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Anxiety assessment: modern methods, scales and biomarkers
What is anxiety?
Anxiety is an emotional reaction to a real or perceived threat, which is accompanied by a feeling of internal tension, anticipation of danger, and physiological changes. Unlike ordinary stress, increased anxiety can become chronic and affect health: the cardiovascular, immune, and digestive systems.
Therefore, timely anxiety level assessment important not only for psychologists, but also for general practitioners, psychiatrists, cardiologists, and neurologists.
Basic methods for diagnosing anxiety
You can assess your level of anxiety using either: self-completed tests, and according to the results laboratory tests or clinical interview. Below is a comparative table of the most common methods:
| Method | Assessment type | Time of holding | Appointment |
|---|---|---|---|
| Beck Scale (BAI) | Psychometric | ~10 min | Self-rated general anxiety |
| Spielberger-Hanin Scale | Psychometric | ~7 min | Measuring reactive and personality anxiety |
| GAD-7 (Generalized Anxiety) | Screening | ~5 min | Identifying generalized anxiety disorder |
| Cortisol analysis | Laboratory | 1 day | Objective biochemical assessment of stress |
| Heart rate variability (HRV) | Physiological | ~20 min | Sympathetic nervous system activation indicator |
Psychometric tests: accessible and informative
Assessment using the Beck, Spielberger or GAD-7 scales allows you to quickly and effectively understand how prone a patient is to anxiety reactions. Such tests are widely used in clinical practice and psychotherapy. For example:
GAD-7 is considered the gold standard in primary care. A score of ≥10 points is the criterion for referral to a psychiatrist.
Beck scale allows you to divide the level of anxiety into minimal, moderate and high, as well as track the dynamics during treatment.
Biochemical markers of anxiety
Although anxiety is an emotional and behavioral category, modern medicine also uses biomarkers, which can display physiological state of the body with chronic stress. Among them:
Cortisol (in blood or saliva): elevated levels indicate hyperactivation of the hypothalamic-pituitary-adrenal axis.
CATECHOLAMINES (adrenalin, noradrenaline): used to assess the function of the sympathetic nervous system.
C-reactive protein (CRP): sometimes elevated in chronic anxiety due to an inflammatory response.
Heart rate variability: low HRV is associated with high anxiety.
When should you see a doctor?
You should undergo an anxiety assessment if you:
Feeling persistent tension or anxiety for ≥2 weeks
You have sleep disorders, digestion, decreased appetite
You often wake up with a feeling of panic.
Avoiding social situations or contacts
You observe fluctuations in blood pressure, heartbeat, tremors
Who performs the diagnosis?
You can do an initial assessment yourself using online tests. However, a formal diagnosis should be made by:
family doctor or neurologist — for primary complaints
psychiatrist — if a mental disorder is suspected
endocrinologist — if hormonal causes are suspected (hyperthyroidism, adrenal dysfunction)
Assessing your anxiety level is not only a matter of emotional well-being, but also important medical indicator, which affects overall health. Early diagnosis helps prevent complications, adapt lifestyle, and select effective therapy — both psychological and pharmacological.
