Primary Care Doctors Urged to Screen Patients for Anxiety, Depression as Mental Health Crisis Worsens

The next time you see your regular doctor, don't be surprised if, in addition to asking you how your body feels, they also ask about how you're feeling emotionally. That's because more primary care practitioners are now screening for mental health conditions.  

Cases of anxiety and depression were already at alarming rates before the COVID-19 pandemic, but since then have skyrocketed. The World Health Organization reports the pandemic triggered a 25% increase in anxiety and depression.  

This increase could be a reason the U.S. Preventive Services Task Force decided recently to recommend primary care providers begin screening patients for anxiety disorders. This follows an earlier recommendation to also screen for possible depression. While the advice isn't mandatory, health providers usually follow USPSTF guidelines. Primary care providers include physicians, physician assistants, and nurse practitioners. 

Anxiety is a condition in which the patient experiences a disproportionate and constant fear of everyday events, and depression is the persistent feeling of sadness or a lack of interest in everyday activities.  

Michele Long, a nurse practitioner in Lancaster, Ohio, said too often patients don't pay attention to their own mental health. 

"When a patient comes in to our office, there's a lot of times they don't know that their symptoms are related to depression and anxiety," she said. 

Since primary care providers are often the first line of defense for a patient's physical needs, they are seen as an important resource for mental health issues, as well. 

"It would be great if patients knew that they could bring up their concerns with us in the office as primary care providers," Long said. "But it is also my responsibility to do depression and anxiety screening on them."

Anxiety screenings usually involve asking the patient to rate the frequency and severity of feelings like nervousness, restlessness, and fear.  Depression screenings center on things like sadness, hopelessness, and thoughts of self-harm. Patients might not realize their primary care provider is trained and qualified to diagnose and treat anxiety and depression.  While these conditions can occur separately, they often present simultaneously. 

"I talk to them and say, 'I'm here. We're going to do this. We're going to get you through this, and get you feeling better,'" Long said. 

Primary care providers can refer patients for therapy, prescribe medication, or both.  Given the dozens of anti-depressants and anti-anxiety drugs available, finding the right treatment can involve a bit of trial and error.  That's why some healthcare professionals use DNA analysis to streamline the process by indicating which medications worked best for other patients with similar genetic profiles. 

"It's a really important tool for them to use when they're thinking about what treatment protocols, or, 'How do I want to treat this patient?' not only with which drugs do they want to pick, but also how they dose these specific drugs," said Fred Fantazzia, general manager of Myriad Mental Health, makers of the GeneSight Mental Health Monitor.