Young women and the silent epidemic of anxiety.
Young women and the silent epidemic of anxiety.
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)
I feel guilt more than I care to admit, tied forever to my body and mind; the female experience is defined it. A trojan horse of outside influence and expectation that attacks from within, guilt is felt in the brain, the heart and the gut. Guilt is selfish and indulgent, yet blistering in its self-loathing nature, with every flaw and every failure (real or imagined) rendered in vivid, inescapable clarity. We wallow in guilt, in its simultaneous cause and effect of the choices we make - a betrayal of self, of one’s own ideals, and of societal standards.
It is the latter that allows (insists?) guilt cloak the female identity and experience. Clichés are shaped by inherent guilt; the bad mother; the loose woman; the crazy shrew. The concept of womanhood is shaped, willingly or not, by self control - health and diet, career and manners, sexuality and emotions. Nature necessitates balance, and control can not exist without weakness - framed by the spectre of failure and, of course, guilt. We’re painted as, and encouraged to be, the shallower sex; the female preoccupation with fashion, beauty and vanity being both an expectation and a flaw.
Vanity is a paradox; an expectation to have pride in one’s appearance and interest in being pleasing and socially acceptable, yet one ingrained with the inherent shame associated with being intrigued, proud or pleased by your own appearance. Vanity is a trait seen as entwined with the weaker, shallower sex - then on the other end of the spectrum, the failure “letting yourself go” and all the projected shame that entails. Both vanity and renunciation are laden with guilt.
Francesca - "My figure has changed a lot since I learned to love myself. I used to feel out of proportion and sort of awkward in my body when I was a teenager - I used to think a lot about how other people saw me and my body. As soon as I committed to gaining a deeper understanding of my body and how it worked (through practicing yoga mostly) it became easier to have compassion for myself and therefore love myself and my body more. I started to notice my figure changing for the better, I felt stronger, more aligned and more feminine. Perhaps it was just my perception though."
More than any other arena, my body has been where guilt has played out. Our bodies are an intimate narrative, a lived experience - intensely personal, yet on display for the world to see. Both common sense and higher thinking plea for us not to be defined by our body, yet how can we not, when it is the most intimate relationship we have, and one that unfolds throughout the course of your life.
Happiness is worn on my body. As with tanned skin during summer, breasts swell from contentment and jeans get tighter. Life is full, and so is everything in it it. Dressing has become an emotionally fraught game of roulette, discarding once-beloved clothes and reaching hopefully for others. I’ve found a new, grateful appreciation for A-line skirts - with their nostalgic, practical (forgiving) femininity. Underwear has been bought, out of both necessity and joy.
I used to be thin. These waxing and waning times of lighter weight were always tied to a heavier soul, hand in hand with stress or heartbreak - or self indulgent periods of restriction and loathing that now seem like a half-forgotten fever dream. Meals to be taken alone were instead not taken at all. I lived on coffee.
Finally acknowledging some responsibility to myself, this year has seen decisive change and a sense of normalcy. I walk nearly everywhere, due to a shift closer to the city centre, and walking as a form of transport rather than exercise has been a revelation to my peace of mind. I now bring my lunch to work for the first time in my whole adult life; a conscious decision on my part to embrace change and the empowerment of balance and responsibility to myself. I’m ashamed to say it’s taken me until the age of twenty-eight to do so; preaching balance but only very recently acting on it.
Jaimee - "I inherited a lot of body issues, as many people do, from my Mother. But also it's our world that tells us that being female bodied, or being femme, means making yourself less, reducing yourself down, taking up less space. That’s just not who I am. It's funny really, when I was skinnier/smaller I held far more negative self-esteem than I do now. I hated every part of myself, every meal was guilt-laden and shameful. [How does guilt around your body make you feel?] Guilt in relation to my body has, in the past, resulted in destructive behaviour against myself. For me, now it’s not about bingeing and purging, or dieting, or working towards arbitrary goals. Now I work on myself, but in a kind way. It’s about self care, and self growth, feeling good and being happy. Loving the feel of my ass after buying my first pair of jeans in a decade or having the strength to care for those I love."
I find myself intrigued and fascinated by the shifting planes of my body.
Some days I acknowledge the unease and helplessness caused by forces outside of my control - age, oestrogen, genetics. My plaintive, pathetic complaints give way to an immediate wave of guilt, as surely I should know better. After all, I can see beauty in a vast array of other bodies, and believe so passionately in inclusivity and acceptance; my insecurity is hypocrisy at best and treason to my own values and that of my gender and our shared history and future.
Other days, when negativity is like last week’s headache, the power of acceptance is liberating. Of course, that mindset is the one we communicate. It would be irresponsible to do anything but. Silently, secretly, I feel betrayed by my thoughts of size, shape and comparison around my own body.
Yasmine - "I feel more and more disconnected from my body, the more my other priorities take over, my body always seems to come last: I skip lunch when I'm busy, I don't get enough sleep when I'm on deadline, I go against it's natural needs too often. I sit behind a computer for too many hours a day, I don't move enough." [How does guilt around your body make you feel?] "Uneasy, disconnected, shitty." [What does balance mean to you?] "That word is a total mirage. I find it's a constant effort to find balance in even the smallest of things, let alone the big, important stuff. I'm aware of myself when I'm out of balance, it's just having the discipline to rectify it, which is only every now and then - mostly due to time restraints. I've recently just given in to the fact that 'balance' will always be something I am searching for."
In most circles (especially those that pride themselves on being empowered and enlightened) dieting is a dirty word, never to be uttered. It’s been replaced by more palatable euphemisms like “wellness” and “clean eating” and a veneer of effortlessness and perfection created by our increasingly digital identities. Bodies are now a lifestyle, a public platform. Bodies are for curating, editing, sharing, validation. The increasingly publicised nature of health and wellbeing, of goals. Goals, a word that’s spread across the internet and the female psyche like a rash; inherently pitting all of us against both each other and ourselves; goals cannot exist without failure.
I watch enviously as friends rise at dawn for herculean workouts and maintain not only a full time job but an abundant social life too. Doing the same however, seems beyond me; the resilient body of my early twenties is now more sensitive, easily fatigued. I feel guilt that I can’t juggle work hours, socialising with health and wellbeing as adeptly as some I know.
Or perhaps, it is that I’m now more in tune with it. Aware of its delicacies and respectful of them. Listening to it for the first time in my life. Accepting that there’s a finite amount of hours in the day; discovering the importance of those moments of stillness; prioritising wellbeing of mind and soul as much as my body. I've learned to listen. As recently as this morning, Francesca reminded me that we "should never do anything today that we don't want to."
As women, we feel expected to lean in to everything. Admitting defeat or reluctance feels like a sign of weakness. Letting myself admit and accept the simple notion that “I can’t” and “I don’t have too” feels groundbreaking, liberating.
More than anything, I feel guilty that I care, guilty that I have discomfort with my body. I see beauty in all other bodies yet, too frequently, struggle to find it in my own. My wholehearted belief in body diversity and visibility makes my self-directed negativity make me feel like a heretic.
Social norms are more diverse than ever, with inclusivity and diversity a constant dialogue; beautiful bodies of all kinds are more visible and celebrated than ever before. As it should be. Yet in the back of our minds remains, ingrained, poisonous self-criticism. Our bodies are deeply personal, and in a way removed from the public dialogue around beauty. Behind closed doors, we stand in front of mirrors, reminding ourselves that we know better than to wish for a different weight or shape; we are smarter than that. Aren’t we? And what of the inevitable daughters and sons we raise and how they see the female form?
The female body as a political object. It wields power, as do the choices we make surrounding it.
With the thankfully shifting and evolving standards of beauty, we need to take pause and ensure our own acceptance is bestowed on our own bodies too - rejecting dissatisfaction, transcending the familiarity of guilt, and instead confronting our own physicality, relishing in every change and shift of it and the narrative of our bodies.
Yasmine - "I think women have a deep instinctive response to everything, when they're open to listening to themselves. I love it when women take a holistic approach to their bodies, and speak about the connection between their head, their heart and their body, it feels very open and connected - to both themselves and something bigger. I love it when women aren't afraid of being seen as vulnerable, I think that takes a lot of strength."
Francesca - "I choose consciously not to live with guilt. If I notice guilt happening inside myself I observe it as an emotion and allow it to pass. I most definitely do not hold on to guilt about or around my body because I know from experience the toxicity and anxiety it can create. I want my body to be strong, clear and healthy so I try and be very perceptive and observant with any emotions that make me feel otherwise."
Jaimee - "Balance means not setting strict goals. Taking things slow, doing what feels good, forgiving myself for sleeping in sometimes and not going to the gym. Eating good food that tastes delicious and that is good to my body. Understanding the intricate relationship between my body and my mind. [I feel best about my body] after a hot shower; Miss Crabb wrapped around my skin; with my skin against someone else's."
At their best, ideas and feelings are a dialogue. The female body in particular is a shared experience, and if we drive the conversation then the parameters are on our terms, so I was so moved to see the photos Ophelia King made in response to my piece Guilt and the Female Body. You can see the whole wonderful series on Yasmine Ganley's anyonegirl.
Adrift in an overwhelming digital world of real-time snapshots, perfect memories and painstakingly crafted insouciance, the endless scroll of the internet seems more and more overwhelming as we all try and capture both the nuances of life and Big Ideas.
However the more I see and the more I Like, the more I want to talk about, well, everything really. So I find myself reaching out, to see if all these somewhat disparate thoughts are more than mine alone. From as close as the next room, to cities much bigger than this, that are too far away to visit on a whim - my close circle of friends both fervidly and wearily debate our passions, skills and choices – not to mention the flux of the world we live in. Questioning how much change we’ve seen in a brief clutch of years, yet how many things also seem stagnant - frustrated with political agendas, thinly veiled xenophobia and excessive consumption, whilst at the same time conflicted with how these opinions and concerns can coexist with our guilty appreciation for things of beauty, finesse and function.
I find myself lamenting time wasted with thumbs to glass; more and more, I find myself stepping away (or trying to). The expanse of information and opinion at our fingertips has made me complacent, and I realised that I rarely read anything that’s not backlit or scrollable. So I decisively made, not a resolution as such, but more a shift in thought and action.
Hence starting a new page (both literally and figuratively), where I shall attempt to create a space for myself, my peers and those whom I love and respect to share, explore and give permanence to the subjects, ideas and frustrations we usually share over cold beers, hot coffee and sporadic instant messages - somewhere for these ideas to exist with more permanence than they usually do.
So bear with me, as I figure this all out. But these are just thoughts, after all.
In just over a week I’ll be celebrating my twenty-eighth birthday. It’s looming in a disconcerting way - not a milestone and not particularly old, yet certainly significant, if only due to heralding the last years of my twenties. I’ve also realised it’s been a decade since my final year of school, a jarringly solid number that’s worth some kind of reflection. The fraught years of being a teenage girl seem so far away, like a headache that slipped away quietly. Or perhaps the headache itself was my early twenties – a hangover of adolescence, with the security of regimented schooling stripped away and nascent responsibilities and freedom curdling alongside the still festering insecurities of those teenage years, when we cared about everything and nothing at all.
This nostalgia of adolescent anguish may also be self inflicted; hours spent watching early seasons of Gilmore Girls, recently deposited on the Netflix catalogue, has made me sentimental for that highly strung intensity, found in its purest essence in a teenage girl – feelings, opinions, hormones and music alike all turned up full volume. The verbal rallies between Rory and Lorelai, spitting out references from pop culture and literature alike, also make me miss repartee - now so limited to the scrolling backlit feeds in front of us.
Wallowing in this imperfect maternal bond gave me more motivation than usual to cross the infrastructural quagmire that is the greater Auckland, and pay a visit to my Mother.
Strangely with the distance of both time and space, her home gives me a greater sense of comfort and stillness than when I lived at home; maybe as it’s a house I’ve never lived in, it has the luxury of being a clean slate – neutral territory, with no memories of tears and fights and the broken crystal tumblers that were victims of my youthful temper.
I wonder if she finds it strange that I used to fit in the crook of her elbow or hide behind her skirts, now that I’m not much younger than she was when I was born. Reflecting on my youth and hers, if my teenage years seem far away, my mother’s must seem impossibly distant. Even the concept of adolescence itself must seem unfamiliar; most of the trappings of my teenage years seem shallow in both nature and purpose. Bar a year or two, my mother was a child until she wasn’t.
Although all societies acknowledge the onset of puberty in some way, the actual concept of a “teenager” is newer than some of my family’s furniture – appearing as an adjective in 1921 and as a noun two decades later. A post-war construct (like so many social initiatives) and a marketers dream, like most shiny new things it appeared in America, as schooling was extended, marriage delayed and child labour frowned upon – all privileges of a country shielded from the theatre of war experienced across the Atlantic.
By the nature of their physical and psychological flux adolescents are drawn to all that is new and untested, I remember my parents trepidation at allowing me to get my own email, teenage years serve the purpose of teaching us to push boundaries and explore privacy, society and how our own identity fits and is formed by these. Lying for the sake of lying, trying on attitudes and personalities with carelessness usually reserved for an old sweatshirt. The pressure imposed on our current swathe of teenagers by our increasingly digital world and society’s unrealistic and unreal standards makes me feel incredibly sad, the constant pursuit of validation and perfection fuelling the insecurity and criticism that have given youth decades of toxicity already.
I’ll admit there’s a large amount of truth in the advice I’ve had meted out to me up until now; awareness and confidence of self (or perhaps it’s really just indifference) do eventually appear, not unlike that forgotten headache. One day I stopped caring, or realised I didn’t have to do so about everything; and whilst I miss being a teenage girl, I’d never do it again. Or maybe I’ve just been watching far too much Gilmore Girls.