Age of (Even More) Anxiety

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by Daniel DeNoon
Oct. 16, 2002

The D.C. sniper. Bioterror. West Nile virus. Sept. 11. War abroad; terrorism at home. The threats and traumas multiply, yet there's little we can do about them. It's the age of anxiety.

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It started building long before Sept. 11. A recent study showed that Americans reported much higher levels of anxiety in the 1990s than they did in the 1950s. By the 1980s, normal children had higher anxiety levels than psychiatric patients tested in the 1950s.

Douglas Mennin, PhD, director of the Yale Anxiety and Mood Center, specializes in the study of worry and generalized anxiety disorder.

"We have been seeing an increase in people with anxiety, especially those with pre-existing worries," Mennin says. "The sense of security people feel has been decreased. Some people are still OK -- they have good coping mechanisms to deal with this. Others have been pushed a little farther over the edge and are not able to cope with what is going on."

Bob Rosenblatt, PhD, is a private-practice psychotherapist in Washington, D.C. He says the ongoing sniper attacks have added fuel to an already-raging fire.

"In the Washington area, we are not healed from our experience of Sept. 11," says Rosenblatt. "This event sort of jacks everybody's anxiety level up another notch. My patients are talking much more about their sense of vulnerability and about being more scared."

Craig Katz, MD, director of psychiatric emergency services at New York's Mount Sinai Medical Center, notes that other periods of U.S. history have been full of terrible acts of war and terrorism. But he agrees that these are the most anxious of times for the current generation.

"My generation never knew this kind of anxiety before, but it is not new for us, or for New York City, or for Washington, D.C.," says Katz. "Many generations are confronted with very real threats and stresses. The fact we don't even remember them any more is a good sign -- it demonstrates our resilience. This is the crossroads we are at now."

The Face of Anxiety

New or not, the anxiety is real. Yet most people don't focus their fears on snipers or terrorism. In times of stress it is everyday life that can begin to seem overwhelming.

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For some 23 million Americans, anxiety is more than a simple case of the nerves.

Here's what it's like having an anxiety disorder.

"Typical worries become torqued up," Mennin says. "If people were worried about their relationships or jobs or finances, these are the worries that become worse."

It may not be a nice feeling, but anxiety in and of itself is not a bad thing. Rosenblatt says that normal anxiety motivates people to take actions that can protect themselves and their loved ones. What he calls "neurotic anxiety" makes a person unable to act.

"Natural anxiety helps you make good decisions about how to live your life and pay attention," he says. "Neurotic anxiety has you hiding under the bed or giving up your normal activities."

Worrying isn't necessarily bad. We're supposed to worry when the going gets tough. It's a natural process. But there's a line that's easily crossed.

"When a person worries more of the day than not, and more days of the week than not; when it is starting to make it difficult to carry out daily activities; or when it makes the day so stressful you have no energy left, it is time to seek help," Mennin says.

How much worry is too much?

"The question to be asked is, 'Do I really need to be losing sleep over this?'" Katz says. "'Is it serving me if I don't go to sleep? Do I really need to be up at the window looking out?' If you are having sleep problems, appetite loss, problems with energy -- how much is this bothering you? If anxiety is getting in the way of going about your daily life or worrying you so much you can't stop, it is time to seek help."

Katz stresses that seeking help doesn't mean defeat. These are hard times. Sometimes it takes a helping hand to get by.

"Getting help doesn't mean you have a psychological condition or that you're crazy," Katz says. "If you have a physical trauma that breaks a bone, it doesn't mean you have some pathology. It just means you need first aid. So for an emotional trauma, there is psychological first aid -- something to help you get through this."

Mennin notes that both psychotherapy and drug treatments are equally effective. As a clinical psychologist, he advises people to try therapy first. Rosenblatt says that people often have the wrong idea about what therapy is for.

"So many people come to a therapist or counselor to help them get rid of their anxiety," he says. "The therapist's job is not to do that but to help people cope with anxiety. Anxiety is a fact of life. We are concerned about the people we love dying and getting sick, about our jobs and homes and what's going on in the world. The therapist's job is not to make anxiety go away but to help people deal with it and go on in their lives in the best way they can. You help them cope with their anxiety but you can't eradicate it."

Coping with Anxiety

There's a lot one can do to deal with anxiety. All of the experts say that activity is the most important thing.

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"Worry serves a purpose -- it pulls us away from the immediate experience of the problem," Mennin says. "We run things in our head, but we don't act. People who worry all the time are always in their head. That is the problem. We have to move on with our lives. That's how we are able to live in times of uncertainty. That is the skill we learn. People have done this throughout history."

Katz says the most important thing is the serenity prayer: a focus on finding the strength to do what one can and on finding the serenity to let go of the things one cannot do.

"Anxiety is all about the feeling that something is going to happen -- when is the next shoe going to drop," he says. "Remind yourself that you are an empowered, capable individual."

The good news is that coping with anxiety makes us better people.

"These are difficult times," Mennin says. "People should recognize that life is tough but not become immobilized. We are built to withstand a lot of worry and pressure. It will make us stronger. Anxiety is around for a reason. If we didn't have it we would be in trouble. It is a signal, but it is just a signal, not an illness. Anxiety disorders happen when people respond poorly to that signal."