About one in 14 people around the world are affected by anxiety disorders at any given time. Those who suffer from these conditions experience impairment, disability, and are at a high risk for substance abuse and suicide. In spite of these considerable risks, research on anxiety is lagging far behind that of other common mental health problems – and many people affected don’t even know they have this condition.
In many cases, a decade or more can elapse before someone who develops anxiety goes to the doctor for treatment. However, waiting this long can have potentially serious consequences. New research suggests that generalised anxiety disorder is associated with a two times higher risk for cancer deaths – but only in men.
How can this be?
Before we talk about the health effects of anxiety, a distinction needs to be made between normal anxiety and pathological anxiety – the kind of anxiety that we looked at in our study. Normal anxiety is something that all of us experience when we’re in threatening situations or when we’re preparing to deal with challenges, such as a stressful job interview.
When the anxiety becomes excessive, impairing and debilitating, however, that’s when an anxiety disorder can develop. For example, people with generalised anxiety disorder worry excessively and uncontrollably about a number of areas of life, they can’t control their worries and have trouble shifting their focus from one topic to another. They also experience symptoms such as irritability, restlessness, and muscle tension.
People with generalised anxiety disorder have difficulty focusing, and often experience insomnia and feel very tired as a result of this. This disorder can interfere with the formation and maintenance of social relationships, productivity at work and educational achievement. Those affected are more likely to be single or get divorced and are at a higher risk for depression compared to people who don’t suffer from this condition.
But many who have an anxiety disorder don’t suspect that they do. One of the reasons for this is that people often think that “anxiousness” is just part of their personality – in effect, that it is an intractable personality trait. This is also why people tend to wait a long time between symptom development and contact with the medical establishment. When help is finally sought, the anxiety has already progressed to an advanced stage, which then becomes more difficult to treat.
Another reason why waiting a long time to seek help for anxiety could be detrimental is that this mental health problem has been associated with increased risk for early death from cancer. But why? Previous studies have linked anxiety to inflammatory processes in the body and suppression of the immune system, which can increase the risk for diseases such as cancer.
Anxiety, therefore, could mask underlying health conditions or could represent an early warning signal for poor health that might occur down the road. Previous studies have shown that anxiety can increase the risk for a host of other negative outcomes, such as heart disease, diabetes, and thyroid conditions; importantly, symptoms of anxiety have also been shown to precede poor health. We have also found, for the first time, that anxiety is associated with an increased risk for early death from cancer in men.
Why are men more susceptible?
One reason may be that men tend to wait a long time before making a visit to the clinic when they feel unwell compared to women. Delay in seeking help can lead to underlying health conditions being detected at a later, more advanced stage, making them more difficult to treat successfully. Women, on the other hand, tend to see the doctor much sooner after experiencing symptoms compared to men, which leads to earlier detection and treatment of health problems.
We analysed data from a large study of more than 20,000 people. The rich data allowed us to look at the link between generalised anxiety disorder, measured in 1996-2000, and deaths from all cancers until 2015. We found that 126 out of 7,139 men and 215 out of 8,799 women had anxiety, and 796 men and 648 women died from cancer during the follow-up period.
Although anxiety could give rise to unhealthy behaviours, such as drinking alcohol and smoking to alleviate anxious feelings, when we accounted for these factors, we still found the same relationship. We also took into account a range of other important factors that could influence the association between anxiety and cancer deaths, such as physical inactivity, previous diagnoses of serious chronic diseases and social class – but the relationship held. There remains the possibility that we did not completely account for lifestyle factors or we may have missed including other factors which could influence the association, but this possibility exists for all research studies.
What can we do about it?
Our research shows that anxiety is not just an intractable personality trait, but could represent an early warning signal for something more serious that might occur down the road.
There are certain measures we can take, however, to alleviate feelings of anxiety and improve our overall health. The mind and body are intricately connected: one influences the other. Therefore, engaging in regular physical activity, getting enough sleep, drinking enough water and avoiding the prolonged use of light-emitting devices, such as smartphones, laptops, and television before going to bed are important for both mental and physical health.
Cognitive behavioural therapy is an effective psychiatric treatment option – and yoga and mindfulness meditation have also been shown to have positive effects on mental health, making you feel less stressed and anxious. According to research from Harvard, doing mindfulness meditation can actually change your brain structure and influence your levels of stress, which is a fascinating discovery.
Until we find out whether administering pharmacological and psychotherapeutic interventions to people with anxiety can contribute to improved health outcomes in the long term, knowing that anxiety could represent an early warning signal for poor health is a valuable step forward.
Olivia Remes received funding from the National Institute for Health Research.