Anxiety: Modern-day epidemic or an affliction only for the wealthy elite?

Anxiety is a natural response to stress, but when it becomes persistent and overwhelming, it develops into an anxiety disorder—a mental health condition affecting millions worldwide.

Despite its widespread impact, anxiety is often misunderstood. Some believe it is a “rich people’s condition,” while others assume it only affects urban dwellers. However, research shows anxiety disorders affect people across all socioeconomic levels, genders, and age groups.

According to Dr Nathan Kamau, a social-emotional learning expert and counselling psychologist, anxiety disorders are among the most common mental health conditions worldwide, characterised by excessive worry, fear, and physiological symptoms such as rapid heartbeat, restlessness, and difficulty breathing.

The National Institute of Mental Health (NIMH) classifies anxiety disorders into several types, including Generalised Anxiety Disorder (GAD), persistent excessive worry about everyday situations, panic attacks, Social Anxiety Disorder, obsessive-compulsive disorder (OCD), and Post-Traumatic Stress Disorder (PTSD) following traumatic events.

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Dr Kamau further explains that lower-income individuals are 1.5 to three times more likely to experience anxiety and other mental health conditions. Financial instability, job insecurity, lack of access to healthcare, and housing difficulties create chronic stress, making those in lower socioeconomic groups highly vulnerable. “Anxiety is often associated with urban living. Cities are fast-paced environments filled with work pressures, social competition, and overstimulation,” explains Dr Kamau. “The constant exposure to noise, pollution, traffic, and social media can heighten stress and anxiety levels.”

A study published in JAMA Psychiatry found that individuals living in urban areas are more likely to suffer from anxiety and mood disorders than those in rural areas. City dwellers often lack strong social support networks, leading to loneliness and isolation—two key contributors to anxiety. Moreover, urban populations have higher access to healthcare, meaning anxiety disorders are more frequently diagnosed.

However, rural populations are not immune to anxiety. Economic struggles, job scarcity, and lack of access to mental health services pose serious mental health risks. While rural areas may provide natural environments that reduce stress, people in remote locations often face social stigma around mental health, making them less likely to seek help.

Anxiety affects people of all ages and genders, but research indicates some groups are more vulnerable. According to the World Health Organisation (WHO) and the American Psychiatric Association, women are nearly twice as likely to be diagnosed with anxiety disorders as men. Hormonal fluctuations, social expectations, and caregiving responsibilities contribute to this disparity. However, men may underreport anxiety due to cultural norms that discourage emotional expression.

Anxiety in children is a growing concern. The Covid-19 pandemic, increased academic pressures, and social media exposure have contributed to rising anxiety rates among young people. The National Institute of Mental Health (NIMH) states that about 31.9 per cent of adolescents aged 13 to 18 experience an anxiety disorder. If left untreated, childhood anxiety can persist into adulthood, increasing the risk of depression and other mental health issues.

Older adults can also struggle with anxiety, triggered by retirement, health issues, and social isolation. However, older adults are less likely to seek treatment, often mistaking anxiety symptoms for normal ageing or physical illnesses.

Generational trends in anxiety are influenced by social, technological, and economic factors. Baby Boomers grew up with traditional values and limited mental health awareness, with anxiety often ignored or dismissed. Meanwhile, Generation X experienced economic changes and work-related stress but benefited from improved mental health discussions. Millennials, facing high job competition, student debt, and social media pressures, report higher anxiety levels but are more open to seeking therapy. Gen Z, digital natives facing cyberbullying, climate anxiety, and social isolation despite hyper-connectivity, report the highest anxiety rates ever recorded.

Dr Kamau explains that there are myths about anxiety, “While stress is a normal response to challenges, anxiety disorders involve chronic worry that disrupts daily life. Unlike stress, anxiety doesn’t always have a clear cause.”

Doctors say anxiety disorders are medical conditions, not character flaws. “They result from a mix of biological and environmental factors. Seeking help is a sign of strength, not weakness,” says Dr Kamau. “Telling someone to ‘relax’ minimises their struggle. Anxiety disorders require proper treatment, which may include therapy, medication, and lifestyle changes.”

The National Institute of Health (NIH) and the American Psychological Association recommend a combination of treatments for managing anxiety disorders: medications, therapy, and lifestyle changes. Cognitive Behavioural Therapy (CBT) helps patients recognise and change negative thought patterns, while exposure therapy gradually exposes patients to feared situations, reducing anxiety responses.

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline help regulate mood, while benzodiazepines offer short-term relief but carry a risk of dependence. Regular exercise, mindfulness, and meditation can reduce cortisol levels, and adequate sleep and nutrition support mental health. “Strong relationships and community support significantly reduce anxiety levels. Group therapy and support networks can be highly effective,” says Dr Kamau.