Whenever Thane businessman Shekhar travels to south Mumbai for a meeting, he sets off over three hours early. This is because he plans his route carefully to ensure he is never more than five minutes from a hospital in case he "suffers a heart attack while driving". Karthik (32), an IIM graduate with a high-powered marketing job, dreads routine meetings. "There is this heaviness in my stomach and my legs seem leaden. It's a paralysing fear that stays until the meeting is over," he says. Shekhar and Karthik (names changed) have anxiety disorders, a group of conditions that can turn ordinary journeys, workplace interactions and social situations into emotional ordeals.
The invisible burden
National Mental Health Survey, conducted by National Institute of Mental Health and Neuro Sciences (NIMHANS) across 12 states between 2014 and 2016, found that 2.57% of adults had an anxiety disorder at the time of assessment. Around 83% of those affected were not receiving treatment, while nearly 60% experienced disability of varying severity, according to the study published in the Indian Journal of Psychiatry in 2022. "Anxiety disorders are frequently under-recognised and inadequately treated. Stigma surrounding mental illness and a lack of awareness contribute to the problem," said psychiatrist Dr Kedar Tilwe of Fortis Hospital, Mulund. Child psychiatrist Dr Kersi Chavda said anxiety can take many forms, from social anxiety and academic stress to persistent, intrusive thoughts. In children, it may manifest as school refusal. Among adolescents facing examinations, anxiety can also present as headaches, body aches or backaches. Social anxiety is another concern, said Dr Chavda. The pressure to appear perfect, amplified by curated virtual lives on social media, can intensify the fear of being judged or found wanting.
When the body's alarm won't switch off
Everyday anxiety is a normal response to uncertainty or danger. An anxiety disorder involves persistent or disproportionate fear that interferes with daily life. A senior psychologist from a civic hospital linked anxiety to the body's built-in alarm system. The alarm is meant to respond to a threat, but sometimes it reacts to a gust of wind as though an intruder were approaching. Psychiatrist Dr Harish Shetty said, "Crowded trains, inadequate sleep, workplace demands, educational pressures, financial worries and concerns about personal safety can keep people in a state of heightened stress." Weakening support systems and reduced emotional connectedness may also be contributing, said Dr Shetty.
Life in the slow lane
In adults, panic disorder can be accompanied by agoraphobia - fear of situations where escape might be difficult or help unavailable if a panic attack occurs.
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"Patients may avoid bri-dges, crowded trains, flights or traffic jams. Some will not travel without their spouses or may turn down promotions or jobs that require them to venture beyond familiar surroundi-ngs," said Dr Tilwe. As a result, he added, it's a life lived in second gear: not ready to take up new challenges as one prefers to stick to known schedules.
It's treatable
Anxiety disorders are treatable, but a trained physician is needed to recognise the problem. Treatment depends on the type and severity of the disorder and may involve psychotherapy, medication or both. "A person with a severe anxiety disorder may need counselling along with medication for up to six months to be able to cope," said Dr Tilwe. Dr Shetty recommends attention to sleep, time management, breathing exercises and meditation. Doctors said reducing excessive caffeine and smoking would help some people manage symptoms.
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