In October, the U.S. Preventive Services Task Force (USPSTF) issued new guidelines for anxiety screening in primary care. They now recommend anxiety disorder screening for everyone between the ages of 8 and 65. USPSTF is an independent panel of medical experts that makes recommendations for disease prevention based on the most recent evidence.
There are several reasons for these new guidelines. The lifetime risk of an anxiety disorder is surprisingly high, and even higher since the COVID pandemic. Anxiety affects about 40 percent of women and 26 percent of men. Only about 10 percent of people with the disorder are diagnosed in the first year. Most people live with the disorder for about 20 years before diagnosis. Studies show that screening tests work, and that treatment is very effective.
Anxiety is a normal reaction to stress that everyone experiences. It may be a protective response that helps you avoid danger. But if that response becomes too deeply ingrained in your brain, you may have anxiety with any mild stress, any reminder of stress, or even stress for no apparent reason. Anxiety disorder is anxiety at a level that affects your ability to live your life normally.
The types of anxiety disorder include generalized, panic, social, and separation anxiety. There are also several anxiety disorders based on fear, called phobia-related disorders. These types have different diagnostic criteria, but there are signs and symptoms that are common to all of them, such as restlessness, fatigue, trouble concentrating, irritability, physical symptoms, insomnia, fear, and worry. Panic attacks are common in panic disorder. Physical symptoms of anxiety can include headache, muscle ache, indigestion, dizziness, or feeling a constant lump in your throat.
The good news is that there are effective and readily available question-and-answer screening tests that are supported by research as effective. If a test shows a possible anxiety disorder, USPSTF recommends a mental health consultation to confirm a diagnosis. Everyone from ages 8 to 65 should be screened at least once. Because anxiety disorders tend to get better with older age, the task force did not find enough evidence to recommend routine screening for everyone over age 65, but older patients can also be screened. How often to screen is left to the discretion of the primary care provider, but people at higher risk for anxiety should be screened more frequently.
Risk factors include a shy personality since childhood, exposure to stressful life events, a history of other mental-health disorders, and a family history of depression or anxiety. It is also important for health-care providers to rule out medical causes of anxiety symptoms, such as thyroid disease.
If you think you may have some of the symptoms of anxiety disorder, you can take an online test to get more information. The results could help you talk to your health-care provider about anxiety concerns. Two short and simple tests that are recommended are the Mental Health America anxiety test (https://screening.mhanational.org/screening-tools/anxiety/) and the Anxiety and Depression Society of America test (https://adaa.org/find-help/treatment-help/self-screening).
Anxiety disorder is one of the most treatable mental health disorders. Talk therapy, such as cognitive behavioral therapy and acceptance and commitment therapy, is the most effective treatment.
An anti-anxiety medication called a benzodiazepine can help control the symptoms of anxiety, but only psychotherapy helps a person change the way they think and act. Lifestyle changes are also an important part of treatment and include exercising, avoiding drugs and alcohol, following a healthy diet, using stress-management techniques, and adopting healthy sleep habits.
Untreated anxiety is dangerous for both physical and mental health. It increases the risk for heart and digestive diseases, and it weakens the immune system. People with untreated anxiety tend to have problems at home, school, and work. They have a much higher risk of substance abuse and depression. This all leads to a poor quality of life and an increased risk of suicide, especially when mixed with depression or substance abuse.
If you are concerned about anxiety symptoms, talk to your primary care provider about anxiety disorder screening. You could try one of the online anxiety disorder tests and bring that with you to show your provider. USPSTF has issued these guidelines because anxiety disorders are a common and significant threat that can be successfully screened for and treated. Starting that process now could save years of difficulty.
