The burden of anxiety disorders is growing across India, especially in the literate and urbanized states, shows the country’s first state-level disease charts published in The Lancet last week.
While anxiety disorders were in the 40th place in 1990 as a contributor to disability adjusted life years (DALYS)—the World Health Organization’s special scale to measure loss of ‘healthy’ years—it climbed to the 26th place in 2016. In fact, the study listed it among the top 10 causes for morbidity across India in 2016 (in terms of YLDs or years lived with disability).
Anxiety disorders, which range from generalised fear to panic attacks and obsessive compulsive disorders, are generally not as crippling as depression but can cause disability and hit economic production.
Maharashtra, Delhi, Andhra, Karnataka and Kerala are among 10 states (see box) that have more problems due to anxiety disorders, said the study. These states also made the transition from communicable to non-communicable diseases, indicating they are more urbanised and literate.
“Urbanisation is a contributor to higher levels of anxiety disorders and depression,” said Dr Pallabh Maulik, an AIIMS-trained psychiatrist who is with the Delhi-based George Institute for Global Health.
The National Mental Health Survey of India 2015-16 said urban metros were witnessing a growing burden of mental health problems that result in disabilities and affect work, family and social life.
Mumbai-based psychiatrist Harish Shetty said anxiety is the mother of all mental illnesses. Making a distinction between anxious thoughts and anxiety disorders, Dr Shetty said, “In this quick and uncertain world, anxiety is ubiquitous. About two-thirds would be anxious while about 10% would have some anxiety disorders.”
Many with anxiety disorders could progress to depression, which is the leading cause for self-harm and suicides. “The key message is that anxiety disorders cannot be ignored. Some of these people could be at the start of a depressive disorder and should be helped at the earliest,” said Dr Maulik.
In recent years, research has linked anxiety disorders to mortality as well. A study by the University of Edinburgh published in the British Medical Journal in July 2012 said that mild mental health problems could be linked to increased risk of death from major causes. A Dutch study in the British Journal of Psychiatry in 2016 said the risk of death by natural and unnatural causes was significantly higher among individuals with anxiety disorders as compared with the general population. It also quoted a meta-analysis about approximately five million deaths worldwide being attributable to mood and anxiety disorders each year.
However, doctors said people with most anxiety disorders could be helped easily. While severe forms of anxiety disorder will need medication, they said that many eastern practices could help the affected persons. “Be it meditation or yoga, eastern practices help people check general anxiety or anxiety disorders,” said Dr Shetty.