While her friends are celebrating the end of COVID-19 lockdowns and a return to parties, Annabelle has largely stayed at home.
“I don't really go out. I don't like crowds of people. I have to find friends who are willing to be OK that sometimes I'm just not going to come to things,” Annabelle says.
The 19-year-old has lived with severe anxiety since she was in primary school.
"It's in your mind and your body … Your heart is going a million miles an hour and your mind is racing," she says.
Living in regional Victoria, Annabelle’s family struggled to get her the support and treatment she needed when she was younger.
"I felt like I was failing her as a mum," her mother Loretta says.
Throughout her teenage years, the anxiety persisted, although the triggers and symptoms changed as Annabelle grew older.
In her early teens, she had frequent panic attacks.
These days she experiences more physical symptoms, like nausea, fatigue, and digestive issues.
"I'm on lots of medication, not only for the anxiety but also for the things that are caused by anxiety that have turned into other serious health issues," she says.
Over the past few years, Annabelle has been able to get professional help from a psychiatrist. And with that support, she has learned how to cope.
But Annabelle has had to adapt during a difficult time.
Anxiety has surged during COVID, but that trend isn't new
Like hundreds of thousands of young people, she has entered adulthood during the pandemic.
As COVID-19 has changed our lives, many Australians have been exposed to psychological distress like never before.
Mental health crisis lines have received record numbers of calls from people needing support, with one anxiety-specific helpline reporting a rise of over 220 per cent.
The pandemic's mental health impact has been labelled the "hidden pandemic", not just in Australia but globally too.
One international study led by researchers from the University of Queensland estimated anxiety disorders grew by more than 25 per cent worldwide in 2020.
A recent report suggests that may have since declined.
But even before the pandemic, anxiety was the most common mental health condition in Australia, with one in four people experiencing it at some point in their lives.
Over the past decade, researchers have noted young people being affected in unprecedented numbers.
Professor Wilkins is the lead author of the annual HILDA survey, which has followed the lives of more than 17,000 Australians for the past 20 years.
In its first decade, the survey showed relative stability in mental health. However, that has changed over the past 10 years.
Professor Wilkins says more than a quarter of women (27 per cent) and about 15 per cent of men under 35 now report they are living with a diagnosed depression or anxiety condition.
Young men are still battling stigma
When Emmanuel Asante started experiencing chest pains in his final year of school, it didn’t occur to him that anxiety could be the cause.
"When it first happened, it was something quite new to me," Emmanuel says.
"I was telling my teacher what I was going through and my teacher rushed me … to the hospital. That's where I was diagnosed."
The now 26-year-old reached out for support from a counsellor.
He says stigma is still a barrier for many young men.
He says sharing his feelings with others used to feel like an admission of weakness, but he now sees it differently.
Increased mental health awareness just one part of the puzzle
While reduced stigma and increased awareness are likely leading more people to seek treatment, Professor Wilkins doesn’t believe that fully explains the rising rates.
"I think part of the increase is actually due to deterioration in mental health in the community and we have some indicative signs of that in the data itself," he says.
"Some of the factors that produce poor mental health, things like financial insecurity and lack of social connectedness, those things have actually increased."
And for young people, those societal changes can have a profound impact at a critical life stage.
"And so the trends we're seeing in terms of mental distress and other mental health conditions are consistent with that.”
Emmanuel says financial struggles were the biggest factor when he experienced an anxiety relapse during Sydney's long COVID-19 lockdowns.
Like thousands of others, the professional artist lost his income overnight.
"We need an audience," he says.
"If we don't get our audience or we don't get to display our artistic talent, then how are we going to feed our families?"
Young people facing new challenges, but women and gender diverse people most at risk
While anxiety has been trending upwards among all young people, it has been particularly prominent in young women.
They are twice as likely as young men to be diagnosed with an anxiety disorder and that gender gap continues throughout life.
Biological differences, including brain chemistry and hormones, are just one reason for this, Jayashri Kulkarni from the Monash Alfred Psychiatry Research Centre, says.
Culture and upbringing can also play a significant role.
"In many cultures, including the Australian way of life, there are differences in the way women and men are taught to react or react to stress and [what are] acceptable behaviours," Professor Jayashri says.
"That can play into a more internalising or inward-looking mode of operating for women, which can predispose them to more anxious behaviours."
There are also social factors, such as the fact women face higher rates of domestic violence and sexual abuse than men, Professor Kulkarni says.
"There is an increased vulnerability in girls and women's brains that tends to have the expression of anxiety more when they've had trauma in their early life," she says.
Transgender and gender-diverse people face even higher rates of anxiety.
One 2015 study found almost 40 per cent of transgender people had been diagnosed with an anxiety condition at some point.
For young transgender and gender-diverse people, anxiety rates are even higher, with one 2017 study finding more than 70 per cent had received an anxiety diagnosis.
Not all anxiety is a disorder, but it's important to make sure it doesn't spiral
The good news is that with the right support, anxiety conditions can be treated.
The most common treatments include psychotherapy or medications, but Professor Kulkarni says it's important to find the right approach for the individual.
For many people, having strong social connections and support from family and friends can make a huge difference.
“The brain is quite malleable and so all of the different positive connections can really … improve mental health," Professor Kulkarni says.
For Emmanuel, that social support has been central to managing his anxiety, and it's a message he hopes other young men will heed.
"It could be your parents, it could be a friend. Just a little conversation, it can actually save a life."
He also finds solace in running and by expressing himself through his art.
"We are emotional beings so if we are going through things … we should be bold enough to let people know,” he says.
Professor Kulkarni emphasises that having some level of anxiety is normal and that it only becomes a problem when someone is struggling to function in their day-to-day life.
"There is an anxiety that is good for us."
While it still limits some parts of her life, Annabelle says she has come to see anxiety as a strength.
"I think it's something I'll have for my whole life and I'm OK with that," she says.
"[Because what] keeps me up thinking all night is also what makes me really good at learning and studying."
Annabelle says she has developed coping strategies, which along with medication, have helped tame the most debilitating aspects of her anxiety.
"Things that have really helped me are pottery and clay as a form of mindfulness, and I love hanging out with my dogs," she says.
And while her life may look different to that of her peers, Annabelle still enjoys plenty of activities with her friends and family, including camping and spending time at the beach.
Despite the challenges, Annabelle feels optimistic about the future.
"I'm super excited for university and the career side of life … because my anxiety fuels that in a positive way that makes me really driven and determined and motivated."
This is the first story from the ABC's Anxiety Project, a special series examining the rising prevalence of anxiety in Australia.
Keep an eye out for more stories in coming weeks.
