Category: Anxiety

Panel Recommends Routine Anxiety Screening for Adults Under 65—Here’s What That Could Look Like The U.S. Preventive Services Task Force (USPSTF) has released a draft recommendation urging the screening of all adults under the age of 65 for anxiety disorders. This recommendation aims to normalize the screening process for anxiety and highlights the importance of identifying these disorders early to provide appropriate care. The COVID-19 pandemic has had a significant impact on people’s mental health, and there is a growing recognition of the increased struggles individuals are facing. The USPSTF believes that clinicians should have the ability to screen for anxiety disorders in order to identify them early and ensure that individuals receive the necessary care. While the USPSTF recommends widespread screening for anxiety disorders, it reiterates the need for screening for depression in adults but does not propose the same level of universal screening as it does for anxiety. This recommendation acknowledges the importance of addressing mental health concerns and the impact they have on overall well-being. By normalizing the screening process, it is hoped that more individuals will receive the necessary support and treatment for anxiety disorders. As the recommendation progresses, it has the potential to impact healthcare by promoting routine screening for anxiety disorders and ensuring that mental health is given the same importance as physical health in clinical settings. It highlights the need for healthcare providers to be equipped to address mental health concerns and provide appropriate care to individuals experiencing anxiety. Staggering Rates of Mental Health Issues in the U.S. The reported rates of anxiety in the U.S. have been increasing over the years, with a significant jump observed between 2008 and 2018. This rise in anxiety rates is particularly pronounced among young adults. The COVID-19 pandemic further exacerbated anxiety issues, with an increase in symptoms of anxiety and depression observed during the pandemic. This global impact prompted the U.S. Preventive Services Task Force (USPSTF) to prioritize the recommendation for anxiety screening. Anxiety disorders often go under-identified and under-recognized in primary care settings. The USPSTF recognizes that it takes an average of 23 years for individuals with anxiety disorders to receive appropriate treatment, highlighting the importance of early screening and access to care. Anxiety disorders are highly prevalent, affecting around 26% of men and 40% of women over their lifetime. Through their review of available evidence, the USPSTF concluded that screening for anxiety in adults under the age of 65, including pregnant and postpartum individuals, can help identify anxiety early and facilitate appropriate care connections. The recommendation for anxiety screening aims to address the common and significant impact of anxiety disorders on individuals’ mental health and overall well-being. By implementing routine screening, healthcare providers can identify anxiety disorders more effectively and ensure that individuals receive timely and appropriate support and treatment. What Would Widespread Screening Look Like? It’s important to note that the recommendation from the U.S. Preventive Services Task Force (USPSTF) regarding anxiety screening is currently in the draft stage and open for public comment until October 17. While the USPSTF findings are influential for doctors, they are not binding and independent from the U.S. government. If the recommendation were to be widely adopted, patients would be asked to complete a questionnaire about their moods and worries during their primary care visits. If a doctor identifies potential concerns regarding anxiety disorders, they would refer the individual to a mental health professional for further evaluation and discussion of diagnosis or treatment options. This initial screening would likely be a one-time occurrence, unless there are specific concerns raised by the healthcare provider. Anxiety screening is a valuable tool for early detection and intervention, as anxiety can often be misinterpreted or normalized as benign stress. By incorporating screening into routine healthcare visits, individuals with anxiety symptoms can be identified and connected to appropriate care. It is worth noting that the recommendation currently applies to adults under 65, and more research is needed to understand the effectiveness of anxiety screening in different demographic groups. The USPSTF did not find sufficient evidence to recommend anxiety screening for individuals over 65, but providers may still consider screening if deemed beneficial. Additional research is also needed to explore screening for depression and suicide risk, as well as their relevance to specific populations based on factors such as race, ethnicity, gender, and sexual orientation. It’s important for individuals experiencing signs or symptoms of anxiety, depression, or suicidal thoughts to communicate their concerns with healthcare professionals, as appropriate assessment and connection to care are crucial for their well-being. Screening Uncovers the Issue, But Barriers to Treatment Endure While the recommendation for anxiety screening is a positive step towards identifying cases of anxiety disorders, it is essential to acknowledge that diagnosis is just one component of mental health care. After individuals are screened and receive a diagnosis, timely access to treatment is crucial, but there are often barriers that can hinder this process. Disparities in diagnosis and treatment rates for mental health conditions, such as depression, have been observed. Studies have shown that a significant proportion of individuals who screen positive for depression do not receive timely follow-up care within three months. Various factors contribute to these disparities, including cost. Affordability can be a significant deterrent for people seeking mental health services, as highlighted in surveys where individuals cited cost as a barrier to accessing the mental health care they need. Insufficient availability of mental health professionals is another challenge. Many areas, especially rural communities and communities of color, face difficulties in accessing mental health services due to a lack of providers. This shortage highlights the need to expand mental health services and improve accessibility across different populations and geographic regions. There is also a need to bridge the gap between primary care providers and mental health professionals. Collaboration and communication between these two sectors are essential to ensure that individuals identified with mental health conditions receive appropriate diagnosis and treatment. Addressing these barriers requires comprehensive efforts, including adequate funding for mental health

Is Anxiety Contagious? Similar to how viruses can be contagious, stress and anxiety can also be "caught" from others, according to Carla Marie Manly, PhD, a clinical psychologist. Mirror neurons in our brain, which are activated when we observe others’ actions or experiences, may play a role in this phenomenon. This means that when we witness someone else’s stress or anxiety, we can internalize those feelings within ourselves. Research has shown that stress contagion is a real phenomenon. A study published in Scientific Reports in 2017 demonstrated that watching anxious speakers led to an increase in heart rates among the viewers, indicating a physiological stress response. Additionally, individuals with higher levels of empathy tend to be more susceptible to absorbing others’ stress, although not necessarily to a greater extent than those with lower empathy. While it’s natural to be affected by the stress and anxiety of others, it’s important to remember that you have the power to mitigate its impact on your well-being. By practicing certain strategies proactively, you can better navigate and cope with stressful situations. These strategies can include self-care practices such as mindfulness, deep breathing exercises, setting boundaries, and seeking support from trusted individuals. By taking proactive steps to manage your own stress and anxiety, you can protect yourself from being overwhelmed by the emotions of others. Remember, you have the ability to maintain your own well-being even in the face of external stressors. Make a Positive Pivot When faced with a situation where your friends are discussing a topic, such as politics, that you would rather not dwell on and want to maintain a positive atmosphere, it can be helpful to validate their points while redirecting the conversation in a more uplifting direction. Jennifer L. Taitz, PsyD, suggests validating their concerns and then introducing a new topic that promotes gratitude and positivity. For instance, you can acknowledge the challenging nature of the current political climate by saying something like, "I understand that these are tough times. Can we take a moment to share something that we’re grateful for?" By shifting the focus towards gratitude, you can set a more positive tone for the conversation. Remember, you have the ability to guide the direction of the discussion and contribute to a more uplifting and enjoyable atmosphere for everyone involved. Label Your Emotions Dr. Jennifer L. Taitz emphasizes the importance of labeling and acknowledging your emotions as a means of regulating them effectively. By giving a name to the specific emotions you are experiencing, you can gain a sense of control over them rather than feeling overwhelmed by their intensity. For instance, if you recognize that you are feeling anxious because your friend Maggie is stressed about her job, and this triggers concerns about your own job security, acknowledging these feelings can be empowering. By confronting and identifying the underlying reasons for your agitation, you can begin to address and manage them more effectively. This process of emotional labeling allows you to gain insight into the sources of your distress and take appropriate steps to address and navigate through them. It helps to create a greater sense of self-awareness and empowers you to actively engage with your emotions rather than being consumed by them. Mentally Remove Yourself From the Situation Dr. Carla Marie Manly suggests employing a visualization technique where you imagine yourself detaching from the situation and adopting the perspective of an impartial observer, such as a researcher or photographer. By doing so, you create psychological distance and release any judgment or emotional entanglement. As you visualize this detachment, it is beneficial to practice deep and focused breathing. Deep breathing activates the parasympathetic nervous system, which promotes a state of relaxation and calmness. This physiological response can further support your emotional detachment and help alleviate any stress or anxiety you may be experiencing. By mentally and emotionally distancing yourself from the stress of others, you recognize that you have the power to choose your level of involvement and not be overwhelmed by their emotions. This technique allows you to maintain your own sense of peace and well-being while still empathizing and supporting others from a healthier and more balanced standpoint. Take Action When you feel anxiety rising within you, it can be helpful to assess whether there is any action you can take to address the issue causing the anxiety. If you determine that there is nothing you can do to change the situation, take a deep breath and visualize releasing it as you exhale slowly. This process allows you to let go of the worry and tension associated with the situation. However, if you realize that there are steps you can take to address the issue, it is important to take action. Even small actions can make a difference. For instance, if consuming too much news exacerbates your uneasiness, you can take a proactive step like disabling news alerts on your phone or setting limits on your social media usage. By taking these actions, you signal to your body and mind that you are actively addressing the situation, which can provide a sense of empowerment and relief. Remember, whether you can directly change the situation or take steps to manage your response to it, every action, no matter how small, can contribute to a positive shift and help alleviate anxiety. Deflect Their Anxiety When a friend is going through a tough time, it’s natural to want to help them. However, sometimes the best way to support someone is to offer them a distraction. Plan an activity together that will take their mind off of their problems. This could be anything from going for a walk to playing a game. Doing something together will help them to feel less alone and give them a chance to relax and recharge. Here are some specific examples of activities that you could do with your friend: Go for a walk or hike Play a game of cards or board games Watch a movie or TV show Go to a

This Is What It’s Like to Be an Adult With Separation Anxiety Have you ever noticed that when your young child starts crying and holds onto your leg tightly whenever you try to leave for work or run an errand, they may be experiencing separation anxiety? It’s a natural part of their development. However, what many people don’t realize is that adults can also experience separation anxiety. It’s not limited to children. When adults have separation anxiety, they may exhibit various symptoms commonly associated with anxiety. These can include a constant feeling of being on edge, difficulty concentrating or thinking clearly, and physical manifestations such as a dry mouth and headaches. These symptoms can be distressing and interfere with daily life. What Exactly Is Separation Anxiety? Separation anxiety is a condition characterized by feelings of fear or distress when being separated from individuals to whom one is emotionally attached. While it is considered normal and even healthy for young children to experience some degree of nervousness or discomfort when apart from their loved ones between the ages of six months and three years, persistent and excessive separation anxiety in later childhood and adulthood can be classified as an anxiety disorder. The crucial aspect of separation anxiety is that the emotions and behaviors associated with it are disproportionate and not aligned with typical developmental milestones. It becomes a concern when the distress and fear experienced during separations become excessive and are not developmentally appropriate for the individual’s age. Symptoms of Separation Anxiety Elizabeth Zakarin, PhD, an assistant professor of psychology at Columbia University Medical Center, highlights several signs that indicate someone is suffering from separation anxiety. These symptoms may not come as a surprise, but they are important to recognize. One key sign is a constant fear of the possibility of being separated from home or loved ones, even in circumstances beyond their control, such as a house fire or natural disaster. Individuals with separation anxiety disorder struggle with situations that take them away from their loved ones. They may experience extreme distress and anxiety when anticipating overnight business trips that require being away from their child or spouse. They may also have recurrent thoughts related to being separated from their loved ones or display overprotective behavior towards their children. Significant life changes, such as going away to college, moving, or getting married, can be particularly challenging for adults with separation anxiety. Furthermore, those with separation anxiety may obsessively worry that something bad will happen to their loved ones when they are away, such as illness or death. They may be reluctant to spend time away from home, even for school or work. These individuals dislike being alone and may have separation-themed nightmares. Additionally, they may experience physical symptoms like headaches, nausea, or heart palpitations when anticipating or experiencing separation from someone they are close to. These feelings and symptoms can significantly impact relationships and daily life. Separation anxiety disorder can have profound consequences in social and work settings, leading to social isolation, difficulties in maintaining employment or career advancement, challenges in relationships, and overall dissatisfaction with life. Who Gets Separation Anxiety? In the past, separation anxiety disorder was primarily associated with childhood, but the understanding has evolved. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now recognizes that separation anxiety disorder can occur in both children and adults, categorizing it as an anxiety disorder rather than solely a childhood disorder. It is important to note that underdiagnosis of adult separation anxiety disorder has been observed, and data from a nationally representative survey suggests a lifetime prevalence rate of 6.6 percent for this condition. While individuals who experienced separation anxiety in childhood are at an increased risk of developing adult separation anxiety, it is also possible to develop this anxiety disorder as an adult without a prior history. Certain factors can contribute to the development of adult separation anxiety. Significant life transitions like moving away to college, becoming a parent, or experiencing a life stressor or loss can trigger this anxiety, particularly in individuals who have an underlying anxiety disorder. Additionally, a family history of separation anxiety disorder or other mental health disorders may increase the risk. Treating Separation Anxiety Effective treatments are available for separation anxiety, providing hope for those experiencing its challenges. Evidence-based therapies such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) have shown success in treating separation anxiety. These therapies can help individuals identify and challenge negative thought patterns, develop coping strategies, and gradually expose themselves to anxiety-inducing situations in a controlled manner. Couples or family counseling can also be beneficial, facilitating healthier interactions and communication between the individual and their loved ones. In some cases, medications such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed to help reduce anxiety symptoms. Open and honest communication with loved ones is crucial. Sharing your experience and concerns can foster understanding and support from those close to you. It is important to engage in these conversations so that your loved ones can be there for you during the treatment process. Seeking professional help from a healthcare provider is essential for an accurate diagnosis and to develop a comprehensive treatment plan. With the right support and treatment, individuals with separation anxiety can make significant progress, resolve underlying issues, and lead fulfilling lives. Remember, you don’t have to face separation anxiety alone. Reaching out for support and exploring appropriate treatment options can provide a path towards healing and improved well-being.

What Is Eco-Anxiety? How Climate Change Is Affecting Our Mental Health The occurrence of natural disasters in 2020, such as typhoons, hurricanes, wildfires, and others, has raised concerns about the impact of climate change. These extreme weather events are becoming more frequent, and scientists are increasingly linking them to the effects of climate change. During late October and early November 2020, the Philippines experienced the devastating effects of two powerful typhoons that caused widespread destruction. Prior to that, Australia faced severe bushfires that resulted in significant loss of forests, homes, and wildlife. In the United States, the summer of 2020 witnessed record-breaking heatwaves, hurricanes, a rare derecho in the central region, and destructive wildfires that painted the skies orange in the western part of the country. The climate crisis we currently face is not only affecting the Earth’s ecosystems but is also causing a growing sense of unease and anxiety among people worldwide. While not a clinical diagnosis with a specific definition, mental health professionals have introduced the term "eco-anxiety" to describe the increasing sentiments associated with these environmental concerns. Eco-Anxiety Definition Eco-anxiety, as described by the American Psychological Association (APA), refers to a chronic fear of environmental devastation. It is a prevalent condition, with a recent APA poll revealing that 68 percent of US adults experience at least some level of eco-anxiety. Among individuals aged 18 to 34, about half report that climate change-related stress impacts their daily lives. What was once considered a niche issue has now become more widespread due to the increasing occurrence of climate-related events. Climate change is no longer seen as a distant concern but as a pressing reality that affects people directly. Eco-anxiety can have both acute effects, triggered by natural disasters, and chronic effects resulting from gradual climate change. These effects can impact mental health in various ways, including trauma, shock, post-traumatic stress disorder (PTSD), compounded stress, strained social relationships, depression, anxiety, suicidal thoughts, substance abuse, aggression, violence, loss of personally important places, loss of control and autonomy, loss of personal and occupational identity, as well as feelings of hopelessness, fear, or fatalism. It is important to recognize and address the mental health implications of climate change, providing support and resources to individuals experiencing eco-anxiety. Who Is Most Vulnerable to Eco-Anxiety Not surprisingly, those experiencing the direct consequences of climate change—wildfires, superstorms, flooding—are especially vulnerable. Scientists have long studied the psychological health effects of environmental disasters to know the mental health impact is very real. After Hurricane Katrina—the 2005 storm claimed over 1,800 lives—one in six survivors showed signs of post-traumatic stress disorder, suicidal ideation, and suicide more than doubled, and 49 percent of those living in an affected area developed an anxiety or mood disorder. Australia’s Black Saturday bushfires in 2009 left 15.6 percent of the affected community with symptoms of PTSD years after the fact. "We’re going to continue to see climate catastrophes and tipping points," says Doherty. "People have become more used to them, but these really super destructive [events] cause a lot of stress and anxiety." The climate crisis also disproportionately impacts communities of color, according to the United Nations, so they too may be at an even greater risk of eco-anxiety. People of color in the US are more concerned about climate change than their white peers, according to a study by George Mason University’s Center for Climate Change Communication. The authors write the heightened worry is because "[people of color] are often more exposed and vulnerable to environmental hazards and extreme weather events." These hazards include but are not limited to, air pollution, flooding, hurricanes, and wildfires. Some of these environmental problems have been constant, multi-generational threats for communities of color. Take air pollution, for example. A 1999 IOM study found people of color are exposed to higher levels of pollution than their peers. More than two decades later, it’s still a harsh, inequitable reality: Studies have repeatedly shown Black and Hispanic communities are more exposed to air pollution than white communities. To further compound the issue, communities of color tend to have fewer resources (e.g. infrastructure, access to healthcare, lower access to aid after climate-related disasters) to mitigate the effects of the climate crisis and deal with the aftermath of an environmental disaster. What Can Help With Eco- and Climate Anxiety? Climate change is a legitimate concern, and it is natural to experience anxiety in response to the threats it poses. Susan Clayton, an expert in climate anxiety, highlights that a certain level of anxiety can be beneficial as it alerts us to the seriousness of the issue. Anxiety serves as a signal that prompts us to pay attention and take action. To alleviate anxiety related to environmental doom, it is important to shift the dialogue and implement policies aimed at mitigating climate change. Creating greater awareness and acceptance of climate change, along with international efforts to address it, can help alleviate anxiety by providing a sense of collective action. During the Trump administration, environmental protection measures were weakened or rolled back, contributing to heightened concerns. However, it is important to recognize that addressing climate anxiety requires more than just government action. Individual approaches to managing anxiety may vary, from seeking more information to reducing exposure to distressing news. Engaging with local activist groups, communicating with local politicians, and taking personal actions can help regain a sense of control and contribute to positive change. Ultimately, it is crucial to remember that the dysfunctional situation lies in the environmental challenges we face, not in the individuals experiencing anxiety. By collectively taking steps to protect our planet, we can make a meaningful impact and work towards a sustainable future.

Study: Mindfulness Meditation Works as Well as Common Antidepressant to Reduce Anxiety Mindfulness meditation has emerged as a promising treatment option for anxiety disorders, with research showing its effectiveness comparable to commonly-used antidepressants. A randomized clinical trial published in JAMA Psychiatry demonstrated the efficacy of mindfulness-based stress reduction (MBSR) in treating anxiety when compared to the antidepressant escitalopram. This study contributes to a growing body of evidence supporting the use of mindfulness as a powerful tool for managing anxiety. The findings suggest that clinicians, insurers, and healthcare systems should consider recommending and providing reimbursement for mindfulness-based stress reduction as a treatment for anxiety disorders. Currently, mindfulness meditation is only reimbursed by a limited number of providers. By recognizing its effectiveness, more individuals can access this treatment option, potentially expanding treatment choices and making it more accessible to patients. One of the advantages of mindfulness meditation is its versatility and accessibility. Unlike some treatments that require specialized training, mindfulness can be taught by non-clinicians, making it a more widely available option. Sessions can be conducted outside of traditional medical settings, such as schools or community centers, providing flexibility in delivering this intervention. The study’s results highlight the potential of mindfulness meditation to be integrated into mental healthcare practices and contribute to the overall well-being of individuals struggling with anxiety disorders. It emphasizes the importance of considering mindfulness as a valid and evidence-based treatment option for anxiety, ultimately improving patient care and expanding treatment choices. Mindfulness Shown to Reduce Anxiety Symptoms With Fewer Side Effects In the study conducted by Dr. Hoge and her team at Georgetown University Medical Center, 276 individuals diagnosed with generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia were recruited. Out of the initial participants, 208 completed the trial, with ages ranging from 18 to 75 and a mean age of 33. The majority of participants were female (75%) and white (60%). Participants were assigned to either the escitalopram group or the mindfulness-based stress reduction (MBSR) group. The escitalopram group received a daily dose of 10-20 mg of the medication, while the MBSR group underwent an 8-week MBSR program. The MBSR program involved attending 2.5-hour group classes twice a week, led by qualified MBSR instructors who taught various forms of mindfulness meditation such as breath awareness, body scans, and mindful movement. Participants also attended a full-day meditation retreat and were asked to practice meditation for 45 minutes daily throughout the entire eight weeks. At the end of the study, the researchers used the Clinical Global Impressions scale to assess the effectiveness of each intervention. Both groups reported an average 30% reduction in anxiety symptoms after the eight-week period. While the medication group experienced more side effects, including increased anxiety, trouble sleeping, decreased libido, headaches, and nausea, the majority of these side effects were mild. About 80% of individuals in the medication group reported at least one side effect, and ten participants dropped out due to side effects. In contrast, the mindfulness group had only one reported side effect of increased anxiety, and no participants dropped out. It is important to note that the MBSR program used in this study focused specifically on mindfulness meditation and cannot be generalized to other meditation practices. The results highlight the effectiveness of MBSR as a specific mindfulness intervention for anxiety treatment. Dr. Hoge emphasized that while mindfulness therapy can be beneficial, it requires time and effort, and seeking guidance from a trained professional in MBSR is recommended rather than attempting it alone. The support of a trained professional can help navigate any challenges that arise during the practice. Mindfulness Can Interrupt Anxious Thought Patterns Mounting research over the past decade has indicated the potential of mindfulness and meditation in improving one’s relationship with anxiety. For example, a study involving medical professionals working in emergency rooms found that those who practiced mindfulness were less likely to experience anxiety and depression. Another review on mindfulness and anxiety revealed that mindfulness-based practices such as MBSR and MBCT have shown efficacy in reducing symptoms of anxiety and depression in individuals with anxiety disorders. These practices help individuals become more aware of their thought processes, allowing them to interrupt and modify them. Anxiety disorders are characterized by persistent worrying thoughts about the future, often centered around negative outcomes and a perceived lack of control. Mindfulness practice, through breath and body awareness and moving meditations, brings individuals back to the present moment and helps regulate the body’s stress response to future thoughts. It allows individuals to rewire their relationship with anxiety by shifting their focus from external worries to the present experience. Mindfulness practice helps individuals recognize that anxious thoughts trigger physiological responses, which can further exacerbate anxiety. By practicing mindfulness, individuals learn not to let these thoughts overwhelm them and develop the ability to set them aside. This interrupts the snowball effect of anxious thoughts and physiological responses. Rather than eliminating anxious thoughts altogether, mindfulness teaches individuals to acknowledge the thoughts without reacting to them, creating distance between the person and the anxiety-provoking thoughts. By reframing anxious thoughts and recognizing them as passing thoughts rather than facts or threats, individuals can interrupt the feedback loop of anxiety. For instance, shifting the thought "I’m scared I’m going to fail this exam" to "I’m having a thought about failing this exam" allows individuals to create a sense of distance and reduce the impact of anxiety. Mindfulness-Based Therapy May Not Be Right for Everyone While mindfulness-based approaches have shown efficacy in reducing anxiety symptoms, they may be more challenging for some individuals to stick with compared to medication. The study found that participants in the mindfulness group were more likely to discontinue their practice over time compared to those on medication. By the 24-week follow-up, only 28% of participants were still regularly practicing mindfulness meditation, while 52% were still taking medication. Engaging in mindfulness-based therapy requires a significant investment of time and effort, including attending sessions and engaging in regular home practice. Not everyone may be willing