pains, dizziness, and shortness of breath
- Changes in behavior, such as avoiding everyday activities you used to do
Using caffeine, other substances, and certain medicines can make your symptoms worse.
How are anxiety disorders diagnosed?
To diagnose anxiety disorders, your health care provider will ask about your symptoms and medical history. You may also have a physical exam and lab tests to make sure that a different health problem is not the cause of your symptoms.
If you don't have another health problem, you will get a psychological evaluation. Your provider may do it, or you may be referred to a mental health professional to get one.
What are the treatments for anxiety disorders?
The main treatments for anxiety disorders are psychotherapy (talk therapy), medicines, or both:
- Cognitive behavioral therapy (CBT) is a type of psychotherapy that is often used to treat anxiety disorders. CBT teaches you different ways of thinking and behaving. It can help you change how you react to the things that cause you to feel fear and anxiety. It may include exposure therapy. This focuses on having you confront your fears so that you will be able to do the things that you had been avoiding.
- Medicines to treat anxiety disorders include anti-anxiety medicines and certain antidepressants. Some types of medicines may work better for specific types of anxiety disorders. You should work closely with your health care provider to identify which medicine is best for you. You may need to try more than one medicine before you can find the right one.
NIH: National Institute of Mental Health
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.