It wasn’t until my first panic attack - lying in the bath with my heart racing, immersed in a sense of dread far deeper than the water around me - that I realised my near constant feelings of panic and discomfort were fragments of a greater whole, and acknowledged anxiety as part of my psyche.

Anxiety is increasingly common and can take the forms of social anxiety, OCD, phobias and generalised anxiety disorders. In the 2011/2012 New Zealand Health Survey, 7.7% of women reported suffering from anxiety (compared with 4.4% of men) and 17.9% had been diagnosed with depression at some point. In 2013, Pharmac reported a 20% increase since 2008 in the prescription of antidepressants, used to treat anxiety, depression and sleep disorders. In the past six months alone, Anxiety New Zealand Trust have seen nearly 200 women between 15-44 for anxiety, double the number of men in the same age bracket. The rise in numbers can be contributed to both an increase in anxiety itself, and an increase in the acknowledgment, reporting and professional help sought.

Many young women I spoke to admitted finding it difficult to share their struggles with anxiety with others, fearing or experiencing people being dismissive. Phoebe feels there is a pressure to be resilient. "I tend to only discuss anxiety with people I trust. I feel like here in New Zealand we have a bit of a 'she’ll be right' mentality and therefore aren’t always as forthcoming with the topic of mental health."

The physical manifestations of anxiety can seem extreme, especially panic attacks. According to Registered Psychologist Nadine Isler from Anxiety NZ Trust, anxiety is like a state of fear. “Your body will react in ‘fight or flight’ mode, and cause physical symptoms [like a fast heartbeat and sweating] as well as thoughts [like] analysing your environment for threats.” It’s common for people to struggle identifying anxiety. “I regularly talk to clients who have only just been able to put a name to what they’re experiencing.” For Jess, 28 , an anxiety attack can be all consuming. “It’s heart wrenching, I can’t see any way out [of a] panic attack. I’m almost beyond help when these happen, there is no way to see past what is happening. My entire body trembles, hands clamp up and I feel like I can’t breathe.”

Anxiety can present in different ways. Rachel, 23 suffered from stomach aches for years. “I started going to the doctors a lot as I had crazy tummy pain, the doctors always told me I had IBS.” Dissatisfied with what she was told, she discovered it was anxiety affecting her body “I was able to realise my tummy problems were more of a mental issue.” Rachel isn’t alone; recent research has revealed the close connection between the stomach and the brain, with biochemical signaling between the central nervous system and the gastrointestinal tract.

Isler agrees the stomach and brain are closely linked, and that it can be viewed as a chicken and egg situation. “It's difficult to know what comes first - is it that anxiety causes physical symptoms like a sore stomach, being unable to digest food, cramps, diarrhoea etc, or is it that people have IBS or gut health problems, which causes them anxiety.” She agrees diet is hugely important to both our mental and physical wellbeing. “What we do know is that the way we eat has a huge impact on our mental health. We're understanding more and more about the gut biome, and what is required to keep the gut healthy, and about how the gut is almost like a 'second brain'.”

Many of the young women I spoke to found anxiety caused compulsive, restrictive behaviour. For Isobel, 29, such behaviours are a daily struggle. “My anxiety takes a VERY controlling shape. It can come out much like OCD - needing to stick to certain routines, or doing certain things before I can relax or calm down... You know it’s a high anxiety week when Sunday sees a trail of 5 neatly folded outfits and a fridge jammed full of smoothies.” Isler says this is common. “Behaviour patterns might include spending hours on specific rituals and compulsions [or] going over and over and over something to make sure it’s perfect.”

Anxiety can be incredibly isolating for women like Kasia, 29. “When it's at its worst I struggle to leave my apartment.” For Hannah, 31, isolation has had social implications. “I very rarely do anything social, it all seems to much for me. I’ll plan things, but hardly ever follow through as the anxiety gets too much. I feel bad, I am never ‘present' in friendships, so while I know a lot of people I have very few friends.” Isobel also admits to reclusivity. “ I often bail on plans last minute because I struggle to admit to myself how badly my anxiety controls me.” Although isolating yourself seems to help, psychologist Nadine Isler warns against avoiding situations that make you anxious. “In the short term you might feel relieved, but in the long term you never get to learn that you would have been able to cope, [therefore] your fear grows.”

Realising I suffered from anxiety was only the first step to understanding it. Acknowledging the situations and thoughts that triggered it took me years. It was only in hindsight that I realised that much of the disordered eating I struggled with was a manifestation of anxiety: fear of losing control, anxiety around my appearance and self worth, and comparing myself with others. Restricting food and punishing myself with exercise became a way to cope, however it ended making my anxiety cripplingly worse as I dealt with feelings of guilt, paranoia and failure. Isobel’s experience is painfully familiar. “ My anxiety rears its ugly head through my relationship with food and exercise. It all really boils down to control. When I don’t feel in control of my life, I need to control the things I can. I can control what I eat, what ingredients go into my body. I can control how much exercise I do. I can control (to some extend) the shape I distort my body into. Even if I can’t control how others think of me. So my anxiety has driven me to eating disordered thinking and behaviours.”

For many, the social pressures around beauty standards are huge, leading to anxiety when we feel we fall short. Bea Elle, 25, finds Instagram has particularly affects how she feels about her appearance. “As a woman of color as there are constantly white bodies being portrayed as a sign of beauty. Even within women of colour, there is a certain type of performative beauty and body positivity which I don't fall into and that used to make me super anxious.”

I wonder about the impact social media is having on all of us; we’re inundated with perfection, just a swipe away. Coupled with the constant validation of likes, this gives us a disturbing yardstick against which to measure our self worth. Anna, 29, couldn’t agree more. “Social media is a beast that runs off people's insecurities and anxiety especially Instagram and Facebook - everyone is curating their lives to be this perfect aesthetically please dream life which you can easily forget is the case and look around or in the mirror and criticise your ‘failings’ but it's important to always remind yourself that it's not real.” For Hayley , the endless stream of apparent perfection can be unbearable. “When I'm at my worst, I can't even face it. I can't bare to see other people living their best lives.” I keep thinking about a recent statement from actor Amandla Stenberg, articulating what’s so unsettling about social media’s pervasive influence on our lives and psyche. “I believe that because of these anxieties and the way our reality is constantly manipulated and altered by social media (a social experiment with psychological effects we have no gauge on) we are experiencing exacerbated levels of severe anxiety, depression and dissociation.”

We’re increasingly defined by what we ‘do’ and with so much visible, flawless success it’s hard to not feel anxiety around the legitimacy of our achievements. Alma admits she’s plagued by uncertainty and anxiety around her work. “ I feel like I've created a brand and now people expect a certain level of work from me and a certain aesthetic and it's overwhelming and scary. What if I run out of ideas? What if I need a break? What if I don't have the means to create ceramic work anymore? What if I take a break and people forget about me? What if my work goes out of fashion?”

As we go through our twenties and careers become more tangible, the sense of expectation and pressure grows - with anxiety around success, and nagging doubts about your chosen path. Comparison is inevitable, and the differing trajectories of yourself and your peers become increasingly more clear. For career-focused Hayley, it can be crippling. “I got feedback that one of my projects needed to be reworked. While on the outside, I project a strong, pragmatic self, I wallowed in my existence all weekend. I doubted whether I was in the right job, right country, right industry. I didn't want to see other people because I couldn't handle seeing other people fulfilled, I couldn't handle hiding all my insecurities. I couldn't check social media, because I hated seeing happy people. Such a small little thing affected how I saw the whole world. I felt sick, my heart pounding, not knowing how to feel better.”

In many ways, with so much pressure to succeed, look great and have an abundant social life (not to mention hobbies, an exercise regimen, and flourishing garden) it’s surprising the statistics around anxiety aren’t higher. Alma laments its prevalence amongst her peers. “It makes sense that me and all of my female friends suffer quite strongly from anxiety. There are so many extreme expectations for women of our age, like we have to stay composed and be pretty and also fit and also pump out a whole lot of work constantly and at a really high standard, we should see enough of our friends and family and partner (providing we have one) as well as work or study full time. I get so overwhelmed and so stressed.”

We’ve seen a dramatic shift in the past decade alone with an increasingly digitised world, not to mention the rise in living costs and career instability that has come with neoliberalist economy policy, and geopolitical turmoil; many of us can barely see our own present let alone the future. Such uncertainty weighs heavily on Anna’s mind. “Our age group have bared witness to the world change completely, we have had the script flipped on us in a big way especially in New Zealand with the recent political climate, the housing crisis and cuts to social spending; it's not the world we were promised as children and it's pretty scary.”

When it comes to my own anxiety, managing it is a day to day thing. Exploring methods of self care can help alleviate it and prevent it from spiraling - from exercise and a healthy diet, to actively avoiding “hangxiety”, these are all conscious steps I take. Alma believes finding time to exercise helps greatly. “I've started running every single morning because it was just getting too consuming, it's half an hour in the morning where my brain is somewhere else and that's so positive.” Anna has found embracing a healthy lifestyle has helped her cope with anxiety. “These days, I rarely drink, I try to eat well and keep my environment healthy. Lately thanks to my partner I have been going on big walks and hikes which gives me a sense of calm and achievement.” Kasia invests in down time. “ If I start feeling overwhelmingly exhausted, I give myself the ok to relax and take time-out to recharge.” List-making is another favoured coping method; when feeling overwhelmed Rachel uses it for even simple tasks. “When I am really anxious I just write a step by step list of what I need to do, I even write stuff down like 'have a shower'. It helps heaps!”

Self care is incredibly important, however so is knowing when to seek professional advice. For Kasia, it wasn’t until things became extreme that she sought help. “I couldn't get myself out of bed let alone our apartment... Only through months of talking and working with [my psychologist] did I realise I had been in such a state of anxiety that it brought on a bout of depression.” Bea Elle also advises seeking help. “I recommend it 100%. Whether it be a trusted GP, psychologist, counsellor, psychologist, they’re professionals for a reason. They’ve studied for a long time. Sometimes they say the harshest things and it comes from a right place. However, if you don't gel with them, find another one. It takes time!”

Even with considered self care and professional health, there are enough external factors in contemporary life that have the potential to compound anxiety. With mental illness an urgent topic in New Zealand, it’s vital to continue a dialogue to aid acceptance, raise awareness and seek change in the funding, access and support for everyone in New Zealand. Although this piece explores anxiety in the realm of young women, it only highlights a fraction of the diverse range of people in our community, many of whom suffer from anxiety and other mental health issues. We need to endeavour to not only talk about our own experiences, but acknowledge and listen to that of those around us - showing support, care and understanding for others. Phoebe stresses the importance of empathy. "Harper Lee put it best when she wrote 'You never really understand a person until you consider things from his point of view… Until you climb inside of his skin and walk around in it.' "

If you’re struggling with anxiety, the first thing to do is talk about it. Find someone you trust, or see a professional. "And remember,” Isler says “therapists are there to help. You may feel you're the only one, but you probably aren't - and we're not here to judge. I have full respect for anyone who asks for help with their anxiety, and the sooner you start, the sooner you might have a solution."

An edited version of this piece titled 'On the Edge' originally appeared in the December 2017 issue of Miss FQ.

Names have been changed where requested. Thank you to everyone who bravely shared their stories for this piece. I am also very grateful to Nadine Isler for her expertise and guidance.

Anxiety NZ Trust's 24/7 hotline: 0800 ANXIETY (0800 269 4389)