Heart attacks? Cancer? No, the West's greatest health problem is anxiety

The writer Patricia Pearson talks about the fears that devoured her life

Patricia Pearson, author of A Brief History of Anxiety... Yours and Mine, worries a lot. "I fret about everything and nothing. After 9/11, a friend died and that combination had the effect of turning me into a hypochondriac. I would lie awake at night listening to a gurgling sound in my abdomen convinced I had cancer." On another occasion, she ordered 12 containers of freeze-dried vegetables after an American report warned of a possible flu epidemic and advised stockpiling food.

As well as inflicting a bizarre set of phobias, anxiety has brought Pearson's life to a complete halt three times: dropping out of university, resigning from a job, and winding up addicted to anti-depressants.

Now 44 and a successful journalist, novelist and married mother of two, she decided it was time to write about her lifelong struggle. "I was diagnosed with generalised anxiety disorder when I was 23 and thought it was a simple chemical imbalance. But I found out this didn't make sense. I wanted to look at what my culture was doing to me."

It is a timely book. In 2002, a World Mental Health Survey report identified anxiety as the world's most prevalent health problem, with stark differences between cultures. Anxiety is most prevalent in America, affecting 28.8 per cent of the population compared with 6.6 per cent in Mexico. In Britain, one in six people suffer from depression or chronic anxiety, affecting one in three families.

Pearson realised she had a problem with anxiety when her first serious relationship came to an end in her twenties, prompting a nervous breakdown. "Up to that point, I didn't understand myself to be anxious. I indulged in a lot of what I call 'hypothetical analytical planning'. So thoughts would whirr around my brain about what I would do if, say, a tornado hit my home, the idea being that if you can foresee events you can control them. Yet when my boyfriend ended our relationship I was paralysed and I just couldn't go on."

The next time she wound up in a psychiatrist's office was when she became a crime reporter. After covering the trial of a serial rapist and murderer, she could no longer cope with the stress of her job. Then, years later, after 9/11 and the death of a close friend, she was put back on anti-depressants.

Looking back, she now realises there were very clear external stresses at work during each bout of severe anxiety. "There were valid causes but at the time I didn't realise, I thought it was all about me, flapping around in the bushes like a lame quail."

In fact, she now sees many factors in the developed world that contribute to an individual's anxiety: ambition and a loss of control, the fear of being unable to cope, and a sense that achievement is no longer linked with merit. "When I was starting out as a writer, my anxiety was enhanced by the fact that I didn't appear to have any control over getting noticed. I had to be really sociopathic and pull all sorts of antics to get attention. You can also see this in corporate culture where being nice, decent and honourable is not going to get you a promotion, and if you are going to climb the ladder in any effective way you have to pull a lot of traps. The result is a pervasive level of unease."

In Mexico, people are less ambitious and expect less control over their lives. "In the US and Europe, people feel they need to be that much more successful in order to have status [and] be valued." Pearson's book points to a reduced number of buffers in modern life that help people stop worrying. So in more traditional cultures, people are likely to live closer to their families, in closer-knit communities, and be actively religious – and thus they are less likely to suffer.

Yet even though anxiety is widespread in Europe and America, most people live with it without seeking help. In Britain, a recent study revealed that only one in four people with a mental illness receive any treatment.

"Anxiety can be invisible. It rages undetected in the mind, both secretive and wild. It can spill over into other things like workaholism, obsessive-compulsive disorder or perfectionism, in my case. I have three friends who have exactly the same problems as me but just don't want medical attention." Part of the problem is that when people do seek help about major traumas such as divorce, they are often put straight on to anti-depressants when they really just want to talk things through. "It's not that the drugs don't work but they shouldn't be the only solution," she says.

Pearson initially felt relief when prescribed Effexor but three months later realised she "had come to feel nothing much, one way or another", and was living an emotional half-life, largely disengaged. It took five years to wean herself off the drugs in what was a difficult and painful process. "I was so angry at the experience," she recalls.

Now Pearson finds mindfulness-based cognitive therapy a useful way of calming down. "I try to separate my worries from myself and look at them almost as if my anxiety was the flu." She also takes refuge in exercise and ritual. "Part of why religion is comforting is that it provides a ritual. My ritual is that I make tea in a certain way at a certain time each day and it just seems to help."

And she offers this advice to others dealing with modern life's uncertainties and demands: "Wager that your life has a purpose, a meaning, and imagine within yourself a light or spark to show you the way."

'A Brief History of Anxiety...Yours and Mine' is published by Bloomsbury USA and available on www.amazon.com

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