The Primary Care Practitioner Role
Anxiety symptoms are extremely common. In the primary care setting, a major task is to determine whether the symptoms are a reaction to a distressing situation, indications of an anxiety or other psychiatric disorder such as depression, or signs of a non-psychiatric condition.
What Is Reasonable to Expect of a Primary Care Practitioner?
- Screen for and establish the specific anxiety disorder diagnosis.
- Develop a treatment plan.
- Be familiar with antidepressants and anxiolytics, as well as psychotropic agents used mainly to augment antidepressants (e.g., antipsychotics, anti-convulsants, mood stabilizers).
- Provide psychoeducation and help patients make an informed treatment choice about medications and psychotherapy.
- Discuss self-help options with patients and support them in using these resources.
- Monitor the patient’s response to treatment
When to Refer to a Specialist
- Following an attempt to treat the patient or earlier if the patient is severely affected by the anxiety disorder
- When an anxious young adult is too fearful to attend school or socialize
- When a patient cannot get to work or maintain usual activities of daily living (e.g., child care, going shopping, hygiene)
- When a patient has multiple comorbid mental disorders (e.g., depression, substance use, suicidality)
- When a patient is being prescribed multiple psychiatric medications
- When a patient is using recreational substances, or over-the-counter medications to alleviate anxiety