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Panic attacks, social phobia, OCD... anxiety is one of the most widespread mental health problems in the world today. We talk to the experts about how to identify the signs and manage its symptoms

I've always loved Pixar's Toy Story films, particularly because the toys capture so many personality types. Buzz is adventurous, optimistic; Woody is loyal, organised (a little controlling); Jessie is feisty and passionate and Rex, the tyrannosaurus and the one I identify with most, is sensitive, with a deep aversion to uncertainty. Sometimes I blame my Taurus traits (we're homebodies, we hate change) for this personal tendency, but the truth is I can't stand not knowing. A lot of possibilities come to mind, from the slightly inconvenient to the outright catastrophic.

On bad days, I completely disarm myself and call my closest friends (ok, I write to them) in a panic. And it seems I'm not alone.

Anxiety is on the rise, so much so that the Institute for Health and Metric Assessment reported in 2018 that 284 million people worldwide suffer from it in one of its manifestations: panic disorder, obsessive compulsive disorder, generalised anxiety disorder, social anxiety. This makes it one of the most widespread mental health problems today. In the USA alone, according to the Anxiety and Depression Association of America, 18% of the population suffers from anxiety each year, but only 36.9% of them seek treatment.

What is anxiety?

"In a broad sense, anxiety disorder is when a person has so much anxiety that it prevents them from doing, or makes it extremely difficult to do, the ordinary things they would want to do," says Dr David Carbonell, psychiatrist and author of the bestselling self-help book The Worry Trap. This manifests itself in a number of ways that can profoundly affect the quality of daily life. It could be avoiding driving in certain circumstances, flying, socialising with groups for fear of awkward encounters; it is essentially when a normal activity causes excessive stress and suffering.

"Anxiety is very similar to fear, only it is fear projected into the future. You look to the horizon and anxiety is the 'what ifs', the uncertainty of what is going to happen. Constantly asking yourself, 'Will I be okay,'" explains Dr. Ellen Hendriksen, author of How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety.

What are your triggers?

The main factors contributing to anxiety remain the same as they were decades ago: difficult relationships, unemployment, loneliness, exposure to trauma, conflict. However, the digital age has added its own set of issues. Being connected 24 hours a day not only means exposure to news (good, bad, catastrophic), it also exposes us to the dangers of data hacking, trolling, system crashes; the obstacles are endless. With the digital revolution also comes a reduction in the need for personal interaction and, with the growth of social media, there is more emphasis on happiness based on metrics such as how many followers or likes you have.

The evolution of technology exacerbates the problem, as it means we no longer have to leave the house to carry out our day-to-day tasks. Things that used to be perceived as stressful, but also necessary, used to force us to deal with situations that we can now easily avoid behind our screens - why engage in a face-to-face conversation, or even make a call, when you can text? Why have a conversation with a colleague when you can use Slack?

How do you start to feel anxious?

There are multiple factors that can contribute to anxiety, one of them being genetics. While you may inherit a predisposition to anxiety from your genes, big changes in your life also act as catalysts - whether it's finishing school or moving away from home for the first time, having a baby or any other uncertainty that brings a change in circumstances. It is often at turning points like these that someone who has never suffered from anxiety before can develop it.

"It is, however," Hendriksen explains, "part of our nature, built into us and largely genetic. It is often triggered by an event, usually a life event, particularly when there is a lot of uncertainty about it, or something happens to us, or we are uncertain about the outcome.

Carbonell agrees: "There are stronger genetic predispositions in some families than in others. I firmly believe that people are simply born with a chance of developing an anxiety disorder, and if they fall into this category, they have a stage where it increases. For panic disorders it's usually somewhere between 18 and early 30s. Independence, adulthood; maybe all these positive changes can suddenly become something to deal with.

Can anxiety be cured?

"People can go into a long period of remission, which may continue for the rest of their lives. The word 'cure' is problematic, as it's not really a disease," explains Carbonell. "Some more extreme versions of anxiety can lead to this mentality, and a dependency on the idea that you have 'cured' yourself. Then the obsession will translate into constantly going back to the attitude that I'd better check if I'm still 'cured'. That will be the downfall. Another thing about the 'cure' is that anxiety is an ordinary part of life, this is just an overloaded version of it".

"Having some anxiety is adaptive and frankly necessary," Hendriksen adds. "It keeps us safe, it keeps us from jumping headlong into a situation. It forces us to stop and think. It's our smoke detector. You wouldn't want to turn it off.