Why Does the U.S. Preventive Services Task Force Recommend That All Adults Get Screened for Anxiety Disorders?

Has the number of people in the U.S. with anxiety disorders increased since the beginning of the COVID-19 pandemic, or did the widespread awareness of mental health issues during the health crisis prompt more people to seek help for their anxiety problems?

Either way, a rise in conditions such as generalized anxiety disorder, social anxiety disorder, panic disorder, separation anxiety disorder, and phobias prompted the United States Preventive Services Task Force (USPSTF) — the council that makes official recommendations on health screenings such as mammograms and colonoscopies — in June to recommend that adults 19 and older be screened regularly for anxiety disorders.

“Anxiety disorders are commonly occurring mental health conditions,” the USPSTF says in its recommendation. “Anxiety disorders are often unrecognized in primary care settings, and substantial delays in treatment initiation occur. Anxiety disorders can be chronic conditions characterized by periods of remission and recurrence. However, full recovery may occur.”

The USPTF recommends that adults get screened as part of their primary care visits using the common Generalized Anxiety Disorder scale, which contains questions similar to those now asked of patients to determine if they are at risk for depression.

We spoke with Stephanie Lehto, PsyD, assistant professor of psychiatry and clinical director of mental health for students, faculty, and staff at the University of Colorado School of Medicine, about the new recommendation and what it means.

How do you define an anxiety disorder? What kind of effect can they have on someone's life?

A disorder means that it has an impact on social or occupational functioning. So it’s impacting quality of life. People will have excessive fear, or they’ll have anxiety. And those are normal emotions. We all have anxiety and fear. They can be helpful in motivating us to do things. But sometimes anxiety can get in the way and make it so we avoid social interactions or struggle with doing some parts of our jobs. Some anxiety disorders can be debilitating, depending on their severity.

What are common signs and symptoms of an anxiety disorder?

Common signs and symptoms of anxiety include:

excessive worry.
restlessness and irritability.
difficulty concentrating.
sleep disturbances.
trouble falling asleep.
staying asleep or experiencing restless sleep.
fatigue.
excessive self-consciousness or feeling overly concerned about being judged or criticized by others.
racing thoughts.
social withdrawal.
avoiding situations that may trigger anxiety.
phobias.
physical symptoms such as rapid heartbeat, sweating, trembling, shortness of breath, dizziness, or nausea.

Have you seen a rise in the number of anxiety disorders over the past few years?

The research shows that since the pandemic started, there has been an increase in anxiety. There also has been an increase in normalization and challenging the stigma around receiving mental health support, so more people are seeking therapy and other services.

Are you surprised by the USPSTF recommendation that adults get screened for anxiety disorders?

It doesn’t surprise me. The USPSTF already had a screening recommendation for depression that has proven to be helpful for people. They did a literature review and determined that screening for anxiety would be helpful for people so they could get treatment and earlier intervention. It will be great to have more people see that this is an issue they can get support for, versus trying to hide it.

What will happen if someone takes a screening test, and their results show they have an anxiety disorder?

What their doctor will probably do is talk through what the options are. Do you want a referral for mental health? Do you want to try medication? There are treatment options that can help point people in the right direction to get the support that will benefit them.

How are anxiety disorders typically treated?

There are medications, there’s behavioral therapy, and there’s the combination of the two. Medications include antidepressants, antihistamines, beta blockers, and benzodiazepines. The psychotherapy could be cognitive behavioral therapy, acceptance commitment therapy, or exposure and response prevention therapy, depending on what’s going on for someone. Sometimes people do talk therapy, too, where they talk through their anxieties. Therapists might combine some of those different modalities as well.

Do you think anxiety screening could be helpful for someone who is having problems but doesn’t realize they have a treatable condition?

It can be really helpful to see it normalized and see that there’s a name for something. When I do group therapy, a lot of times the feedback that I get is that it’s really helpful to see that other people have the same issues or the same concerns. The common humanity piece about recognizing a problem and going into treatment is that you’re not weird or strange. There’s nothing wrong with you. It’s a disorder, and people can get better.