These tools can evaluate your anxiety symptoms; here’s how they work and what you can expect
If you’ve been feeling more anxious than usual, it can be hard to tell if those feelings are a reasonable response to something stressful or worrying in your life or a sign that you have generalized anxiety disorder (GAD). Many people dismiss feelings of anxiety as temporary, or something they just need to “get over,” when in reality, they are struggling with a common—and, typically, treatable—mental health condition. The prevalence of anxiety disorders has only grown since the start of the COVID-19 pandemic, making it all the more important to identify and treat new signs of emotional distress.
If you think you might have anxiety, it’s important to seek help as soon as possible so you can get the right treatment and start feeling better. When reaching out to a healthcare provider, you may be asked to take an anxiety screening test. Here’s what you need to know about what these tests are, what types of questions they ask, and what your results can tell you.
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What is an anxiety screening test?
An anxiety screening test is a tool used to evaluate whether you have symptoms that would benefit from a visit with your healthcare provider. It’s typically a short patient health questionnaire administered by a healthcare professional, though you can self-test online at home, too—as long as you have a plan to meet with a professional once you get with your results. These tools assess your symptoms, as well as their frequency and severity, to help you and your provider understand the scope of your anxiety.
There are many different screening tests for anxiety, such as:
- Beck Anxiety Inventory (BAI)
- Generalized Anxiety Disorder 7 (GAD-7)
The most commonly used tool is the GAD-7, says Lindsey Rae Ackerman, LMFT, CHHC, the adult & teen mental health clinical director for the Clear Recovery Center in Los Angeles.
“The GAD-7 is a great tool because it is a self-reporting questionnaire that measures anxiety symptoms and their severity over a two-week period,” explains Ackerman. “It is reliable, relatively easy to perform, and the person is essentially screening themselves, which removes any added pressure or anxiety associated with other tools that are performed by a clinician.”
In just seven questions, the GAD-7 can help you see a clearer picture of your anxiety on a scale ranging from mild to severe anxiety. It can be used in people from age 13 to older adults. But although the GAD-7 is considered a highly accurate tool, other tests may be used depending on the circumstances. Your healthcare team will pick the best tool for screening your particular symptoms.
Anxiety screening questions
In general, all anxiety screening tests are designed to assess the level of your day-to-day anxiety by asking questions about your symptoms. According to Michele Goldman, Psy.D., the media adviser for Hope for Depression Research Foundation, the GAD-7, in particular, identifies types of symptoms, the frequency of symptoms, and how difficult the symptoms are to manage.
For each of the questions on the GAD-7, you’re asked to select how often you’ve experienced a specific symptom over the past two weeks. Options include “not at all,” “several days,” “more than half the days,” and “nearly every day.”
Some of the symptoms asked about on the GAD-7 include:
- Feeling nervous or edgy
- Having trouble relaxing
- Worrying about many different things
- Becoming easily irritated or annoyed
Each symptom, combined with the frequency you choose, scores you a number between 0 and 3. At the end of the test, your total number is used to place you on an anxiety severity scale.
As useful as the GAD-7 is, however, all of these anxiety screening tests have limitations. The GAD-7 can’t evaluate specific types of anxiety disorders, for example, or determine whether the severity is impairing your function, says Dr. Goldman. Someone with elevated scores on the GAD-7 could have panic disorder or social anxiety disorder—there’s no disorder-based differentiation.
Anxiety screening results
Anxiety tests are usually scored based on the responses provided by the individual, says Ackerman, and how they are scored depends on what specific test is used. Since most people take the GAD-7, we’ll use it as a point of reference here.
The GAD-7 is scored on a scale of 21, based on those 0 to 3 ratings we described. In other words, if you’ve experienced a symptom “not at all,” you’ll choose 0, but if you’ve experienced it “several days,” you’ll choose 2.
After you’ve done that for the seven questions on the questionnaire, those results are tallied up and then you or your provider will place your overall score in one of these brackets:
- 0-4: Minimal Anxiety. Your anxiety levels are typical and probably don’t warrant any follow-up or treatment.
- 5-9: Mild Anxiety. Your anxiety symptoms are noticeable and may interfere with some of your social or professional responsibilities, but they are usually not inhibitive. Therapy may help you develop coping skills.
- 10-14: Moderate Anxiety. You feel anxious more often than not and your anxiety often impacts your professional life and your relationships, but your symptoms are not debilitating (i.e., you can go about your day, though it may sometimes be quite difficult).
- 15-21: Severe Anxiety. You may experience physical and behavioral symptoms of anxiety, and this disrupts your ability to function. You may feel persistently or frequently anxious, and your anxiety may seriously affect your personal and professional life.
Once you have your results, what happens after that depends on where and how you took the screening tool, says Dr. Goldman. (If you self-tested at home, it’s up to you to reach out to a healthcare provider for follow-up).
“If the person who administered [the test] is a qualified mental health professional, you should prepare to be asked additional and more detailed questions about your anxiety,” Dr. Goldman explains. “If the person is a primary care doctor, they might have some additional questions for you, or they might suggest you consider talking to a mental health professional, such as a therapist or counselor, or beginning medication, which they will prescribe.”
Accuracy of screening tools
Anxiety screenings can vary in accuracy, not necessarily because the tests aren’t effective but because there is so much variation in how they’re administered.
“The accuracy of anxiety screenings varies depending on the screening tool being used, the individual being screened, and the purpose of the screening,” says Ackerman, who adds that factors like test sensitivity and specificity—or how well the test can correctly determine if you have anxiety or other mental disorders—matter, too.
But the GAD-7 has been proven to have good sensitivity and specificity, notes Ackerman, when it comes to detecting anxiety disorders; the caveat is that the accuracy of the test might be lower if conducted in a non-clinical setting, i.e., on your home computer.
It’s also important to remember that anxiety screenings can be a useful first step in identifying an anxiety disorder, but they are not diagnostic in themselves: “Anxiety is a complex condition that can manifest in many different ways, and it is important to keep in mind that screening tools may not show the full extent or severity of symptoms,” says Ackerman.
Still, the GAD-7 tends to outperform when compared to other tests: In a 2014 study, the GAD-7 was more accurate in detecting anxiety disorder symptoms in pregnant and postpartum women than other tests. You can avoid many of the potential harms of screening at home by working with your healthcare team if you start to experience anxiety symptoms.
Anxiety can be a lifelong condition or a transient one; symptoms may come and go unpredictably or begin in childhood or adolescence and remain with you throughout adulthood. Some people go through periods of anxiety triggered by difficult or traumatic life events, stress, illness, or certain medical conditions, hormonal changes, or physical or emotional abuse, while other people experience anxiety symptoms not tied to any obvious cause.
There are many ways to cope with anxiety and treat your symptoms. Treatment may not always make anxiety go away fully, but it can reduce your symptoms and allow you to regain more function in your daily life.
Some treatment options include:
- Therapy: Dr. Goldman says that cognitive behavioral therapy (CBT) is the most evidence-based treatment for anxiety, and is focused on the relationship between what we think, how we feel, and how we behave. Dialectical behavior therapy (DBT) can also be helpful for learning coping strategies related to strong emotions, she adds, and ways to regulate your nervous system when you have anxiety. Psychotherapy may also be recommended.
- Mindfulness or meditation: According to Dr. Goldman, mindfulness and meditation can happen as formal treatments (mindfulness-based stress reduction, or MBSR) or in more informal ways, such as grounding practices, guided visualizations, and muscle relaxation training.
- Medication: Prescription drugs used to treat depression, like selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines, are also commonly used to treat anxiety. Drugs like Prozac (fluoxetine) and Zoloft (sertraline) have been shown to be effective in treating symptoms of GAD.
You may try these individually or together as part of a collaborative mental health care plan. Work with your various care providers to find the combination that alleviates your symptoms and improves your overall well-being. If you have thoughts of suicide or self-harm, please seek help immediately. Go to your nearest emergency room or call a help line such as the National Suicide Prevention Hotline.