Science·In Depth

Anxiety disorders: a mental illness on the rise

Kendra Fisher talks about the anxiety disorder that kept her from playing hockey with Team Canada. While there have been inroads in helping people with anxiety disorders, the stigma of mental illness is still a concern.

A young woman speaks out

When Kendra Fisher was a young woman she had a dream, a dream of playing on Canada's Olympic women's hockey team.

Fisher worked hard  — and just when she was about to have it all her life spun out of control. At a Team Canada try-out in 1999, her anxiety disorder incapacitated her to the point she could not continue in the training camp.

"The dream absolutely changed," she recalls. "Back in the late 90s I started to feel not right, that's the best way I could explain it then. Certain situations just got to be too much for me to cope with. I started to feel anxious, I started to feel heart palpitations and my stomach was wrong and I couldn't swallow and I would get dizzy … I didn't know what was going on and I didn't know how to get help for it." 

The good news on Fisher's story is that she learned how to cope with her disorder and she says she now lives a very productive and happy life. At 31 she's a goalie in the Canadian Women's Hockey League and a senior resource manager with Zylog Systems. Fisher is also keen to share her story to help others via her Facebook and Twitter  accounts. 

The not-so-good news is that more young Canadians appear to be suffering from serious anxiety. At least one psychologist says anxiety disorders now affect as many as 25 per cent of patients seeking his help for mental illness.

Ten years ago, anxiety disorders affected 12 per cent of the Canadian population. 

Generalized anxiety disorder

Generalized anxiety disorder involves "excessive anxiety and worry occurring more days than not for a period of at least six months, about a number of events or activities.  GAD is characterized by "difficulty in controlling worry." (Centre for Addiction and Mental Health) 

Something has changed to make life seem more challenging and anxiety-ridden, especially for young people. One study released in January 2010 shows depression and suicidal thoughts are on the rise on campuses in Canada and the U.S. Another American study released in January shows stress levels among college freshmen is at an all-time high. 

Oren Amitay, a psychologist who has been practising for 11 years in Toronto, is outspoken in his belief that helicopter parents who enforce too many activities for children and parents who constantly jump in to fix their kids' problems are the cause of many anxiety issues.

"I see young people in my practice who are not equipped to deal with life, they get anxious, overwhelmed."
Oren Amitay, a Toronto psychologist, says therapy can be effective in treating anxiety disorders. ((Oren Amitay))

Amitay also thinks the "tiger mom" or no-nonsense parenting methods like those of Amy Chua  mean there are too many pressures on the children, and that children live in constant fear of their parents finding out they are not perfect.

Fisher, by the way, says she has a very supportive family and many friends and that during various stages of her hockey career, she's had the support of the entire town of Kincardine, Ont. The night she broke down at the Team Canada camp her father and mother helped her through the ordeal. 

Katy Kamkar, a clinical psychologist at the Centre for Addiction and Mental Health in Toronto, agrees that counsellors are seeing more cases of anxiety among young adults. She says the economy is playing a big role in making life more challenging for them.

"It used to be that if you got a good education, you would get a good job," Kamkar says. "But today young people are uncertain of finding a job, they have a lot more debt, they are working while studying, finishing later, more fatigued and some are starting families while still in school and juggling all of this causes a great deal of stress."

While there may be more anxiety among the young, treatment methods have improved over the past decade. 

The most common treatment is cognitive-behavioural therapy, which has been refined over the years. It is a controlled, step-by-step process in which the patient faces his/her fears. "It helps the patient to get some control over anxiety which is often irrational," Amitay says. 

Kendra Fisher speaks out about her long struggle with severe anxiety. ((Janet Thomson/CBC))

Kamkar points out that the internet and social media tools such as Facebook can be positives in fighting anxiety. People can find information that just wasn't available to them pre-web, and social networking tools, she says, let young people gather more knowledge and communicate more and so help to reduce the stigma.  Fisher, for example, uses Facebook to tell her story.

Six main anxiety disorders

  • Phobia.
  • Panic disorder (with or without agoraphobia)
  • Generalized anxiety disorder
  • Obsessive compulsive disorder
  • Acute stress disorder
  • Post-traumatic stress disorder

"Drugs are also better today," Amitay says.  "They can be better directed to specific issues with better doses and monitoring, fewer side-effects."

Two things stand in the way of making even more progress in helping young people.

"There's still very much a stigma attached to having a mental illness," Kamkar says. 

That's why Kendra Fisher is speaking out.

"I think the words that I associate most with what I have been through and had for the longest time are failure, degrading, embarrassment, shame," she says. "I was well on my way to representing our country at the world level — at the highest level — and all of a sudden I couldn't even get out of bed … It's not like you can see my illness, you don't see when I'm having a bad day, you don't see when I'm having a bad moment or struggling and in my case a lot of that is because I didn't want anyone to see it and what I've come to realize is that's exactly why these stigmas exist because people like me have very successfully learned how to cope."

"We need to do more work to gain awareness of the symptoms, helping people to know when they need to see a doctor, and to remove the concept of stigma," Kamkar says. 

Physical symptoms of anxiety disorder

  • Muscle tension
  • Inability to relax
  • Restlessness, irritability
  • Sleep disturbed by worry

The other obstacle is the cost of treatment. 

Most government health plans will pay if someone is referred to a psychiatrist, but it is difficult to find one in many parts of Canada. Most other mental health experts are not covered.  Instead, people must pay upfront to see psychologists and other therapists.

"This shouldn't be so daunting," Amitay says. "Private insurance plans will often cover the therapy sessions and if not, many psychologists are open to discussing a sliding scale of fees."

Ontario, in particular, has seen a push to set up a central call centre where people in crisis can access a wide range of services. The service was launched in the U.S. almost 10 years ago and is making inroads across Canada. 

In Ontario, the 211 website gives phone numbers for distress lines, hospital emergencies and where to call if one is in psychiatric crisis.

Fisher has a clear message for today's young people in distress. 

"My advice is, there is hope … there are ways to feel better. There are coping skills to be learned, there are people to support you, there are therapies that exist. It's not easy to talk about the worst moments of your life, but in doing so you'll find the help and support you need." 





With files from Janet Thomson