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Richard Kyte: With anxiety levels spiking, it's time to look at the cause

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Last week the U.S. Preventive Services Task Force, an advisory panel that provides healthcare screening guidelines, recommended that all adults younger than 65 be screened for anxiety. Earlier this year they recommended anxiety screening for youth.

The historic rise in anxiety levels is especially acute among young adults. According to the National Survey on Drug Use and Health, anxiety increased from 8% in 2008 to nearly 15% in 2018 among 18- to 25-year-olds.

Anxiety is a significant and urgent health problem. Getting a handle on it requires diagnosing cases earlier so they can be treated. The catch is that behavioral health is woefully underfunded, and providers are overburdened. Counseling services in most schools and universities have reached their limit. When students are referred to outside services, they often find themselves on a months-long waiting list for an initial visit.

The more one studies the situation, the more it looks like increasing screening and hiring more therapists is a losing game. It’s like bailing water out of a sinking boat. At some point, you have to fix the leak. The big question is: What is causing the rising rates of anxiety?

Those experiencing anxiety point to things going on in their lives or out in the world, such as discrimination, harassment, trauma, health, safety, finances and politics. But people have always faced severe difficulties, and it’s just not true that things are objectively worse today than they were for previous generations.

Perhaps we should look at the ways we think about things instead of the things themselves. What if the reason for rising rates of anxiety is not that things are getting worse but that we are getting worse at thinking about things in constructive ways?

A study published last year in the Proceedings of the National Academy of Sciences reports that cognitive distortions — patterns of thinking associated with anxiety and depression — have surged in the last few decades. The authors speculate that our society may be undergoing a collective depression.

Anxiety does not just happen because there are stressors in a person’s life. Anxiety is what is known in psychology as an internalizing disorder. There is a fault in the way one processes incidents, and that results in various forms of distress, from worry and fear to episodes of insomnia and panic attacks.

The best way to deal with an internalizing disorder is through the cultivation of mental discipline. But that takes time and practice. A person who spends years cultivating a self-image that depends on things turning out the right way and people seeing them the way they want them to, shouldn’t be surprised when their lives fall apart. All the king’s therapists and all the king’s counselors won’t put them back together again.

At one point in time, it was assumed that developing mental discipline was an essential part of education. That is after all, why the various branches of academic study are known as “disciplines.”

But in recent decades two things have happened. First, our educational system has elevated STEM fields and professional studies such as health care, business, law and education. What they all have in common is learning how to manipulate and transform the outside world. At the same time, the areas of study that traditionally taught young people how to develop internal discipline — philosophy, religion, literature and the arts — have been declining and changing their focus. Increasingly, the humanities seek to maintain relevance by focusing on subjects like “applied ethics,” “cultural studies,” “women’s studies” and “professional writing,” most of which have an external focus.

The result is that we are gradually getting better and better at transforming the world outside our heads at the same time that we are getting worse and worse at controlling the thoughts going on inside them.

One sign that we are losing our minds is the fact that wellness is now a $4 trillion industry. People know something is wrong and are grasping at solutions. The marketplace is happy to provide those solutions in the form of essential oils, biohacking, facial exercises, fitness apps, yoga classes and detox regimens. It’s not that any of these things are bad, it’s just that they don’t address the root of the problem. Exercising, for example, will certainly make a person feel better, but it won’t fundamentally change the way they think about things.

The problem, as the Stoic philosopher Epictetus pointed out nearly 2,000 years ago, is that the more we focus on changing the world around us to make us feel better, the more we feel emotionally tethered to it. If our emotional life is bound too closely to the circumstances outside our heads, then no matter how much better we make things, we will always feel as if we don’t have control over our lives.

There will always be those who experience severe forms of anxiety and need therapy to help them cope with their affliction. But when we see a huge increase in anxiety levels across the population in a relatively short period of time, that’s a clue something is seriously wrong.

The chief cause of anxiety is not what happens in the world but the way we think about what happens. Fortunately, that’s something we can control, and we have centuries of wisdom to help us do that better. We just have to turn to it once again.

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