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“Only thing we have to fear is fear itself”
-Franklin D. Roosevelt
This phrase was spoken by president Franklin D. Roosevelt in his inaugural address in 1932 when our country was in the throes of the Great Depression and still recovering from the devastation of WWI that had ended less than a decade and a half prior. His words were prophetic as our society has now found itself more secure and healthier than ever before, yet anxiety is the next epidemic looming around the corner and is likely related to our current epidemic of drug abuse.
When you look back at history, the world was a scary place. I was recently reading about Genghis Khan and the 12th century was scary place beyond imagination. In Asia there were feudal villages and cities where being raided would result in rape, pillaging and mass murder. Genghis Khan and his soldiers would destroy entire cities, slaughtering men, women, children, even dogs and cats. In Europe, there were wars throughout Europe and one’s possessions and safety were never guaranteed. This occurred for millennia and the current security that humans enjoy is just a brief moment in our species’ time.
As we look back in our country just a couple of hundred years ago, life was no picnic. Mothers often died in childbirth. Death was always just an infection away as most people died from disease. The average life expectancy in the United States for whites born in 1850 was 39, and much of this was related to a high rate of childhood death. If you were Native American, your outlook was very bleak. Death was always potentially around the corner. You didn’t have time to think about it because all but a privileged few were working long days to meet their basic needs. Most of this was improved by modern sanitation practices.
Now let’s look at our modern society. The average citizen of the United States does not have to fear death from war or invasion. There are small threats such as terrorism. Of the 2.6 million deaths in the United States in 2014, 32 were secondary to terrorism. That is increasing recently, but we are still discussing less than 200 deaths in a year. You should be much more afraid of driving to work tomorrow than of a terrorist attack. At 44 years old, I’m probably not going to die from the flu or an abscess that takes over my body. My children don’t have to fear meningitis, polio, tetanus, etc. We live in a very secure world.
So why are we all so anxious? In Shasta County, of approximately 140,000 adults, 24,228 had a prescription for a benzodiazepine (Valium, Xanax, Ativan, Klonopin, etc.) last year. These medications have been associated with an increased risk of death by any cause. How could we be so incredibly anxious that one out of six adults in our county requires dangerous medications to cope? One in four in the United States suffers from a mood disorder. We live in a world with more security and safety than ever before, with decreasing risks of lethal disease, decreasing risk of death from violence. Why are we so anxious?
First, let’s look at why we have anxiety. In your brain is something called the amygdala which is responsible for your fight or flight response. If you were primitive man, you never knew when another Neanderthal would decide to kill you for your really cool bear skin loin cloth or a mountain lion might decide to see if you taste like chicken. If you lived in colonial America, you were surrounded by death, disease, and whomever we were fighting that day. In today’s society, you don’t have a lot of threats to be afraid of and your amygdala gets bored. Now instead of being afraid that you will be torn apart by wolves, you’re afraid of whether that guy will return your text, that you didn’t study enough for your test, if your boss is going to be mean to you today, or maybe a homeless guy will aggressively ask for change. Instead of safe spaces from arrows, you need a safe space because someone may say a word that triggers you. You may have a panic attack because someone cyber bullied you on Facebook.
We now fear words and ideas because concrete life threats have abated. In universities, the bastion of free speech and free thought, speakers are being turned away because adult students might get their feelings hurt. These are the same adults who were expected to run into the line of fire in WWII and were proud to do it. Our brains have not adapted to the security in which we live and inappropriately apply mortal fear to truly trivial things.
We live in a society where our basic needs are generally met. Food is available to everyone. You can argue about “food insecurity” but I’ve worked as a physician in three states and in inner city environments and I have never seen anyone starve from lack of food. Although homelessness is a problem, there are many programs to help and shelter is available to some extent to most people. We even give out free cell phones to those with low income. Medical care is accessible to all through insurance, the Affordable Care Act, or safety net clinics. Perhaps parents who decline vaccination for their children should be a little more worried about the consequences of their decisions but that’s for another column.
Now we know that our anxiety may be the result of a bored amygdala, now what? There are people who truly suffer from anxiety and require medications. If your anxiety is significantly interfering with your life, you should see a medical provider for help. For most of us, medication is not the answer. Many have found yoga and meditation to be very helpful to manage their stress. It is more accessible than ever as there are many apps that can guide you through yoga and meditation. Mindfulness has demonstrated positive physical and mental health outcomes and may be worth looking into if you are finding your stress and anxiety difficult to manage (e.g. mindful.org). Cognitive behavioral therapy with a trained therapist has been demonstrated to be as good as medications with much fewer side effects. If you have children or care for others, take time for yourself.
Depending upon your beliefs, our brains were either designed or evolved for constant mortal threats. That same mechanism unfortunately impedes our sense of security and happiness and causes stress and anxiety. Instead of being a victim to the modern world, you can choose empowerment and find ways to train your brain for the modern world that is safer than ever.
The good news is that you can train your brain, and with the right mindset your life will be better and you won’t be “triggered” by the next Trump rally.