A worm lives in the apple of human happiness. That worm is anxiety. However accomplished, happy, and admired, a person might be, the well of anxiety never runs dry. It is the unsolvable problem that gives rise to many others, from addiction and suicide to depression, obesity, and economic failure.
To Live is to be Anxious
Wild rabbits nibble nervously with constant alertness to movements in the background, to sounds, and to the odor of predators. Their anxiety is valuable because—as a popular prey species—it keeps them alive.
Subsistence humans had fewer predators but had to be on constant alert for large cats, poisonous snakes, or biting insects that were a serious threat to adults and children alike.
Of course, humans were top predators in addition to being prey. Even top predators, such as lions have something to fear and it is not uncommon for lions to be attacked and killed by a herd of water buffalo defending their young.
There is some safety in numbers and humans lived in groups of over forty individuals prior to the Agricultural Revolution. That helps explains why our species is so highly social. When we communicate our fears to others, we typically feel that our worry is lessened.
Social living minimizes both real dangers in the environment and also imagined ones. Ironically, social interactions are themselves a major source of anxiety because they can affect the social support available for difficult times.
The Social Dimension of Anxiety
Social interactions mostly contribute to feelings of calm and security. This mood is strengthened by close social contact that stimulates the release of oxytocin (the cuddling hormone) in much the same way as interactions between mothers and offspring (1). So, contact with trusted friends and associates reduces anxiety.
In developed countries, families are smaller and we may spend much of our time surrounded by strangers that is potentially anxiety-provoking.
Franz Kafka described an alienating world where the individual is dwarfed by a totalitarian state that remains distant and unknowable. He was indirectly describing modern life in which the local community has evaporated, leaving us vulnerable to distant and alien authority.
Whatever one thinks of the paranoid fantasy world of a Kafka novel, he touched a chord by depicting a political landscape where the individual is isolated and powerless.
Although social interaction may relieve anxiety, interacting with large numbers of people may also be a source of anxiety, particularly if many of them are strangers.
Perhaps that is why social events are so often accompanied by alcohol consumption. Of course, in our society, alcohol is the most popular anti-anxiety drug. Other drugs in the same category exert similar effects on the brain: They suppress activity in the cerebral cortex thereby relieving feelings of anxiety and inhibition.
Given the important role that anxiety plays in alerting us to dangers around us—whether physical, or social—it follows that the most popular drugs of abuse are anti-anxiety drugs and medicines (including sedatives, muscle relaxants, and sleeping pills).
Opiates like heroin and oxycontin are in a different drug category but feature powerful calming effects. Marijuana is also used to help people chill out even though it is classified as a hallucinogen.
Suffice it to say, if anxiety were not such a prevalent experience, large segments of the population would not be addicted to drugs, whether prescription or recreational.
Health Costs of Chronic Anxiety
Drug addiction is a huge and growing problem. Untreated anxiety is a threat to health and longevity as well. Some sense of the scale of these problems is derived by looking at the range and scope of its effects on mental disorders and health.
Although treatable by non-chemical interventions, anxiety disorders are the most common ones in the sense that most people experience fears that are out of proportion to the actual threat posed. They may fear flying or dread the number 13. Severe obsessions and compulsions are much less common.
Anxiety may be a problem in itself but it is even more significant as a contributor to more serious illnesses.
Chronic anxiety contributes to clinical depression and depression may contribute to heart disease in the sense that diseases are biochemically related (2). So if the problem of anxiety disappeared tomorrow, a lot of clinical psychologists and psychiatrists would be out of work.
The same is true of many other medical specialists. Beginning with heart disease (still the leading killer in many developed countries) the toll includes common gastrointestinal diseases that are aggravated by stress, and reaches out to the entire metabolic syndrome (i. e., obesity-related disorders) that are the single most important health threat in developed countries.
Unhealthy eating patterns can be a reaction to anxiety that exacerbates the risk of obesity in sedentary populations—particularly those who are disadvantaged by social inequality (3).
Because anxiety is built into us as a mechanism of self-preservation, it is going nowhere. While social occasions are often accompanied by anti-anxiety drugs, chemical solutions to anxiety are not the only ones and mostly yield further health problems.
Anxiety rises in developed countries compared to agricultural ones and I believe this phenomenon reflects changes in how communities are organized, as I will discuss in a later post.
1 Uvnas-Moberg, K. (1998). Oxytocin may mediate the benefits of positive social interaction and emotions. Psychoneuroendocrinology 23: 819-835.
2 Dhar, A. K., and Barton, D. A. (2016). Depression and the link with cardiovascular disease. Frontiers in Psychiatry, 7, 33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800172/
3 Wilkinson, R., & Pickett, K. (2010). The spirit level: Why greater equality makes societies stronger. New York: Bloomsbury Press.