Do you also suffer from anxiety?

More and more young people are suffering from anxiety. Anxiety disorders are now considered the most common mental illness in the USA. 

Experts agree that recurring anxiety symptoms and diagnosable anxiety disorders are on the rise. In fact, an alarming number of millennials (people aged between 23 and 38 in 2019), teenagers and even children are suffering from anxiety. Unfortunately, it is no exaggeration to call the disorders an "epidemic".

How many people suffer from anxiety?

The American Anxiety and Depression Association estimates that 40 million adults in the U.S. - roughly 18 percent of the population, or nearly one in five people 18 and older - suffer from an anxiety disorder.

However, anxiety disorders occur all over the world - with similar frequency. In Germany, too, many people suffer from anxiety disorders - over 12 million to be precise!

A 2019 survey by the American Psychiatric Association (APA) found that 68 percent of respondents would describe themselves as "very or somewhat anxious" most of the time.

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What are fears?

Anxiety is defined as "a feeling of worry, nervousness or unease". This is usually directly related to an upcoming event or a major uncertainty.

Many of us feel nervous or anxious from time to time - that's normal. What is not normal, however, is spending the majority of your time in anxiety and not being able to manage these strong feelings. The lives of people with anxiety disorders - their relationships, performance at work, family commitments and other daily activities - are usually affected by the condition.

Different forms of anxiety

The National Institute of Mental Health lists the following conditions as the main forms of anxiety disorders:

• Generalized anxiety disorder (GAD), which affects about 3% of the population and is characterized by uncontrollable, persistent, excessive and unjustified worry.
• Obsessive-compulsive disorder (OCD), in which thought loops (obsessions) lead to repetitive behavior (compulsions).
• Social anxiety disorder (SAD), which is characterized by a great fear of social or performance situations. These typically begin around the age of 13 and usually last for many years.
• Panic disorders (PD), in which sufferers experience recurring unexpected panic attacks.
• Phobias or strong fears of - or aversion to - certain objects or situations.
• Post-traumatic stress disorder (PTSD), in which those affected have considerable difficulty recovering after terrible events.
• Anxiety is also linked to depression. It is estimated that around half of people with anxiety also show symptoms of depression.

What is an anxiety attack?

Anxiety attacks, also known as panic attacks, affect about three percent of the U.S. population.

Symptoms of an anxiety attack, which often peaks within minutes, include the symptoms listed below (i.e. general symptoms that people with anxiety generally suffer from) as well as palpitations, dizziness, trembling and shortness of breath. These attacks can have clear triggers or come out of nowhere. They usually lead to a sense of loss of control and a feeling of impending doom.

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Symptoms

Symptoms of anxiety disorders are related to the body's "fight-or-flight" response. This describes physiological reactions to perceived attacks or threats. These symptoms can affect pretty much any body system: the central nervous system, the endocrine system, the digestive system, the cardiovascular system, etc.

The symptoms of anxiety include:

• persistent worry (the most common symptom of generalized anxiety disorder)
• Muscle tension, tightness in the chest and neck pain
• Palpitations and high blood pressure (especially during panic attacks)
• Sleep disorders, restlessness and insomnia
• Digestive disorders, such as constipation, diarrhea or loss of appetite
• Irritability, mood swings and depression
• Concentration difficulties
• Sweating
• Inability to socialize

Anxiety often occurs together with other physical or mental illnesses (co-occurrence)

• Eating disorders
• Migraine or tension headaches
• Digestive disorders, e.g. irritable bowel syndrome
• Sleep disorders
• Substance abuse
• ADHD
• Chronic pain
• Fibromyalgia

Causes

What is the main cause of anxiety disorders? There is not just one cause. People develop anxiety disorders for very different, very complex reasons.

However, known risk factors include gender (usually female), stressful life events in childhood and adulthood, family history, low income, chronic illness and shyness in childhood.

The most common causes of anxiety disorders are

• Stress due to challenging life circumstances: Many people report that problems in their lives lead to stress. These include exhaustion due to overtime, long commutes, unemployment, money worries, loss of a friend or close relative, loneliness, isolation and bullying.
• Traumatic life events, including violence, abuse or rape
• Genetic, familial predisposition that leads to certain personality traits (excessive worry)
• Disorders of serotonin production
• Excessive alcohol consumption
• Drug use
• High caffeine or sugar intake
• Hormone fluctuations, e.g. in connection with thyroid problems, pregnancy, PMS and the menopause

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Why are anxiety disorders becoming more common these days?

People have suffered from many of these causes in the past. So what has led to the rise in anxiety disorders over the last decade?

As described above, many of those affected are worried about their health, safety, finances, political circumstances and relationships. Experts believe that these concerns are exacerbated by the following:

• News broadcasts around the clock
• the rise of social media
• the almost constant digital accessibility
• A busy schedule
• Too little time for regular exercise
• little sleep
• No time for relaxation and leisure

We are also generally eating more unhealthily, taking more medication, which can increase anxiety, and suffering from troublesome chronic illnesses.

In the Washington Post, experts recently explained that "compulsive substance abuse and other addictive behaviors are responsible for the profound sadness and depression felt by many in the United States." One example of this is the ongoing opioid crisis.

For this reason, some argue that fears should not be seen as the problem of individuals. Rather, they are inextricably linked to far-reaching social issues such as political upheaval, environmental disasters, trauma and discrimination.

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Are anxiety states caused by different factors in men and women?

Scientific research suggests that this could be the case. Women suffer more frequently from panic attacks and generalized anxiety disorder, especially in conjunction with depression. The reasons for this are at least partly sexual abuse and hormones.

Age also plays a role. The National Alliance on Mental Illness (NAMI) explains why millennials in particular are often referred to as the "anxious generation":

This was the first generation to grow up with the internet and social media. However, these technological achievements can make life more competitive and complicated. Young people often compare their personal and professional achievements with those of others.

According to NAMI, this can lead to low self-esteem and insecurity. Millennials have the world at their feet. At the same time, there is a lot of pressure on them. They feel like they constantly have to be "at the ready". They have to look and sound perfect and act as if they have everything under control.

A 2015 study by American University highlighted the positive aspect that millennials are typically more accepting of people with mental illness and more likely to get help. The reason for this is that they have heard a lot about anxiety, depression, eating disorders and suicide in their childhood and youth.

Statistics

Below you will find some revealing facts about the prevalence of anxiety disorders:

• Which age group is particularly affected? Different ethnic groups/ethnicities and people of all ages seem to be more worried than in previous years. The APA survey mentioned above found that millennials are more anxious than older people. However, the baby boomer group shows the greatest increase in anxiety disorders and symptoms. In industrialized countries, it is estimated that 50 percent of mental health problems develop by the age of 14, and 75 percent by the age of 24.
• Anxiety disorders now affect eight to 25 percent of young people between the ages of 13 and 18. This can lead to problems at school and difficulties with socialization as well as an increased risk of substance abuse.
• In which country do most people suffer from anxiety disorders? Studies by the World Health Organization (WHO) have shown that more people suffer from anxiety in richer countries than in poorer ones. The WHO estimates that around one in 13 people worldwide suffers from anxiety. Australia, New Zealand, the USA, Spain, Ireland and France have the highest rates of anxiety.
• A significant number of Americans describe themselves as "very stressed". According to a Time magazine report on the "Stress in America" survey, 63 percent of Americans say the state of the nation is a significant source of stress for them. 59 percent also believe the United States is at the lowest point they can remember in their country's history." About 40 percent of Americans report feeling more anxious than they did a year earlier. Another 40 percent said they felt just as anxious.
• They are most concerned about the security of their own family, health, spending/finances, politics and relationships.
• Only around one in three (37 percent) people who suffer from anxiety are undergoing treatment.
• Compared to those who do not suffer from an anxiety disorder, sufferers visit a doctor three to five times more often and have to be treated in hospital six times more often.

How are fears treated?

Conventional treatment options:

• Anxiety medication is usually prescribed as standard. Medication can be used to alleviate severe anxiety symptoms. These include serotonin reuptake inhibitors (SSRIs), serotonin/noradrenaline reuptake inhibitors (SNRIs), serotonergic drugs called buspirone and tranquillizers such as benzodiazepines or antidepressants. But beware, medication often has more disadvantages than advantages!
• Those affected usually also receive therapy, usually behavioral therapy. This allows thoughts to be steered in a different direction, physical symptoms to be alleviated and the overall behavior of those affected to be changed. Behavioural therapy is used to identify, question and neutralize unhelpful or distorted thoughts.
• Mindfulness-based approaches are also used to alleviate anxiety. These include guided meditation as well as acceptance and commitment therapy, which encourages behavior that is in line with the patient's value system.

Natural treatment options:

• Relaxation techniques (exercises for body and mind) such as deep breathing, meditation, yoga and acupuncture
• Regular exercise, especially aerobics or cardiovascular training and any other sport you enjoy
• Eat a healthy diet: foods rich in vitamin B, products with plenty of magnesium, calcium and omega-3 fatty acids (e.g. olive oil, nuts and seeds, salmon, fruit and vegetables, whole grains and probiotic foods).
• Avoid overtiredness and sleep between seven and nine hours every night.
• Create a reliable daily schedule for yourself. This includes a regular sleep-wake cycle, regular meals and good organization of your daily routine.
• Record your thoughts and worries in a diary. Also write down what you are grateful for.
• Avoid excessive consumption of alcohol, caffeine and sugar.
• Use supplements and essential oils that support the nervous system. These include adaptogenic herbs, magnesium, vitamin B complex, amino acids such as GABA and essential oils such as chamomile oil and lavender oil.
• Voluntary activities and social contacts
• Join a self-help group - either locally or online.

Concluding remarks

Anxiety disorders are on the rise, especially among young adults (millennials), children, adolescents and baby boomers.

The most common symptoms include physical symptoms such as palpitations and sleep disorders as well as emotional symptoms such as poor attachment, mood swings and depression. Sometimes those affected also suffer from panic attacks. Signs of an anxiety attack include trembling, shortness of breath and feelings of impending doom.

What causes anxiety disorders?

Common causes include difficult life circumstances, trauma or abuse, substance abuse, genetic or family history, poor lifestyle choices such as lack of sleep, poor diet and lack of exercise.

Anxiety can be treated as follows: Medication (with caution), therapy (behavioral therapy), relaxation techniques, regular exercise, dietary changes and taking supplements.

 

Sources (in English):

Craske, M. G., Stein, M. B., Eley, T. C., Milad, M. R., Holmes, A., Rapee, R. M. et al. (2017, May). Anxiety disorders. Nature Reviews, Disease Primers, 3:17024, doi: 10.1038/nrdp.2017.24

Fernandez-Rodriguez, M., Rodriguez-Legorburu, I. & Lopez-Ibor Alcocer, M. I. (2017, September). Nutritional supplements in Anxiety Disorder. Actas Espanolas de Psiquiatria, 45(Supplement):1-7

Dugas, M. J., Brillon, P., Savard, P., Turcotte, J., Gaudet, A., Ladouceur, R. et al. (2010, July). A Randomized Clinical Trial of Cognitive-Behavioral Therapy and Applied Relaxation for Adults With Generalized Anxiety Disorder. Association for Advancement of Behavior Therapy, 41(1): 46–58, doi: 10.1016/j.beth.2008.12.004

Hasheminasab, M., Kheiroddin, J. B., Aliloo, M. M. & Fakhari, A. (2015, May). Acceptance and Commitment Therapy (ACT) For Generalized Anxiety Disorder. Iranian Journal of Public Health, 44(5): 718–719

The National Institute of Mental Health (2018, July). Anxiety Disorders. Verfügbar unter: https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml]

Marie, J. (2017, December). Millenials and Mental Health. National Alliance on Mental Illness, Verfügbar unter:  [https://www.nami.org/Blogs/NAMI-Blog/February-2019/Millennials-and-Mental-Health]

Locke, A. B., Kirst, N. & Shultz, C. G. (2015, May). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician, 91(9):617-24

BAndelow, B. & Michaelis, S. (2015, September). Epidemiology of anxiety disorders in the 21^st century. Dialogues in Clinical Neuroscience, 17(3):327-35

Andreescu, C. & Varon, D. (2015, July). New research on anxiety disorders in the elderly and an update on evidence-based treatments. Current Psychiatry Reports, 17(7):53, doi: 10.1007/s11920-015-0595-8