“Anything that helps with diseases doesn’t help with anxiety disorders”
The percentage of Dutch people with an anxiety disorder has increased in recent years, with 15 per cent of adults now suffering from it. How does an anxiety disorder emerge? And what can we do about it? This is what Neeltje Batelaan, professor of psychiatry at Amsterdam UMC, is giving her inaugural lecture on Thursday 5 September.
Why do more and more adults suffer from an anxiety disorder?
“That’s a good question that we don’t know yet. There are some risk factors for anxiety disorders such as poverty and low education. So if those increase in society, it is not surprising if anxiety disorders follow. It may also be that certain risk factors have become more prominent, for example, that having little money is worse today than it was 20 years ago. A PhD student is now working to find an answer to that.”
“What we do know, however, is that anxiety disorders have increased and particularly in the youngest age group of 18-35 years. The numbers come from the Nemesis study, a survey by the Trimbos Institute that measures the mental health of adult Dutch people roughly every 10 years.”
Is an anxiety disorder something that easily arises in student life?
“Yes, three quarters of people with anxiety disorders have them before the age of 25. The student age is a vulnerable stage of life; panic disorder, for example, very often arises during student life. You go to a new city with a new study, a new house and make new friends. Those are a lot of stressors at the same time. And if you are vulnerable to anxiety, then anxiety can crop up during such a period. The type of anxiety may not necessarily be related to what you are experiencing at the time. If you are prone to going through your back, for example, then that also happens precisely at stressful moments.”
What characterises someone with an anxiety disorder?
“People often think that someone with an anxiety disorder is anxious all day long, but that is not the case. However, they do see danger very quickly; alarm bells are constantly going off in their brain. They overestimate the risk of something bad happening and also the consequences. Someone who sees danger starts avoiding situations. Logical, because if you are afraid of heights, you won’t book a holiday in the Alps either. But that avoidance works like an oil slick with anxiety: you start avoiding more and more and then your life becomes more and more limited.”
How does an anxiety disorder arise?
“Surely that is a complex interplay of all sorts of factors. There is a genetic component: a child of parents with mental health problems has an increased risk. Learned behaviour also plays a role: if a parent is afraid all the time, then young children adopt it. Personality traits is a factor. In addition, an anxiety disorder can arise from early childhood trauma, where a young child has experienced abuse, neglect or violence in a family.”
“Sometimes there is a trigger for an anxiety disorder, such as a new job, but much more often it is a more insidious, gradual process. If you become increasingly accustomed to reacting with anxiety, that reaction wears out a pattern in your brain. With anxiety, you need to prevent that wearing in. Because once it becomes ingrained, it becomes more and more persistent. I think that’s very much underestimated.”
What can you do to prevent an anxiety disorder?
“I think it is very important to recognise that while anxiety is a normal emotion, it can also get out of hand. That is why I advocate for more knowledge and expertise on anxiety in society. Because everything that helps with other diseases is wrong with anxiety. For instance, you can help someone with a broken leg by offering to go to the supermarket. But with anxiety, you then start helping avoidance. Soon the person will not dare to go to the corner shop or to the letterbox either. Reassurance, too, is often counterproductive. It is better to encourage people to endure the fear, so they notice that it will go away by itself.”
“This is also largely what therapy is based on. When you expose yourself to your fears, you notice that the disaster you feared does not happen. Your alarm bells still go off at first, but you can learn that you don’t have to attach any consequences to it. In this way, your fear subsides and the alarm bells go off less often. We should actually translate that pattern into a kind of therapy-light. If we ensure that there is more knowledge and expertise in society, then we – as parents, friends, GPs or colleagues at work – can very easily keep each other on our toes and encourage someone not to lapse into avoidance. Just like you can say to a friend: shouldn’t you take up sports.”
Neeltje Batelaan delivers her oration Anxiety-related disorders: from nature to approach on Thursday 5 September at 15:45 in the VU main building on Boelelaan. The oration is freely accessible.
