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Susan Says: The American anxiety epidemic

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Anxiety has recently become the number one mental health issue in North America – it flew past depression as the most prominent mental health problem around 2011. It is now estimated that over one third of the North American adult population experiences anxiety. These recent statistics rank America higher in anxiety disorders than any other nation worldwide.

Recently UCLA researchers surveyed more than 200,000 incoming college freshmen, and they found that students reported all-time lows in overall mental health and emotional stability, along with high levels of anxiety. Unfortunately, this trend is also being seen in high school and even in middle school kids. As a nation, we are all growing more anxious!

Anxiety and stress are physical and emotional responses that our minds and bodies activate to protect us from perceived dangers. Evolution has programmed us with a “fight-or-flight” response, which is a physiological reaction to a perceived harmful event, attack, or threat.  Multiple hormones are released by the sympathetic nervous system causing increased blood pressure, and heart rate. Muscles tense, pupils dilate, and breathing becomes rapid and shallow in preparation to turn and fight or run away.   

Today, however, today most of us aren’t running from tigers or hunting and gathering food in the woods. In fact, we spend billions on being “safe” with crash proof cars, increased food and drug regulations, security systems for our homes, and cell phones that keep us in constant contact with the world.  Now the things that trigger our fight-flight response and often put us over the edge are an over-loaded email inbox, morning rush hour, or losing the keys before running out the door. This anxiety strikes at the most unexpected of times, and makes us feel things in our life are far worse than they really are–resulting in fear, uncertainty, circular and racing thoughts, and inability to function normally.

Behind this epidemic of anxiety may be our lack of a sense of community. Human contact and kinship have always helped to alleviate anxiety (our evolutionary ancestors were always safer in numbers).  Today we are often isolated from extended family and friends as we pursue careers elsewhere, and a good majority of social contact especially among our youth is overwhelmingly achieved through social media. We may be working longer and longer hours due to the constant pressure to succeed with little time for relaxing with friends. Another culprit behind increasing anxiety disorders is the incessant exposure to negative media reports. It’s nearly impossible to turn on the TV, or open a web browser without being assaulted with notifications of a new world disaster (or two, or three…)

Americans more than doubled their spending on anti-anxiety medications like Xanax and Valium, from $900 million to $2.1 billion between 1997 and 2004, and treating anxiety with potentially very addictive drugs continues to rise. Although pharmaceutical drugs can help moderate our bodies’ physical response to stressful thoughts or stimuli, non-pharmaceutical treatments, like cognitive behavioral therapy (CBT) are beginning to replace drugs as the preferred treatment for anxiety disorders.

Cognitive Behavioral Therapy for anxiety provides a person with interactive face to face contact and support. This type of therapy teaches individuals how to calm their mind and put their physical reactions in context. Learning controlled breathing slows the physiological stress reaction which then allows the person to work on stopping the cycle of increasing anxiety. For example, worries and anxieties tend to grow more powerful when we allow them to accumulate in our subconscious. You can interrupt the accumulation of anxieties by bringing them into the forefront of your mind and acknowledging their presence. Rather than trying to control the anxiety, individuals are taught to step back and observe themselves being anxious. This involves noting the physical symptoms (clenched muscles, shallow breathing, racing heartbeat) and then asking: Are my fears appropriate to my current actual level of danger? Simply taking stock of the anxiety and consciously acknowledging the uncomfortable sensations for what they are (vs. indications that you are in physical danger) can make them feel less intense.

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Even when medication is necessary, it will work much better with interventions such as psychotherapy, establishing regular exercise routines, and decreasing caffeine and other substances that increase stress responses. Also, learning to manage interpersonal stress with others by setting firm limits and boundaries regarding what you are capable of, will ultimately help reduce anxiety.   

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