The Importance of Screening for Anxiety and Depression

In September of 2022, the United States Preventive Services Task Force (USPSTF) released draft recommendations stating that all adults under age 65 should be screened for anxiety and depressive conditions.

The Task Force, an independent voluntary panel of national experts in disease prevention and evidence-based medicine, cites that Americans are reporting symptoms of mental health conditions following the height of the COVID-19 pandemic. These recommendations are backed by recent data from the Centers for Disease Control (CDC), which found that more than 30 percent of Americans have symptoms of an anxiety or depressive condition.

This new draft recommendation is directed to individuals who have not been diagnosed with a mental health condition or have not shown signs of depression or anxiety. Mental health conditions are routinely underdiagnosed and undetected in our healthcare system. The goal of the recommendation is to improve detection rates of mental health conditions among Americans.

Encouraging Americans to screen for anxiety and depression will help destigmatize mental illness and facilitate conversation around managing and treating mental health conditions.

Understanding Anxiety and Depression

While feelings of anxiety can be normal in response to anticipation of a stressful or frightening event, anxiety disorders arise when the worry and stress interfere with our ability to function in our day-to-day activities. Anxiety often causes paralyzing feelings that cause us to avoid situations, preventing us from enjoying our lives.

Common anxiety feelings

“I know there’s nothing I can do about it now, but I just can’t get my mind off of it.”
“I can’t help but feel that everyone is judging me, even if they don’t know me.”
“I can’t sleep because I just keep thinking about everything.”

Depressive conditions are more than being down or sad about an event. Depression is a

collection of symptoms that cause you to withdraw from your life, often with a loss of joy and vitality.

Common depression feelings

“It’s like I’m watching life from a distance instead of living in it. I want to change it, but I don’t feel motivated to.”
“I feel exhausted all the time, and every little task is tiring. I want to go home and be done for the day, even when I’m already at home. It’s really hard to leave my bed.”
“Physically, it feels like I am sick. My body is breaking down. Mentally, I feel like I deserve this.”

What to expect for anxiety and depression screening

Anxiety

The anxiety screening scales endorsed by the US Task Force are based on anxiety feelings and symptoms. You will first be asked to rate these two feeling statements on a scale of 0-3 in the context of the past two weeks.

Feeling nervous, anxious, or on edge
Not being able to stop or control worrying

If you score above a certain threshold, you will then be asked a series of follow-up questions. These questions expand on the previous questions to evaluate the following symptoms of anxiety:

Trouble relaxing
Restlessness
Constant worry
Irritability
Fear of what may happen

Depression

Like the anxiety screening scales, the depression screening scales will start with an initial short screener question, followed by a longer questionnaire if you screen positive. Again, you will be first asked to rate two depression feeling statements on a scale of 0-3 during the past two weeks.

Little interest or pleasure in doing things
Feeling down, depressed or hopeless

Follow-up questions include an evaluation of these depression symptoms:

Loss of interest in daily activities
Poor sleep quality or oversleeping
Low appetite or overeating
Feelings of guilt, failure, or worthlessness
Suicidal thoughts

Screening for anxiety and depression will benefit us

Anxiety and depression are common and debilitating health conditions. As evidenced by the surge in demand for mental health services during the pandemic, a substantial portion of Americans require mental health treatment. During the first year of the pandemic, the global prevalence of anxiety and depression increased by 25%.

There is concern that the current system cannot handle more patients needing treatment for anxiety or depression. For many, receiving treatment for their mental health is impeded by long waitlists.

Alternatively, increased screening for anxiety and depression promotes mental health education and reduces stigma. Elevating awareness of mental health will facilitate funding and research. Ultimately, these factors will improve access to treatment in the long run.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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About the Author: Ryan S. Sultán, MD, is a board-certified adult and child psychiatrist who trained at Columbia, Cornell, and Harvard, and is the Director of Integrative Psych in Manhattan. His expertise includes evaluating and treating ADHD, anxiety, depression, and substance use.

Dr. Sultán is also a National Institute of Drug Abuse and National Institute of Mental Health researcher and an Assistant Professor of Clinical Psychiatry at Columbia University, where he researches substance use and mental health medications in youth.

You can find his practice’s website here.

Photo by Todd Quackenbush on Unsplash

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