Factors affecting mental health in the US, according to survey 1:52
(CNN) --
All adults under the age of 65 should undergo anxiety screenings, according to the influential US Preventive Services Task Force (USPSTF), which released a new report last month. draft recommendations.
The recommendations, which help guide doctors' decisions, aren't final until a public comment period concludes later this month.
However, it is the first time that the national think tank has recommended screening for anxiety in such a large section of the US population.
What symptoms can people have?
How often should anxiety screening be done and what does it consist of?
What treatments exist?
And what do these recommendations mean?
US Task Force first proposes recommendation to screen for anxiety in adults
To answer these questions, we spoke with Dr. Leana Wen, a CNN medical analyst, emergency room physician, and professor of health policy and management at the George Washington University Milken Institute School of Public Health.
She is also the author of "Lifelines: A Doctor's Journey in the Fight for Public Health."
CNN: How common are anxiety disorders?
Dr. Leana Wen:
According to the US Preventive Services Task Force draft recommendations, the lifetime prevalence of anxiety disorders is 26% for men and 40% for women .
This means that about 1 in 4 men and 4 in 10 women will develop an anxiety disorder at some point in their life.
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Clearly this is a problem that needs to be addressed.
Anxiety, like depression and other mental health issues, should be treated with the same attention we give physical health issues.
I am glad that the task force has issued recommendations that will increase awareness of the need to diagnose anxiety.
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CNN: How do you define anxiety?
Wen:
This is an important clarification: it is crucial to distinguish feelings of anxiety from a medical diagnosis of an anxiety disorder.
Anxiety is a normal reaction to stress.
Everyone feels some level of nervousness about situations in their life.
Anxiety disorders are characterized by persistent and excessive fear or anxiety that affects a person's ability to function.
They can lead people to avoid situations, social engagements, professional functions, dates, or even daily tasks, for example, and affect their jobs, education, and personal relationships.
Anxiety disorders include a number of diagnoses, such as generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias.
CNN: Are there any population groups that may be at higher risk for anxiety?
Wen:
The presence of some other mental health condition increases the likelihood that a person will develop anxiety disorders.
For example, depression and anxiety often coincide.
A large study found that 67% of people with depression also had an anxiety disorder.
There is also a relationship between anxiety disorders and tobacco and alcohol consumption.
Stressful life events, such as job loss, bereavement, or pregnancy, can also increase the likelihood of anxiety disorders.
(The draft recommendations also acknowledge the need for further research on the prevalence of anxiety disorders in population groups defined by race and ethnicity, sexual orientation, and gender identity, among others.)
CNN: What are some of the symptoms of anxiety disorders?
Wen:
People with anxiety disorders can experience a wide range of symptoms: being restless and restless, having a sense of panic or doom, having difficulty concentrating or sleeping, and experiencing panic attacks.
Panic attacks are characterized by palpitations, shortness of breath, or cold, tingling hands.
It is important to note that many people with anxiety disorders may have other physical symptoms.
For example, some develop headaches, stomachaches, nausea, and fatigue.
Because the symptoms of anxiety disorder are so varied, they are often not easily detected and diagnosed.
CNN: How often should doctors screen their patients for anxiety?
Wen:
The working group's draft recommendations don't specify.
This is because there is not yet enough research to say that detection of anxiety has to occur in a certain time interval.
The national task force advocates a "pragmatic approach" that "could include assessment of all adults who have not had it before and the use of clinical judgment to consider other factors, such as underlying health conditions and events of life, to make decisions about whether further evaluation is necessary for people who are at high risk.
What this tells me, as a clinician, is that if we have never examined a patient for anxiety, it is good practice to do so at least once.
(This usually involves patients filling out a questionnaire and/or answering a series of questions during a medical appointment.)
Then, depending on what we have detected in a patient's changing circumstances, we can re-assess.
For example, we might make an assessment if a patient has had a recent life change, has been diagnosed with depression or another mental illness, or has reported increased alcohol use.
Doctors should also be on the lookout for other symptoms that may indicate an underlying anxiety disorder.
CNN: What treatments are there for people who have been diagnosed with an anxiety disorder?
Wen:
Like depression and some other mental health diagnoses, anxiety disorders can be treated with pharmacotherapy, psychotherapy, or both.
Pharmacotherapy includes medications, while psychotherapy includes cognitive behavioral therapy that is done by working with a psychologist or other mental health specialist.
Doctors also often recommend lifestyle changes, such as meditation, exercise, and reducing alcohol and tobacco use.
Some patients need continuous treatment.
Many receive treatment for a period of time and then are followed up to see if they may need it again.
The bottom line is that the treatments work.
They reduce the symptoms of anxiety disorders and help people bring well-being back into their lives.
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CNN: What should someone do if they think they might have an anxiety disorder?
Wen:
There are online screening tools that people can use to see if they might have anxiety, including the Generalized Anxiety Disorder scale.
Anyone who thinks they might have an anxiety disorder should make an appointment with their primary care doctor.
If they already go to a mental health specialist, they might as well go directly to that person.
It is important to tell your doctor about all your symptoms.
Some that don't seem directly related may actually point to an anxiety disorder.
There is no need to waste time either, the treatment exists and it works.
If you had a physical health problem, for example, headaches due to migraines or stomach pains due to ulcers, you would want it addressed.
Mental health problems should be treated in the same way, with the same level of urgency.
CNN: Why do the recommendations say screenings should be for adults under 65? What about children or elderly people?
Wen:
The task force specifies that the evidence is strongest to support routine screening for anxiety in adults younger than 65 years.
That doesn't mean that children or older adults shouldn't have an anxiety assessment.
It is good practice for clinicians to be aware of anxiety symptoms or concerns in all of their patients, regardless of age, and likewise for patients to raise the possibility of anxiety symptoms with their health care provider.
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CNN: What's the next step for the task force's recommendations, when will they go into effect?
Wen:
These recommendations are at the draft stage for now, which means that the working group is asking for comments from the public until October 17.
I anticipate they will be finished by the end of this month.
Even then, it remains the responsibility of healthcare professionals to apply anxiety screening to their patients.
I hope the recommendations achieve their crucial goal of raising awareness of anxiety disorders and getting more patients treated for this mental health problem.
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