Forget weed, wine and xanax: Science has better ways to treat anxiety
Angie Landeros knew her daughter had always been shy. “Very, very shy,” she says. “She always felt awkward talking to other kids her age.”
Then came the COVID-19 lockdowns in March, 2020. Ten years old, Landeros’ daughter began feeling unbearably self-conscious seeing herself on the computer screen during Zoom lessons. When her elementary school went to a hybrid format that required most kids to attend in person, some days she’d refuse to go. Once she had a full-blown panic attack in the car and began kicking and screaming. On another day, says Landeros, “she literally ran out the door to hide from us.”
Landeros and her husband, Michael Bloch, are psychiatrists at the Yale Child Study Center, so they knew what their daughter was going through: social anxiety disorder. She wasn’t the only one. According to a national survey by the U.S. Census Bureau, adults reporting symptoms of anxiety and depression on a near-daily basis jumped to 41 percent in 2021, from 11 percent in 2019. (It dropped to 32 percent in 2022, still nearly triple the pre-pandemic level.) Nearly eight in 10 adults said COVID-19 was causing significant stress in their lives, according to a survey by the American Psychological Association (APA).
The pandemic is only one of many anxiety-provoking headlines. Climate change has 59 percent of young people feeling very or extremely worried, an international survey published in the Lancet medical journal found. School shootings have 57 percent of teens and 63 percent of adults somewhat or very worried, according to a Pew Research Center survey. The 2020 election was a “significant” source of stress for two-thirds of adults in the U.S., a survey by the APA found, compared to just over half in 2016. The economy is a major source of stress for 87 percent of Americans and the Russian invasion of Ukraine is stressing out 80 percent of U.S. adults, a Harris poll found early this year.
Anxiety has become so widespread—and, to many Americans, downright disabling—that in September the U.S. Preventive Services Task Force, an independent panel of experts in primary care and preventative medicine, recommended that all adults under age 65 get screened for the condition, which could bring much-needed treatments to many more people.
The sheer presence of highly anxious, high-profile celebrities may also be removing some of the stigma associated with anxiety. Pop singer Shawn Mendes has opened up about his crippling anxiety, which led him to cancel his world tour in July. Justin Bieber likewise scrapped his concert tour in September, admitting that he has battled anxiety attacks for two decades. Even Oprah Winfrey has confessed to suffering a nervous breakdown due to the stress over her many show business commitments. In the past year, big-name athletes Simone Biles (gymnastics), Kevin Love (basketball), Michael Phelps (swimming) and Naomi Osaka (tennis) have openly discussed their struggles with anxiety.
Fortunately, scientific insight into what causes anxiety, and the range and effectiveness of available treatment options, is also on an upward trend. Anxious temperaments, recent studies have found, run in families, not only because of common genetics but also child-rearing styles, which have much to do with anxiety in children. The most effective treatments, new studies show, is not with lengthy courses of psychotherapy—and definitely not with cannabis. Instead, doctors and scientists who specialize in anxiety now recommend relatively short-term therapy that helps children confront what makes them anxious, rather than shrink from it. As for medications, most experts advise against so-called “anti-anxiety” drugs, strangely enough, because of their side effects. Antidepressants, they say, work far better.
“When I began my career in the 1980s, there was nothing known about how best to treat anxiety disorders,” says Dr. Wendy Silverman, professor of child psychiatry and director of the Yale Child Study Center’s Anxiety and Mood Disorders Program. “We’ve made enormous progress since then.”
More people may soon find out firsthand about the progress in anxiety treatments. The task force’s recommendations, together with similar ones issued last spring for children, means that physicians may soon routinely ask children and adult patients under age 65 about anxiety, just as they currently do about cigarette smoking and alcohol use. Although the recent recommendations for adults is not yet final—the public has until October 17 to make comments—the goal is to bring the latest treatments to bear on this acute mental health problem.
Published: October 12, 2022
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