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Anxiety Disorders: Identification and Intervention

People with anxiety disorders are three to five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than those who do not experience anxiety disorders (Anxiety and Depression Association of America). Anxiety disorders can go undiagnosed due to significant overlap in physical and mental health symptoms. It is common for anxiety to present as fear or worry, but may also present as anger or irritability. Mortality risks are increased due to associated physical causes, such as cardiovascular disease, and suicide. Physicians should screen to rule out causes of particular symptoms which may be somatic as a result of anxiety.

Common Symptoms of Anxiety

  • Physical Symptoms: Rapid or pounding heartbeat
  • Shortness of breath
  • Excessive sweating
  • Tremors or twitches
  • Headache
  • Fatigue or weakness
  • Insomnia
  • Nausea or upset stomach
  • Frequent urination or diarrhea

Psychological Symptoms:

  • Feelings of apprehension or dread
  • Feeling restless or irritable
  • Feeling tense or jumpy
  • Anticipating the worst
  • Constantly watching for signs of danger
  • Constant worry
  • Obsessive thoughts

Screening for Anxiety

Screening for anxiety disorders can be completed in various settings. Members with positive screens should be referred to an in-network mental health provider for complete assessment.

GAD-7 (Generalized Anxiety Disorder) – 7-question screening tool to identify whether a complete anxiety assessment is needed. Recommended for ages 17 and up.

PC-PTSD (Primary Care Post-Traumatic Stress Disorder) – 4-item screener designed for the primary care setting to screen for post-traumatic stress disorder

Population-Specific Considerations

Child/Adolescent

Anxiety disorders are one of the most common forms of mental disorders among children and adolescents (SAMHSA).

31.9% of adolescents have an anxiety disorder (NIMH).

Different types of anxiety within the child/adolescent population include:

  • Separation Anxiety
  • Phobias
  • Social Anxiety
  • General Anxiety
  • Panic Disorders
    Adult/Elderly
    Anxiety disorders are twice as common as dementia and 4 to 6 times more common than depression in the elderly.
    For adults, anxiety is associated with:
    • Poorer quality of life
    • Significant distress
    • The onset of disability

Stats/Facts

Anxiety disorders develop from a complex set of risk factors: genetics, brain chemistry, personality, and life events (ADAA).

Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder (ADAA).

Treatment and Resources

Treatment approaches may include a combination of medication, therapy, and support. Additional resources for members and providers may include:

SAMHSA’s Understanding Anxiety: A Young Adult Fact Sheet

National Institute of Mental Health: Anxiety Disorders

Anxiety and Depression Association of America

SAMHSA’s Understanding Anxiety: A Caregiver’s Guide

Molina Healthcare Case Management