Anxiety is the most common psychiatric complaint, and has its causes in a malfunctioning of our prehistoric fight-or-flight response. Daniel Smith has written a book about the anxiety epidemic, after suffering for decades with a complaint that’s cruellest effect is shutting down our ability to love, writes Lynne Malcolm.
New Yorker Daniel Smith has lived with chronic anxiety for most of his life—well, at least since he was 16, after he lost his virginity to two older women.
Yes—some young men may not think that was so bad, but it launched Mr Smith into his first period of acute, constant, ‘seize-you-by-the-shirt-lapels’ anxiety. The truth is, as Mr Smith writes in his book Monkey Mind: A Memoir of Anxiety, anxiety disorders can be triggered by just about anything.
Anxiety is by far the most common psychiatric complaint—with double the sufferers of depression. An anxiety disorder involves a degree of distress caused by unjustified, persistent worry: obsessive compulsive disorder, agoraphobia, social anxiety, hypochondria and panic attacks.
‘It feels when anxiety is really acute as if anything around you is a terrible threat to you, catastrophe is about to befall you,’ Mr Smith says.
‘Anxiety is a state of nervous vigilance. You look around for the source of it; it could be anything. It could be the sandwich you’re eating for lunch, it could be the person that you’re living with, it could be the job that you’re in the middle of trying to do.’
Some level of anxiety is normal in humans, Mr Smith says. ‘[I]f we hadn’t been anxious when we were evolving on the African plains lions would have eaten us. And if we weren’t anxious now we would get burned by the hot stove more often than we do, or get hit by cars more often than we do.’
But it’s important to distinguish between normal day-to-day worry and an anxiety disorder, in the same way that we distinguish between a diagnosis of depression and just feeling a bit down. When anxiety starts to control your thoughts rather than you controlling them, it’s a good idea to get help.
Dr Paul Morgan from Sane Australia says that for patients with anxiety disorders it’s often the case that chemical messengers associated with the flight-or-fight mechanism have gone haywire.
‘It’s as though there’s a big red button inside your brain that says “Panic, get the heck out of here,” and this button has somehow got stuck down when you have an anxiety disorder and your brain is going: “It’s an emergency!”’ Dr Morgan says. ‘It’s an emergency but it isn’t.’
Environmental stresses—including the pressures of everyday life—also play a role. And while our modern standard of living is better than ever, it can be argued that the super-abundance of choice in modern life is particularly anxiety inducing, Mr Smith says.
‘It seems comic, but we are met with so many choices now. The internet has broken this wide open; there are so many options and the result is very often a sense of paralysis and a kind of extended adolescence. If I choose one thing I am closing off a thousand other lives and that can be very terrifying.’
Even so, he doesn’t think we live in ‘The Age of Anxiety’.
‘I did a little reading up on the fourteenth century, which was a period in which people’s uneasiness spiked terribly for very good reason: there were roving hordes of mercenaries in the countryside; there was the black plague, which wiped out nearly 50 per cent of the population of Europe; there was a traumatic schism in the church; there were all sorts of terrifying things going on—war, famine. Now that produces anxiety.’
Mr Smith says that the worst thing about an anxiety disorder is the inability to love—the sense of being locked into oneself. Very often people experiencing anxiety are so distressed that they look for someone to blame, and that person is usually a family member or loved one.
‘People often ask me, “What can I do for my brother, my wife, my husband, my child who is anxious?” And it pains me to have to say nothing. It’s that person’s responsibility or it’s up to that person to learn new ways.’
Dr Morgan has also had personal experience of an anxiety disorder. He says he’s always been a bit of a perfectionist and slightly obsessive from childhood—but he developed chronic anxiety many years ago, when he was working very hard on a project and put himself under a lot of pressure. He began to obsessively worry about anything and everything and felt strangely guilty for no rational reason. Eventually he realised he needed help and got a referral from a GP for some therapy. He says it changed his life.
Dr Morgan says that sometimes anti-anxiety medications, which are called anxiolytics, are prescribed if the person is so severely affected by anxiety that it causes them extreme distress, but caution should be taken because of potential side effects and the risk of developing a dependency. He says they should only be prescribed for short-term use and that psychotherapy is by far the best long-term treatment.
Despite having ‘as many therapists as King Henry VIII had wives,’ Mr Smith was finally able to find a therapist who helped him manage his anxiety: a practitioner of cognitive behavioural therapy, which teaches techniques to change unhelpful and destructive thought processes.
‘[W]hat you have to do is find a way—find a discipline—to change that pathway, to carve out a new pathway, and to keep doing that practice probably—for someone like me—forever,’ Mr Smith says.
And when that fails, he falls back on the advice from his brother, who made a chance suggestion a few years ago which Mr Smith was at first sceptical about.
It was to listen to the soundtrack of the beautiful Hollywood romance Singin’ in the Rain with Gene Kelly and Debbie Reynolds.
Listen to more on anxiety and its neurological and environmental causes with Lynne Malcolm on All In The Mind.