Your anxiety is not trivial or shameful

It’s small wonder the cost-of-living crisis is a major factor

The theme for 2023’s Mental Health Awareness Week, which ends on Sunday, is anxiety. Do we really need a dedicated awareness week for a condition that we all recognise, in some form or another? Is there a danger that increased awareness results in us over-medicalising what could be considered the relatively trivial levels of anxiety that are a feature of modern life?

Even when it feels acutely uncomfortable, anxiety is often short-lived and manageable, and not in need of a specific diagnosis or pharmaceutical or psychological treatment. However, this is far from the full picture.

For many years, I experienced generalised anxiety disorder. It was part of a combination of psychiatric illnesses that left me seriously unwell. A recent, brief anxiety attack sent me straight back to the days when I had a permanent knot in my stomach, was jittery and nauseous and unable to think straight. I had a persistent tremor, constant anxiety sweating, and every thought sent me spiralling into fear.

Experiencing those feelings again reminded me of how physically and mentally draining anxiety can be, especially if it endures every waking hour. On the day of the recent attack, deep breaths and a bike ride helped ease the symptoms. Back in the day, even if I’d been capable of getting on a bike, it wouldn’t have had the slightest effect.

In its severe and/or chronic form, anxiety is anything but trivial. It has a significant impact on mortality, both through suicide and because of the physical effects on the cardiovascular system. Stress and anxiety are closely related, but one distinction puts stress as a reaction to external stressors which vanishes when those stressors disappear, whereas anxiety persists.

However, the water is muddied when stressful circumstances are prolonged, and that is exactly what is happening with the current cost-of-living crisis.

A recent study for the charity See Me found that more than half of Scots thought their mental health had been affected by the economic crisis, a figure that rises to 82% in the most financially precarious households.

This year, the Trussell Trust noted record levels of food parcel distribution in Scotland, up 30% in 2022-23 compared to the previous year. In one study, a third of Scottish adults reported that they had skipped meals last winter, and more than half said they hadn’t turned the heating on.

Add in soaring inflation and recent increases in interest rates, with knock-on effects for mortgages and rent prices, and it is small wonder that the cost-of-living crisis is a major factor responsible for increased levels of stress and anxiety in the population.

And, yet, many people are not seeking help. Only a third of those whose mental health had been affected by the current situation had discussed it with anyone. When asked why (not), many said that they were worried about how people would react, or that they didn’t want to bother them, as if it was shameful or not deserving of attention.

There are a variety of useful techniques to help manage mild anxiety. Outdoor activity, exercise, healthy diet, socialising, and reduction in the intake of harmful substances (drugs, alcohol, nicotine) all have a role. But even these simple remedies are not readily available to everyone, and more serious cases may require medical intervention.

However, since disease burden is so closely aligned to social issues, it is crucial that we also focus on society-wide mechanisms to help individuals and families impacted by the cost-of-living crisis.

There are many political and legislative ways this could be done, such as an immediate ban on the forced installation of prepayment energy meters, and an end to the associated disadvantageous tariffs.

The extension of eligibility and rate of Scottish child payments was a welcome move, and has had a measurable impact, but could go further. Initiatives such as Citizens Advice Scotland’s mental health and money good practice guidance for creditors should be widely adopted.

In the meantime, the message I hope resonates during this year’s Mental Health Awareness Week is that anxiety isn’t trivial, shameful or a personal failing.

The shame is that we treat it as if it were.