Help! There’s an Epidemic of Anxiety! (Part I)

By Neuroskeptic | April 26, 2009 8:32 am

All British journalists are psychotic. Pathologically obsessed with “mental health issues”, and suffering from grandiose delusions of their competence to discuss them, these demented maniacs…

Sorry. I got a bit carried away there. But you’ll forgive me, because I was just following the example of seemingly everyone in the British media these past couple of weeks. If you believe the headlines, we’re in the grip of an epidemic of anxiety:


BBC: UK society ‘increasingly fearful’


The Telegraph: Britons ‘living in fear’ as record numbers suffer from anxiety

The Independent: var articleheadline = “Britain is becoming a more fearful place – and the economy is paying the price”;Britain is becoming a more fearful place – and the economy is paying the price. The Indie also ran a comment by Janet Street-Porter – “The main reason people feel anxious is loneliness.”, thanks Janet, qualifications: none, career path: fashion journalist – and a piece by a clinically anxious person – “I reckon a root cause of my anxiety is the modern notion that we can do away with risk by anticipating every imaginable danger.”

It all started with a report by the Mental Health Foundation called In The Face Of Fear. The Mental Health Foundation are a perfectly decent charity organization, although they have a prior history of endorsing slightly dodgy research. One of their previous reports, Feeding Minds: The Impact of Food on Mental Health, presented a simplistic and overblown account of the effects of nutrition upon mood and drew heavily on the “work” of Patrick Holford, vitamin pill peddler and well-documented crank. Parts of the present report are, unfortunately, dodgy as well, as you’ll see below.

In The Face of Fear is actually quite thought-provoking piece of writing, but you wouldn’t know that from reading the newspapers. The headlines are all about the supposed surge in anxiety amongst the British population. This, however, is the dodgiest part of the report. Firstly, the report’s authors surveyed 2246 British adults in January 2009. 37% said that they get frightened or anxious more often than they used to, 28% disagreed, and 33% neither agreed nor disagreed.

That’s it. That’s the finding. It’s really not very impressive, because quite apart from anything else, it relies upon the respondent’s ability to remember how anxious they were in the past. You just can’t trust people to do hard stuff like that. I know exactly what I’m worried about today – I can’t remember very well what I worried about ten years ago – so I must be more worried today! Of course, this could also work in reverse, and people might forget their past lack of anxiety and wrongly say that they are less anxious today.

The survey also found that 77% of people said that “people in general” are more anxious than they used to be, while just 3% disagreed. But remember that only (at most) 37 out of those 77% said that they themselves were actually more anxious. Hmm. So the real finding here seems to be that there is a widespread perception that other people are becoming more anxious, though it’s anyone’s guess whether this is in fact true. The report itself does note that

more than twice as many of us agree that people in general and the world itself are becoming more frightened and frightening as agree that they themselves are more frightened and anxious

This was rather too subtle for the newspapers, though, who reported… that people are becoming more anxious.

In The Face of Fear also cites a government study on the mental health of the British population, the Adult Psychiatric Morbidity Survey. Their use of this data, however, is selective to the point of being deception. This was a household survey of a weighted sample of the British population. That section of the population who live in houses and don’t mind being interviewed about their mental health, that is. Diagnoses were made on the basis of the CIS-R interview, which scores each person on a number of symptoms (including “worry”, “fatigue”, and “depressive ideas”). Each person is then given a total score; a total score of 12 or more is (arbitrarily) designated to indicate a “neurotic disorder”.

This was done in 1993, 2000 and 2007. The 2007 report notes that overall, levels of neurotic disorders increased between 1993 and 2000, but then stayed level in 2007. In terms of anxiety disorders, there was a very small increase in “generalized anxiety disorder” (from 4.4% to 4.7%), which mostly happened between 1993 and 2000; there was an increase in phobias, from 1993 2.2% to 2007 2.6%, but rates peaked at 2.8% in 2000; and “mixed anxiety and depressive disorder” increased from 7.5% in 1993 to 9.4% in 2000 to 9.7% in 2007.

What to make of that? It’s hard to know, but it’s clear that any worsening in anxiety levels occured some time between 1993 and 2000. Mysteriously, while the Mental Health Foundation report cites the 1993 and the 2007 figures, and makes much of the increase, it simply ignores and does not mention the 2000 figures, which show that any increase has long since stopped. It’s history, not current events. Back in 2000, you might recall, the twin towers were still standing, The Simpsons was still funny, and Who Let The Dogs Out was top of the charts.

Overall, the evidence that people in Britian are actually feeling more and more anxious is extremely thin. In fact, I would say that it’s a myth. It’s a very popular myth, however: 77% of the population believe it. Why? Well, the fact that the Mental Health Foundation seem determined to make the data fit that story can’t be helping matters. The newspapers, not to be outdone, focussed entirely on the scariest and most pesimissitic aspects of the report.

A poor show all round, but – as always on Neuroskeptic - there are some important lessons here about how we think about threats, social change, and “crisis”. Stay tuned for the good stuff next post.

[BPSDB]

CATEGORIZED UNDER: controversiology, media, mental health
  • Tom Grabowski

    The Mental Health Foundation (MHF) is projecting its own management’s anxiety and fear out on to the UK population as this trendy ‘charity’ has long earned its crust ‘ cut and pasting’ other peoples research in an alarmist way to draw attention , free publicity and funding towards itself.

    The MHF which operates out of a suite of luxurious offices on London’s South Bank has indeed been involved in some dodgy research and questionable MH policies in the past. Most recently , like many of Britain’s major MH charities , MHF backed a barmy DWP iniative to create an army of thousands of CBT therapists to get ‘ millions ‘ of people with MH issues ( yes, MHF is one of the charities that routinely pushes the idea that 1 in 4 of us are insane ) back into work.

    Only the years of painstaking research and £100 million of NIMHE funding didnt quite stretch to looking at how the economy was performing. Once the recession hit the Government quietly ditched the scheme which left MHF and many other MH charities wondering where the money would come from next.

    You can see where this is heading…..

    At this time of year the MHF is usually talking up the wheeze it has of getting middle class city workers on sabbaticals to take ‘ sponsored ‘ bike rides and treks round Cuba and the Sahara to raise funds for , well, itself . This year the MHF is a little concerned about how this self-serving sponsored holiday racket will be received so its thrown all its weight behind trying to launch a national MH campaign to protect the nations mental health.

    MHF’s website is now emblazened with banners warning citizens about the creeping dangers of fear and anxiety.

    George Orwell would have been impressed!

    The funding bids were probably in the post long before the media ran with the ‘Fearful Britain’ headlines . Fear pays!

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    Heh. I’ve got a post on the “1 in 4″ claim coming up which I’m sure you’ll like, Tom…

    I must admit that I was insufficiently cynical to see this as nothing more than a fund-grabbing attempt – but surely it can’t be a coincidence.

  • http://www.blogger.com/profile/08267358477365539807 The Last Liberal Atheist

    I just had to comment to address one serious mistake in your post:

    Back in 2000, you might recall, the twin towers were still standing, The Simpsons was still funny, and Who Let The Dogs Out was top of the charts.Uh, no, The Simpsons was not funny in 2000. That was Season 11/12, two of the worst ones ever to disgrace the show. “Kill the Alligator and Run”. That’s all I need to say to prove my point.

    Anyway, I’d buy that people are more fearful. Remember, the world’s full of media out to sell their product with fear these days. The overblown crap listed here is a case in point.

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    I stand corrected. The Simpsons jumped the shark in 1999 with “Thirty Minutes over Tokyo”, the end of season 10.

  • Anonymous

    everyone would be much happier if we spent our time talking about the simpsons instead of being worried. The Guardian had an article saying that the simpsons stopped being funny with ‘deep space homer’ which is series 5! Madness!

    Also fear is a good game! Play that too…

    G.

  • http://www.blogger.com/profile/17064348309163649672 Mandy

    Not a big fan of Mental Health Foundation…because I really can’t work out what purpose they serve apart from promoting themselves.

    I think MHF is trying to find a niche for itself…after all there are other charitable organisations with remits for the mentally ill (debatable what difference they make but they are there). Perhaps MHF sees itself as the saviour of everyones’ mental health and it’s new remit is to up the ‘anxiety’ hype in order to then provide its remedies (based on spurious and biased evidence gathering). Am I being a tad too cynical?

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    I don’t know much about the MHF vs other mental health groups (Mind, Rethink, etc.) I tend to think of them as all of a piece – good people doing some good work but with some dubious ideas.

    I was at a Mind drop-in center the other day (as a visitor) and there was a note on the wall saying that the local Mind chapter (or something) had resolved to petition the local health authority against the use of “psychosurgery”.

    Given that there are about 5 or 10 psychosurgeries performed in this country annual (all of them in Dundee), and all of them on a strictly voluntary basis, this struck me as rather pointless. But symptomatic of the kind of 60s mentality that persists in such groups…

  • http://www.blogger.com/profile/04121355020141229899 lisacx

    I just had a kerfuffle with MHF,(chirpstory: http://chirpstory.com/li/3328) I did support them & do a free tweet as there were people I've worked with many years ago on board and I presumed work would be same thrust. While I think of complaint to make & removal of tweet, I've been concerned over the promotion of a 'to pay for' mindfulness course. I've had mindfulness as part of my treatment, but I'm not happy with the lack of solid research into efficacy as it's hard work and very time consuming. It's also available at no cost or low cost, and I'm afraid I think the pushing of 'anxiety' is linked to the pushing of their mindfulness program. It's part of the creeping 'choice' & 'privatization' that I'm very wary of, esp. when it comes to mental illness and a lack of evidence. It also seems a hat tip to the anti-psychiatry movement. That mindfulness and homeopathy are 'harmless' compared to psychotropic medication just isn't true if someone is jolly ill.

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    Thanks for the comment.

    I feel the same way as you – the “choice” agenda is deeply troubling.

    In physical health it's bad enough: I go to a doctor because I don't know what's wrong with me and how best to treat it. If I did, there'd be no point going, so I'm not in a good position to make a choice, the doctor is.

    With mental health it all gets more complicated, on the one hand doctors understand mental illness less well than, say, cancer… but on the other side, the whole point about mental illness is that it impairs your ability to take decisions, so promoting “choice” in such cases is rather odd. Certainly when I was depressed my choices were terrible & in retrospect it's a shame I didn't take professional advice more seriously.

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No brain. No gain.

About Neuroskeptic

Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.

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