Anxiety in Sri Lanka
A Summary

New Insights into Anxiety in Sri Lanka

A Summary by Hiranthi Munasinghe

Anxiety disorders are a common mental health problem in Sri Lanka, affecting an estimated 10-20% of the population. The patterns of anxiety in Sri Lanka have changed over time, with anxiety disorders becoming more common among men and people in urban areas. The civil war in Sri Lanka also had a significant impact on the mental health of the population, and many Sri Lankans continue to experience anxiety and other mental health problems related to the war.

Some of the factors that contribute to anxiety disorders in Sri Lanka include:

  • Poverty
  • Social stigma
  • The civil war
  • The COVID-19 pandemic
  • Academic pressure
  • Workplace stress
  • Relationship problems
  • Health problems

Symptoms of Anxiety and Depression in Adolescent Students

A study conducted in Sri Lanka found that 36% of adolescent students screened positive for depression and 28% screened positive for severe anxiety. Females screened positive for depression and anxiety significantly more than males, and students in classes facing barrier examinations at the end of the year had the highest positivity rates. The study authors recommend that school mental health development programmes in Sri Lanka concentrate more on reducing examination-related stress, and in particular focus on female students. They also recommend that policy decisions be made to reduce competition for higher education, and that a nationally coordinated survey on mental health of adolescent students be carried out.

The symptoms of anxiety and depression in adolescent students can be similar to the symptoms in adults, but there are some important differences. For example, adolescents with anxiety may worry about upcoming exams, school performance, or social situations. Adolescents with depression may feel sad, hopeless, or withdrawn. They may also lose interest in activities that they used to enjoy.

Anxiety:

  • Excessive worry or fear
  • Feeling restless or on edge
  • Having a hard time concentrating
  • Having trouble sleeping
  • Feeling irritable or angry
  • Having physical symptoms, such as a racing heart, sweating, or dizziness

Depression:

  • Feeling sad, hopeless, or withdrawn
  • Losing interest in activities that used to be enjoyable
  • Having trouble sleeping or sleeping too much
  • Having changes in appetite or weight
  • Feeling tired or having low energy
  • Having trouble concentrating
  • Having thoughts of death or suicide

Key Findings on Anxiety in Sri Lanka

A number of studies have been conducted on anxiety in Sri Lanka. Some of the key findings from these studies include:

  • Depression, anxiety, and stress are common among undergraduate nursing students. A study by Rathnayake and Ekanayaka (2022) found that over 50% of undergraduate nursing students in Sri Lanka reported mild to extremely severe symptoms of depression, anxiety, and stress. The study also found that self-rated physical health and self-rated mental health were the factors most closely related to negative emotional states.
  • Adult ESL learners in Sri Lanka also experience high levels of anxiety, especially those whose L1 is Tamil. A study by Ratnayake and Ekanayaka (2023) found that 88% of adult ESL learners in Sri Lanka reported experiencing anxiety, with students whose L1 was Tamil reporting higher levels of anxiety than students whose L1 was Sinhala. The study also found that students faced anxiety in the form of communication apprehension/anxiety, test anxiety, anxiety regarding negative evaluation, and anxiety in the ESL classroom environment.
  • Patients with rheumatoid arthritis are more likely to experience depression, anxiety, and stress than the general population. A study by Wijewardena et al. (2022) found that the prevalence of depression, anxiety, and stress among patients with rheumatoid arthritis in Sri Lanka was higher than the general population. The study also found that functional deterioration, disease activity, and presence of co-morbidities were associated with these mental health issues.
  • Sri Lankan undergraduates studying in countries affected by COVID-19 reported significant levels of stress, depression, and anxiety. A study by Amarasingha et al. (2022) found that the prevalence of depression, anxiety, and stress among Sri Lankan undergraduates studying in Russia, India, and Sri Lanka during the COVID-19 pandemic was 11.58%, 11.58%, and 3.16%, respectively. The study also found that online learning facilities and university workload had a significant impact on the anxiety levels of state and non-state university undergraduates in Sri Lanka.
  • A study conducted among undergraduate nurses in KIU, Sri Lanka during the COVID-19 pandemic found that the prevalence of anxiety, depression, and stress were 13%, 7%, and 3%, respectively. The study also found that working experience was associated with depression, anxiety, and stress, while age was associated with the level of anxiety and depression.
  • A cross-sectional study conducted among healthcare professionals, military professionals, and the general public in Sri Lanka found that a reasonable proportion of participants experienced depressive symptoms (39.25%) and severe anxiety (12.8%). Military professionals showed depressive symptoms (73.50%) and severe anxiety (32.4%) predominantly. The study also found that only the level of education and professional engagement affected depressive symptoms and severe anxiety. Having a high level of education was a protective factor for depressive symptoms and severe anxiety compared to lower level education, while being a healthcare worker (HCW) and military professional were identified as risk factors for depressive symptoms and severe anxiety compared to the general public.
  • A study conducted among undergraduate learners of English language in Sri Lanka found that the anxiety levels of female undergraduate learners and the male undergraduates have no substantial difference; however, it was also disclosed that female learners were more enthusiastic in learning English as a Second Language when compared with the male learners. The study reveals that the learners from the both gender groups possess a significant level of anxiety due to the requirements of the job market and as most of the courses in Sri Lankan universities are carried out in English.

Lack of Research

The research on anxiety in Sri Lanka is still in its early stages. More research is needed to understand the full extent of the problem and to develop effective prevention and treatment strategies. 

Some of the challenges to conducting research on anxiety in Sri Lanka include:

  • The stigma associated with mental health problems
  • The lack of data on the prevalence and incidence of anxiety disorders in Sri Lanka
  • The limited amount of research on specific types of anxiety disorders

Resources

  • Mental Health in Sri Lanka (2022). World Health Organization.
  • Anxiety Disorders in Sri Lanka: A Comprehensive Review (2016). Abeysinghe, A.M.S., & Wijeratne, L.D.S.
  • The Impact of the Civil War on the Mental Health of Sri Lankans (2017). Chandrasiri, S.
  • Anxiety Experienced by Adult ESL Learners in Sri Lanka: A Case of First Year Undergraduates of University of Peradeniya (2023). Ratnayake, J.C., & Ekanayaka, E.M.P.
  • Depression, Anxiety and Stress Among Undergraduate Nursing Students in Sri Lanka (2022). Rathnayake, S., & Ekanayaka, J.
  • https://capmh.biomedcentral.com/articles/10.1186/1753-2000-4-10/metrics
  • Gunarathna, TMIM, Madumali, PHIK, Inoshi, D, Lasanthi, GDC, Gamage, SD, & Senarath, NSASN*. (2023). Prevalence and factors associated with stress, anxiety, depression among undergraduate nurses in KAATSU International University (KIU), Sri Lanka during COVID-19 pandemic. Sri Lankan Journal of Nursing, 18(3), 1-10.
  • Darshi Sundarapperuma, Thamudi, Kodagoda Gamage, Madushika Wishvanie, Rathnayake, Nirmala, Weeratunga, Eranthi Bimalee, & Jagodage, Hemamali Madhushanthi Hirimbura. (2022). Psychological disturbances encountered by the healthcare professionals, military professionals and general public in Sri Lanka during COVID-19 pandemic: a cross-sectional study. Journal of the College of Community Physicians of Sri Lanka, 53(3), 237-244.
  • Weerakoon, I., Zhang, Z., & Maniam, V. (2023). A systematic review of sources of English language anxiety. Sri Lanka Journal of Social Sciences and Humanities, 3(1), 117-125.
  • Amunugama, AMWDGK*, & Wickramasinghe,WADDU. (2022). Second language anxiety among undergraduate learners of English language in Sri Lanka: a gender based study. Journal of the University of Kelaniya, 16(2), 1-10.