Summary
An anxiety disorder is a general term for a grouping of disorders that involve feeling anxious. Anxiety disorders, while very common, are very treatable. There are six types of anxiety: generalized anxiety disorder, panic attacks/panic disorder, obsessive-compulsive disorder, phobias/irrational fears, social phobia/social anxiety disorder, and post-traumatic stress disorder (Anxiety Disorders and Anxiety Attacks). Anxiety is generally treated through therapy, medication, and transcranial magnetic stimulation. (Facts & Statistics) Since these treatment options can become extremely expensive without insurance it is crucial to make them available at an affordable price.
Background
“Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18% of the population” (Facts & Statistics). This means that, on average, 9 out of every 50 Americans will be affected from an anxiety disorder.
While anxiety itself is not deadly, it is often paired with mental illnesses that increase the risk of suicide. “It is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder” (Understand the Facts: Depression). In addition to depression with an accompaniment of an anxiety disorder there are also specific anxiety disorders associated with higher risks of suicide.
“Panic disorder is associated with a risk for suicidal thoughts. Studies report that up to 18% of people with panic disorder attempt suicide and up to 38.5% regularly harbor suicidal thoughts, with the risks being higher in people with both panic disorder and depression. Social phobias and OCD also increase the risk of suicide. If a person has an anxiety disorder and a mood disorder (such as depression), the risk for suicide is even higher” (Simon, H., & Zieve, D, 2013).
Self medication also plays into the mortality of an anxiety disorder. “Some people with GAD and panic disorders may use alcohol or drugs to self-medicate” (Simon, H., & Zieve, D, 2013) which can be deadly if an overdose occurs. In addition to suicide risks, anxiety disorders also contribute to physical illnesses that can become deadly without proper treatment. “Anxiety has been associated with several heart risk factors, including unhealthy cholesterol levels, thicker blood vessels, and high blood pressure” (Simon, H., & Zieve, D, 2013) due to an overload of stress and fear.
The diagnosis of general anxiety is more common among children aged 13-18, at 25.1% (Any Anxiety Disorder Among Children, 2005), than adults aged 18+, at 18.1% (Any Anxiety Disorder Among Adults, 2005). The diagnosis of severe anxiety is more common among adults aged 18+, at 22.8% (Any Anxiety Disorder Among Adults, 2005) , than children aged 13-18, at 5.9% (Any Anxiety Disorder Among Children, 2005). In children there is no significant difference between ages within the 13-18 range but a significant difference in sex was found. Males between the ages of 13-18 are 9.8% less likely to be diagnosed with anxiety than females this age who are at 30.1% (Any Anxiety Disorder Among Children, 2005).
In adults there are more significant differences. Sex plays a role in the percentage of people that are affected by an anxiety disorder. Adult women are 60% more likely to experience anxiety over their lifetime than adult men. Race plays a role as well; non-Hispanic blacks are 20% less likely and Hispanics are 30% less likely than non-Hispanic whites to experience anxiety over their lifetime. Age also contributes to the person’s risk factor. Adults between the ages of 30-44 are most likely to experience anxiety (35.1% of the US population). Next comes ages 45-59 (30.8% of the US population). Then 18-29 (30.2% of the US population). Lastly, 60+ (15.3% of the US population). (Any Anxiety Disorder Among Adults, 2005) Social factors affect a persons risk factor as well.
“More socially alienated populations have higher levels of anxiety. For example, a study of Mexican adults living in California reported that native-born Mexican Americans were three times more likely to have anxiety disorders (and even more likely to be depressed) as those who had recently immigrated to the U.S. The longer the immigrants lived in the U.S., the greater their risk for psychiatric problems. Traditional Mexican cultural and social ties seemed to protect recently arrived immigrants from mental illness” (Simon, H., & Zieve, D, 2013).
Anxiety disorders are extremely prevalent in today’s society and therefore need more attention to decrease the amount of people affected by them. With more attention to these disorders less people will have to go untreated and therefore will have a better and more productive life.
Anxiety is problem that many people deal with today and have dealt with for thousands of years. Over the course of time anxiety has evolved to better prepare humans and animals for survival by recognizing danger and applying the correct response to it. The fear of danger is another way of describing anxiety and the desire to stay away from it. In an article written by Meredith Small (2007), “The Evolution of Anxiety”, she talks about her personal experiences with anxiety while leading into the facts about the evolution of anxiety. She brings up Randolph Neese, a psychiatrist at the University of Michigan, who studies the evolutionary theory and how it can be applied to mental illness. She writes that he believes “Instead of calling mood disorders such as anxiety or depression ‘illnesses,’ he believes there might be good evolutionary reasons for feeling blue or scared; these feelings are not necessarily diseases or disorders, but adaptations.”(Small, 2007).
When thinking about anxiety as an adaption we can can form a hypothesis on where the anxiety is rooted from. Anxiety in its most basic form can be traced all the way back to an animal’s kill or be killed mentality. Humans and animals have evolved over time to survive as long as possible and it is this same anxiety that keeps us out of certain situations that could put us at risk of harm or potentially death. Small goes on to conclude that:
“Anxiety is an extended version of the fight–or-flight response which evolved to keep us alive; an animal without fear is a dead animal. But humans have a penchant for dragging the fight-or-flight response into every situation and holding onto it until we are sick. What helps, Nesse claims, is realizing anxiety is not necessarily a bad thing but a good thing, because anxiety attacks often keeps us from certain unpleasant situations” (Small, 2007).
Human’s adaptations involving the fight-or-flight response have evolved over time because day to day life has changed significantly. What produces anxiety in a human nowadays most likely did not exist in the first generations of mankind. For example, modern humans in the U.S. most likely would produce anxiety if they were standing in the middle of the highway with cars coming towards them. This is because modern-day humans know that getting hit by a car can lead to fatal injuries. This was not a problem in the hunter-gatherer generations because automobiles did not exist, but other issues were that have been eliminated from society. Since previous threats have been eliminated from day to day life, it is useful for modern-day humans to not have an irrational fear involving a threat that no longer exists.
Many studies have shown that anxiety disorders are genetic. “If you have first degree relative a mother, father, brother, or sister that has a disorder whether its OCD, panic disorder, etcetera you have an elevated risk” (Smoller, J., & Ressler, K). The idea of evolutionary perspective can be applied to the fact that offspring are at a higher risk of developing an anxiety disorder if a first degree relative has one. This is because, as more people are reproducing after the first signs of anxiety disorders developed, offspring from those couples are at a higher risk of developing an anxiety disorder.
Anxiety disorders, from an evolutionary perspective, are people’s bodies malfunctioning the natural ongoing battle of anxiety to keep us safe. Without this natural anxiety we would not have a way to properly assess certain situations that might put us in harms way. To contrast this, without natural anxiety, anxiety disorders would be eliminated from society. While the latter is the ideal situation the solution that has been briefly mentioned is not reality.
Public Health Recommendation
In order to begin fixing our nation’s anxiety problem it is important that we recognize two things. First, anxiety is the most common mental illness in the U.S (Facts & Statistics) and second, anxiety disorders are almost always treatable through professional care (Facts & Statistics). In order to help the huge number of Americans suffering from anxiety, awareness must be raised on symptoms of anxiety and treatment options for anxiety. Also, treatment needs to be made available and affordable for all Americans.
Since anxiety disorders are such common mental illnesses, it is important that awareness is raised on symptoms of anxiety and treatment options. In order to raise awareness there should be an ad campaign outlining symptoms, treatment methods, and where to get treatment for anxiety. This would allow information on this mental illness to reach many Americans who may not know that they have anxiety or how to go about getting treated for it. Also, doctors should be urged to try and diagnose and treat patients who may have anxiety more proactively so that no one goes undiagnosed or untreated.
Anxiety is extremely common amongst children between the ages of thirteen and eighteen. Children tend to feel more vulnerable and watched at school than elsewhere, because of this we recommend that resources be made readily available in school for children suffering from anxiety. We urge schools to try and help diagnose students with anxiety by implementing a system of screening their student bodies for behavioral and emotional problems. The most effective method of doing so is the Behavioral and Emotional Screening System, also known as the BASC-2 BESS (Treating Childhood Anxiety in Schools, 2015). It is also important that schools encourage students with anxiety to seek treatment as well as provide resources and a safe environment for them to receive treatment.
Our final recommendation is to make sure treatment is available for everyone by making it reasonably affordable. The two main ways anxiety is treated are therapy and medication. Since “some therapists may charge as much as $200 or more per session, [although] most will charge $75-$150 a session” (Cohen, M. B.) many patients requiring therapy won’t be able to pay for it. In addition to therapists being expensive, medicine is as well. Required prescriptions can be far too expensive for people without insurance. In order to effectively treat anxiety nationwide we need to ensure that everyone can afford their preferred means of treatment