2026年2月23日 / 美国东部时间上午5:00 / KFF健康新闻
在经历了漫长而痛苦的化疗、手术和放疗疗程以治疗乳腺癌后，萨迪亚·扎普（Sadia Zapp）陷入了焦虑——这种焦虑并非她生活中长期存在的可控状态，而是一种更深沉、更令人分心的情绪。
“每一点小疼痛，比如膝盖疼，”她说，都让她担心“这是我人生道路的尽头”。
作为纽约一名40岁的传播总监，扎普成为近年来数百万开始服用抗焦虑药物的美国人之一。对她来说，这种药物是能提升血清素的Lexapro（草酸艾司西酞普兰）。
“我很喜欢它。效果非常好，”她说，“它真的帮我控制住了焦虑。”
美国疾病控制与预防中心（CDC）的调查数据显示，服用抗焦虑药物的美国成年人比例从2019年的11.7%跃升至2024年的14.3%，其中大部分增长发生在新冠疫情期间。这意味着增加了800万人，总人数达到约3800万。年轻人、拥有大学学位的人群以及自我认同为LGBTQ+的成年人中，服用比例的增长尤为显著。
萨迪亚·扎普在接受乳腺癌手术后开始服用抗焦虑药物。她表示，药物帮助她减轻了心理负担，重新找回了专注力。 （Jackie Molloy/KFF健康新闻拍摄）
尽管精神科药物日益获得公众认可，并可通过远程医疗预约更便捷地获取，一类名为选择性5-羟色胺再摄取抑制剂（SSRIs）的抗抑郁药的普及却引发了“让美国重获健康”（Make America Healthy Again）运动支持者的强烈反对。这些支持者声称这类药物有害。医生和研究人员表示，百忧解（Prozac）、左洛复（Zoloft）和Lexapro等药物是治疗许多焦虑症（包括广泛性焦虑症和恐慌症）的一线疗法，尽管它们已被证实可长期安全使用，但却被歪曲为具有成瘾性且危害广泛。
卫生与公众服务部部长小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）抨击了SSRI类药物使用范围的扩大。在1月29日的确认听证会上，他声称自己认识一些人，包括家庭成员，他们戒断SSRI药物的难度堪比海洛因成瘾者。最近，他又表示其部门正在研究SSRI及其他精神科药物使用与校园枪击等暴力行为之间可能存在的关联。
食品药品监督管理局（FDA）专员马蒂·马卡瑞（Marty Makary）也曾暗示，孕妇使用SSRI可能导致不良分娩结果。
SSRI常见的副作用包括胃部不适、脑雾和疲劳。部分SSRI还可能降低性欲并引发其他性功能副作用。
然而，南加州精神科协会主席帕特里克·凯利（Patrick Kelly）表示，对许多人而言，这些副作用较轻且可耐受，治疗慢性焦虑的益处远超副作用带来的困扰。“肯尼迪关于SSRI的言论完全没有任何证据或事实依据，”凯利评价道。
最近一项综合性研究显示，超过一半服用SSRI的广泛性焦虑症患者，其焦虑症状至少减轻了50%。约1/12的患者因副作用而停止服用SSRI。
“当治疗得当且辅以适当的心理治疗技术时，SSRI确实非常有效，”洛杉矶执业精神科医生艾米丽·伍德（Emily Wood）表示。
MAHA将焦虑归咎于不良饮食和缺乏运动
“让美国重获健康”（MAHA）运动的支持者部分将一系列健康问题（包括焦虑、抑郁和其他精神健康障碍）的增多归咎于不良饮食选择和久坐不动的生活方式。作为补救措施，他们呼吁采取措施减少超加工食品的消费（近年来研究已将此类食品与抑郁和焦虑联系起来），并减少屏幕时间，转而增加锻炼。
精神科医生通常鼓励将健康饮食和运动作为焦虑和抑郁的辅助治疗手段。伍德表示，无需药物即可控制焦虑的人也应考虑接受谈话疗法。联邦数据显示，2019年至2024年间，美国成年人使用心理健康咨询的比例大幅上升，这与远程治疗的普及密切相关。“焦虑症是我们的精神疾病中对认知行为疗法反应特别好的一类，”她说。
但药物治疗确实能提供帮助。
研究表明，怀孕期间服用SSRI对母婴的风险较低。相反，“抑郁会增加母婴出现各种并发症的风险，”伍德补充道，并指出政府官员近期关于孕期使用SSRI的言论“可能会对这些女性造成实际伤害”。
一些突然停用抗抑郁药物的人会出现恶心、失眠或其他症状，尤其是突然停药时。“但‘成瘾’这个概念并不适用于这些化学物质，”凯利强调，这一观点也得到了多项研究的支持。
不过，苯二氮䓬类药物（如Xanax）存在成瘾风险，这类药物常作为焦虑的二线治疗方案，且与阿片类药物联合使用时会增加患者过量服用的风险。在去年的国会听证会上，肯尼迪也曾谴责苯二氮䓬类药物的过度使用。
伍德指出，苯二氮䓬类药物在短期使用时效果显著，但需要密切监测和护理。“它们是治疗急性焦虑的绝佳药物，但不适合长期作为抗焦虑药物，因为随着时间推移会产生依赖性，”她说，“如果你每天服用，就需要越来越大的剂量才能达到同样效果，然后必须逐步减量停药。”
此外，越来越多的人偶尔会使用普萘洛尔（propranolol）等β受体阻滞剂来缓解焦虑。一些人会在公开演讲或其他重要场合前使用β受体阻滞剂来预防心跳加速，尽管这类药物未获FDA批准用于治疗焦虑，属于“超说明书用药”。
β受体阻滞剂可能导致头晕和疲劳，但“不会成瘾，对降低自主神经系统活动非常有帮助，能从‘战斗或逃跑’反应转为更中性的状态，而且非常安全，”伍德解释道。
社会变化推动抗焦虑药物使用增加
医生和研究人员认为，以下几种主要理论可以解释为何更多人开始服用抗焦虑药物：社交媒体使用增加、社交隔离加剧以及经济不确定性上升。
此外，这些药物相对容易获取。许多人从家庭医生处获得SSRI和苯二氮䓬类处方，另一些人则通过简短的远程治疗预约获得药物。
许多社交媒体网红分享他们的心理健康挣扎经历，减轻了年轻人的病耻感，鼓励他们寻求帮助。最近一项研究显示，约三分之一的青少年通过社交媒体获取心理健康信息。
然而，当结合基于社交媒体趋势的自我诊断趋势时，抗焦虑药物获取便利性的提升可能成为问题。在谷歌搜索“在线购买Xanax”时，会出现当天治疗的广告承诺，但小字免责声明会注明“不保证处方”。
“我认为增加获取渠道是好事，但这与‘在线订购Xanax’完全不是一回事，”凯利说。
年轻人是抗焦虑药物使用增加的主要驱动力。18-34岁美国人服用抗焦虑药物的比例从2019年（该数据首次公布的年份）的8.8%上升至2024年的14.6%。相比之下，65岁以上成年人的服用比例变化不大，CDC数据显示。
新冠疫情及封锁措施极大地增加了许多美国成年人（尤其是年轻人）的压力水平。
数据还显示，服用抗焦虑药物的女性多于男性。宾夕法尼亚大学社会学系主任兼教授杰森·施尼特克（Jason Schnittker）表示，这是因为女性更需要这些药物。她们也更可能报告自己的焦虑情绪，而医生“倾向于或更容易在女性患者中发现焦虑问题，而非男性患者”。
更广泛的社会趋势也可能在起作用。施尼特克指出，多项研究表明，在20世纪和21世纪的大部分时间里，后代人群的焦虑症患病率持续上升。著有《不安：焦虑、社会变革与现代心理健康的转变》（Unnerved: Anxiety, Social Change, and the Transformation of Modern Mental Health）一书的他表示，日益加剧的收入不平等可能是部分原因——人们因经济地位改善的压力而感到焦虑。社交和宗教活动被更多的孤立生活方式所取代，人们对他人也变得更加多疑，在陌生人面前产生不安感。
对于癌症幸存者扎普来说，在服用Lexapro几个月后才开始看到明显效果。她说，当效果显现时，感觉自己的思绪不再混乱，更容易集中注意力。她也接受了谈话疗法，但现在仅靠药物就能稳定慢性焦虑。
“它确实帮助我重新恢复了日常的生产力，而不再整天被焦虑困扰，”她说。
KFF健康新闻的霍利·哈克（Holly Hacker）、迈娅·罗森菲尔德（Maia Rosenfeld）和莉迪亚·祖拉夫（Lydia Zuraw）对本文有贡献。
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As more Americans embrace anxiety treatment, RFK Jr. derides medications
February 23, 2026 / 5:00 AM EST / KFF Health News
After a grueling year of chemotherapy, surgery, and radiation to treat breast cancer, Sadia Zapp was anxious — not the manageable hum that had long been part of her life, but something deeper, more distracting.
“Every little ache, like my knee hurts,” she said, made her worry that “this is the end of the road for me.”
So Zapp, a 40-year-old communications director in New York, became one of millions of Americans to start taking an anxiety medication in recent years. For her, it was the serotonin-boosting drug Lexapro.
“I love it. It’s been great,” she said. “It’s really helped me manage.”
The proportion of American adults who took anxiety medications jumped from 11.7% in 2019 to 14.3% in 2024, with most of the increase occurring during the COVID pandemic, according to survey data from the Centers for Disease Control and Prevention. That’s 8 million more people, bringing the total to roughly 38 million, with sharp increases among young adults, people with a college degree, and adults who identify as LGBTQ+.
Sadia Zapp started taking anxiety medication after surgery and treatment for breast cancer. She says it has helped reduce the noise in her mind, allowing her to focus again. Jackie Molloy for KFF Health News
Even as psychiatric medications gain public acceptance and become easier to access through telehealth appointments, the rise of a class of antidepressants called selective serotonin reuptake inhibitors, known as SSRIs, has triggered a backlash from supporters of the “Make America Healthy Again” movement who argue they are harmful. Doctors and researchers say medications such as Prozac, Zoloft, and Lexapro are front-line treatments for many anxiety disorders, including generalized anxiety disorder and panic disorder, and are being misrepresented as addictive and broadly harmful even though they’ve been proved safe for extended use.
Health and Human Services Secretary Robert F. Kennedy Jr. has decried broadening SSRI use. During his Jan. 29 confirmation hearing, he said he knows people, including family members, who had a tougher time quitting SSRIs than people have quitting heroin. More recently, he said his agency is studying a possible link between the use of SSRIs and other psychiatric medications and violent behavior like school shootings.
Food and Drug Administration Commissioner Marty Makary has also suggested that SSRI use among pregnant women could lead to poor birth outcomes.
SSRIs’ common side effects include upset stomach, brain fog, and fatigue. Some SSRIs also can reduce libido and cause other sexual side effects.
For many people, however, the side effects are mild and tolerable and the benefits of treating chronic anxiety are worth it, said Patrick Kelly, president of the Southern California Psychiatric Society. “The statements about SSRIs were just not grounded in any sort of evidence or fact,” Kelly said of Kennedy’s comments.
A recent comprehensive study showed that over half of people with generalized anxiety disorder taking an SSRI saw their anxiety symptoms reduced by at least 50%. Side effects prompted about 1 in 12 to stop taking an SSRI.
“When it’s being done right and when you’re also using appropriate therapy techniques, SSRIs can be really, really helpful,” said Emily Wood, a psychiatrist who practices in Los Angeles.
MAHA blames anxiety on poor diet, lack of exercise
Supporters of MAHA have partly blamed poor dietary choices and the increase of a sedentary lifestyle for the rise of a number of health problems, including anxiety, depression, and other mental health disorders. As a remedy, they have called for measures such as reducing consumption of ultraprocessed foods, which studies in recent years have connected to depression and anxiety, and cutting back on screen time in favor of exercise.
Psychiatrists often encourage a healthy diet and exercise as an adjunctive therapy for anxiety and depression. Wood said those who can manage anxiety without medication should also consider talk therapy. The proportion of American adults using mental health counseling boomed from 2019 to 2024 as teletherapy grew in popularity, federal data shows. “Anxiety disorders are amongst our psychiatric disorders that really respond well to cognitive behavioral therapy,” she said.
But medication can help.
Studies show the risks of taking SSRIs during pregnancy are low for mother and child. By contrast, “depression increases your risk for every complication for a mother and a baby,” Wood said, adding that recent statements by government officials about SSRI use during pregnancy are “potentially leading to real harm for these women.”
Some people who stop taking antidepressant medication will experience nausea, insomnia, or other symptoms, especially if they quit suddenly. But “the concept of addiction simply does not apply to these chemicals,” Kelly said, a statement backed up by studies.
Addiction, though, is a possibility with benzodiazepines such as Xanax that are often a second line of treatment for anxiety. These controlled substances can also increase the risk of opioid overdose in patients taking both types of drugs. During congressional hearings last year, Kennedy also decried benzodiazepine overuse as a problem.
While benzodiazepines are effective for short-term use, they require monitoring and care, Wood said.
“Those are really great meds for acute anxiety and not great as long-term anxiety medications, because they are habit-forming over time,” Wood said. “If you’re taking them on a daily basis, you’ll need more and more to get the same effect, and then you have to come down from them in a tapered way.”
And an increasing number of people are also occasionally taking beta-blockers such as propranolol for anxiety. Some people use beta-blockers to prevent a racing heart before a public speech or other big moments, even though they are not FDA-approved for treating anxiety and are prescribed “off-label.”
Beta-blockers can cause dizziness and fatigue, but they are “nonaddictive, really helpful for bringing down the autonomic nervous system, going from fight or flight to something more neutral, and really safe,” Wood said.
Social shifts drive increased use of anxiety meds
A number of leading theories could explain why so many more people are taking anxiety medication, including increased social media use, more isolation, and heightened economic uncertainty, physicians and researchers say.
Plus, the medicines are relatively easy to get. Many people obtain SSRI and benzodiazepine prescriptions from their primary care physician. Others obtain the medications after a brief teletherapy appointment.
Many social media influencers talk about their mental health struggles, easing some stigma among young people and encouraging them to get help. About a third of teens in a recent study said they get mental health information via social media.
Still, increased access to anxiety medication can be a problem when combined with a trend of self-diagnosis based on social media trends. A Google search for “buy Xanax online” leads to sponsored promises of same-day treatment, though fine-print disclaimers clarify that a prescription is not guaranteed.
“I think increased access is good, but that’s not the same thing as, you know, ordering Xanax online,” Kelly said.
Young adults are largely driving an increase in anxiety medication use. The proportion of Americans ages 18 to 34 taking anxiety medication rose from 8.8% in 2019 — the first year such survey data became available — to 14.6% in 2024. By contrast, the rate didn’t change much among adults 65 and older, CDC data shows.
The pandemic and COVID lockdowns greatly increased stress among many American adults, particularly young adults.
And data shows more women than men take anxiety medication. Jason Schnittker, a department chair and professor of sociology at the University of Pennsylvania, said that’s because they’re more likely to need them. They are also likelier than men to report when they feel anxious, and doctors are “inclined or see anxiety more readily in their female patients than their male patients,” Schnittker added.
Broader trends could also be at work. Schnittker said studies have shown anxiety growing more prevalent among ensuing generations for much of the 20th and 21st centuries. Schnittker, author of “Unnerved: Anxiety, Social Change, and the Transformation of Modern Mental Health,” said growing income inequality could be partly to blame, with people feeling stress over improving their economic status. Social and religious activities have been replaced by more isolation. And people have become more suspicious of others, creating a sense of unease around strangers.
For Zapp, the cancer survivor, it took a few months on Lexapro before she started seeing clear results. When she did, she said, it felt like her mind was less noisy, making it easier to focus. She also underwent talk therapy, but now her chronic anxiety is stabilized on medication alone.
“It definitely helped me get back to my day-to-day in a way that was productive and not just riddled with my anxieties throughout the day,” she said.
KFF Health News’ Holly Hacker, Maia Rosenfeld, and Lydia Zuraw contributed to this report.
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