When are specialist consultations indicated in the management of anxiety disorders?

Updated: Mar 27, 2019
  • Author: Nita V Bhatt, MD, MPH; Chief Editor: David Bienenfeld, MD  more...
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Answer

Most often, psychiatrists are consulted. Psychology consultation and testing is indicated if cognitive impairment is of concern or if the patient may be a candidate for CBT. Social work consultation may be helpful if coping skills are markedly impaired.

In anxiety disorders secondary to a general medical condition, specialty consultation may be indicated. Cardiology consultation is indicated when symptoms include heart rate irregularity or abnormal blood pressure. Neurology consultation is indicated when symptoms include headaches or visual field abnormalities, balance abnormalities, or mental status changes. Endocrinology consultation is indicated when symptoms include heat or cold intolerance, problems with fluid balance, or mood swings due to cortisol abnormalities.

To reduce muscle tension, manual manipulation or massage therapy can be helpful in nonpharmacologic approaches. Treatment with a licensed practitioner is important, as there have been cases of sexual abuse or battery with nonlicensed nonprofessionals.


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