Anxiety Management in Primary Care

Anxiety is a natural stress response but becomes problematic when excessive. Common types include GAD, panic disorder, social anxiety, OCD, PTSD, and health anxiety. It can impact daily functioning and health. Primary Care Role: PCPs often first detect and manage anxiety. Early intervention improves outcomes, and they handle comorbidities. Recognizing Symptoms: General signs include restlessness, fatigue, and sleep issues. Specific symptoms vary by disorder (e.g., excessive worry for GAD, panic attacks for panic disorder, and health fears for health anxiety). Health Anxiety: Patients excessively worry about having a serious illness despite normal medical tests. Key signs include frequent doctor visits and health-related online searches. Screening: Use validated tools like GAD-7, SPIN, and the Health Anxiety Inventory for assessment. Treatment: First-line meds include SSRIs and SNRIs; CBT is effective for most anxiety disorders. Lifestyle changes and psychoeducation are also key. Referral: Refer for severe symptoms, lack of improvement, or complex cases (e.g. PTSD, health anxiety). Special Populations: Consider different anxiety presentations in children, older adults, and during pregnancy/postpartum. Barriers: Time constraints, stigma, and limited resources can hinder care. Health anxiety can strain doctor-patient relationships. Key Takeaways: Early identification and a multimodal approach (medication, therapy, lifestyle changes) are critical. PCPs are essential for managing anxiety and making referrals when needed.