Anxiety treatable, but 83% of affected did not get help

Anxiety is normally the body’s response to uncertainty or danger. It can help people notice risks and prepare. An anxiety disorder is different because fear becomes persistent or disproportionate. It begins interfering with ordinary activities, relationships, travel, work or education.

The article compares this response with an alarm system. The alarm should react to a real threat, but it may sometimes respond to a gust of wind as though an intruder were approaching. A person may then feel intense fear even when the situation is not truly dangerous. Physical symptoms can accompany that fear.

This distinction matters because anxiety disorders can be missed or mistaken for ordinary stress. The National Mental Health Survey found that 83% of affected people were not receiving treatment. Doctors say trained physicians must recognise the disorder, because treatment depends on its type and severity and may include psychotherapy, medication or both.

The National Mental Health Survey found that 2.57% of adults had an anxiety disorder at the time of assessment. The survey was conducted by NIMHANS across 12 states between 2014 and 2016. Its findings were published in the Indian Journal of Psychiatry in 2022.

The most striking treatment figure was that around 83% of people affected were not receiving treatment. Nearly 60% experienced disability of varying severity. These figures show that anxiety disorders can affect functioning while remaining unrecognised or untreated.

The article links this gap to stigma surrounding mental illness and a lack of awareness. Dr Kedar Tilwe said anxiety disorders are frequently under-recognised and inadequately treated. Because anxiety disorders are treatable, recognising symptoms and obtaining assessment from a trained physician can help determine whether psychotherapy, medication or both are needed.

When anxiety becomes severe or remains untreated, ordinary activities can become emotional ordeals. A person may dread meetings, avoid journeys, or struggle with work and social situations. Anxiety can also produce disability; nearly 60% of affected people in the survey experienced disability of varying severity.

Shekhar travels from Thane to south Mumbai more than three hours early. He plans his route so he is never more than five minutes from a hospital, fearing a heart attack while driving. Karthik feels heaviness in his stomach and leaden legs before routine meetings, with fear lasting until the meeting ends.

These experiences can narrow a person’s choices. People may avoid crowded trains, bridges, flights or traffic jams. Some will not travel without spouses, and others may reject promotions or jobs requiring unfamiliar travel. Doctors describe this as living in “second gear,” though treatment can help people cope.

Anxiety does not look the same at every age. In adults, it can include social anxiety, persistent intrusive thoughts, panic disorder and fears connected with travel or work. Routine meetings and ordinary journeys may feel overwhelming rather than manageable.

Among children, anxiety may show up as school refusal. Adolescents facing examinations may report headaches, body aches or backaches. Social anxiety can also affect people more broadly, especially when they fear being judged or found inadequate. Curated virtual lives on social media can intensify pressure to appear perfect.

These different forms matter because anxiety may not always be recognised as a mental-health problem. Physical complaints or avoidance can hide the underlying fear. The article says a trained physician is needed to recognise the disorder and identify treatment based on its type and severity.

Avoidance often grows from fear that escape will be difficult or help unavailable if panic occurs. In adults, panic disorder may be accompanied by agoraphobia, a fear of situations where assistance or an easy exit may not be accessible. The person may therefore avoid places that others consider routine.

Dr Kedar Tilwe described patients avoiding bridges, crowded trains, flights and traffic jams. Some refuse to travel without their spouses. Others turn down promotions or jobs requiring them to leave familiar surroundings. The fear can also make routine meetings feel physically heavy and emotionally paralysing.

The key mechanism is the body’s alarm system staying on high alert. Crowds, workplace demands, poor sleep, financial worries and safety concerns can maintain heightened stress. Avoidance may provide short-term relief but can leave a person living in “second gear.” Doctors say these disorders are treatable with appropriate care.

Anxiety disorders are treatable, but treatment must match the type and severity of the problem. Doctors may recommend psychotherapy, medication or both. A trained physician is needed to recognise the disorder and decide what support is appropriate.

Psychotherapy can provide counselling and help a person cope with fear, avoidance and daily pressures. Medication may also be needed when symptoms are severe. Dr Kedar Tilwe said someone with a severe anxiety disorder may need counselling along with medication for up to six months to become able to cope.

Treatment is only one part of management. Dr Harish Shetty recommends attention to sleep, time management, breathing exercises and meditation. Doctors also said reducing excessive caffeine and smoking would help some people manage symptoms. The article stresses that early recognition matters because stigma and limited awareness leave many affected people untreated.

The body has a built-in alarm system designed to respond to danger. Everyday anxiety is a normal reaction to uncertainty or threat. It can prepare someone to act. The problem begins when the alarm stays switched on or responds too strongly, producing fear that is persistent, disproportionate and disruptive.

A senior psychologist from a civic hospital compared this process with an alarm reacting to a gust of wind as though an intruder were approaching. Crowded trains, poor sleep, workplace demands, educational pressure, financial worries and safety concerns can keep people in heightened stress. Reduced emotional connectedness may also contribute.

When the alarm misfires, a person may feel physical heaviness, panic or a powerful need to escape. They may avoid meetings, travel or crowded places even without immediate danger. Because this response can impair daily life, trained assessment is important. Doctors say anxiety disorders can be treated with psychotherapy, medication or both.