- A federal task force is recommending that all adults under age 65 be screened by primary care physicians for anxiety disorders.
- Experts say anxiety can stem from a variety of sources, including stress, previous trauma, and family history.
- Treatments include medication, psychotherapy, and behavioral therapy.
More than 40 million adults in the United States are affected by anxiety disorders.
Yet, only about 37 percent receive treatment for the condition.
With that in mind, the U.S. Preventive Services Task Force (USPSTF) is now recommending that primary care physicians routinely screen adults under 65 without anxiety symptoms for anxiety disorders.
The task force previously recommended that doctors screen children and teens ages 12 to 18 for anxiety as part of their regular healthcare. The recommendation enhances recommendations for depression screening by primary physicians.
USPSTF officials say they have added adults under 65 to the recommendation because the benefits from screening outweigh any potential harm.
The benefits of screening include early identification and treatment of an anxiety disorder. The risks include inaccurate screening, which could result in unnecessary follow-up and treatment. Screening might include brief questionnaires about fears and worries and how these thoughts interfere with daily functioning.
“Anxiety screening can be built into healthcare. At every health visit, doctors can ask a few questions about anxiety and mental health,” says Thea Gallagher, PsyD, a clinical psychologist in the Department of Psychiatry at NYU Langone Health. “We already do this for physical health. We should do it for mental health as well.”
“Screening can catch many symptoms that you might not see as anxiety. For example, trouble sleeping, jitteriness, irritability, or feeling on edge can all be signs of worrying or stress. These can impair a person’s daily functioning, Gallagher told Healthline.
The review leading to the new recommendations began before the pandemic. However, officials say the guidance is timely because of the mental health problems resulting from the pandemic.
Based on the screening results, primary care physicians can refer someone for a more thorough evaluation by a mental health professional.
“The task force found that ‘more research is needed to recommend for or against screening for anxiety in adults over 65,” said Dr. Christopher Dennis, the chief behavioral health officer of Landmark Health.
“In our experience, screening all patients, including those over 65, had identified previously unknown and treatable conditions. This allows us to engage patients in treatment actively and monitor their progress,” Dennis told Healthline.
“Experiencing occasional anxiety is a normal part of life,” Dennis said. “However, people with anxiety disorders frequently have intense, excessive, and persistent worry and fear about everyday situations. Anxiety disorders often involve repeated episodes of sudden or intense anxiety and fear or terror that reach a peak within minutes.”
“These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger, and can last a long time,” Dennis added.
There are several
- Generalized anxiety disorder
- Panic disorder
- Social anxiety disorder
- Post-traumatic stress disorder
Each type of anxiety has unique symptoms, including excessive, intense, or irrational fears. Episodes of anxiety include shaking, sweating, chest pain, and a pounding heart. However, it can also be a persistent low-intensity fear or worry that prevents you from enjoying or participating in activities.
Scientists don’t yet understand the exact cause of anxiety but believe it is a combination of physical, emotional, and genetic factors, including:
- Family history of anxiety or other mental health disorders
- Medical conditions such as depression, cardiovascular disease, or diabetes
- Previous trauma or abuse
- Substance abuse
- Ongoing stressful situations, such as occupational hazards
In recent years, scientists have been exploring how specific brain regions that control fear and emotions can contribute to anxiety disorders.
There are highly effective treatments for anxiety, such as:
- Psychotherapy, including exposure therapy and cognitive behavioral therapy
- Stress reduction techniques such as mindfulness, meditation, yoga, and deep breathing exercises
Lifestyle changes, such as getting enough sleep, regular exercise, eating a healthy diet, and avoiding alcohol, caffeine, and smoking, can also help reduce anxiety symptoms.
“Cognitive behavioral therapy (CBT) has proven efficacy in treating many anxiety disorders, Clarissa Silva, MSW, a behavioral scientist and creator of Your Happiness Hypothesis, told Healthline.
Silva said some examples of CBT treatments include:
- Trigger acknowledgment – becoming aware of how an anxiety trigger impacts symptom expression. Journaling the triggers and how the episode began
- Trigger desensitization – exposing you to the stimulus so often that it no longer causes anxiety
- Trigger prevention – developing and incorporating strategies to reduce and prevent future anxiety symptoms
“CBT is ideally delivered professionally, but some self-monitored techniques and apps can help reduce symptoms temporarily. One of the best methods to prevent all anxiety triggers is to re-learn coping strategies,” she said.