Our Daily Friend in Disguise: Anxiety in the 21st Century - Part I
The rise of mental disorders - including worry and anxiety - is becoming a social phenomenon that is drawing the attention of scholars from different academic and praxis fields - such as sociology, behaviour science, psychobiology, neurobiology, therapeutic studies, and other fields. In this article I will refer to one specific tendency that in some situations can develop into a mental disorder: the tendency to be anxious, which many of us feel, especially during this pandemic time. But as somebody once said: this pandemic didn’t create problems, it just magnified what was already there. Of course, the covid19 pandemic and lockdown accentuated many symptoms in our society, and anxiety is only one of them.
Anxiety has been recognised as a fast growing tendency in the past few decades.
The phrase “we are living in an anxious age” has become mainstream in our days. We are concerned and worried about global issues, life, work, health, well-being, injustice, our personal lives, our precious ones, as well as our career, the best outcomes of a project, and in general about our future. Many of us also find ourselves anxious, even if not permanently, at least more often than we would like to be, in dealing with challenges.
The World Health Organisation has done a global research in 2015 (published in 2017) on “Depression and other Common Mental Disorders”(1). This research revealed that mental disorders are on the rise and becoming a significant global health issue - with the rise in anxiety being one of them. The prevalence of anxiety disorders globally and regionally estimates the total number of people living with anxiety disorders to be 264 million in 2015, globally. This represents a 14.9 % increase since 2005.
According to the WHO document: anxiety disorders refer to a group of mental disorders characterised by feelings of anxiety and fear, including generalised anxiety disorder (GAD), panic disorder (PD), phobias, social anxiety disorder (SAD), obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). As with depression, symptoms can range from mild to severe. The duration of symptoms typically experienced by people with anxiety disorders makes it often a chronic rather than episodic disorder. Researchers also looked at how this disorder affects general health conditions in people and they found that common mental disorders lead to considerable losses in health, wellbeing and functioning. These losses can be quantified at the population level by multiplying the prevalence of these disorders by the average level of disability associated with them, to give estimates of Years Lived with Disability (YLD).
Anxiety disorders are ranked as the 6th largest contributor to non-fatal health loss globally and appear in the top 10 causes of YLD in all WHO Regions - African Region; Eastern Mediterranean Region; European Region; Region of the Americas; South-East Asia Region; Western Pacific Region. According to this research in 2015 in Europe, the Netherlands had the highest number of anxiety disorders, with more than 1 million cases (6.4 % of population). Norway had the highest rate of anxiety disorder per population - with a total representation of 7.4%. It seems like we are dealing with a significant growth of anxiety in the past 10 years.
Anxiety is defined by Cognitive Behavioural Therapy as a call to action generated by a perceived threat. Note that this is a perceived threat, not an immanent threat. In her book 'Don’t Feed The Monkey Mind', Jennifer Shanon (2) who is a behavioural therapist and struggled with anxiety disorder herself describes it as a monkey who is always chattering “Ooh! Ooh! There is something wrong … do something!” In order to overcome anxiety she invites her readers to picture it as a monkey rather than as a monster, that makes you feel powerless. This way you won’t feel overwhelmed by your anxiety feelings and could distance yourself from them. This process is called diffusion, in behavioural therapy - separation, distancing from the part of you that over-reacts and regaining the ability to rationalise. In other words anxiety should not define you it is a part of you from which you can dissociate. For Shanon, anxiety is rooted in an inherited over-reactive nervous system. This means that some people are wired to worry more often and be anxious therefore more susceptible to develop anxiety disorders.
Dr. Kathleen Smith(3) is a therapist who uses the Dr. Murray Bowen (psychotherapist) theory that doesn’t focus on mental illness but rather on the challenges of being human in the relationships which affect them. In particular, she seeks to understand the patterns of managing anxiety in families that became instinctive (4). One way of managing your anxiety is a life long process of building a solid principled self by observing your anxious behaviour, evaluating it, and interrupting your auto-pilot (meaning your anxious functioning).
At the root of these approaches to dealing with anxiety is self-awareness, being conscientious, as well as calming techniques from yoga and meditation. The author calls this process differentiation - which is focussing on managing your self, your emotions (basically to stay calm) instead fear of, and also managing other people’s expectations and reactions to you, or your acts/behaviour, or your decisions, etc..
Another way of dealing with anxiety is to build resilience. Resilience is the capacity of dealing with feelings and thoughts linked to complex, difficult, or unexpected situations and circumstances we encounter. The ability to recover quickly from adversities and accommodate unfavourable situations is often coined as being anti-fragile. This ability is something that can be trained by developing certain patterns of thinking that help us get through. What attitude I have towards adversity and what significance I give to events is essential in building resilience. This is the opposite to panic or stress. In order to build resilience one can follow 5 steps:
- control your attitude more than controlling other people and events;
- ask help from other people;
- focus on finding solutions not complaining;
- take care of your self (work-rest balance, relaxation, giving up vices, making time for your hobbies, etc…)
- don’t despair, don’t lose your hope (“ the greatest dark is right before the sunrise”)
It is amazing how much the human sciences and brain sciences have advanced, developing different approaches in therapy, in methods, in techniques, and also in treatments for mental disorders. This is the perspective from one side. There is also the perspective of how different religions have developed spiritual practices to deal with anxiety tendency and disorders. Different people witness different solutions being efficient for them in their battle with anxiety. Many of those theories especially psychobiology have roots in the evolutionary theory of origins of human beings. The assumption is that in pre-historical times humans had to deal with life dangers on daily bases in order to survive physically - so we developed a neurological pattern and an autopilot mechanism against danger and life threats. Neurobiology describes our brains response to danger in 3Fs - fight, flight, or freeze. This is usually how we tend to react to situations that our brain perceives or clearly see as dangerous and/or associated with pain. This is an amazing mechanism that helps us to protect ourselves and our precious ones when there is a real danger. This way we keep ourselves out of trouble - not walking over the edge of a terrace on the 30th floor of a high-rise building, or equally protecting a child from a busy and dangerous road. The problem arises with our tendency to react the same way to perceived or imagined threats - and when this alert state of mind is triggered and persists, it can lead to permanent worry, feelings of anxiety, and even develop into anxiety disorder(s). As with other mind disorders or physical diseases, anxiety can be cured, might be difficult to cure, or may remain uncured.
One of the uncured examples is described by Pierce Taylor Hibbs in his book on anxiety in which he reveals his struggle with anxiety in the form of panic attacks. “I’ve gone from lying in the foetal position, convinced I couldn’t leave my room without dying to taking a train into Philadelphia by myself for jury duty. I’ve gone from being paralysed by fear because of a thirty-minute commute to watching God work through my nerves in a six-hour traffic jam. I’ve gone from refusing to attend events with large groups of people to praying intensely for those surrounding me in public places. Don’t get me wrong—I still struggle. Many things still draw out my anxiety, but I’ve seen God do so much through it that I can say without hesitation: “God, I’m okay if you keep using this.” (5)This is a story of dealing with anxiety and trying different cures - such as therapy, drug treatment, as well as working it through by faith with prayer and spiritual discipline, not ridding myself of anxiety but rather learning how to live a meaningful life.
I would call anxiety our disguised friend. It is like a friend (or relative) who thinks they know better than you what you should do in a certain situation. They want to give their advice and persist in doing so - not realising that they are actually giving you a dis-service (like the saying: “Shall I help you or better not interfere?”)
It is certainly not wrong to be concerned or worried about our safety, security, outcomes, relationships and to strive to prevent or avoid as much as possible things that could be a threat or danger - whether physical, relational, in our work, in our business/project successes, our professional careers, our financial situations etc. Still - the enormous paradox of our age is that anxiety is growing in the very population group and ages where relatively few daily threats or real threats are experienced. Unlike life for our prehistoric ancestors, we have easier lives, relative access to food, and many of us have work - compared to a few decades ago even, due to the enormous advances in science and technology, in good health care, in disease control, in safe means of transportation, and basics such as fire alarms as well….when else has it been so (relatively) easy to get everything?
“Some say that anxiety is excess future, depression is excess past and stress is excess present.” (6)
It seems like we are more and more concerned about an unknown future, in our generation. There are scholars who suggest that pollution and a bad environment may be the causes of growing anxiety. Others blame it on our life style. Others also consider that although many of the physical threats our ancestors faced have been reduced or ruled out, more abstract threats have replaced them: including worries about the economy or our environment, anxieties about our appearance, our social standing & professional success (7).
As Christians, we also need to front up and deal with mind disorders, as we are not immune to these. We too are concerned about people, we love our family and friends, we love to be loved, we go to work, we want to do our best, we want to build a professional career and to bring christian influence, we want to share the gospel and to be accepted as Christians in our society, we want to live long and healthy lives. All these challenges imply possibilities for both success and failure, gain and loss, life and death - and these worries can stack up to reach levels of (chronic) anxiety.
What then does the Bible say about to anxiety? Does it say anything at all? Can we consult the Bible in our ‘age of anxiety’? Is there any overlap between what medicine, health care and human sciences have to say and what the Bible contains on the topic? How as Christians are we to respond to anxiety in our own lives, and in the lives of our precious ones?
Read more about this in Part 2 - coming soon!
(2) Don't Feed the Monkey Mind: How to Stop the Cycle of Anxiety, Fear, and Worry, Jennifer Shanon, 2017, New Harbinger Publications
(3) Everything isn’t terrible. Conquer your insecurities, Interrupt Your Anxiety, and finally calm down, Dr. Kathleen Smith, Hachette Books, NY, 2019
(5) Struck Down but Not Destroyed: Living Faithfully with Anxiety, Pierce Taylor Hibbs, Independently published, 2020
(6) Julian Melgosa and Michelson Borges, The Power of Hope - Overcoming Depression, Anxiety and Stress, 2017, Review and Herald Publishing Association
Cover photo: Egin Akyurt on Unsplash