Once a taboo topic, the US is shining a spotlight on anxiety. The US Preventive Services Task Force recently updated its guidelines and, for the first time, is recommending all adults between 19 to 64 get regularly screened for a possible anxiety disorder even if they are not showing symptoms.
“It’s good to hear that the medical community is taking up more mental health issues,” says Dr. David Tzall, a licensed psychologist in New York City. “This was something that was long overdue because people are going to most likely see their medical provider, but not a mental health provider. And this is a way to have a continuous level of care and potentially catch someone when they are feeling anxious or even depressed.”
Anxiety disorders affect 15 million adults in the US, yet only a small number affected are actively seeking treatment. One reason for not seeking care is that people feel reluctant to go get help because of fears of being judged for being mentally ill. Others might recognize they’re anxious but may not feel like their feelings warrant a trip to the doctor.
Everyone gets anxious, whether it’s from a looming deadline at work or dealing with money problems. No one should have to live with this unbearable stress — especially if it’s starting to interfere with your daily routine. The updated recommendations are also a sign that anxiety is normal and not something you have to power through. Help is available.
There are a lot of different stressors that increase a person’s anxiety. As an adult, anxiety commonly comes from the stress of work-related issues, family problems, financial concerns, and major life changes. An anxiety-producing event is developing a medical condition like heart disease or cancer. Not only are you thinking about the condition, but you must now confront the possibility of death.
More recently, the COVID pandemic has been a stressor to all. People’s lives came to a grinding halt, and many felt alone in their distress when receiving the news of a layoff or their loved one passing away. The lost sense of security and normalcy contributed to a 25 percent increase in anxiety and depression. It was especially hard among young people who had a greater risk for suicide and self-harming behaviors.
There are times when it might feel like anxiety springs out of nowhere. Dr. Tzall says past traumas like childhood abuse and accidents can trigger anxiety. Genetics is another big piece of the puzzle. Having a family history of mental health problems will raise the likelihood that you develop anxiety.
The updated recommendations placed special emphasis on screenings in pregnant adults or those who have just given birth. Feeling anxious is a completely normal feeling. Not only are you worried about your child, but it’s also a time when your hormones are all over the place. The stress hormone cortisol, for example, tends to increase during pregnancy because it plays an important role in fetal development. But constant stress and anxiety can do the opposite, harming the well-being of mother and child. “If you can manage the anxiety during pregnancy, it’s likely going to help after the pregnancy,” Dr. Tzall explains.
Your mental health provider may use a variety of tests involving questionnaires to screen for a potential anxiety disorder. Dr. Tzall compares it to a structured interview where people are asked questions like their eating habits, how long they have thought about hurting themselves, or when did they start having feelings of hopelessness. There may also be other tests to measure the severity of a person’s anxiety where they can rate the anxiety from being manageable to excessive or extreme distress. Your doctor might also perform a physical exam to rule out other explanations for your symptoms such as hypothyroidism or side effects of medication.
Dr. Tzall says anyone having thoughts about suicide or self-harm should seek out care. It does not matter if you do not have any plan or intention at the time because there is a chance of these intrusive thoughts getting worse over time. You’ll also want to take a critical self-evaluation of your life. Are you disengaging from activities that you previously found fun? Are you avoiding certain places? Are you up most of the night ruminating and replaying past incidents? Anxiety can manifest into physical symptoms, so you’ll also want to identify any unexplained GI issues, trembling, and restlessness.
Once you get screened for an official anxiety diagnosis, the next step is deciding what therapy is the right fit for your needs. Jeanette Lorandini, a clinical social worker at SuffolkDBT, says there are three main questions you need to ask yourself:
- Do I want to be in therapy for a few months, or am I willing to do it long-term?
- Do I have insurance with mental health coverage?
- Would in-person or virtual be better for me?
“These questions will help you start the process and narrow down the options,” Lorandini explains. “The first steps can often be the hardest because they’re new. Your therapist will understand and appreciate the work it took to get there.”
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