In 2012, the government of Canada estimated that 700,000 Canadians over the age of 15 are afflicted with generalized anxiety disorder (GAD). In 2018, a survey of 1,500 Canadians, commissioned by Yahoo Canada, reported that six out of 10 respondents aged 18–29 self-reported managing anxiety.
Symptoms of GAD include persistent, unwarranted, and uncontrollable worry about many things. Although feeling stressed or anxious during a challenging time is normal, people with GAD find it hard to stop worrying, even when there isn’t a threat. GAD may also cause physical symptoms such as digestive issues, muscle aches, sweating, fatigue, and insomnia.
However, there may be hope for those with GAD, according to a recent research paper in the Journal of Affective Disorders. Dr. Esme Fuller-Thomson, Director of the Institute for Life Course and Aging and a professor at the Factor-Inwentash Faculty of Social Work at the University of Toronto, and Kandace Ryckman, a recent U of T graduate and a senior project lead at the Health Commons Solutions Lab, co-authored the paper.
The co-authors based their study on the 2012 Canadian Community Health Survey-Mental Health, a large-scale, nationally representative survey conducted by Statistics Canada. The survey found that 72 per cent of respondents diagnosed with GAD were in remission the year before it was conducted, and 40 per cent were in “complete mental health.”
Most people with GAD experience full remission
The aforementioned Yahoo survey also found that four out of 10 Canadians believe that there is no cure for anxiety. However, in an interview with The Varsity, Fuller-Thomson said that although a large number of people with an anxiety disorder “cannot imagine being in optimal mental health again,” the study suggests that recovery for most is not only possible but likely.
“Our findings indicate that most people experience full remission from the disorder, and a sizeable minority reach a flourishing state of mental health,” Fuller-Thomson said.
According to the 2016 National College Health Assessment conducted across U of T’s three campuses, as many as 64 per cent of students had experienced “overwhelming anxiety” in the previous year. Given the ongoing mental health crisis at U of T, Fuller-Thomson’s findings might give hope to students struggling with their mental health.
Positive and negative factors that impact mental health outcomes
The co-authors wrote that “ideally, the clinical goal for individuals with a history of anxiety disorder is not only to remit from the disorder, but also to reach optimal well-being.” The authors used the Keyes’ model of complete mental health when assessing the respondents’ well-being. This model presents mental health and mental illness as distinct continua and emphasizes the role of multiple factors, including emotional and social ones, in “flourishing” or complete mental health.
Fuller-Thompson and Ryckman found several factors that predict better mental health outcomes, including a lack of disability, absence of substance abuse, good physical health, and “positive coping strategies” like turning to religion or regular exercise. One of the most important predictors of good mental health was the presence of a confidant. This suggests that social connections can be vital for people who experience anxiety.
In an interview with Science Daily, Ryckman said that “the social support that extends from a confidant can foster a sense of belonging and self-worth, as well as increase feelings of security.”
The factors that can impede mental health include “a lack of social support, poor physical health, functional limitations, insomnia, and a history of depression,” as Fuller-Thomson noted.
A major limitation of the study is that the dataset didn’t include psychotherapy or medication as factors that could affect a person’s recovery from GAD and their mental health in general, something that warrants further research.
The significance of the findings for underrepresented groups
When asked about the significance of the findings for less privileged social groups — particularly Indigenous peoples in Canada, who have faced a long pattern of discrimination — Fuller-Thomson referred to a recent 2019 study that she was the lead author of, which looked into the mental health of Indigenous people living off-reserve.
The results were largely similar to this study: social support played a crucial role in mental well-being. However, the 2019 study also noted that poverty was a serious impediment to mental health.
Fuller-Thomson noted that “the definition of excellent mental health sets a very high bar.” The authors used three criteria for evaluating excellent mental health in a patient: reporting feeling happy or satisfied with life almost every day in the past month; “high levels of social and psychological well-being in the past month”; and being free from “depressive disorders, suicidal thoughts, and substance dependence” in the past year.
“In other words, remission from GAD is necessary but not sufficient for achieving complete mental health,” added Fuller-Thomson.