What exactly is anxiety?

What is anxiety?

Anxiety is a nebulous term that covers a great deal of psychological ground. At the thinnest end of the wedge, before an exam or a job interview, we might feel anxious. This is both understandable and normal; it is not a cause for concern.

Anxiety is only a problem when it extends beyond logical worry in an unreasonable, unwarranted, uncontrollable way. Situations that should elicit no negative emotions all of a sudden seem life-threatening or crushingly embarrassing.

At the widest end of the wedge, anxiety can arrive as a symptom of another mental illness, such as panic disorders, post-traumatic stress disorderphobias, or obsessive-compulsive disorder (OCD).

When anxiety is a person’s primary symptom, it may be referred to as generalized anxiety disorder (GAD). The National Health Service (NHS) in the United Kingdom summarize GAD neatly.

“People with GAD,” they explain, “feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue.”

GAD affects around 6.8 million people in the U.S. — or more than 3 percent of the country’s adults.

Another common form of anxiety is social anxiety, which affects people more specifically in social situations.

It might make someone very self-conscious, perhaps not wanting to eat or drink in front of others, fearing that people are talking about them, or worrying about being lost in a crowd. It comes in many forms.

Today, “anxiety disorders are the most common mental illness in the U.S.,” affecting around 40 million adults — almost 1 in 5 people.

Globally, the World Health Organization (WHO) say that almost 300 million people have an anxiety disorder.

Anxiety disorders are not new, either. In fact, Robert BurtonTrusted Source wrote this description in The Anatomy of Melancholy (1621) referring to a patient of Hippocrates. It will resonate with anyone who has ever experienced anxiety.

“He dare not come into company for fear he should be misused, disgraced, overshoot himself in gestures or speeches, or be sick; he thinks every man observeth him.”

Interestingly, anxiety is not just a human experience, and evolution is ultimately to blame (or thank); as with other animals, humanity’s survival relies on our natural ability to feel anxious about genuinely dangerous situations and to be on guard.

It is when this life-saving mechanism is triggered at inappropriate times or gets stuck in the “on” position that it becomes a problem.

So, to the first big question: is anxiety really affecting us more now than it has in the past? Is anxiety on the up in the West, or, in a modern society where good mental health is a goal in itself, are we just more likely to notice and discuss it?

Is anxiety more prevalent in the West?

A large study that was published in the journal JAMA PsychiatryTrusted Source in 2017 set out to answer this exact question. In particular, the researchers looked at GAD.

One might expect that, since mental illness tends to be more commonTrusted Source in areas of the U.S. that have a lowerTrusted Source socioeconomic status, anxiety might also be more prevalent in countries with a lower socioeconomic profile.

Additionally, in less wealthy countries, people can be under substantial stress; finding food, water, or safety might be an issue in some regions.

However, it is important to remember that GAD is about feelings of anxiety that are unreasonable. In a country where there is genuine struggle, higher levels of anxiety might rightly be considered justifiable and therefore not a diagnosable condition.

The study, involving 147,261 adults from 26 countries, concluded:

“The disorder is especially common and impairing in high-income countries despite a negative association between GAD and socioeconomic status within countries.”

In other words, within each country, GAD is more prevalent in less wealthy regions. However, as a whole, it is the residents of wealthier countries who are more likely to experience GAD, and their lives are more significantly impacted by it.

Breaking down the statistics, the scientists found that lifetime estimates for GAD were as follows:

  • low-income countries: 1.6 percent
  • middle-income countries: 2.8 percent
  • high-income countries: 5.0 percent

This is in line with other research that found a higher prevalence of anxiety in wealthier economies.

In the WHO’s Depression and Other Common Mental Disorders Global Health Estimates report that was released in 2017, they compare prevalence estimates of mental disorders across global regions.

When they compare the levels of depression, no single area has significantly higher rates. When it comes to anxiety disorders, however, it’s a different story; the Americas are head and shoulders above all other regions, including Africa and Europe.

Interestingly, though the U.S. and the West in general do seem to be taking the lead in the anxiety stakes, it may not stay this way for long; the very same report explains that common mental health disorders are increasing in lower-income countries “because the population is growing and more people are living to the age when depression and anxiety most commonly occurs.”

Added to this, anxiety tends to be less common in older adults. Also, because the average age of U.S. individuals is slowly rising, the percentage of people with anxiety disorders may gradually decline.

To conclude this section, although other countries might be catching up, it does seem that anxiety is more common in wealthier nations and perhaps the U.S. in particular — but is it getting worse?

Stay Healthy Research Team

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