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  • Natasha J. Thomas, MD

The Anxiety and Panic Series: An Exploration of the American Brand of Fear

At the outset of this series, my main intention was to uncover the reasons America has the most anxious population in the world. At times, I wonder if calling us "anxious," though, is accurate. Remember when we began the series, we defined "anxiety" as uncomfortable, excessive anticipation about a real or imagined event. And we distinguished anxiety from fear by defining fear as reasonable apprehension about a real threat. In America, the lines between those things that are real threats and those things that irrationally provoke anxiety have become very, very blurred.

Regardless of all the potentially polarizing facets of American culture, our commonalities are abundant. I'm of the opinion that America can't ever access true greatness if it is a fragmented, panicked, mess. In this beautiful, sprawling, powerful yet broken country, what on Earth is going on?

Americans have some of the same worries as people anywhere in the world: family, finances, health, education, spirituality, etc. However, over the course of my training and career, I have taken care of Americans from vastly different demographics, across three different states. And despite their differences, they all seem to have an intense fear of loss. Of course, a person from anywhere in the world may feel the fear of loss. In America, though, that fear is intense. It drives substance dependence, suicides, depression, and many types of anxiety. Interestingly, it seems for many there's something unsettling in the message that they live in the "greatest country on Earth." The truths of our experiences make us either disbelieve this is a land of equal opportunity, or feel shame for struggling in a country where success "should" be right at your fingertips.

I understand that these issues are a matter of perception. Both fear and anxiety can alter perception drastically. Nonetheless, there are 6 common issues that seem to be plaguing the minds of the average American. Each one is undergirded by the fear of loss - loss that we believe would undercut our pursuit of the American dream.


Threat of Violence

I have provided psychiatric care in some of the most dangerous areas in the country and only recently began to hear the fear of violence generalize to the entire population. Before, it did seem to be limited to urban areas and certain minority groups. Now everyone seems to be worried that either they'll be shot and killed, or their children will be. How many of your Facebook wishes for children returning to school have gone from having a "successful" year to having a "safe" year? Believe it or not, America does not have the highest amount of gun violence in the world. In fact it is not even in the top 10 or 20 countries most impacted by fatal shootings. However, we are reportedly 25 times more likely to be shot than people in other developed nations. Living in the throes of it, the statistics don't seem to matter much. It's the sense that shootings can happen in our fun and "safe" places, or while innocently going about our day, that put us all on edge.

Racial Conflict

America's history with racial conflict is indisputable. Though this isn't the place to explore why it persists and in some ways seems to be worsening, what really strikes me as a therapist is the fear that multiple racial groups have about being targeted for genocide. It's true, people are afraid there are forces trying to wipe them out, destroy them, hunt them. I honestly am not in the position to determine the legitimacy of this fear. However, I can say that it is contributing to serious levels of panic, especially in men, from every ethnic group. It negatively influences the perception we hold of those from a different ethnic/racial background and spurs violence that can take the form of everything from physical assault, to subtle insults, to racist power plays. For some communities there is a persistent dread of being killed - just for being the "wrong color."

Political Discord

There's no hiding the fact that our most recent presidential election was a majorly polarizing event in this nation. Over the past two years, countless people have described how many of their significant family and friend relationships have dissolved over differing political opinions. People dread the holidays even more than usual now. Some have had to vow to avoid political discussions with family, others have blown up into ugly shouting matches. Some people have been disowned. And for those who don't have this type of conflict, instead I see a great deal of worry that their group is under attack. They feel voiceless and defenseless. And then are those who don't know what to believe, rattled by the unbelievable gap in what is reported as "truth" from various news sources. Prior to 2016, though, Americans also worried heavily about terrorist attacks, a repeat of 9/11, and differed over our military presence in various countries.

Celebrity Worship

America has an interesting relationship with its rich and famous. Though most people are very critical of our celebrities, Americans are setting their standards by the trends set in Hollywood. People are looking to celebrities to inform their spiritual belief systems, their political parties, their financial behaviors, investments and large purchases, and their physical appearance and dressing trends. This is a culture that assigns high value to the narcissism of being seen, elevated and worshipped, which I believe is the true underpinning for the "success" of social media companies. So many want to be viewed, followed, liked, etc. Celebrity worship drives anxiety because it contributes to an obsessive tendency to strive for material wealth and physical perfection. When we see that our lives look nothing like a celebrity's life does to the outside world, we fear we've lost the chance to ever experience real freedom and success.

The Medical Industry

Can a nation be wealthy, if not truly healthy? I guess it depends on if that wealth is meant for everyone. I'm sure I don't have to tell you that the difficulty in finding access to care, access to adequate levels of insurance, and access to affordable medication is a daily struggle for many people in America. Anxiety about illness, life expectancy and even joyous things like childbirth runs higher in America than you'd expect. We are inundated with commercials about pharmaceutical products and spend more than any other nation on "healthcare." However, our health system doesn't even rank among the top 10 or twenty nations in the world. Mistrust of the medical establishment, another issue that used to be relegated to certain groups of people, is beginning to generalize. Despite differing views on the solutions to our healthcare crisis, everyone agrees something needs to be done.

Epidemic Loneliness

Loneliness causes and results from a sense of loss - as one reflects on relationships that have been lost due to death, misunderstanding, or simply changes in circumstance. People are more lonely now in developed countries than ever before in history, despite the relentless "connection" seemingly offered by social media. It is a public health crisis, as loneliness leads to a decline in the physical and mental health of those affected.

In my practice, I see this impacting the elderly and young families the most, though I know all of us can feel it. I witness the elderly struggle for outlets for friendships. Many elderly women have outlived their spouses. And elderly men that are surviving may be caregivers. Naturally finding new friendships is difficult when access to transportation may be limited, fluctuations in health and strength are frequent, and declining financial liberty looms overhead. Young couples starting families often face marital discord and feelings of overwhelm and failure. They would benefit from a community approach to raising families, which incorporates mentorship and support. Instead, with their limited experience and wisdom, they are trying to "figure it out" on their own, resulting in a host of grave societal issues. It's a worrisome problem, since solid family units are the strength of a nation.


What if...

Now, in general, I teach people with anxiety to avoid "what if" thinking. That's because people normally think of what can wrong - and those thoughts are scary. But for a second, I'd like to consider a "what if" that might promote understanding. What if another cause for the American problem of anxiety is that our very foundation as a nation has been weakened by unresolved emotional conflict and anger between those who inhabit this space.

Just as I believe buried pain, fear, resentment, etc. can erupt into anxiety and panic in an individual, I believe the same can be true for a nation. Just as an individual has a sense of what hidden pain is sabotaging their progress, so does a nation. And when it is ignored, it manifests as all manner of disorder. What if America worries about loss as a corporate body because we subconsciously feel we're on a shaky foundation? What if America is anxious and afraid, because She is unhealed? What toll does it take on us as a group to live in a country where we feel mistrustful and hateful toward our neighbors?

Next week, we are going to begin to outline the solutions to:

  • The 9 types of anxiety

  • The causes of anxiety

  • The specific factors in American culture that contribute to anxiety

And as we have this discussion, please also consider how the spirit of the nation can be repaired. I'm going to ask you to contribute to the discussion by submitting (either below in the comments or through email), your ideas on how American society can move toward healing the rifts between us.

I hope you're enjoying this series as much as I enjoy writing it for you! Looking forward to hearing from you soon!

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