Let's talk about anxiety

Anxiety disorders are the most common type of mental disorder, affecting 1 in 6 (17%, or 3.3 million) Australians, followed by affective disorders (such as depressive episodes) (8%), and substance use disorders (such as alcohol dependence) (3%). (1)

People with anxiety or generalised anxiety disorder (GAD) feel worried or anxious much of the time and these persistent thoughts can interfere with their lives. Even minor things can lead to intense feelings of panic or impending doom. Often this anxiety can be accompanied by other mood disorders, social anxiety and/or depression. They may misuse drugs or alcohol and have physical symptoms like irritable bowel syndrome, stomach aches or headaches. Causes can stem from changes in brain functioning (neurotransmitter balance), family history/genetics, stressful life events and psychological factors.

Children are even more at risk of anxiety — 7% of Australian children are affected by anxiety disorders; it is the second most common disorder after ADHD currently. We know mental health problems can have a substantial impact on children's wellbeing and evidence shows us that mental disorders in childhood can predict mental illness in adulthood (2, 3).

Early intervention seems to be vital for children considering that anxiety disorders have been found to begin earlier in life than previously thought (4). Due to the high disease burden, interventions and prevention programs may need to begin at a much earlier age — even in preschool children aged 4–6 years (9, 10). In adolescence, suicide and self-inflicted injuries now outrank asthma as the leading cause of disease burden, while anxiety and depression rank 2 and 3 (5). Only 56% of children with symptoms are apparently receiving professional help (6).

Some programs in Australia currently being delivered to children — including preschool children — are the Preschool Paths Program, Fun Friends, and Play Skills for Shy Children (SST); you can read more about them in the reference below (4). Programs delivered to parents include Cool Little Kids (11), which was effective on follow-up 12 months later and, in a small long-term subset, was still found effective in girls 11 years later (not boys). Other programs include Tuning into Kids (12) and the better-known Triple P: Positive Parenting Program, where “parents are taught to self-regulate emotions and behaviours in themselves so that they are better able to manage child behaviour, and help their children learn how to self-regulate” (13). You may find these courses are running nearby or online; ask your local doctor, psychologist or mental health centre.

Anxiety and depression in childhood has been linked to maternal depression and anxiety, stress due to family dysfunction, problematic attachment styles and low sense of maternal self-efficacy (which could be linked to lack of support or domestic violence) (7).

Psychological distress and COVID-19

In the longitudinal COVID-19 Impact Monitoring Survey Program, researchers from the Australian National University found a substantial increase in psychological distress between February 2017 and April 2020 — the equivalent of an increase of 8% to 11% of people reporting a serious mental illness. Increases were seen particularly for young Australian adults: the proportion of people aged 18–24 experiencing high psychological distress rose from 14% in 2017 to 22% in April 2020.

Over the course of the pandemic, psychological distress fluctuated, reaching highs in April 2020, October 2020 and October 2021. As of January 2022, distress remained elevated compared with February 2017 (14).

Anxiety is on the rise and a very common presentation in the clinic.

Symptoms I see commonly in patients with anxiety

• Persistent worrying thoughts
• Negative thinking
• Self-blame
• Self-harm
• Insomnia
• Eating disorders
• Panic attacks
• Hormonal imbalances
• Mood swings
• Meltdowns
• Feeling of overwhelm
• Inability to perform normal tasks
• Inability to socialise
• Inability to feel good for any length of time

In children, anxiety can manifest as

• Sleep disorders
• Poor behaviour / “naughtiness”
• Tantrums
• Fussy eating
• Stomach aches
• Irritability or teariness
• Clinginess
• Attention-seeking behaviour
• Constantly seeking approval
• Apologising constantly
• Separation anxiety
• Avoidance behaviour

First of all, it is vital that you get support if you or your child are suffering any of the symptoms above. Talk to your doctor, psychologist, counsellor, social worker, natural therapist or naturopath about options. Talk therapy or psychological counselling may be useful. How about starting a regular meditation practice?

You are not alone — help is out there; reaching out is the first step. Understanding anxiety can help you feel that it is not your fault. Anxiety is a real, treatable condition.

I can prepare a herbal medicine tonic to support you and recommend supplements for nervous system support in the short term where appropriate.

My top 10 herbs for anxiety

• Passionflower — calms and focuses the nervous system; studies suggest usefulness for benzodiazepine withdrawal (always with your doctor) and insomnia.
• Verbena (vervain) — a gentle tonic that soothes the soul.
• Withania (Ashwagandha) — traditionally used in Ayurveda to support the stress response and adrenal balance.
• Liquorice — supports digestion, liver and adrenal function; tastes good too.
• Lemon balm — calming, antiviral; can support the gut and an overactive thyroid (which may present with anxiety, insomnia or racing heart).
• Oats (green/straw) — nourishing; can help during nicotine withdrawal and soothe irritated nerves and mood swings.
• Skullcap — useful for tension headaches and when you need to pause and take a break.
• Chamomile — underrated; soothes digestion and stomach cramps while calming an exaggerated stress response.
• Lavender — often used for hormonal balance, insomnia and nervous tension.
• Kava — sedative; can help with panic attacks or when winding down is difficult.

Discuss suitability in pregnancy, blood pressure and with your practitioner before use.

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Fin Mackenzie — Naturopath, Green Door Health
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