Abstract: Anxiety disorders are the most common of mental illnesses, but relatively little is known about how to detect them from language. The primary clinical manifestation of anxiety is worry associated cognitive distortions, which are likely expressed at the discourse-level of semantics. Here, we investigate the development of a modern linguistic assessment for degree of anxiety, specifically evaluating the utility of discourse-level information in addition to lexical-level large language model embeddings. We find that a combined lexico-discourse model outperforms models based solely on state-of-the-art contextual embeddings (RoBERTa), with discourse-level representations derived from Sentence-BERT and DiscRE both providing additional predictive power not captured by lexical-level representations. Interpreting the model, we find that discourse patterns of causal explanations, among others, were used significantly more by those scoring high in anxiety, dovetailing with psychological literature.