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Health experts say all adults 65 and under should be screened for anxiety disorders


Earlier this year, an influential panel of health experts issued a draft recommendation saying that doctors should screen all adults under 65 years old for anxiety. Today, for our series on anxiety, we will explore what those recommendations mean and how to best access treatment. NPR's health correspondent Rhitu Chatterjee joins us now. Hi, Rhitu.

RHITU CHATTERJEE, BYLINE: Hi, Juana. So glad to be here.

SUMMERS: Glad to have you. So start by telling us a little bit more about these screening recommendations.

CHATTERJEE: So they come from what's called a U.S. Preventive Services Task Force. And they're recommending that primary care physicians should screen all adults 64 years and under for symptoms of anxiety. So, you know, every time you or I go to the doctor, we'd be asked a set of questions from a standardized screening tool. And if somebody is experiencing symptoms, their doctor can then connect the person to appropriate treatment. And I spoke with Dr. Rebecca Brendel. She's the president of the American Psychiatric Association. And she says screening people is a critical first step, especially given just how common anxiety disorders are.

REBECCA BRENDEL: It's estimated that about 20% of Americans at any given point in time are experiencing symptoms of an anxiety disorder.

CHATTERJEE: And that could mean generalized anxiety disorder, social anxiety disorder, obsessive compulsive disorder. And I should add that having high levels of anxiety on any particular day doesn't necessarily mean that somebody has a disorder. That's something for a mental health care provider to diagnose, ultimately.

SUMMERS: You know, we hear so much about how overwhelmed doctors already are, and this would be adding another thing to their plate. I mean, is that even feasible?

CHATTERJEE: It's a great point. But as Brendel points out, many doctors are already screening for depression. You know, every time I go to see my primary care doctor here in D.C., a nurse asks me about my mood when she's taking my weight and blood pressure. And it really doesn't take that long. And Brendel says that depression screening, which has been going on for a few years, has really had an impact.

BRENDEL: What we do know is that for people who screen positive for symptoms of depression, they are getting care at the point of primary care contact, and that's really important.

SUMMERS: And, Rhitu, how are anxiety disorders treated?

CHATTERJEE: So there are really good evidence-based treatments, and anxiety disorders do respond well to them. The treatments include medication and psychotherapy, and a combination of the two are particularly effective. And a specific type of therapy called cognitive behavioral therapy, or CBT, is the most effective. And it includes something called exposure therapy. So the person with the disorder is exposed slowly to a specific trigger for anxiety in the presence of a mental health care provider until, over many sessions, the person becomes more comfortable and no longer feels anxious when they encounter that trigger.

SUMMERS: And to me, this raises a question of access, right? What if you're someone who lives in an area where there just aren't that many therapists?

CHATTERJEE: That's such an important question, Juana, because access to mental health care providers is a huge issue. And some of that is because of a shortage of providers. And many are even leaving their professions because of burnout since the pandemic. And also because reimbursement rates for mental health care providers are really low. And that essentially translates into many people who need help don't get it, people like Eleanore Regenthal, who's a full-time student, and she struggled with anxiety through the pandemic. She lives in Mocksville, N.C., which is a rural area.

ELEANORE REGENTHAL: There's definitely no chance of finding therapists out here. But when I was closer to the city, there were a plethora of therapists, psychologists, psychiatrists nearby. Still, none of them were accepting new patients.

CHATTERJEE: And one of the ways in which health care providers are trying to address this is by having primary care doctors consult with a psychiatrist so they can do some of that front-line mental health care. And this model is called a collaborative care model. Now, I have to admit that there is a lot more that needs to happen on that front to improve access, but it's the general direction that the field is headed.

SUMMERS: That's NPR's Rhitu Chatterjee. Thank you so much.

CHATTERJEE: Thank you, Juana. Transcript provided by NPR, Copyright NPR.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.
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