All Adults Under 65 Should Be Screened for Anxiety

The U.S. has an anxiety problem. Just under a third of all adults in the country will experience an anxiety disorder at some point in their lives, according to the National Health Institute. Lots of us experience anxiety, but an anxiety disorder is when your worries, fears, and concerns interfere with your daily activities and responsibilities. This can include generalized anxiety, separation anxiety, social anxiety, and various phobias.

That’s why the U.S Preventive Services Task Force is recommending that all adults under age 65 be screened for anxiety at least once a year – even if they aren’t showing symptoms or seeking mental health services.

The change in policy comes amid growing concern about depression, suicide, and anxiety. While the recommendation isn’t mandatory, it will likely change the way doctors in the U.S. practice medicine.

The Task Force, which published its findings in JAMA, said all adults ages 19 to 64 should be screened for anxiety during regular physicals and checkups, including pregnant women and those who are postpartum. Last October, the Task Force recommended that all children ages 8 to 18 be screened for anxiety as well. The agency said it didn’t find sufficient evidence to screen adults over the age of 65 for anxiety.

Providers can use questionnaires and screening tools to assess their patients’ mental health with questions like “How often do you feel nervous, anxious, or on edge,” “Have you been so restless that it is hard to sit still,” or “Do you regularly feel afraid that something awful might happen?”

The group consists of a panel of doctors and health experts appointed by the Department of Health and Human Services tasked with preventing the spread of illness and disease through early detection.

Dr. Wanda Nicholson, vice chair of the task force, called the announcement a “call to action” for providers and health facilities.

Screening all adults in this age group for anxiety can help remove the stigma of dealing with a mental health issue, so patients don’t feel like they are being singled out.

“There are a lot of patients who come to primary care who may be experiencing symptoms but don’t bring them up,” Michael Silverstein, vice chair of the task force told The Washington Post. “So, it’s about finding people and alleviating that burden earlier rather than waiting for them to come to their doctors with signs or symptoms.”

The Task Force also reiterated its earlier recommendation that all adults in the same age group be screened for depression.

Screening more people for anxiety will increase the number of people diagnosed with mental health issues, and it’s not clear that these individuals will find the help they need.

Estimates show some 160 million Americans live in areas with mental health professional shortages. The policy will likely put more pressure on an already overburdened mental healthcare system. But detecting these issues sooner can help reduce the number of people struggling with anxiety later on in life.

“There’s a potential bottleneck at the beginning when we have a lot of professionals who are already stretched thin providing services to people who’ve had anxiety problems or depression that are persistent and chronic and therefore require more effort and energy,” Lynn Bufka, associate chief of practice transformation at the American Psychological Association, told the Post. “If some of those individuals had gotten help sooner, they may not have required as long of a course of care.”

“If we can begin to shift so that people get a level of care that meets their needs sooner, that, in the long term, will be beneficial for the balance within the system,” Bufka added.

Detecting the symptoms of anxiety can be difficult, as the condition manifests in people in different ways. Some patients have been living with anxiety their entire lives, making it a part of their personality.

“People who struggle with GI illness, pain or sleep disturbances often don’t make the connection that there might be an underlying anxiety issue contributing to that,” said Natalie Dattilo, clinical psychologist at Brigham and Women’s Hospital and instructor at Harvard Medical School. “I’ve met with people who’ve been struggling with anxiety for so long that they’ve come to accept it as who they are and haven’t realized the ways in which their anxiety has kept them from doing things, and how limited their life has become as a result of the anxiety.”

However, mental health experts note that occasionally feeling anxious isn’t the same as having an anxiety disorder.

“We want to recognize that just because you’re having some of these problems — you’re irritable or you’re worrying often — that in and of itself does not mean you have an anxiety disorder,” Erlanger Turner, associate professor of psychology at Pepperdine University, explained.

Sign up for a screening the next time you get a checkup.