Don’t be surprised if, during your next checkup, your doctor asks about your anxiety and stress levels. The U.S. Preventive Services Task Force released a new draft recommendation that all adults under age 65 (including pregnant and postpartum persons) be screened for anxiety, which has been on the rise in recent years in part in response to such events as the pandemic and inflation. According to the World Health Organization, anxiety and depression increased 25 percent on a global scale in the first year of the pandemic.
The Task Force did not include people 65 and older in their recommendation because “the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety” in that population. However, we advise that older people experiencing symptoms of anxiety on a continuing basis—such as not being able to stop or control worrying, worrying too much about multiple things, difficulty relaxing, and feeling restless—should talk with their doctor.
In another recent statement, the Task Force recommended anxiety screening for children and adolescents ages 8 to 18. That guidance was finalized in October. The draft recommendations for adults will be finalized in coming months.
Anxiety disorders—which include generalized anxiety disorder, social anxiety disorder, panic disorder, and substance/medication-induced anxiety disorder—often go unrecognized and undiagnosed by primary care doctors, which can delay treatment for years.
One screening tool that may be used by your doctor as part of the assessment is the GAD-7, which asks seven questions about anxiety levels over the past two weeks. The score indicates if you have minimal, mild, moderate, or severe anxiety. The Task Force suggests that adults be screened if they haven’t been before, but how often screening should be repeated can be left to clinical judgment based on the patient’s history, medical conditions, risk factors, and life events.
Key, however, is for there to be follow-up and treatment of anxiety disorders. While anxiety is a normal human response in many situations, treatment is advised when it becomes intense enough to interfere with daily life—not only to alleviate the mental symptoms but also to prevent the physical effects that can occur from a constant state of anxiety, such as to the cardiovascular system, immunity, and digestive processes. Among the best treatments is cognitive behavioral therapy (CBT), where you learn ways to put stressful events in perspective. Depending on the type and level of anxiety, meditation, yoga, walking in nature—or medication—may be of value.
