Rich countries have higher rates of anxiety than poor countries, according to a large study just published in JAMA Psychiatry. And in findings that surprised even the researchers, people in wealthy countries reported that their anxiety interfered in their daily lives more so than anxious residents of lower-income nations.

Researchers from the WHO World Mental Health Survey Consortium analyzed 150,000 interviews in 26 countries over 12 years to see how many people in each country exhibited symptoms of generalized anxiety disorder, or GAD. GAD, as STAT explains in a post about the findings, is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as “excessive and uncontrollable worry that affects a person’s life.”

Australia and New Zealand topped the list with the highest lifetime rates of GAD at 8 and 7.9 percent, respectively. The United States had the third-highest rate, at 7.8 percent. Nigeria and Shenzhen, China, considered lower-income in the study, had drastically lower rates — .1 percent and .2 percent. Even more surprising is the fact that higher-income anxiety sufferers rated anxiety’s effect on their day to day functioning as more bothersome than lower-income anxiety sufferers.

The researchers offer a few necessary caveats. First, it’s possible that the real numbers (in wealthy and poor countries) are higher than reported — not everyone is comfortable disclosing that they struggle with anxiety. Second, cultural norms could potentially lead to low disclosure rates in lower income nations where openness around mental health issues may not be encouraged, as STAT explains. Remember too that worries are relative and that sources of anxiety differ no matter where you live.

Nonetheless, the study is an important step to understanding how anxiety manifests around the world, which is essential for developing better prevention and treatment options. “We’re trying to make the case with these data that this is a disorder that is reasonably prevalent and associated with a substantial role impairment,” according to lead author Ayelet Meron Ruscio, a psychology professor at the University of Pennsylvania.

Adding more science to the conversation around mental health can raise awareness and help destigmatize mental health issues. It’s important, if you’re able to, to speak up or seek help to address anxiety that interferes with your daily life — finding ways to cope is essential to your mental and physical well-being.

Read more about the findings on STAT.

Originally published at journal.thriveglobal.com