Anxiety is the most common mental health condition in Australia, and we are better at talking about it than we have ever been. So, why does it still take the average person diagnosed with an anxiety disorder more than eight years to seek help?
A new survey by government-funded not-for-profit NPS MedicineWise shows most Australians underestimate how long it takes people with anxiety to visit a health professional.
According to the survey, which is part of an education campaign to raise awareness of anxiety and its available treatment, 69 per cent of Australians think it takes less than five years for a person to seek professional help for an anxiety disorder.
In reality, only 28 per cent of people who are subsequently diagnosed with an anxiety disorder seek treatment in the first year of experiencing symptoms. It takes, on average, 8.2 years of living with symptoms before people ask for help.
Gemma Latter is a 23-year-old pharmacy student from Mt Isa. As one of the one in seven Australians who live with an anxiety disorder, she says the condition has gripped her for her entire life.
“I had my first panic attack at 10 but didn’t know what it was,” she recalls. “The problem was, when I was younger I never really opened up about it or told people.”
If she did open up, Latter says she was “shut down” or felt judged as “being a bit of a sook”.
“The biggest barrier was the stigma and disbelief that, coming from a relatively advantaged lifestyle and family... I didn’t have a reason to be this way, so it was silly of me to think I had a disorder.”
The survey showed that, although Australians are reluctant to seek help for anxiety, most of us do know where to look for further information (71 per cent say they would go their GP, 48 per cent to a psychologist, and 37 per cent to Dr Google) and are aware that effective treatments exist (69 per cent cited lifestyle changes, 66 per cent counselling, 54 per cent mindfulness and meditation techniques, while 46 per cent knew of prescription medication).
“Much of [the] delay relates to the time it takes to realise that what you are experiencing could be part of an mental health problem, such as an anxiety disorder,” explains Dr Jeannie Yoo, GP and medical adviser at NPS MedicineWise.
Like Latter, many people experiencing the symptoms of an anxiety disorder think it is a personality flaw or “just me”.
When the symptoms are so chronic or become so debilitating that they realise something might be wrong, they are often unaware that help is at their fingertips and needn’t be expensive.
Only 13 per cent of respondents realised that online treatment programs are an effective – and often free – option for treating anxiety.
“Clinical studies have shown that online treatment programs can be just as effective as face-to-face treatment,” Dr Yoo says. “Online treatments may be an accessible option for some people, and many of these programs are available for free.”
For Latter, what ultimately helped was a combination of approaches including medication, mindfulness and meditation, as well as a little trial and error ("I tried five different medications and have tried multiple psychologists").
"I’m very stable now," she says. "I’d say to my past self, all that time ago, that it is daunting and overwhelming, and sometimes it seems like no one will understand or possibly can. But by reaching out [and] talking to people, you’ll find a lot of people like you, you’ll get a support network and you’ll find there are lots of ways to try and help things along. It can’t be cured [but] it can be managed."
What is an anxiety disorder?
Anxiety is a normal response to a stressful situation. Often described as being nervous, worried or on edge, physiological symptoms of anxiety may include a pounding heart, shortness of breath, dizziness, trembling and the sensation of "butterflies in the stomach".
When the anxiety response is experienced frequently over a long period of time, is out of proportion to the stressor (or occurs even in the absence of an apparent stressor), and is affecting a person’s daily life, it constitutes an anxiety disorder.
How do you choose a treatment?
Dr Alison Mahoney, senior clinical psychologist at the Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent’s Hospital, suggests talking to your GP as a starting point.
"When in doubt, I’d recommend Cognitive Behavioural Therapy (CBT) because it’s the most available and has the strongest evidence-base. It’s brief, practical, and skills-based and focuses on what you can do with the here and now," Dr Mahoney explains.
"Mindfulness-based therapies are also short-term and practical and it’s a good alternative to CBT."
Schema and insight-based therapies are more long-term and are a way of exploring longstanding issues, Dr Mahoney explains, adding there are pros and cons to any method of treatment.
- Face-to-face treatments are rewarding but can be expensive and hard to access, depending on where you live.
- Telehealth, online and books are all more affordable and accessible options but require more discipline unless you choose a clinician-guided program, which she recommends.
- Evidence-based online programs include eMHPrac, This Way Up, and MindSpot.
"There’s no one size fits all," Dr Mahoney assures. "There are lots of great treatment options. The message is: don’t delay."