Anxiety disorders have gone through the roof in the past 30 years. While in 1980 only two to four percent of Americans were diagnosed with an anxiety disorder at least one time in their life,  it is nearly 30 percent today.

A team of writers has now set out to examine what makes anxiety a disorder. They took a closer look at occurrences like social anxiety, phobias, fear of public speaking, generalized anxiety and so on.

Among their findings: Anxiety has been around ever since we started walking. But it has only recently been called a disorder.

“Fears, worries, and apprehensions are painful and ubiquitous aspects of human existence, whether they are common or idiosyncratic, specific or diffuse, rational or irrational” write Allan Horwitz and Jerome Wakefield in their new book “All We Have To Fear: Psychiatry’s Transformation of Natural Anxieties into Mental Disorders. They are both professors, one in sociology, the other in the Conceptual Foundations of Psychiatry.

What they are trying to say is that fear is a part of life. Our early ancestors, who walked the planes and had to fight for their lives in much harsher environments than we have today, were afraid of predators and natural disasters.

Today, our livelihoods are threatened by economic decline, overpopulation and cut-throat competition.

At the same time, people are much more mobile than in the past. Families and communities have become more and more unstable, and people are afraid of losing not just their jobs but their social safety net as well.

There’s plenty to be afraid of. But is it abnormal to have these feelings?

Part of the development is that more and more people seek professional help. What used to be taken care of by family elders or priests, is now the role of the therapist. We are much more comfortable revealing our vulnerabilities to someone outside of our regular circle than admitting them to, or burdening a relative.

Therapists have to be paid, so in order for insurances to cover the treatment, there has to be a condition that is somehow outside the range of the norm.

What used to be normal anxiety is now a disorder. Normal sadness is now depression. Someone with anger issues used to be seen as having a temper. Now, it’s bipolar disorder.

We have to ask ourselves when fears are a normal part of development, and when they start to take on a life of their own. As soon a we can accept that many of our modern day worries are a part of being human rather than a disease, we can face them with more courage and readiness.

The authors conclude: “The basic challenge humans face is not to avoid acquiring fears — they are largely part of our nature — but rather to learn how to overcome the many currently useless innate fears that we experience.”

This is what we as psychotherapists can do: to reassure our clients that our fears must be dealt with in order to move past them. Which happens to also be the definition of braveness: it’s not about the absence of fear. It’s about staring it in the eye.


photo credit: Alaina Abplanalp Photography