Anxiety disorders are the world's most common mental health problem . But it isn't always easy to get professional help, with long waiting lists in many countries.
Authors
- Barbara Jacquelyn Sahakian
Professor of Clinical Neuropsychology, University of Cambridge
- Christelle Langley
Postdoctoral Research Associate, Cognitive Neuroscience, University of Cambridge
Worldwide, only about 28% of people with anxiety receive treatment. The figure is similar for the UK, and in the US about 37% receive a treatment . This is due to a number of factors such as lack of resources, including mental health staff, and stigma associated with mental health problems.
But if you're struggling to get help, there are things you could try at home in the meantime - including some novel technologies. To understand how they work, let's first take a look at how anxiety is expressed in the brain and body.
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The symptoms of anxiety are cognitive and emotional as well as physiological. They can include trouble concentrating and making decisions, feeling irritable or tense and having heart palpitations or shaking. Trouble sleeping and feelings of panic or impending danger are also common.
These symptoms often start in childhood and adolescence. Sadly, it frequently continues into adulthood, especially if untreated .
There are many genetic and environmental factors involved in the development of anxiety. These can include competition and pressure at school, university or work or financial worries and lack of job security. Social isolation and loneliness are also common factors, often a result of retirement, home working or stemming from bullying or maltreatment in childhood.
Such experiences may even rewire our brains. For example, our neuroimaging study has shown that maltreatment in childhood is linked to changes in the connectivity of the brain's centromedial amygdala, which plays a key role in processing emotions, including fear and anxiety, and the anterior insula, which processes emotion among other things.
Anxiety is commonly associated with depression or other conditions, including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder. During the COVID pandemic when the prevalence of anxiety and depression increased by 25% , people with such neurodevelopmental conditions exhibited more emotional problems than others.
According to the Children's Commissioner this is still on the rise with 500 children per day being referred to mental health services for anxiety, more than double the rate pre-pandemic .
Researchers are still uncovering new ways for professionals to help treat such people. For example, in our recent study, we noticed that suicidal thoughts and depression were more common in children with anxiety who were also very impulsive . This could impact the treatments they receive. So the science of how to best treat anxiety is constantly moving forward.
Tech solutions
Unfortunately though, waiting lists for even receiving a diagnosis can sometimes take years. Neurotechnology can, at least in part, help fill the gap before symptoms get worse. There are a number of startup companies in the anxiety space, working on both hardware and software for anxiety management.
Technology for managing anxiety is rapidly advancing, offering alternatives and complements to traditional therapies. Moonbird, for example, uses a handheld device that guides users through paced breathing with gentle physical movements. You essentially feel the device move in your hand and breathe along with it. Research has shown that such breathing can help the nervous system to reduce anxiety symptoms.
The company Parasym influences brain regions involved in mood and stress regulation. People can use it by wearing a small device that applies mild electrical micro impulses running through the vagus nerve, which runs from the ears and downwards trough the neck and activates a key part of the nervous system.
Neurovalens and Flow Neuroscience are exploring non-invasive brain stimulation, such as transcranial "direct current stimulation (tDCS)". This can be applied by using electrodes placed on the scalp to deliver a mild, constant electrical current to alter brain activity. These devices ultimately target the prefrontal cortex to support the regulation of emotions. One scientific review of tDCS studies in anxiety has concluded that some research clearly showed benefits of tDCS for treating anxiety symptoms, although larger scale and longer duration studies were needed.
How we experience life events and feel or react to them also influences physiological functions such as our heart rate. You will have experienced how having a meaningful conversation creates a special connection between two people. This can actually manifest in the body as increased synchronisation of your heart rates and other functions. This is termed "physiological synchrony" and is thought to be important for positive social interaction.
Unfortunately, in common conditions of anxiety, including social anxiety and postpartum maternal anxiety, heart rate can become less variable and therefore less able to synchronise. Therefore, a device that promotes physiological synchrony would be beneficial. The company Lyeons is currently developing such a device, targeting anxiety, post-traumatic stress disorder and ADHD.
On the digital side, Headspace offers structured meditation and cognitive behavioural therapy based programmes. Similarly, ieso offer typed text-based CBT therapy for mild to moderate anxiety and low mood. These platforms use guided meditation, breathing exercises and behavioural tools to help users build emotion resilience and reduce anxious thought patterns.
Other emerging tools also include virtual reality, which is being explored for exposure therapy and immersive stress reduction, in particular. All these technologies have used scientific and medical information to offer diverse options that address both mind and body.
If we can halt the trend towards increasing numbers of people suffering from anxiety and find ways to improve access to effective treatments, it will lead to a better quality of life for individuals and their families, improved productivity and wellbeing at work and promote a flourishing society.
Barbara Jacquelyn Sahakian receives funding from the Wellcome Trust. Her research work is conducted within the NIHR Cambridge Biomedical Research Centre (BRC) Mental Health and Neurodegeneration Themes.
Christelle Langley receives funding from the Wellcome Trust. Her research work is conducted within the NIHR Cambridge Biomedical Research Centre (BRC) Mental Health and Neurodegeneration Themes.
