The rise of the anxiety disorder

"Women often have high expectations of themselves and blame themselves when things go wrong."
"Women often have high expectations of themselves and blame themselves when things go wrong." Photo: Stocksy

"I had my first panic attack when I was 29," says Bianca Dye. "The world was spinning and I couldn't speak properly. It's a feeling of dread and tightening in the chest. I just snapped. I had to take weeks off work. It was absolutely terrifying. My life changed from that moment. And not in a good way."

Back then, the former radio DJ and media personality wouldn't have dreamed of telling anyone about her panic attacks and her subsequent diagnoses of generalised anxiety disorder. Now, 12 years on, she has become somewhat of a poster girl for the anxiety generation.

Having the courage to speak up about her condition meant she found a burgeoning band of supporters who identify with the disconcerting sensations of being anxious most of the time.

"The world was spinning": Bianca Dye.
"The world was spinning": Bianca Dye. Photo: Robert Peet

"It's been very hard to admit I have it because people cock their heads and think I'm crazy," she laughs. "And I think, 'If I'm crazy, then one in four of us are crazy too'.

Dye has gone from denial to starting an Instagram page, Anxiety Free, posting for its 7000-plus followers inspirational messages and quotes from celebrities who have owned their anxiety status. These include Amy Poehler, Amanda Seyfried (who admits she drinks to cope with interviews), Ariana Huffington and Ruby Rose, who declared in 2013 that she was retreating to deal with her mental health issues.

"If you don't have some little semi-colons amongst the craziness, it all comes crashing down around you," says Dye. "My aim is for people to feel less alone."

Digital Media entrepreneur Mia Freedman also recently divulged her years-long struggle with anxiety and subsequent nervous breakdown, during which she endured 12 days "in a state of crippling panic and anxiety", a feeling she describes as "frantic dread".

Not so long ago, anxiety was written off as good old-fashioned worry or stress, its sufferers expected to "just get over it". It wasn't until the 1980 edition of the Diagnostic and Statistical Manual of Mental Disorders that "anxiety disorders" made an appearance.

Anxiety is now the most common mental disorder in the country – one in four Australians, mainly women, will experience an anxiety disorder during their lifetime – and medical practitioners are now more likely to diagnose a range of symptoms that may have once been dismissed.

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"People are more willing to talk about it, they're more likely to self-report," says Dr Stephen Carbone, a former GP who is now Beyond Blue's leader of policy, research and evaluation, reflecting on the stark increase in anxiety diagnoses revealed in the 2007 National Survey of Mental Health and Wellbeing. He says anxiety disorders are part genetic predisposition and biological make-up, and part life experiences and current environment. "There's no doubt that stressors in people's lives are on the increase," he says.

Scott Stossel, author of My Age of Anxiety, agrees that although there is a "genetic susceptibility" to anxiety and depression, the age we live in doesn't help matters. "Certain aspects of our current historical moment do make this a highly anxious time," says Stossel, a long-term anxiety sufferer.

Dye believes her anxiety is hereditary ("both my parents are intense") but stems more from her childhood, being shuffled between various homes after her parents divorced. "I'm not resentful, I feel loved," she says. "But I didn't learn how to keep myself calm, and unless that gets addressed you grow into an anxious adult."

Everyone experiences "base level" anxiousness and worry from time to time but abnormal levels of anxiety manifest in myriad ways, from sleeplessness and debilitating phobias to overwhelming panic.

Dr Carbone says it becomes a "condition" when it's excessive, long-lasting and "disabling". "There are physical symptoms like sweaty palms and rapid and shallow breathing, the feeling that something terrible is going to happen," he says. "It's also associated with withdrawal and avoidance."

Psychiatrist Dr Ben Teoh believes anxiety is more prevalent among women (one in three Australian women will suffer an anxiety disorder at some stage, compared with one in five men) partly because of the pressure of balancing work and family. But, he adds, women are also more inclined to seek help.

Dr Carbone says women tend to be caregivers, a role that puts more stress on their day-to-day lives. "Women often have high expectations of themselves and blame themselves when things go wrong," he says.

"There are socially determined beliefs and expectations that women are responsible for everyone else's happiness and that it's all up to you and you don't look after yourself as much as others. If you get into that mindset it can tip over into an anxiety condition."

When social researcher Rebecca Huntley led The Working Mum study, a part of the Ipsos 2012 Mind and Mood report, she was surprised by the extent to which the recipients laid claim to anxiety.

"Women feel like they have to do everything or the wheels will fall off," says Huntley. "Australian women are notoriously bad at asking for help. They feel overwhelmed and need to retreat into themselves. One woman said, 'Sometimes I wish I could have a car accident where I'm not seriously injured but just enough to go to hospital for a couple of days to be left alone.' "

Anxiety sufferers, such as Chloe*, say the condition can knock you for six. "It's a level of not coping, an energy all on its own, and I didn't know which problem to solve first. You're not quite sure what to do with it."

"It was sick hot dread ... one of the most excruciating experiences of my life," writes author Kerri Sackville of the first of her two full-blown panic attacks (one of the most common symptoms of anxiety). Sackville chronicled her lifelong battle with the disorder in the aptly titled The Little Book of Anxiety: "Your thoughts take over, as you helplessly watch yourself being carried away to places of dread and fear."

This sense of powerlessness among women, particularly mothers, is not new to our generation, every era featuring its own version of what the Rolling Stones famously dubbed, "mother's little helper". Jane Austen's Mrs Bennet clutched smelling salts to calm her "nerves". Our mothers and grandmothers famously had "a Bex and a good lie down", and later Valium to cope with what Huntley calls their "thwarted ambition" after forgoing careers to take care of children.

These days, the stress is in doing too much, merging those careers with motherhood. "From the days when women were not allowed to have a life, when life was not full enough, now women take drugs to cope with life being too full," says Huntley.

While psychologists say the first line of treatment should be psychotherapy or counselling, many anxiety sufferers are prescribed medication. These include anti-depressants such as SSRIs (including Prozac and Zoloft), beta blockers (to tackle performance anxiety) and benzodiazepines, such as Valium.

Xanax (alprazolam) was once the go-to drug for mitigating anxiety, but was rescheduled by the Therapeutic Goods Administration to Schedule Eight (drugs of addiction) last year after lobbying by mental health experts in response to increasing illicit use and evidence of dependence. This means doctors now think twice about prescribing it.

As Huntley observed in her 2012 study, it was seen as an "accepted drug" among certain women and she was shocked by the "normalcy" around it. "Some women had it in their handbags and offered it around," she says. "They saw it as a useful coping mechanism."

Eliza* recalls that the drug gave her "instant relief" from her anxiety, whitewashing her emotional pain.

"I could go to sleep, not stare at the ceiling feeling sad and thinking about my problems," she says. "Without that opportunity to zone out for that period of time, knowing I could whack myself out, my thin skate across depression would have gotten worse. I just wanted the sadness to go away."

She admits she was "fearful" of Xanax's addictive nature ("I Googled it") and always saw it as a short-term solution. "I was given a script and medication without any other support. They should come with a hug."

Dr Teoh says for most anxiety sufferers "we need to look at the underlying psychiatric or psychological problems".

That is the hope of many mental-health practitioners: that for sufferers of anxiety, the focus switches from the drugs that mask the disorder to the need to deal with the disorder itself.

Cognitive behaviour therapy is "way more effective than drugs", says Gavin Andrews, professor of psychiatry at the University of NSW. It can be done in a matter of weeks, research proving recipients tend to "stay well", he says.

Dr Carbone agrees there are many effective "reachable techniques" in combating anxiety: yoga, meditation, mindfulness and a healthy diet.

Kerri Sackville says that for her, therapy is the only thing that has touched the sides, helping her "to understand the genesis of my anxiety on my childhood and in my genes".

And Bianca Dye has been able to get a handle on her anxiety with meditation, which she practises regularly. "I see my anxiety as a gift now," she says. "It's made me more compassionate and empathetic and spiritual. I can say, 'There's a fellow anxious person.' It forces you to look within yourself and see the answers are inside you. Now I can't live my life any other way." 

*Names have been changed.

Beyond Blue 1300 22 46 36.

Via Daily Life