Datafolha: Brazilians have anxiety and sleep problems – 08/19/2023 – Equilíbrio

Three out of ten Brazilians feel anxious, have problems sleeping and eating always or often. A quarter expressed little interest or pleasure in doing things, and a fifth reported difficulty with attention or concentration.

Even so, only 7% of the population evaluates their personal mental health as bad or terrible, with the age group between 16 and 24 years old being the most dissatisfied (13%). In general, 70% of Brazilians consider their mental health to be excellent or good, and 23% consider it to be fair.

The data were measured in a survey by Datafolha, carried out from July 31st to August 7th. 2,534 people aged 16 or over were interviewed in 169 municipalities. The margin of error is plus or minus two percentage points. The Brazilian population aged 16 and over is estimated at 158 ​​million people, according to the 2022 Census.

There is a clear dissonance between reported symptoms, which denote problems with mental health, and how people assess their general emotional state.

While only 5% of men and 9% of women consider their personal mental health to be bad or very bad, 23% and 38%, respectively, feel anxious always or often.

Among women, 27% had already been diagnosed with anxiety and 20% with depression, double the rate recorded among men (14% and 10%, respectively).

Just over a fifth of the population (21%) surveyed visited a psychologist, therapist, psychiatrist or mental health professional in the last 12 months. The same percentage had a diagnosis of anxiety, 15% of depression and 8% of attention deficit hyperactivity disorder (ADHD).

For psychiatrists interviewed by Sheetthe dissonance between self-perception of mental health and reported symptoms can be explained by the lack of understanding and stigma surrounding the topic.

“The population has no idea that sleeping badly, eating too much and feeling unpleasing in their usual activities are indicative of a depressive condition. They associate mental health problems with more serious disorders, psychoses, chemical dependency”, says Rodrigo Martins Leite, collaborating professor at the Institute of Psychiatry at the Hospital das Clínicas in São Paulo.

Psychiatrist Jair Mari, professor at Unifesp (Federal University of São Paulo) and current coordinator of mental health for the São Paulo government, has the same perception. “People confuse the concept of mental health. They think that, by saying that it is not good, it can mean a serious mental illness, such as schizophrenia. And there is a whole stigma around these disorders.”

The data also reinforce what other surveys have already shown: women’s mental health is under more pressure than men’s. Just over a quarter of women (26%) feel little interest or pleasure in doing things, while among men the rate is 23%. Sadness, depression and lack of hope are reported by 13% of them and 7% of men.

The relationship with sleep and food is also not going well: 35% of women report difficulty sleeping or sleeping too much and 35% have little appetite or overeat. Among men, the rates are 25% and 33%, respectively.

The impact is greater in classes D and E, where 37% have sleep problems with great frequency, compared to 29% among Brazilians in class C and 25% in classes A and B. As for eating problems in these classes, the rates are of 35%, 30% and 22%.

“All over the world, women have higher rates of depression and anxiety and there are several psychosocial factors that explain this as a double, triple workload. In the peripheries, greater exposure to violence and adversity are additional risk factors”, says the milk psychiatrist.

Considering the nine symptoms evaluated in the survey —little interest or pleasure in doing things; sad, depressed or hopeless; trouble getting to sleep, staying asleep, or sleeping too much; tired or without energy; little appetite or overeating; bad about yourself, or that you are a failure, or that you have let yourself or your family down; difficulty concentrating on things like reading or watching TV; you feel that your speech and movements are slow, or the opposite, restless and agitated; anxious—12% of Brazilians gather five to eight of them with high frequency. Among women, this rate is 15% —twice the rate recorded by men (8%).

Microentrepreneur Thaís Silva Vilela, 32, says she feels the stigma of depression firsthand every time she faces crises and decides to stay at home, resting. “No one understands depression as [entendem] a physical illness. It’s like this: ‘get up and go to work anyway’. Do I need to make an excuse, invent a physical illness to stay at home?”, he asks.

Currently, she says she has been oscillating between anxiety and depression. She is accompanied by a psychiatrist and psychologist and uses medication for these conditions. “In anxiety, we want to do everything at once, we want to take care of the world. The accelerated thinking makes us not sleep”, she reports.

Earlier this year, she says, she suffered “a low” due to a personal problem. “I started to have depressive symptoms, not wanting to get out of bed, not doing anything. I just want to sleep, but I can’t because my head is racing.”

According to Thaís, mental health problems began in 2017, after facing burnout syndrome. At the time, she worked at an insurance company and spent 20 days in a clinic. Over the next six months, she was monitored daily at a day hospital, where she underwent various therapies.

After that period, she was fired, lost her health plan and decided to give her life another direction. Today she is in the sixth year of veterinary school and has a small business of dog walkers. “The hospitalization, the therapies helped me a lot to understand that I am the one who has to deal with my problems, nobody is going to do it for me”, she says.

Like Thaís, 28% of people between 25 and 34 years old visited a mental health professional in the last 12 months. It is the highest rate among all age groups. The rate rises to 32% among those with higher education and to 40% in the income range above ten minimum wages.

The survey also shows that there is a bottleneck between the diagnosis of anxiety, depression and attention deficit hyperactivity disorder (ADHD) and medical and drug treatment — only 9%, 6% and 3% of Brazilians are treating these conditions, respectively.

With regard to depression, the rate of treatment (with and without medication) among women is three times that of men (9% against 3%). In anxiety, it is double (13% against 6%), and in ADHD, the same (3%).

“There is a lack of access both in the public and private systems to mental health services and professionals. There are regions of the country where they do not exist, and primary health care is often not prepared to deal with this demand”, he says. Rodrigo Leite.

According to psychiatrist Jair Mari, the current mental health public policy, with the Caps (psychosocial care centers), is very much focused on the most serious conditions. “There is a hiatus. A person with depression, anxiety, with attention deficit disorder, with bulimia, cannot be seen.”

For him, Datafolha data show that this idea that Brazilian society is very medicalized is not real. “Those who are medicalized are the rich, who have access to psychoanalysis, psychiatrists, medication. We live the law of inverted care. Those who need it, don’t have it. And those who don’t need it, have too much.”

Christian Kieling, professor of the Department of Psychiatry at the Federal University of Rio Grande do Sul (UFRGS), points out that, in Brazil, mental health is still seen as a privilege, not a right. “Most care takes place in private offices. The person has to be very well off to be able to take care of his mental health or he has to be very bad to get treatment in the public network”, he says. “And those who are between these two poles are often neglected.”

Stigma is also another obstacle, according to Rodrigo Leite. “If the person does not admit to having a problem, this ends up delaying the search for help or even preventing it”, says the psychiatrist.

The Datafolha survey also assessed Brazilians’ perception of physical health. Again, only a minority (6%) considers it bad or terrible, an index similar to that of mental health. Among men, 72% classified it as excellent or good and 23% as regular.

“Both evaluations appear with the same magnitude, so primary health care needs to have a look, at least, of equating physical and mental health”, says Kieling.

For Rodrigo Leite, Brazilians are normalizing having poor physical and mental health. “We are normalizing having depression, being obese, not doing physical activity. The social perception of illness is not cool.”