Anxiety is growing into a peculiarly American phenomenon. How did we become the world's leading exporter of worrywarts?
America is turning into a country of hand-wringers. Nearly one in five of us -- 40 million American adults -- suffer from anxiety disorders, the most common class of psychiatric ailment we have. By comparison, a mere one in ten are plagued with mood disorders like depression, the second most-common class of psychiatric problems. Panic attacks often besiege Daniel Smith, author of the new anxiety memoir Monkey Mind, out July 3, while others suffer from generalized anxiety disorder, persistent and excessive worrying about everyday things; social anxiety disorder; and a host of other fretful conditions.
So we're more anxious than anything else -- and also more anxious than anyone else, beating out all other nations in our race to the top of the nerve-racked list. According to a recent World Health Organization study, 31 percent of Americans are likely to suffer from an anxiety problem at some point during their lifetimes -- compared to 25.3 percent of those in Colombia, and 24.6 percent in New Zealand, the countries that rank second and third. You'd think people in developing or unstable states -- those preoccupied with concerns farther down on the Maslow Scale -- would be more anxious than we are. Not so. "According to the 2002 World Mental Health Survey, people in developing-world countries such as Nigeria are up to five times less likely to show clinically significant anxiety levels than Americans, despite having more basic life-necessities to worry about," writes Taylor Clark, author of Nerve: Poise Under Pressure, Serenity Under Stress, and the Brave New Science of Fear and Cool. "What's more, when these less-anxious developing-world citizens emigrate to the United States, they tend to get just as anxious as Americans.
"The United States has transformed into the planet's undisputed worry champion," Clark adds.
Things only seem to be getting worse, unfortunately. "Surveys show that stress levels here have progressively increased over the past four decades," says Paul J. Rosch, MD, Chairman of the Board of The American Institute of Stress. New research indicates that anxiety will continue to grow with modernity: Millennials and Generation Xers are more nervous than their elders and less capable of handling the pressure in their lives, much of which comes from worries related to money and work. The screws are tightening for our kids, too: A 2011 study from UCLA found that first-year college students are more tense than ever before. The pressure starts well before they graduate from high school, of course: "American teens, and perhaps even pre-teens now, with Ivy League-obsessed parents, experience sleep deprivation, lack of downtime, and stress due to round-the-clock efforts to create impressive resumes for college admissions," says Carrie Barron, M.D., a New York psychiatrist and co-author of The Creativity Cure: A Do-It Yourself Prescription for Happiness. "Too many hours slumping over screens and study tasks leads to depression and anxiety."
For adults, jobs are the leading source of stress, says Rosch, who points out that work-related anxiety has multiplied in recent years -- both for the unemployed and the employed. So many companies have down-sized and so many industries have shrunk that employees who manage to hold on to their jobs are expected to work longer hours; they have more and more to do, and less time to do it to their satisfaction.
But it's not just the recession -- which is affecting countries around the globe -- that's to blame for America's nervous temperament. Even if the economy were in great shape -- as it was in 2004, when we spent $2.1 billion on anti-anxiety meds, almost double the amount we spent in 1997 -- we'd still be chewing our nails. Here's why.
Reimagining American meritocracy
Despite the fact that most Americans believe our country is still The Land of Opportunity, the greatest meritocracy in the world, the United States is actually a terrible place for fortune-seekers. Chris Hayes, author of the new book Twilight of the Elites: America After Meritocracy, notes that when citizens of different countries are polled about their perception of how easy it is to start off poor and work their way up to wealth, "the U.S. is near or at the top in terms of people who say 'yes.' And yet it is also near the bottom in terms of actual social mobility."
In other words, as Hayes argues in his book, America isn't truly a meritocracy. Sure, the Civil Rights movement, feminism, and equal opportunity laws have helped to remove many of the barriers to success -- but people at the top tend to stay at the top, from clique to clique, and generation after generation. "Those who climb up the ladder will always find a way to pull it up after them, or to selectively lower it down to allow their friends, allies, and kin to scramble up," Hayes writes.
The powerful are liable to game systems (like school admissions processes) designed to reward merit; they'll also go to great lengths to maintain their bank accounts and their positions (consider, for instance, just about everyone involved in creating the subprime mortgage crisis). And despite the fact that we are all supposedly born with the same legal rights, the elite are rarely punished for their misdeeds, particularly compared to those lower down on the socioeconomic chain. "The idea that we are a meritocracy is a vast oversimplification, a self-serving and self-justifying one," says Hayes. "If you believe that the model is that those who are smartest and hardest working end up with the most power or the most lucrative jobs, then ... one conclusion to draw from that [is] that the people currently occupying those positions must be meritorious, which I think is an insidious myth."
The game is rigged from birth
Sociologist Stephen McNamee makes some similar points in his 2004 book The Meritocracy Myth, though he emphasizes the circumstances we are born into as a determining factor in where we'll end up. "The race to get ahead is a relay race in which we inherit a starting point from our parents that in itself creates huge inequalities of opportunity unrelated to the merit of discrete individuals, including, and especially, unequal access to educational opportunity," McNamee explains. Being born to wealthy, powerful, or well-credentialed parents doesn't just help to ensure an individual will have elite educational experiences; his childhood and college experiences in turn ensure that he will make important social connections and fit in culturally, multiplying his chances for unusual success.
"The SAT was supposed to level the playing field so that the Ivies, for example, were not just the provenance of the elite," Barron notes. But the game has become rigged in favor of the wealthy, who can afford to pay for years of test prep and college application tutoring for their children. And yet, in a strict sense, meritocracy often fails for those privileged kids, too. Barron points out that many work extremely hard, and do all the "right" things, yet can't get into the college of their choice because they're not unusual enough.
The meritocratic pressure-cooker
The idea that we can accomplish anything we put our minds to is so pervasive that we often have a lot on our minds. We feel pressure to take on more responsibilities and to make the "right" choices -- and we beat ourselves up when we fail, as Princeton professor Anne-Marie Slaughter, the former director of policy planning for the State Department, wrote in this month's Atlantic cover story . "Millions of women feel that they are to blame if they cannot manage to rise up the ladder as fast as men and also have a family and an active home life (and be thin and beautiful to boot)," she wrote. And unsurprisingly, perhaps, women suffer from a number of anxiety disorders -- including generalized anxiety and panic attacks -- at a rate twice as high as that for men.
But men feel the heat, too. As McNamee puts it: "A reasonable argument could be made that the race to get ahead in America is particularly stressful. If Americans believe that individuals 'get what they deserve' based on their merit (innate abilities, having the right attitude, working hard, playing by the rules), then distain for the unsuccessful is seen as warranted." Comedian D.L. Hughley makes a similar point in his forthcoming book, I Want You to Shut the F#ck Up: How The Audacity of Dopes is Ruining America: "There's this American idea that we're a meritocracy, that people reach the top through the virtue of hard work and perseverance. But the flipside to that thinking is that the poor ... must be flawed, lazy, stupid, or whatever other terrible adjective you would like to use. They didn't work hard enough in some kind of way but had every opportunity."
We all have too many choices
This cultural preoccupation with success as a reflection of worthiness means that decision-making is particularly stressful for us. "Anything about a decision that ... [is] less than perfect is a rebuke to the decision maker," says Barry Schwartz, author of The Paradox of Choice: Why More is Less. Westerners seem particularly sensitive to decision-related regret, as Schwartz notes. He describes a study that he co-authored, currently being reviewed for publication, that used questionnaires to gauge how subjects from the U.S., Europe, and China thought about decision-making. The Chinese "have much less of their core selves on the line with each decision they make," Schwartz says. "For Chinese (and other Asians), sense of self and self-worth are not tied up so much with notions of individual autonomy and choice. So a bad pair of jeans is just a bad pair of jeans. In the U.S., it's a bad pair of jeans AND a statement about you. Think how much weightier your decisions are if every one you make tells the world something about who you are."
Our decision-making anxiety is exacerbated by our tendency to imbue all sorts of decisions with vital importance. For a recent study, Stanford psychology professor Hazel Markus and her colleagues asked Indian and American participants to report how many choices they'd made while doing a series of small tasks. "Though everybody made the same series of decisions" -- choosing a desk to sit at, choosing a pad to use, choosing whether or not to eat free candy, and so on -- "Americans thought that they'd made twice as many choices as the Indians, 20 compared to 10," Markus says.
Having to make too many decisions on a regular basis can stress us out, as can the wild abundance of options we have to choose from. "Too much choice can paralyze people and make them anxious," says Markus. "It used to be good enough to send your kid to preschool or to college. Now you have to choose the perfect one -- and then the perfect teacher and extra-curriculars -- or you are a failure as a chooser, as a mother, as an American."
Technology has multiplied the possibilities, for consumers and socializers. "Online, you can look at literally every option, from every retailer in the world [whereas] a generation ago, you'd go to the one or two department stores in town," says Schwartz. "Instant portable communication encourages people to keep their options open until the last minute, so that they don't miss out on something better. A generation ago, people actually made plans."
But we don't all have the same choices
Another study that Markus conducted found that the more choices we have, the less empathetic we become, and the less supportive of public policies aimed at benefitting society. That points to another problem related to choice: We don't all have the same options, but many at the top tend to assume we do, despite how much the conditions that we are born into delimit and affect all kinds of subsequent decisions -- like whether or not we'll go to college, what kind of school we'll go to, and what type of work we'll do. "Not everyone has the same choice set or the opportunity to choose among good alternatives," as Markus puts it.
"Good choice is not evenly distributed throughout society, so beating people up for [making] bad choice[s] is unfair," says Markus. And yet, because we believe we live in a meritocracy, we often do just that -- and beat ourselves up for it, too.
The Obama example, and genetics
When arguing that anyone can overcome a difficult youth, meritocracy cheerleaders like to point to Barack Obama -- a half-black man raised by a nomadic mother after his father left the two of them. But while Obama's father may have been absent, he was also a charismatic academic who received a master's in economics from Harvard and managed -- along with his second wife, an anthropologist who received her Ph.D. from the University of Hawaii -- to pass some excellent genes to the current president. Like the ones that helped form his exceptional brain: An April 2012 report out of UCLA provides further evidence that DNA determines intelligence, to a large extent. Genetic inheritance also dictates, to a significant degree, how ambitious and optimistic a person is, other traits important for success. Obama's good looks represent yet another powerful advantage. And while he may not have had a conventional family life, his mother was a strong positive force in his life, as were her parents. ("His maternal white grandparents, who had a great deal of influence in his life and also raised him for periods growing up, were solidly middle class," McNamee notes.)
All this isn't to say that many true underdogs haven't managed to achieve exceptional things. "Some individuals do overcome adversity and beat the odds," McNamee acknowledges. But McNamee points out that that wild success stories often involve a substantial amount of luck, as much as merit. Moreover, he says, "exceptions do not prove the rule. Individuals win the lottery but that does not change the fact that the odds of doing so are very remote."
What the recession demonstrates about luck
When using meritocracy calculators to assess achievement, we often overlook or dismiss how much luck can affect lives. If any good has come of the current economic crisis, it's how much harder doing that has become. "Merit hard liners downplay the effects of luck," says McNamee. "But the imperfections and ultimate uncertainty of both the stock market on Wall Street and the labor market on Main Street add an undeniable element of luck into the mix." And while the U.S. government does have a history of passing laws aimed at equalizing opportunity and eliminating discrimination, it has simultaneously encouraged great economic disparities. "Major structural changes in the U.S. economy such as de-industrialization, automation, and globalization have displaced workers quite independent of the merit of individuals," says McNamee. "The historical decline in self-employment and the concomitant rise and dominance of large oligarchic corporations (including chains and franchises) have created barriers of entry for starting and sustaining small businesses and sharply reduced the entrepreneurial path to mobility."
Those at the top sometimes fail to understand how much their wealth and power are a function of their environment. "Often those who are privileged," writes McNamee, "at least compared to the very poor, do not recognize or acknowledge these advantages and often mistakenly attribute their 'success' to individual merit alone -- i.e. being born on third base having thought you hit a triple."
Dealing with anxiety in a meritocracy
But getting back, now, to the question of anxiety: Should we be thinking about ways to make America more of meritocracy in the hopes of quelling our stress? Says McNamee: "A pure meritocracy is not possible and may not even be desirable." (Just ask Harrison Bergeron.) Far more important, he argues, is debunking the myth of meritocracy, harmful "because it provides an incomplete explanation for success and failure, often mistakenly exalting the rich and condemning the poor."
Indeed. As Alain de Botton noted in his engaging book Status Anxiety, there's a much darker side to the meritocracy story. "If the successful merited their success, it necessarily followed that the failures had to merit their failure," he writes. "Low status came to seem not merely regrettable but also deserved. ... To the injury of poverty, a meritocratic system now added the insult of shame."
That, and the pain of anxiety.