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OVER the past few years, I have noticed an increasing number of people sharing their experiences of feeling anxious, whether it is celebrities opening up in interviews or friends chatting over a drink. This got me thinking: are more people feeling anxious these days or are they just more willing to talk about it?
This apparent uptick seems to be seen in studies of anxiety prevalence – but dig into the details and the picture isn’t so clear. As for what is behind this possible rise, the covid-19 pandemic is an obvious cause, yet it isn’t the only one: economic and political factors may also play a role.
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Let’s look at the pandemic first. “It was a phenomenon that none of us had experienced, a global issue that understandably caused a huge amount of stress,” says David Smithson at the charity Anxiety UK. “Who wouldn’t be worried?”
Rising anxiety
Levels of anxiety rose at the start of the pandemic, with the World Health Organization reporting a 25.6 per cent increase in anxiety disorders in 2020 as lockdowns and other restrictions were brought in and people grappled with an unknown virus and its impact on their lives. But this rise didn’t persist, according to a review of 177 studies looking at people in high-income countries, with levels falling as the pandemic continued.
This chimes with Smithson’s experience. “We saw that rise through demand for our support services from the start of the pandemic for about two years,” he says. “We have seen, in the last 12 months or so, that demand has dipped down and it’s back now at pre-pandemic levels.”
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But anxiety levels had been rising before the pandemic started. In the UK, diagnoses of generalised anxiety disorder rose in people aged 18 to 44 between 2014 and 2018, for example, with the largest increases seen in women and young people. In the US, self-reported feelings of anxiety rose in adults aged 18 to 49 from 5.1 per cent in 2008 to 6.7 per cent in 2018, with greater increases again seen in the youngest.
Talking about mental health
One explanation for this is that people may be more willing to seek support following campaigns encouraging individuals to talk about their mental health. However, while stigma about mental health conditions in general decreased up until the early 21st century, there is some evidence that this trend has now stalled.
“Over the short term, the past 10 years or so, there is no evidence that willingness to admit to these issues has increased,” says Ronald Kessler at Harvard University. “As a result, evidence for increased reports in trend surveys are likely due to genuine increase in prevalence.”
Short-term and situational anxiety, which could be related to things like economic and political stressors, is the type that is rising, he says. “There is little evidence for increases in the early-onset chronic type of serious anxiety that is likely to be influenced heavily by biological factors.”
Global anxiety rates
Yet this increase isn’t global. One study, based on data collated in 2022 by the Global Burden of Disease project, looked at the prevalence of anxiety disorders in 204 countries around the world. It found that Portugal had the highest rate, at 8671 cases per 100,000 people, followed by Brazil, Iran and New Zealand.
Europe and the Americas were the regions with the highest rates, while Africa and Asia had the lowest. The study suggests this increased incidence in higher-income countries could be due to a range of different factors, such as diet, lower levels of physical activity and a more individualistic culture.
Other possibilities for these variations include methodological differences, for example studies based only on the records of those seeking treatment can’t account for those who don’t or can’t access healthcare. Conversely, self-reported surveys can sometimes struggle to differentiate between everyday feelings of anxiety and clinically significant anxiety, so may overestimate levels in a population.
Whatever the reasons behind the increase, it does seem to be present – at least in some countries. It looks like we may be having this conversation for a while yet.
This article is part of a special series on anxiety.
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