Why the U.S. Preventive Services Task Force Now Recommends Screening Adults for Anxiety Disorders

The best medicine is preventive medicine, and most of us are familiar with preventive health screenings. When we go for a check-up, we’ll have our blood pressure checked, we’ll be screened for diabetes with a blood test, and may be scheduled for a mammogram or a colonoscopy. 

These screenings save lives by detecting the early signs of illness when they’re easier to treat and before they can cause serious problems.

The U.S. Preventive Services Task Force (USPSTF) recently added a new screening test to their list of recommendations. It’s for anxiety disorders. Anxiety may not appear to be as serious as high blood pressure, diabetes, or cancer, but mental illnesses can have profound effects on a person’s life, and can be debilitating or even life-threatening.

Anxiety disorders are actual illnesses, and that’s very different from the experience of occasional anxiety. Everyone gets anxious sometimes. It’s a normal, unavoidable human emotion. 

Johnny Carson, who hosted The Tonight Show for 30 years, said he suffered terrible stage fright before nearly every show. For almost anyone, a job interview, a first date, or a big presentation at work can trigger feelings of apprehension, worry, and nervousness.

But that’s not what an anxiety disorder is. 

People who live with an anxiety disorder experience abnormal activity in the brain regions responsible for alarm. That triggers symptoms of anxiety for no apparent reason at all. This is the essential feature that distinguishes anxiety as a disorder from “normal” feelings of anxiety that are provoked by an actual perceived threat.

People with generalized anxiety disorder (GAD) worry all the time over seemingly trivial things. Intellectually, they may know there’s no point in worrying, but it’s outside of their control. 

Anxiety disorders also have physical effects. There are both acute symptoms like rapid heart rate and sweating, as well as chronic symptoms like muscle tension and difficulty winding down at the end of the day.

Social anxiety disorder produces intense discomfort in social situations, sometimes making it almost impossible to venture out in public.

Panic disorder is characterized by episodes of intense fear, accompanied by a racing heart, feelings of suffocation, chest pain, and an overwhelming sense of doom. What’s unusual about this illness is that the attacks may come out of the blue for no reason at all, sometimes striking in the middle of the night during sleep.

A patient of mine with panic disorder experienced panic attacks about once a month. They were unpredictable and unprovoked, often occurring while she was quietly sitting at her desk. She had lived with this disorder for most of her life.

On 9/11, she was in downtown Manhattan when the World Trade Center was attacked and had to run for her life to escape the cloud of dust chasing her down the street. 

She was terribly frightened but didn’t have a panic attack. Despite the catastrophic events unfolding around her, her brain was functioning normally that day. Her panic disorder wasn’t triggered by events we might think of as being panic-inducing—it followed its own logic. 

Over the course of a lifetime, anxiety disorders affect about 25% of men and 40% of women. Unfortunately, they’re often missed by healthcare providers, and people suffer for years before a diagnosis is made. 

That’s why universal screening is so important. In the United States, the median amount of time between the onset of an anxiety disorder and starting treatment is 23 years. That’s much too long, because anxiety disorders are serious illnesses.

People with an anxiety disorder live in a state of constant stress. That can lead to physical problems such as nausea, stomach cramps, and diarrhea. It can interfere with sleep and make it more difficult to recover from illness and injury. It also raises the risk of heart disease. 

Anxiety disorders can limit social opportunities, as people tend to avoid situations that may increase their anxiety. They can make it hard to concentrate at work, leading to potential loss of income and unfulfilled potential. 

While they’re often underappreciated, anxiety disorders can have terrible effects on a person’s life, and the implementation of routine screening will benefit millions of people.

Receiving a diagnosis of an anxiety disorder can be frightening. Some people may even feel shame, mistakenly confusing a medical illness with character weakness. 

But the diagnosis is, in fact, good news. The earlier an anxiety disorder is recognized and treated, the better the outcomes. Screening takes only minutes, typically involving a 7-item multiple-choice questionnaire. 

It’s easy. It’s quick. And it can change your life.