If you’re under 65, your next check-up could include a new screening — one for anxiety.
A panel of medical experts is, for the first time, recommending that adults under the age of 65 get screened annually by their primary care physician for the increasingly common mental health condition, even if they don’t have symptoms.
Doing so can help identify an anxiety disorder early on so people can be connected to care, U.S. Preventive Services Task Force member Lori Pbert said in a Sept. 20, 2022 statement, when the group's draft recommendation was first posted. The recommendation was finalized on June 20, 2023, and published in the medical journal JAMA.
“This is, I think, sorely needed and sorely overdue,” says Robert Hudak, M.D., a psychiatrist at University of Pittsburgh Medical Center Western Psychiatric Hospital.
Anxiety disorders are the most common mental health issue in the United States. Over 15 percent of adults reported experiencing symptoms of anxiety in 2019, according to the Centers for Disease Control and Prevention (CDC). Earlier federal data shows roughly 20 percent of U.S. adults have an anxiety disorder. And the pandemic has only aggravated the issue, sending cases soaring above these estimates, both in the U.S. and abroad, studies show.
“I really think the COVID pandemic shined a light on the impact that daily stress and anxiety can cause on people,” says Lauren Gerlach, a geriatric psychiatrist and assistant professor in the department of psychiatry at the University of Michigan Medical School.
One CDC report found that between August 2020 and February 2021, the percentage of adults with recent symptoms of an anxiety or a depressive disorder increased from 36.4 percent to 41.5 percent.
The numbers have declined some since the height of the pandemic, says Gail Saltz, M.D., a clinical associate professor of psychiatry at New York-Presbyterian Hospital/Weill Cornell Medical College and a psychoanalyst at the New York Psychoanalytic Institute in New York City. But there are still plenty of lingering stressors that can impact anxiety levels, like loss of a loved one from COVID-19 or economic hardships, she says.
Despite its prevalence, anxiety is often unrecognized in primary care settings, the U.S. Preventive Services Task Force says, and few providers screen for it. But checking for warning signs in patients who aren’t exhibiting clear symptoms could “substantially increase the likelihood that patients receive treatment in a timely manner, potentially saving years of suffering,” the USPSTF says.
If left untreated, anxiety disorders can lead to a number of other health issues. For example, individuals may have trouble functioning normally at home, at work, or in their relationships, Saltz points out. “And leaving that go for long periods of time obviously has real ramifications for a person’s ability to stay engaged in their family, with friends, with work, career development, all of that,” she says.
Untreated anxiety can also lead to clinical depression and can have an impact on everything from blood pressure to peptic ulcer disease to chronic pain disorders. What’s more, it can cause high levels of cortisol, a stress hormone, to circulate in the body. “And we know that chronic high levels of circulating cortisol have damaging effects on the body and the brain,” Saltz says. (Overexposure to cortisol can increase a person’s risk for heart disease and memory and concentration problems, according to the Mayo Clinic.)
“[Anxiety] affects such large numbers of people, and the ramifications of lack of identification and therefore treatment are so substantial that this could make a public health impact,” Saltz said about the recommendations.