Is There An Anxiety Epidemic?

The way that anxiety manifests itself has not really changed over the centuries. We’re still plagued by the same forms of anxiety disorder as our ancient ancestors—but the things that trigger our anxiety have certainly changed.

We still experience many traditional causes of anxiety such as poor health, difficult relationships, unemployment, poverty and disadvantage, loneliness, work stress, and exposure to violence, trauma, and conflict. Even in our modern world, some of these traditional sources of anxiety are on the rise. These include loneliness; relationship factors such as divorce; violence and abuse including childhood abuse and neglect; increased working hours and more stressful work procedures; and a general sense of lack of control over our own destinies – especially among our youngsters who are introduced to the possibility of failure earlier and earlier in their lives as a result of increased systematic educational testing.

Thankfully, some of the traditional causes of anxiety are generally on the decline, factors such as poverty, poor health and to some extent unemployment. But they leave in their place new anxieties, such as income inequality, living with long-term disability, and the stresses of modern day job seeking[1].

In addition, modern technology has provided some entirely new sources of anxiety for the present generations. These include 24-hour perpetual connectivity, the need to multitask across a range of different activities, and increasingly emotive news alerts and doomsday scenarios. Very soon almost every appliance in our houses will be connected to the Internet, fueling fears of identity theft, data hacking, phishing, grooming, and trolling. Even that bastion of modern day living, the computer, brings with it daily worrisome hassles that include crashing hard drives, forgotten passwords, and the frustration of daily transactions that begin to seem strangely distant when all we’d like to do is speak to a real person.

Riding on the back of our daily computer stresses is the perpetual connectivity provided by social media. The first recognizable social media sites were created in the mid-1990s, so most youngsters under the age of 20 will never have lived without the curse of social media. And a curse it can be. Social media use is associated with social anxiety and loneliness and it can generate feelings of disconnectedness when we view what seems like the rich lives and social successes of others. A consequence of social media use is that youngsters count their social success in terms of metrics such as the number of friends they have on sites like Facebook, not the number of genuine confidants they have – confidants who would be true friends in times of difficulty and need.

To supplement this rash of new, modern anxieties is a gradual shift in the social ethos surrounding anxiety. This change has been almost contradictory in the messages it sends to us. We’re told anxiety is a legitimate response to the stresses of modern living, and anxiety is almost considered a status symbol that signals how busy and successful we are.

But we’re increasingly told that anxiety is an emotion in need of treatment. Diagnostic categories for anxiety problems have burgeoned over the past 30 years, the pharmaceutical industry is keener than ever to medicalize anxiety and sell a pharmaceutical solution for it, and social campaigns that increase awareness of mental health problems such as anxiety valiantly attempt to destigmatize it, and then help us to identify and seek treatment for it.

But it would be irresponsible of me to claim that all is doom and gloom on the anxiety epidemic front. Roughly 1 in 5 people regularly suffer distressingly high levels of anxiety but there’s no significant evidence that this ratio has increased over the years[2]. But even if that ratio stays the same, as populations grow, more and more people will suffer anxiety and will be seeking treatment for it as awareness of mental health problems increase. On the other side of the coin, 2 out of 5 people tend to experience only low levels of anxiety, and will rarely need to seek treatment unless they encounter extreme life events that elicit extreme responses.

New psychosocial treatments for anxiety are continually being developed, and we now have specialized CBT programmes for most if not all of the main anxiety disorders[3]. In addition, access to basic forms of CBT for common mental health problems such as anxiety has increased significantly in a number of countries with the successful introduction of programmes such as IAPS (Improving Access to Psychological Therapies)[4]. Computer-based CBT for anxiety is an increasingly effective medium through which sufferers can be helped to recover[5]. But even with the most successful evidence-based psychotherapy and pharmaceutical procedures, we’re still some way from helping 100% of people to recover from anxiety disorders, and some anxiety disorders such as OCD and GAD can be debilitating life-long conditions resistant to both current medications and psychotherapies[6].

To improve the range of interventions available, we need significantly more funding for mental health research. The level of funding for mental health research is pitiful when compared with that provided for research into other medical problems[7], and arguably much of the funding that is available goes to medical and neuroscience programmes rather than the psychological research that would be needed to develop more effective, evidence-based talking therapies[8].

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So, is there an anxiety epidemic? Contemporary definitions of the term ‘epidemic’ no longer allude to disease as a necessary condition and consider an epidemic anything that negatively impacts the health or welfare of a large number of people in a population[9]. One in five people in the UK suffer high levels of anxiety at any one time[10]; one in nine people worldwide will experience an anxiety disorder in any one year[11]; anxiety prevents you from working, learning, or performing your social and family responsibilities to your full potential; anxiety and stress account for over one-third of all work-related ill health[12] and costs over £100 billion in England each year in lost productivity and reduced quality of life[13]; and anxiety can kill – even sub-clinical levels of anxiety can increase the risk of mortality by 20%[14].

So, yes, we do have a modern anxiety epidemic, but then so have most previous generations. The difference is that in our modern era we have a whole set of new and evolving anxieties and a growing awareness of anxiety as a potentially distressing and disabling state. We’ll need to rise to the contemporary challenges that this presents in terms of understanding the causes of anxiety and the suffering it conveys, dealing with the economic cost to society that anxiety imposes, developing new and more effective evidence-based intervention and prevention programmes, and providing more realistic levels of funding for mental health services and research.