In the country with the highest prevalence of anxiety in the world, people with a mental disorder are still the target of prejudice, according to the World Health Organization (WHO).
Heart palpitations before an exam, nervousness in an important meeting or sweaty hands on the first day at work. Chances are that you have experienced one of these symptoms.
Now, if you’re having trouble sleeping, are out of breath in an important meeting, and can’t focus on work because you’re only thinking about the worst, you should be aware of this. What you consider normal may be a psychiatric disorder and requires a medical evaluation.
If not treated properly, anxiety can become a calamity and trigger other mental disorders such as depression, which affects approximately 300 million people worldwide, according to the Pan American Health Organization (PAHO).
19yearold student Julia de Mello Precioso is one of 18.6 million Brazilians who suffer from an anxiety disorder.
“In the beginning I felt unmotivated, my heart was racing extremely, I had shortness of breath, drastic mood swings. But over time those symptoms got worse and it got to the point where I just cried and didn’t feel like socializing anymore.”
Stories like hers are becoming more common in the world, especially in the wake of the coronavirus pandemic. Data from the World Health Organization (WHO) shows that in the first year of the Covid19 pandemic, the global prevalence of anxiety and depression increased by 25%.
“One of the main explanations for this increase is the unprecedented burden of social isolation resulting from the pandemic, alongside restrictions on working ability, seeking family support and active social life. Loneliness, fear of contagion, suffering and the death of loved ones were stressors that led to anxiety and depression,” said Antônio Geraldo da Silva, President of the Brazilian Association of Psychiatrists (ABP).
According to the most recent major global mapping of mental disorders conducted by the WHO, Brazil has the world’s highest prevalence of anxiety disorders.
To give you an idea, around 9.3% of Brazilians suffer from pathological anxiety. Then come Paraguay (7.6%), Norway (7.4%), New Zealand (7.3%) and Australia (7%).
Experts interviewed by BBC Brasil cite high unemployment, periodic shifts in economic direction and a lack of public safety as the main factors behind the high prevalence of anxiety disorders in the population.
“Brazil has a high rate of violence that causes many people to leave their homes for fear of being robbed. I’m afraid that creates fear,” stressed Rafael Boechat, Professor at the Faculty of Medicine at the University of Brasília (UnB).
Psychologist Adriana Botarelli, who specializes in receiving patients with mental disorders, says economic difficulties themselves contribute to the high numbers of anxious people.
“Most of the Brazilian population has little access to psychiatric services, many hours of work per day, uncertainties about the future and a poor quality of life. All of these factors bring with them feelings of fear, worry and anguish.”
Gerardo Maria de Araújo Filho, professor in the Department of Neurological Sciences, Psychiatry and Medical Psychology at the Medical School of Rio Preto (Famerp), believes that the excessive use of computers and smartphones also explains the high prevalence of anxiety in Brazil.
“The social network creates a number of demands on people. You practically want to be thin and athletic like the influencer.”
A study conducted by the Canadian Journal of Psychiatry proved that the more screens used, the greater the anxiety.
At the same time, a report published by digital market analysis company App Annie pointed out that Brazil tops the podium for countries with people who spend the most time online.
To give you an idea, on average Brazilians spend almost five and a half hours a day in front of their devices.
Alongside Indonesia, this is the highest mobile phone usage among the 17 countries analyzed in the report (which also includes South Korea, Mexico, India, Japan, Turkey, Singapore, Canada, US, Russia, UK, Australia, Argentina, France, Germany and China) based on data collected from the iOS App Store, Google Play and other online stores.
Children are more vulnerable
Among the most vulnerable age groups to be diagnosed with an anxiety disorder, children and adolescents lead the way.
However, experts heard from BBC News Brasil point out that all people are susceptible to being diagnosed with an anxiety disorder throughout their lives.
João*, for example, loved playing with his friends, going to school and spending time with his family. Everything changed with the pandemic and the 13yearold boy had to spend more time at home.
Then the mother noticed the teenager more irritable, anxious and with excessive worry. They were the first symptoms of pathological anxiety.
“My mum realized she really needed help when I started isolating and tired of activities that I enjoyed as a teenager.
Like João*, several other young people in Brazil were diagnosed with anxiety in 2022.
Mapping conducted by the São Paulo State Ministry of Education in collaboration with the Ayrton Senna Institute showed that 69% of students in the São Paulo state network reported experiencing symptoms of anxiety or depression during longdistance activities caused by the pandemic.
“Fear occurs more frequently in childhood and adolescence because people do not yet know the world. It is a phase when the human is still developing and the child is extremely vulnerable to what is happening. So a parental argument at home.” , for example, it can trigger anxiety in the child,” says Gerardo Maria de Araújo Filho, professor at Famerp.
Ênio Roberto de Andrade, director of the psychiatric service for children and adolescents at the Hospital das Clínicas de São Paulo, says that the warning sign that indicates that it is not normal anxiety but an anxiety disorder is generally the influence of the Symptoms in the person is life. Person.
“The most indicated treatment for anxiety in childhood and adolescence is cognitive behavioral therapy (CBT), and when it fails, drug treatment is associated. It is also worth starting CBT in adults, however, starting with pharmacotherapy, as a rule, is very common”, scored.
How to avoid an anxiety disorder
Research shows that pathological anxiety is directly related to the learning process, the environment the person fits into, or the patient’s genetic factors.
In some cases, for example in the learning process, this can be avoided based on the guidance of parents and educators.
“An example is mothers who won’t let their children do a number of things for fear they will get hurt,” Ênio explained.
In the environment part, the recommendation to reduce the likelihood that children will experience pathological anxiety is to prepare a less fearful environment, i.e. without “triggers”.
On the other hand, if anxiety stems from genetic factors, there is nothing you can do to avoid it, just see a doctor.
“Whenever the symptoms begin to interfere with the person’s life, it is time to see a psychiatrist to have the condition evaluated. Fear and sadness are normal human traits, but from that moment they prevent us from leaving home, working, leading and active social life, interacting with other people, we should seek help,” said Antônio Geraldo da Silva, President of the Brazilian Association of Psychiatrists (ABP).
Psychophobia gets in the way
One of the major challenges in tackling high rates of anxiety is the strong stereotype that reigns about mental disorders. In Brazil, prejudice against people with mental disorders is called psychophobia.
Jorge* well remembers experiencing symptoms of anxiety as a teenager and encountering resistance at home to seek specialized help.
“First my mother took me to a spiritualist center. She was a bit reluctant to take me to the doctor, but when the symptoms persisted we made an appointment to see a psychiatrist. That’s when I discovered I had an anxiety disorder. “
Psychologist Adriana Botarelli believes that demystifying mental health and popularizing the idea of seeking specialized help is the way for Brazil to overcome the high prevalence of anxiety.
“Many people still find it taboo to talk about mental disorders and end up not caring about disorders, either for fear of being called ‘crazy’ for undergoing psychological and psychiatric treatment, or for fear of Drugs because they think they are becoming dependent or sedated.”
Antônio Geraldo da Silva, president of the Brazilian Association of Psychiatrists (ABP), says that ideally, children and adolescents should be able to speak openly about mental health early on in school and at home so that they can grow up free of the stigma associated with older people.
“We need public policies that promote care and break that stigma. Only in this way can people with mental illness live independently and autonomously, have employment opportunities, pursue their goals and enjoy opportunities with dignity and full social inclusion,” said Silva.
For those who are currently living with fear in a harmonious way, the secret is not to deny their feelings.
“Today I did physical exercises again, I can control my thoughts better and recognize when I am anxious. The help of a professional and willpower are key,” said Julia.
Gerardo, on the other hand, explains that it is more important than participating in therapy for the patient to recognize how to use fear to their advantage.
“The big question isn’t whether or not you’re scared, but its intensity. I always say that from 0 to 10, a fear from 3 to 3.5 is a ‘good’ fear. This is the dose of fear we need to carry out our activities. If it goes beyond that, it is already a warning sign.”
Types of Anxiety Disorders
generalized anxiety disorder: Your main characteristic is excessive and general concern without obvious reasons in everyday situations. That is, the patient always expects that something bad will happen and remains in a state of constant apprehension.
panic disorder: Its main feature is an intense and sudden feeling of anxiety, followed by physical symptoms (including rapid heartbeat and breathing, cold sweat, shortness of breath, dizziness, tremors). These episodes can occur at any time and last up to 30 minutes.
Social Anxiety Disorder: People with social anxiety disorder or social phobia have great difficulty interacting with other people. This can refer to a discussion with a group or even presenting a work to the class in a classroom setting. Thus, the trigger for the development of typical anxiety symptoms is usually in the area of socialization. In this way, the social phobia contributes to the patient trying to isolate himself more and more and to avoid his sources of anxiety.
Agoraphobia: is the anxiety disorder associated with being in situations or places where there is no easy way out. In general, these are cases with no obvious immediate danger, but despite this, the person is anxiously looking for a way out. One of the most common cases of agoraphobia is usually not being able to stand being in crowded or very closed places like on a bus or plane. Those suffering from this disorder also do not feel comfortable in elevators and other small spaces.
PostTraumatic Stress Disorder (PTSD): Its main feature is recurring and intrusive memories of an event that was very distressing for the patient. This traumatic episode can range from an accident to the death of a loved one. What sets PTSD apart from conventional shock or sadness is the prevalence of its symptoms, which range from trouble sleeping to increased alertness.
Acute Stress Disorder: The main difference between acute stress disorder and other types of anxiety is that it usually occurs after experiencing or witnessing a specific traumatic event. Therefore, the patient relives this event over and over again and constantly torments himself with it. Since it is an acute condition, it usually does not last long. Symptoms usually subside within a month. However, it is still valid to seek a diagnosis from a specialist in order to assess the case and receive the appropriate treatment.
Selective muteness: it is mainly characterized by the inability to communicate verbally in social situations. The case differs from social phobia or social anxiety disorder in that it usually ends before puberty or adulthood.
Separation Anxiety Disorder: this feeling of homesickness can express itself much more strongly in the form of separation anxiety disorder. In this case, the patient experiences feelings of anxiety and despair when detaching from an environment that he finds familiar and comfortable.
SubstanceInduced Anxiety Disorder: Certain substances can also cause anxiety disorders. This ranges from conventional medicines to dangerous drugs such as cocaine, heroin, marijuana and others.
*The report preserved the real names of João and Jorge.
This text was published in
https://www.bbc.com/english/articles/c4ne681q64lo