We live with an epidemic of anxiety. In 1980, 4% of Americans suffered a mental disorder associated with anxiety. Today half do. The trends in Britain are similar. A third of Britons will experience anxiety disorder at some stage in their life, with an explosion of reported anxiety among teenagers and young adults. Anxiety, depression, self-harm, attention deficit disorder and profound eating problems afflict our young as never before.
Anxiety has always been part of the human condition – as has depression and tendencies to self-harm – but never, it seems, on this scale. A number of trends appear to be colliding. This is an era when everyone is expected to find their personal route to happiness at the same time as the bonds of society, faith and community – tried and tested mechanisms to support wellbeing – are fraying. Teenagers in particular – fearful of missing out – are beset by a myriad of agonising choices about how to achieve the good life with fewer social and psychological anchors to help them navigate their way. Who can blame them if they respond with an ever rising sense of anxiety, if not panic?
At the same time there has been a transformation in individuals’ willingness and society’s readiness to accept that the resulting anguish is not something inherent in the human condition – but often a form of malady that should be recognised and treated. In Jean Paul Sartre’s Nausea, the (anti-) hero, Antoine Roquentin, is so plagued by wondering if existence has any purpose that he becomes intensely depressed and listless. Nausea was celebrated as breaking new literary ground in the 1930s, illuminating the essence of the human condition. Today Roquentin would be diagnosed with general anxiety disorder, and prescribed an antidepressant or invited to undergo a course of cognitive behavioural therapy.
Is there, however, too great a readiness to pathologise the anxiety of being alive? Almost certainly. There is great and growing unease in parts of the psychology and psychiatry professions that too many practitioners have become trigger happy – too quick to prescribe mood-altering drugs to patients only going though life events, ranging from bereavement to divorce, which are naturally anxiety inducing.
Life never was and never can be an uninterrupted progress towards utopian bliss. Grief following the loss of someone beloved, a great ambition thwarted or simply witnessing one’s body age or wither through illness are all concomitants of being alive – pains alongside life’s many wonderful pleasures On the other hand, there is no doubt that the patients complaining of acute mental anxiety feel intensely disturbed beyond some normal level of anxiousness – and that teenagers can feel this more acutely still.
You cannot listen to mental health campaigner Natasha Devon – sacked last week from her role as a mental health champion for being too vocal, articulate and daring to criticise government policy on testing in schools – without recognising that she is addressing a social reality. Young women in particular are ever more transfixed with how they look to the point that, for a growing proportion, it is translating into mental health disorders with physical side-effects – bulimia, anorexia and self-harm. Asking them to snap out of it is not going to work. And while there probably is too great a readiness to pathologise anxiety, doctors and counsellors, faced with a growing epidemic, are only responding as best they can. To ignore what is going on would be equally damnable.
What to do? Devon’s campaign is part of the answer. Critics of the 30-year rise in the belief system that holds that economic and social wellbeing originates in as much individualism and free market as possible (along with diminished social, public and state institutions) usually focus on the exterior consequences, ranging from heightened inequality to weakening rates of innovation, investment and productivity. They are right, but there is another less frequently made criticism – what this worldview is doing to our mental lives.
Happiness – when individual liberty is seen as all-important – lies in exercising choice and taking responsibility for our own lives. Get the choices right, and self-realisation, self-fulfillment and happiness will follow. Get them wrong and you risk mockery and marginalisation. Teenagers know as never before that they must get their choices right, pass their exams – and many will have 24/7 parents “helping” them in their quest. However, the act of making many choices with necessarily imperfect information perforce induces anxiety and stress – and once they are made, happiness does not automatically follow. Small wonder that teenagers in general, and teenage girls in particular, find the whole experience traumatising – as do their elders, even if they have better-developed emotional and psychological resource to deal with it.
Which is why Devon’s efforts to create a social movement to open up body image issues are so important. It is good that there is less stigma associated with mental health disorders: in January the prime minister endorsed such destigmatisation while announcing an extra £1bn to address mental health issues.
But there must also be an effort to get at the roots of what is happening – and that lies in more social interaction, and stronger social and public institutions that don’t make individual choice the alpha and omega of everything. The government could never go that far – which is ultimately why Devon was sacked. The governing party will never feel at ease with social movements.
For happiness can never result from the exercise of choice alone: we are social beings, and the building blocks of happiness lie in looking out for each other, acting together, being in teams and pursuing common goals for the common good. Families, schools, colleges, unions, newspapers, sports clubs and even firms should all understand that such commonality should be part of their core DNA.
Teenagers, for instance, need parents who understand that parenting is less about being friends with their children – partners in their kids’ exercise of choice. Rather, parenting is about creating strong families in which parents have to lead and exercise authority – havens from the 24/7 intrusiveness of social media.
For a generation the doctrine has been that the quest for a common good – in schools, in unions, in the delivery of public services – should be trumped by the expression of choice. The result is the anxiety epidemic. It can’t and won’t go on. Expect more Natasha Devons – and ultimately, one hopes, change.