Anxiety: The silent killer

It is currently 3 am on the clock beside my bed. I have checked it three times already, at 15-minute intervals. I lay here, awake, thinking about the exchange I had with the store clerk today. Was I rude? Did I make his already unbearable day even more excruciating? Maybe I should go back tomorrow. Apologise. Make less small talk. Maybe that will make him hate me less.

This is just one simple example of the millions of trains of thought people with anxiety go through on a daily basis, starting from just one exchange with a store clerk to making life-changing decisions. Even though such thoughts may seem trivial or even silly to some; weeks, months and years of having these types of thoughts can lead a person to a deep, dark pit of depression. As illustrated by the immortal words of Julia A.F. Carney, "Little drops of water, make the mighty ocean."

Anxiety is defined by Merriam-Webster Dictionary as "apprehensive uneasiness or nervousness usually over an impending or anticipated ill," which, if left untreated for too long, may lead to long-term depression. Depression itself is defined as "a mood disorder marked especially by sadness, inactivity, difficulty in thinking and concentration." Even though this definition is accurate in its own sense, it does not even begin to capture the mental rollercoaster anxiety causes people to go through every day over the smallest of things including just deciding what to order in a restaurant.

The truth is that people do not pay that much attention to mental illness because it is not always visible. Well, at least not to the naked eye. No one knows about the knot in the pit of your stomach that you have had for just way too long nor do they know about the nausea you feel all day. They have no idea that the reason you miss classes, work or social events is because you have no energy left to do anything else since you spent it all just getting out of bed that morning; and you cannot explain it to anyone because you, yourself, do not understand it. And whenever someone asks you what is wrong, it is always the same answer: "Oh, it is nothing. I am just tired."

The time has come to recognise the millions of people suffering from anxiety as well as the people we lose to it every day. Photo: PAHO

Depression is rarely noticeable. It is not always scarring on your hands and legs or red puffy eyes. It can be the happiest smile you have ever seen or the freest laugh you have ever heard. Sometimes the happiest people can be dying inside and you would never know. There are millions of people out there who feel this way and the least we can do is our part to encourage them to talk about it, to not feel ashamed to seek help. Someone talking about their physical illnesses would not feel ashamed; why should people talking about their mental illness feel that way?

According to the World Health Organisation, one person dies every 40 seconds and the data is even higher for attempted suicide. Studies also show that stress can lead to heart disease. Takotsubo Cardiomyopathy, or better known as Broken Heart Syndrome, is a temporary heart condition which can cause severe heart muscle failure in response to extremely stressful situations. This shows that stress can literally cause your heart to stop working; and yet, we still take it lightly.

In a 2014 research article titled "Mental Disorders in Bangladesh: A Systematic Review", a review was conducted on the 'literature of mental health disorders in Bangladesh', which is a very narrow field. 32 articles were found which concluded a prevalence of mental disorder from 6.5% to 31.0% in adults and 13.4% to 22.9% in children. It was further pointed out in the article that mental illness in Bangladesh is a grossly underrated and under-reported topic. 6 years later, not much has changed in this regard. We are still as ignorant as we were 6 years ago, which is deeply saddening.

In another article written in 2015 titled "Autism, Stigma and Achievements of Bangladesh", it was again pointed out that mental disorders such as depression got no attention at all even though with proper treatment, patients suffering it from could lead a perfectly normal life. However, such patients are reluctant to get treatment due to the fear of being stigmatised. Patients of other mental disorders such as schizophrenia are also highlighted in said article, stating how they are wandering the streets of this country 'homeless, careless and undiagnosed'. Even though two important Acts have been passed for the protection of disabled people, including autism and schizophrenia, namely the Disability Rights Law 2013 and Neuro-Developmental Disability Protection Trust Act 2013, it offers limited implementation in case of schizophrenia due to 'stigma, lack of concern… and social participation'. 

Further studies conducted during the pandemic have shown that the mental health of the general public is worse now more than ever. A web-based cross-sectional survey carried out in late-August showed that 15% of university students in Bangladesh had moderately severe depression while 18.1% were severely suffering from anxiety. Please note that this sample size of this survey comprised only 476 people. This uncertainty of life has gripped us all in one way or another be it in the financial capacity or watching our loved ones fight for their lives. 

Eight cases of suicides had been reported, during the first 3 weeks of April this year ranging from a 30-year-old man losing his job and failing to feed their family to a 10-year-old girl who had been scolded by her father for wanting food after starving for two days.

The time has come to recognise the millions of people suffering from this disease as well as the people we lose to it every day. It is time to normalise seeking help and stop seeing it as a shameful act. What sort of example are we setting for future generations? Should we not work towards a safe and understanding environment for them? Should we not send the message that their mental health matters? That no matter what happens, it is okay to talk about it instead of bottling up their feelings inside?

We need more than a single day a year to spread awareness about this very real problem that has gripped and paralysed so many people. We need to encourage more and more people to talk and seek help. Anxiety and depression are very real and we need to start treating it as such. Reach out to your loved ones, check in on them. You never know who might be a victim of this wretched disease.