High Anxiety

On July 19, 2015 an article titled The Anxious Americans was found in The New York Times. According to the article, about one in five or 18% of Americans are anxious, have an anxiety disorder diagnosis and spend over $2 billion per year on anti-anxiety medications. Not only that, but in 2002, statistics from A World Mental Health survey [14 countries were studied], found that Americans were the most anxious people-had clinically significant levels of anxiety higher than even individuals living in Nigeria, Lebanon and the Ukraine.

In 1924, Otto Rank postulated that the trauma of birth was the first experience of anxiety and was prototypical of future anxieties. Even if that’s not true, anxiety [an emotional state associated with apprehension or dread] is certainly experienced beginning in infancy, as a result of and during the child rearing process. Anxiety can be a realistic fear response of something painful. It is a signal of potential danger in which Freud hypothesized that the ego attempts to avoid. Further, anxiety or tension can be the result of an internal impulse or state, signifying a conflict between the ego ideal, the image of the ideal self-versus the image of the real self or the result of something in the external environment-like a sound of a shooting gun.

Many believe that anxiety can be found in the unconscious, and that inner feelings themselves cause this emotional state. Alfred Adler, for one, suggested that infant’s experience helplessness. And that feels like a sense of inferiority which leads to the will for power-superiority. And that the goal and lifestyle of the individual reflects that dynamic. Karen Horney suggested that anxiety is the most painful experience a person can have and must be avoided at all cost. These feelings originate as a child experiences being isolated and helpless and is driven toward security and safety. Thus, anxiety is all pervasive, hidden and subjective.

Having an anxiety disorder diagnosis is associated with motor tension- shakiness, or inability to relax; autonomic hyperactivity- sweating, heart pounding, dry mouth; apprehensive expectation -worry, fear, anticipation of misfortune; vigilance and scanning-hyper attentiveness, difficulty in concentration, irritability. Of course, we have a great majority of physical and mental health experts, a huge insurance-based industry, along with the gigantic pharmaceutical complex with plenty in our pill popping quick fix culture.

We know that there are many parenting styles and philosophies regarding child rearing, and that many say they intend to rear their child differently than they were. Of course, these parents are likely both employed working long hours in an economy that favors some. These anxiety-guilt driven individuals more than likely are overprotective and overindulge their remarkable-special children who can become anything they desire. The cliché spare the rod and spoil the child often fits and describes the parenting philosophy or pattern of behavior. Could imperfect parenting, working long hours and making lots of money be associated with this diagnosis?

Certainly, we have to add war, terrorists and poverty to the anxiety-medication diagnosis equation. Members in our government play a role in the perpetuation of these issues and then tell us they are here to protect us from these dangers. Unfortunately, more bombs, guns. bullets, and the talk of Second Amendment rights do little to mitigate the pain. Nor does alcohol, drugs, and electronic games, professional sports, movies, solve the problem even though it does help with the distortion of reality. Even our defense mechanism of repression does not totally protect us from our internal emotion.

Some might say that our philosophy of the mind is the issue. They would point to the self-help industry, which teaches us to pay attention to our inner experience if we want to succeed and be happy we need to know how we feel according to the Stanford professor T. M.Luhmann. He goes on to point out that Americans believe that excessive sadness is a cause of sickness. And research in 1980, demonstrated that Americans associated chronic pain with depression. However, in China, receiving treatment for bodily pain was permissible and was not related to some inner mental state. This anthropologist interviewed people with schizophrenia. And in our country, if you hear voices that meant you were crazy. However, in India, the woman with active hallucinations was not at all worried about her emotional state. The professor’s point was that the way we think about our mind might explain our overuse of anxiety medication.

This anthropologist is also suggesting that different cultures, different societies also explain differences in mental health treatment. He talks to a third world country woman about apparent hallucinations [His credibility is what?-Where does he get his expertise?] He reported that this woman was fine with whatever she was experiencing. Perhaps in a Third World country, one can have different psychological experiences than a person in a high functioning school educated, high stress, and work environment milieu. The level of functioning in our country and society is different, compared with an agrarian-based society with high unemployment, poverty, etc. Let’s compare strawberries with strawberries and blueberries with blueberries. Further, allow this anthropologist to remain within his own field of expertise.

In my opinion, part of the problem lies within our pharmacy-based health insurance industry. Psychotherapy visits are considered too expensive and so insurance plans of today have limitations as to the number of therapy visits per year. The industry does not have limits as to the number of pills that can be prescribed. Pills are better for the pharmaceutical industry and for the insurance industry. Monitor the medication. It’s quick, easy and familiar.

The causes in learning how to deal and confront our internal and external fears require therapeutic work. Not all people are psychologically minded or are good candidates for psychotherapy. I grant that. The fact that psychotherapy and medication is more effective than medication alone is irrelevant. The key variable is cost. Cost to the insurance industry and their partner the pharmaceutical industry. These two elements rule and prescribe the level of treatment. It’s a shame that more money- funds are not spent on therapy research. We certainly don’t want to know the answer. Somebody might want to make changes in the treatment of anxiety. I still think Socrates was right “Know thyself.”