Fifteen Eighty Four

Anxiety disorders cause people to experience a range of mental and physical problems but can be difficult for health professionals to diagnose. Understanding the language that people experience to describe anxiety, including how this differs depending on your age, your gender and your culture, can help to identify the best treatments and support options for people living with anxiety disorders.

We collected data from an online forum dedicated to anxiety support to investigate the range of ways that members talk about anxiety. We downloaded contributions covering a period of over 8 years, including posts from over 17,000 different contributors from all around the world. This amounted to approximately 21 million words written by people with some experience of anxiety disorders.

Linguistic analysis often involves the consideration of specific word choices, which can be difficult when trying to navigate millions and millions of words. Our approach combines our linguistic expertise with computer software tools. The tools help us to identify patterns in the data. For example, we could consider which words are the most frequent or which are more frequent when you compare the posts from one set of contributors to another. These techniques are established in the field of corpus linguistics and have been applied to investigate how patterns in language contribute to wider discourses, as well as a range of other language-based research questions.

Beginning with general descriptions around the word ‘anxiety’, we found that while some people set out to establish that anxiety disorders are a serious medical condition, describing it as an ‘illness’ and a ‘condition’, others focussed on representing anxiety as a ‘normal’ part of human life. Similarly, some members of the forum emphasised how terrible anxiety is, using ‘catastrophising’ language such as ‘debilitating’ and ‘horrific’, compared with others who used minimising strategies e.g., by using phrases likes ‘it’s just anxiety’ or talking about anxiety as ‘manageable’.

Information provided about members of the forum gave us the opportunity to compare female contributors to male contributors and while – generally speaking – ways of speaking about anxiety were similar, our linguistic analysis highlighted some finer distinctions. For example, male contributors were more likely to talk about anxiety as an illness condition that had come on at some point in their lives and which could be addressed or ‘cured’ like other health concerns. Female contributors were more likely to discuss anxiety as a more consistent part of themselves, explaining that they had always been ‘an anxious person’, for example.

Most of the contributions to the forum came from people based in the UK or the USA and our analysis showed that ideas about cultural norms influenced the kinds of strategies that members discussed in relation to managing their anxiety. For instance, the notion of the British ‘stiff upper lip’ lent itself to a kind of stoicism and show of fortitude when dealing with the troubling effects of anxiety. Contributors from the USA more often discussed their plans to visit a ‘new doctor’ and try different combinations of medications, reflecting the capacity, in the highly privatised US health system, to ‘shop around’.

Our investigation of different age groups in the forum provided insights not only into generational differences in the experiences of anxiety but also to the dynamics of the forum, as new members sought the wisdom of those who had developed coping strategies over the course of managing anxiety for long periods of time. Thus, while younger contributors (in their 20s) emphasised the difficulties brought about by anxiety, middle-aged members tended to recommend medication or therapy and older members endorsed various meditation, relaxation and distraction techniques.

Through examining the patterns in the language of the forum, we have been shown the value of this online peer group, alongside the kinds of medical support that members will get from their doctors. The way that members replied to other contributors highlighted the importance of empathy and affiliation in the forum, the reassurance that someone experiencing anxiety was not alone, or the advice of how to manage the side-effects of medication, for example. As we tracked the long-term participation of participants, we saw developments from the ‘crisis’ moments experienced by new members who had exhausted their own solutions to the role of advisor and advocate of tried-and-tested behaviours that longstanding members engage in on a daily basis.

In our exploration of this anxiety support forum, we have been able to document just some of the ways that people talk about anxiety and different strategies can relate to whether that person is in their 20s or their 60s, whether they live in the UK or the US, as well as individual preferences. People also talked about the impact of anxiety in terms of expectations related to their gender, such as their position in relation to their family or social support networks. If health professionals are aware of these different strategies, they can appreciate the breadth of perspectives, and experiences of anxiety, and potentially modify their own descriptions accordingly. Similarly, with a better understanding of the interactional dynamics of online forums, health professionals can direct people with anxiety to resources like this to provide an additional form of support that might not be available to them offline, or through medical intervention.

Our methodological approach was – to a large extent – data-driven, meaning that we directed our attention on areas that our software tools helped us to identify were characteristic of the contributions of the forum. This enabled us to comment on what members use the forum for and how their interactions tend to unfold. Researchers interested in the lived experience of a range of health concerns can adopt the approaches we report in this work and can extend our analysis of anxiety disorders to different forms of reported experience. Language is not the only resource for treating anxiety disorders. Nevertheless, we hope to have shown how important the language choices are in helping those experiencing anxiety to work towards managing its impact.