Anxiety and depression are at unprecedented levels worldwide and the numbers are growing. The World Health Organization (WHO) describe it as an epidemic, and estimate that 615 million people are suffering from one or other of these debilitating diseases. A staggering number, that in all likelihood is an indication only of the depth of the problem; anxiety as documented by the WHO, is primarily a developed nation’s issue. The 800 million living in extreme poverty in India for example are not polled, and are too overwhelmed by the daily demand for survival to even question if they feel depressed or anxious; so too the 500 million living on the margins of life in sub-Saharan Africa, or rural China.
What are the factors that create such a fear-inducing, hostile environment; why do so many people regard the world as unkind, intolerant – life as something to be feared?
The royal radio station, BBC Radio 4, recently ran a programme dedicated to anxiety. It was a ‘phone in’. Listeners were invited to share their stories of anxiety and those of their family members. Many callers spoke of being reduced to tears, when listening to the accounts being related often by parents: children unable to face school, teenagers who cannot leave the house, middle-aged men too anxious to face the world and women unable to step out of their homes and engage with life for fear of ridicule.
A recurring theme was a lack of self-confidence and an inability to live up to expectations – perceived or actual. Expectations constructed at school where competition and conformity rule the classroom, within relationships in which a list of qualities and attitudes are deemed to be required, and at work where the profit imperative rules and those who maximise returns, succeed. Debilitating feelings of inadequacy and inferiority flow from such negative, restrictive ideas of self, causing inhibition of all kinds (mental, emotional and physical) and feeding anxiety. Such effects make it more difficult for people to step into unknown areas, enquire, take risks, try something new, apply for work, dare to fail, raise their hand with an opinion or question, challenge authority – parents, teachers, employers, ‘the state’.
‘Status anxiety’ and ‘image anxiety’ were repeatedly mentioned by the listening experts, unfamiliar terms to the layman; symptoms of our materialistic, image-conscious times – which impacts on all, but afflicts young people particularly. In Britain The Guardian reports that “anxiety disorders affect one in eight children. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse.” And in the US, anxiety blights the lives of 25% of teenagers (30% of girls), under pressure no doubt to meet an unattainable ideal: look amazing, pass exams, achieve great grades, be sporty, dance well etc., etc.
"It started when I was 15," Claire says. "When I realised that I wasn't pretty or intelligent, or as good as I thought I was." After suffering with the condition for 11 years she was forced to take a month off work – from her ‘dream job’ with Penguin in London. The panic attacks from which she has suffered since she was a teenager had started to dominate her life. "I thought: I need to do something about this, because panic attacks are the worst. You feel like you're going mad, like you're going to die; worrying about everything, feeling out of control, wondering what you sound like and what you look like. The voice in your head, it's constant. You can't stop it. It's exhausting."
Image and status anxiety relate not only to physical appearance, but the conditioned image of who and what we are, or think we are in the context of a society that judges by looks, position, wealth and social background; status – the station attained or bestowed – conditions how we are seen by others, and is regarded as all-important. In such a shallow social environment the accumulation of material riches is given undue emphasis. The meeting of need – food, shelter, health care and education – is replaced with the fulfilment of desire, the cultivation of want. Sufficiency is laughed at, abundance encouraged, waste and the erosion of human dignity ignored. And if, as is the case for the majority, the means to satisfy the pressure to consume compete and dominate, are lacking, self-worth falters, anxiety envelops, depression threatens and suicide lies in wait. And for those able to shell out on all that is decreed desirable, the weight of expectation and comparison amongst peers brings about its own pressures.
Economic inequality and anxiety
One of the major causes of anxiety is wealth and income inequality. Evidence published by Richard G Wilkinson, author of The Impact of Inequality shows that in developed countries, mental illnesses “were three times as common in societies where there were bigger income differences between rich and poor.” Meaning “an American is likely to know three times as many people with depression or anxiety problems as someone in Japan or Germany,” where inequality is not as extreme. Inequality feeds a range of negative social issues, a distrust of other people being one. This, Wilkinson says, is “partly a reflection of the way status anxiety makes us all more worried about how we are valued [or devalued] by others.”
The division between the comfortably off and those struggling to survive on poor wages or low benefits is growing, and the gap between the stupendously rich and the rest is greater than it has ever been; in January 2016, Oxfam UK reported that a mere “62 people [currently] own as much as the poorest half of the world's population [3.6 billion people whose meager wealth has shrunk by a trillion USD since 2010]…. this number  has fallen dramatically from 388 as recently as 2010 and 80 last year”, an inevitability within a system that is inherently unjust – and by design. This is the Age of Inequality; it is a gross form of social injustice, a moral crime that creates divisions, feeds (understandable) resentment and works against humanity’s essential unity. Peace and harmonious living is impossible whilst extreme poverty and excessive wealth exist. This suits the ruling elite – a privileged coterie made up mainly of the wealthy, corporations and banks – they do not want the masses to be economically secure, emotionally stable or psychologically content; a perpetual state of unease, insecurity and fear is cultivated to facilitate the greatest degree of control, allowing for the manipulation of behavior, the exploitation of millions, if not billions and the erosion of human dignity.
Wealth inequality translates into unequal education health and employment opportunities, differing access to arts and culture – which are becoming increasingly elitist – gated worlds of privilege for the rich and run down ghettos or uniform housing estates for the poor. Social divisions, fear and exploitation are fed, attitudes of superiority and inferiority, dominance and subservience cultivated. In a study headed by Sheri Johnson at the University of California, Berkeley it was found that conditions such as “mania and narcissism are related to our striving for status and dominance, while disorders such as anxiety and depression may involve responses to the experience of subordination.”
Under the current socio-economic model, ambition is promoted and people are encouraged to strive for ‘status and dominance’ – it’s a ‘dog eat dog world’, ‘everyone’s out for themselves, look after number one’ and such like. The epidemic of anxiety and depression is but one consequence of such a selfish, violent environment. If we are to substantially tackle the worldwide mental health crisis we need to replace such worn out destructive attitudes with values that unite people, encourage cooperation, sharing and mutual understanding. When such principles of goodness prevail, a healthy society will evolve with social justice and trust at its heart, diffusing tensions, making the realization of peace a possibility.
In addition to social pressures, a variety of situations and emotional demands trigger anxiety: Uncertainty, and the longing for security – emotional, romantic, economic, health – the reactions of others to what we say and do; anxiety that one may lose a loved one to death, to someone else, through a misunderstanding, a ‘falling out’. Anxiety is fear; it inhibits and conditions action. Freedom from anxiety will naturally follow the overcoming of fear. Fear is complex, of course, subtle and hard to reach, entwined with desire and pleasure. Freedom from fear and its crippling effect is dependent on release from desire and pleasure, this the Buddha made clear: in that treasure trove of truth, the Dhammapada, we find(chapter 16 verse 212) “from pleasure arises sorrow and from pleasure arises fear. If a man is free from pleasure he is free from fear and sorrow.”
And as the great teacher J. Krishnamurti put it “fear and pleasure are the two sides of a coin: you cannot be free of one without being free of the other also. You want to have pleasure all your life and yet be free of fear—that is all you are concerned about. But you do not see that you feel frustrated if tomorrow’s pleasure is denied, you feel unfulfilled, angry, anxious and guilty, and all the psychological miseries arise. So you have to look at fear and pleasure together.”
Psychological fear is a product of time, not chronological time, but time as thought; we are anxious, not about what is actually taking place, but what may happen in the future – whether that be moments, days or years ahead: the coming interview, making the next month’s rent, meeting a new person, etc. Claire, “like Freud defines her anxiety as a threat that is objectless, and located in the future.” Place oneself firmly in the now and mitigate the impact of psychological fear – admittedly easier said than done. Total commitment to the activity of the moment, with no thought about its result, impact, success etc., will help hold the mind steady, arrest its momentum; as the Buddha taught “when you walk, just walk, when you eat, just eat.”
Strategies that reclaim control often prove helpful: Cognitive Behavioral Therapy (CBT) is recommended by various mental health charities, and can be beneficial. Whilst we all have the responsibility to change the way we individually respond to life as it impacts us, it is clear that the present socio-economic atmosphere encourages certain behavior and creates the circumstances in which fear is, if not inevitable, highly probably – certainly to those with a sensitive nature and a predisposition to worry. A new and just system is urgently needed to allow people to live healthy, harmonious lives free from anxiety. One that isn’t rooted in competition does not revolve around money or foster comparisons. A model that instead of promoting selfishness and greed, encourages values arising out of a sense of unity and brotherhood: cooperation tolerance, understanding and fairness; Principles of Goodness that have been buried under a stifling blanket of greed and suspicion.
Our problems, individual, collective and environmental are interconnected. Anxiety, like many other crises facing humanity, is part of the river of consequences flowing from a certain approach to life. We have allowed systems of governance and control to evolve that work against humanity’s inherent unity, are detrimental to our health and the well-being of the planet.