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Amid mental health crisis, new recommendation says adults should be screened for anxiety

By Katie Kindelan and Sony Salzman, ABC News Jun 21, 2023 | 5:04 AM
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(NEW YORK) — A group whose recommendations become the standard medical policy nationwide has issued a recommendation saying all adults under the age of 65 should be screened for anxiety during their lifetime.

The U.S. Preventative Services Task Force recommendation, issued Tuesday, is the final version of the draft recommendation it issued last year. While the newly issued recommendation is not mandatory for doctors, the task force carries enormous weight in the medical community and its recommendations often change the way doctors practice medicine.

The recommendation suggests that doctors screen any patient who has never before been screened for anxiety during their next doctors’ visit. This could be during a primary care appointment, an OB-GYN appointment or another general practitioner.

It calls on physicians to use standardized anxiety screenings like existing questionnaires to assess whether patients may have some of the signs and symptoms of anxiety. Anyone who screens positive for anxiety should be referred to a mental health professional for a confirmation of their diagnosis and treatment.

Last year, the task force said children ages 8 to 17 should be screened for anxiety. With the adoption of this new guidance, it means that all Americans ages 8 to 64 should be screened for anxiety.

The recommendation comes amid a growing recognition of anxiety disorders in the U.S.

Studies conducted prior to the coronavirus pandemic suggested that around 1 in 5 adults were living with an anxiety disorder, according to the National Alliance on Mental Illness.

Anxiety is a feeling evoked when someone experiences fear of something bad happening, and it can lead to avoidance, panic attacks, excessive worrying or other symptoms. Anyone can have anxiety at times, but when anxiety becomes overwhelming to the point that it consistently interferes with daily life, it can be an anxiety disorder, according to the National Institute of Mental Health.

The new task force recommendation is intended as one way to help prevent mental health conditions from going undetected, according to Lori Pbert, Ph.D., a clinical psychologist and University of Massachusetts Chan Medical School professor, who serves on the task force.

“What we found was that screening for anxiety in adults younger than 65, including people who are pregnant and postpartum, can help identify anxiety early so people can be connected to the care they need,” Pbert told ABC News last year. “This recommendation is specifically for individuals who do not have a mental health diagnosis and are not showing recognized signs or symptoms of an anxiety disorder.”

Anyone with symptoms of anxiety should seek screening immediately, and not wait for their next primary care visit, according to the task force.

What to know about anxiety disorders

Like most mental health conditions, anxiety falls on a spectrum, with differing degrees of severity.

There are four main types of anxiety disorders.

Generalized anxiety disorder, or GAD, is described as worrying “excessively about ordinary, day-to-day issues, such as health, money, work, and family,” according to the Office on Women’s Health. Women with GAD may be anxious about just getting through the day, may have difficulty doing everyday tasks and may have stress-related physical symptoms, like difficulty sleeping or stomachaches, according to the Office on Women’s Health.

Panic disorder, also twice as common in women as in men, may see people having panic attacks, described by the Office on Women’s Health as “sudden attacks of terror when there is no actual danger.” People having panic attacks may feel like they’re having a heart attack, dying or losing their minds.

A third type of anxiety disorder, social anxiety disorder, is diagnosed when people “become very anxious and self-conscious in everyday social situations,” including embarrassing easily, according to the Office on Women’s Health. People with social anxiety disorder can often have panic attack symptoms around social situations.

The fourth type of disorder, specific phobia, is an intense fear of something, such as heights, water, animals or specific situations that possess “little or no actual danger,” according to the Office on Women’s Health.

Each type of anxiety disorder can bring with it different symptoms, but they all involve a “fear and dread about things that may happen now or in the future,” according to the Office on Women’s Health.

Treatment for anxiety disorders often includes a combination of counseling and medication, and both together are often most effective.

When it comes to counseling, cognitive behavioral therapy is often used to help people change thinking patterns around their fears, according to the Office on Women’s Health. With medication, a prescription medication often taken daily to treat and prevent future episodes of anxiety on a long-term basis is different than a medication such as Xanax or Valium that is intended for infrequent treatment of acute anxiety, as they can be addictive.

Other factors such as physical activity, nutrition and mindfulness can also play a role in coping with anxiety, although less is known about the role they play in treating anxiety disorders, according to the National Center for Complementary and Integrative Health, an entity of the National Institutes of Health.

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