Can America’s most common affliction be a force for good?
By Laura Turner
(Photo: Sodanie Chea/Flickr)
When it’s three o’clock in the morning and you’re anxious, the whole world doesn’t exactly fall apart, but stretches endlessly before you. On one such night recently, I sat in a ball on the desk chair in my home office and breathed rapidly but quietly, so as not to wake my husband sleeping in the next room. My mind, incapable of holding one thought for more than a few seconds, communicated in zaps and bolts that traveled down my spine. A car drove by outside and I thought about how much I would have liked to trade places with its driver, with anyone who was awake at this hour not because they were panicked but because they were leaving a club or driving to work or taking their infant around the block in a last-ditch effort to get them to sleep. San Francisco was dark and still outside my window, but inside, I was suffering.
In America, 40 million people live with some form of anxiety. It ranges from the annoying to the completely debilitating, varying from person to person and from day to day. It affects women almost twice as much as it does men. Economists estimate that our collective anxiety costs billions of dollarsin missed work and distraction every year. The relational and cultural costs are harder to estimate, but they exist and cause their own problems. Anxiety takes many forms, some of them contradictory: neediness and aloofness, empathy and disregard. But most of all, the shape of anxiety is fear. And we don’t live in a culture that encourages us to understand our anxiety. We are told to get over it, or else to use it as fuel to motivate us toward the more capitalistically appropriate goal of “success.” I once saw a therapist who told me to take my anxiety by the hand every time it popped up and walk it out the door. “Just keep doing it,” she nodded at me, “and eventually, it will stay out.” I tried this trick for hours, but the anxiety came back immediately after each dismissal. Ironically, in this case, trying to get rid of anxiety kept me from getting any work done.
There is an American obsession with productivity that has infiltrated how we deal with anxiety. In recent months I’ve come across a spate of articles advising that people, by some alchemical turn, spin their anxiety into something better, more useful. “Turn Your Anxiety Into Productivity/Success/Excitement,” business-minded headlines declare.
The Anxiety and Depression Association of America estimates that “anxiety disorders cost the United States more than $42 billion” annually in lost revenue or health-care services. Our first instinct is to solve for the $42 billion, not the anxiety.
I worry that I am only as valuable as I am productive. A recent bout of sickness kept me in bed for nearly a week and inspired a handful of panic attacks focused on my lack of productivity. Stuck inside without even the ability to write a coherent sentence, I felt my own worthlessness as near to me as the yellow bowl I kept by my bedside for occasions when I couldn’t make it to the bathroom to throw up. To be productive is to have constant justification for existing: See? I did this. I’ve earned another day. If I can outwork my anxiety, perhaps I can outsmart it, outstrip it, outrun it.
In a capitalist society, every individual is worth as much as he or she can produce. In light of that, it makes sense that we would want to turn anxiety into something productive. The Anxiety and Depression Association of America estimates that “anxiety disorders cost the United States more than $42 billion” annually in lost revenue or health-care services, and our first instinct is to solve for the $42 billion, not the anxiety. Hence all the tricks meant to spin an anxious yarn into productive fabric.
Paradoxically, the only thing that helps me with my anxiety is to accept that it is something I will struggle with for most, if not all, of my life. When I was growing up, my mom used to tell me that everyone has three words — three things that cause them pain and growth consistently throughout their lives. Anxiety is one of mine. Acknowledging and accepting my anxiety is a little bit like going through a tunnel: It’s dark, constricted, and occasionally terrifying, but what’s the alternative? Staying put? Climbing a mountain while pretending the tunnel wasn’t there all along? I don’t need to turn my anxiety into something else for it to be worthwhile.
Anxiety isn’t all bad, and can be instructive if we will let it. I am convinced that part of the reason we try so hard to tell people to get rid of their daily anxiety is that anxiety is, more often than not, a female affliction. Since it’s more common than depression, we would expect anxiety to have generated a similar — or even larger — amount of literature and attention. But the reality is that you could build a fortress with the number of depression memoirs that exist and have a really hard time finding even a brief history of our understanding of anxiety. We glamorize the men who have suffered depression articulately — William Styron, Ernest Hemingway, F. Scott Fitzgerald — but dismiss anxious women as “nervous Nellies.” A series of 2008 studies revealed that women were more likely than men to have their heart attacks misdiagnosed as a symptom of anxiety. Women are nearly twice as likely to experience anxiety than men, and girls are more likely to develop anxiety disorders than boys as they enter adolescence by a factor of six to one.
“Fabulous women are often anxious,” Audrey Gelman tweeted earlier this month. Gelman is fabulous by any account: A public relations consultant who worked on Hillary Clinton’s 2008 presidential campaign and has helmed other political campaigns for Democratic causes, Gelman has also been featured in Vogue and Vanity Fair before she was even 30 years old. What we don’t talk about is how frequently, in order to become fabulous — productive, admired, accomplished — women are driven by their anxiety.
Anxiety is a tax on ambiguity. It’s the price we pay for living in a world of choices and constraints, and women are among our most constrained citizens. In trivializing anxiety or telling someone to get over it, we are fundamentally misunderstanding the nature of the disorder. So many of us still imagine anxiety as a preoccupation with the future that could be overcome if you would just chill out for a second — a kind of useful, preventative apprehension. But until doctors can write a prescription for chill (medical marijuana doesn’t count), we have to conceive of anxiety as something persistent, something lasting, something un-get-rid-of-able. Anxiety is a reflexive shape-shifter that can and does take many forms, mostly inhabiting the mind as fear. When a person experiences constant fear of the future, out of all proportion to the circumstances at hand, it becomes a disorder.
But it is possible that anxiety can actually be a force for good. “All our evolutionary ancestors who didn’t get anxious, they died and didn’t pass on their genes,” says Jonathan Horowitz, a clinical psychologist and founder of the San Francisco Stress and Anxiety Center. Anxiety functions as an important warning system, alerting people to potential threats. For some, it can even be an asset: “Think of a job like being a lawyer or a compliance officer or an operational executive, a lot of your job is scanning the environment to see what could go wrong,” Horowitz says. “If you’re not an anxious person, you’re going to be terrible at that job.” In other words, anxiety sufferers can find meaning in life precisely when they lean into the skill set that anxiety has given them rather than trying to transform their fears into something else entirely.
Anxiety is a tax on ambiguity. It’s the price we pay for living in a world of choices and constraints, and women are among our most constrained citizens.
Our current age rewards fractured identities: The more you can do, the better. What have you accomplished? What do you have to show for yourself? What books have you published? Do you have children? What are their grades? Do you have hobbies? To be a productive American in the 21st century is to be split into your discrete parts and analyzed for efficiency all the way down the line. Our national obsession with efficiency used to have to do with factories and assembly lines. Now it is people we want to make efficient. The trouble is, people weren’t made to be machines. We might produce a great deal of work with a minimal amount of effort, but at what cost in the rest of our lives?
Historically, moral philosophers like Immanuel Kant have conceived of anxiety as “incompatible with virtue.” But in a culture where freedom is one of the highest values, the ability to choose will have a paralyzing effect on some of us. That awareness of ambiguity gives a person a deep sense of dread, or anxiety. In his classic book The Denial of Death, Ernest Becker glosses the Danish philosopher Soren Kierkegaard’s interpretation of anxiety: “Man’s anxiety is a function of his sheer ambiguity and of his complete powerlessness to overcome that ambiguity.” In other words, our lives as people who make choices are inherently anxiety-producing. Horowitz translates this formulation for our modern times: “I think it’s fair to say that America right now is a really stressful place to live. This is a highly individualistic society,” he says. “People buy into this belief that it’s all about me, it’s all on me, I need to succeed and if I don’t succeed materially that’s a reflection on me and my character and that’s very much an American belief.”
For both Kierkegaard and Horowitz, anxiety serves many purposes, then, even good ones. It warns us when we are in danger, it reminds us to work harder when the stakes are high, and it can even make us lead better lives if we let it. Living with an awareness of death — not in a Hallmark movie way where the hero has one last day to live, but in possession of a clear mind about our mortality — can lead to a better quality of life.
So what do we do? There is someone around every corner to offer solutions — a Buddhist freedom from desire might allure some, while others suggest that the love (and accumulation) of wealth is the beginning of true freedom. I have tried every choice offered to me when it comes to anxiety, from walking it out the door to surrendering completely to fear to learning, finally, to accept it, and even at times to love it. “Your anxiety is almost like a friend who’s really well-meaning who is always telling you not to do things,” Horowitz says. Anxiety is “taking care of you,” sometimes too well, in order that you can be aware of what you might encounter on the road ahead.
My panic attacks have stopped for now, and these days I am sleeping through the night. Still, I wake up every morning with fear about what will go wrong in the day ahead, about how I will be perceived and what I will fail at. My job is to pick apart the threads of that anxiety and set aside what is unhelpful. Then, looking at the rest of it, I ask a simple question: What do you have to teach me today?