"Nerve": Why is America so anxious?

We're a nation of worrywarts, even in good times. But what causes us so much stress and fear? An expert explains

By Jacob Sugarman
Published March 20, 2011 6:01PM (EDT)

We don't need a global crisis to be reminded that fear and life in the 21st century seem to go hand in hand. Whether you're a professional basketball player trying to sink a game-winning jump shot in the closing seconds of a playoff game or a lowly journalist scrambling to meet your deadline, chances are your nerves have gotten the best of you at one point or another. You wouldn't be human if they didn't. In fact, fear recognition and the fight-or-flight reflex embedded in our neurochemistry is part of what has enabled our survival and evolution from chest-pounding primates to iPad-wielding bipeds. As we might guess from the endless stream of television commercials for psychopharmaceuticals, Americans have an especially tough row to hoe in the fight against anxiety. Despite our prosperity, statistics show that we're as susceptible to nervous disorders, if not more so, than any nation in the world.

But why do we respond to specific stressors the way we do? And why do certain individuals demonstrate a steely resolve when they might just as easily buckle under the pressure? More important, what lessons can we extract from these intrepid souls? Blending narrative storytelling with investigative research, Taylor Clark's "Nerve: Poise Under Pressure, Serenity Under Stress, and the Brave New Science of Fear and Cool" offers a fascinating glimpse into why we worry and helps explain what we talk about when we talk about fear. Clark is the author of "Starbucked: A Double Tall Tale of Caffeine, Commerce and Culture" and he's written for GQ, Slate and Psychology Today. Over the phone, we discussed why traffic jams are so maddening, the plight of the neurotic second baseman and the secret to eradicating your biggest worries (spoiler alert: You can't).

Do catastrophic events like the Japanese earthquake or the situation in Libya tend to affect global levels of anxiety, or are they normally confined to the afflicted country?

It's certainly the case that major catastrophes spark widespread anxiety in the countries where they hit. A great example of this is how incredibly overinflated Americans' fears about terrorism grew after 9/11. In one poll that was conducted in the aftermath of the attacks, respondents said that the average American had a 48 percent chance of being injured in a terrorist plot over the next year. As it turned out, the odds were more like 0 percent. On a global scale, it's a little harder to gauge.

Is the United States more prone to higher levels of anxiety than other nations?

Put simply, we are. Perhaps the most puzzling statistics are the ones that reveal that we're significantly more anxious than countries in the developing world, many of which report only a fraction of the diagnosable cases of anxiety that we do. One of the reasons for this is that the people in many of these third-world nations are more accustomed to dealing with uncertainty and unpredictability. I talk about this a fair amount in the book, but lack of control is really the archenemy of anxiety. It's its biggest trigger.

That explains the disparity in anxiety levels between the United States and the developing world, but why are we more anxious than, say, your average European nation?

It's hard to pinpoint an answer, but I think Americans have become extremely vulnerable to the pressures of the 21st century. For the past 50 years, we've been getting progressively more anxious in good economic times and bad, so we can't even blame it on the recession. As I was conducting research for the book, psychologists pointed to three basic reasons why our psychic state is deteriorating. The first is a simple matter of social disconnection. As we spend more time with our electronic devices than we do with our neighbors, we lose our physical sense of community. Social isolation flies in the face of our evolutionary history. The second major cause is the information overload that we're experiencing with the Internet and the 24-hour media cycle. We're all aware of it, but I'm not sure we realize how big an impact it's having on our brains. The third explanation can be attributed to what one psychologist refers to as a culture of "feel goodism" -- the idea that we shouldn't ever have to be upset and that all our negative emotions can be neutralized with a pill. This to me feels like a distinctly American phenomenon.

How does anti-anxiety medication fit into the picture? Have the increasing number of prescriptions made a dent in our high levels of anxiety, or are they merely a symptom of our condition?

Most people don't realize that Xanax and Valium are no longer the medication of choice for anxiety disorders. This is because they're palliatives. They mask the anxiety of the moment to a certain degree, but they can't eradicate the feeling entirely. But it shouldn't be. Conquering your anxiety is more about altering your patterns of behavior, so that's why so many psychiatrists now favor antidepressants. They can help you become less avoidant by slightly altering your point of view. Ultimately, however, I think medication has been something of a mixed blessing in the battle against anxiety. There's really no question at this point that it's being overprescribed, so it's hard to accurately measure its success rate.

In your research, which jobs did you find to be the most stressful?

You might think that jobs that require the biggest amount of work or the longest hours would be the worst, but that's not actually the case. The most anxiety-producing jobs are the ones in which the employee has very little control over what he or she does during the workday. One of the more compelling studies that I talk about in the book compares musicians in smaller, chamber groups with those that play in a larger orchestra. The former proved to be a lot less anxious than the latter because they got to decide their own schedule. Orchestral musicians tend to be at the mercy of a tyrannical conductor who decides when they play, what they play and when everyone can take a bathroom break. The notion of executive stress syndrome -- the idea that bosses and corporate executives experience much higher levels of anxiety than their underlings -- has proven to be total bullshit. Executives tend to have more control over what they're doing, and they often displace their anxieties on the people that work beneath them.

So a run-of-the-mill production assistant is more stressed out than an air traffic controller?

We love to point a finger at air traffic controllers, but we may need to stop. Objectively speaking, their job has gotten more stressful in the last quarter-century. There are fewer of them employed now and they're dealing with more traffic than at any point in the history of air travel. The difference is that Ned Reese, who headed the training for our country's air traffic controllers for a number of years, has completely radicalized the selection process. Rather than pick people based on their physical proficiency, he began hiring controllers with a very a specific psychological makeup. We might see their work as stressful, but they tend to think of it as simply challenging.

Why are we preternaturally fearful of traffic jams? And does this explain our fathers' bad behavior on the road?

Traffic is this modern phenomenon that perfectly needles all of our stress spots. The most frustrating thing about a traffic jam is not that we're stuck sitting there. For the most part, we're perfectly comfortable in our cars. The problem is that we have no control over what's going on -- we have no idea as to when the traffic will eventually let up. Those are the exact ingredients that make people anxious. Anger and fear are very similar physiologically, so that's why some people get stressed and some people get pissed. It's all part of the same fight-or-flight reaction cycle.

How much can preparation mitigate our feelings of stress? Do you buy the theory expounded upon by Malcolm Gladwell in "Outliers" that elite performance requires 10,000 hours of practice?

Nobody would question the fact that preparation is the single most important thing we could do to respond well in a stressful or fearful situation. In these moments, our brains get cluttered and it becomes a lot harder to figure out what the correct course of action is. Preparation lays the circuitry for us to react without having to think. As far as the 10,000-hour rule is concerned, that finding had been floating around for years before Gladwell decided to champion it. One thing that "Outliers" fails to point out is that practice alone is not enough. Anders Erickson, a psychologist at Florida State University who studies peak human performance, argues that practicing the same thing over and over again does not ensure that you will respond well in a stressful situation. The trick is to challenge yourself so you're constantly improving your skills.

Can we exacerbate our feelings of anxiety by trying to quell them?

At the risk of making a sweeping generalization, there's a massive divide in this country between people who get easily anxious and those who don't. The latter tend to tell the former that they should "just relax" or "not worry about it." They mean well, but this is probably the most inane piece of advice they can possibly offer. So often, we make ourselves miserable trying to control what can't be controlled. The way to get into a productive relationship with your emotions is by working with them rather than against them. If someone told you to "just be happy," you'd think they were stupid or crazy.

You explain that certain phobias can be made extinct by repeated exposure to what scares us. But if we could confront our fears in the first place, we might not have them. Isn't this something of a chicken or egg argument?

This question speaks to one of the central dilemmas of anxiety disorders. The only way to beat these feelings -- and by beat I do not mean extinguish so much as get in a more comfortable relationship with -- is to put yourself in the very situations that make you so uncomfortable. Look at [former NFL coach] John Madden, whom I discuss in the book. He suffered from a fear of flying and for decades he drove across the country to get from game to game. It's absolutely staggering to think about the quantity of hours that he lost because he refused to confront his demons. It's always easier to avoid something we're afraid of than to face it head on.

In a chapter called "The Clutch Paradox," you do a wonderful job of dispelling a popular sports myth -- that some athletes are inherently more clutch than others. My question is: Why do so many seem to choke so consistently? Why are certain major leaguers like Chuck Knoblauch and Rick Ankiel never able to regain their form after falling down a psychological rabbit hole?

These kinds of breakdowns are a lot more pernicious than people realize. [Former MLB player] Steve Sax, whom I interviewed for this book, told me that his trouble throwing the ball to first base was the hardest thing he ever went through aside from losing his parents. We have this image of athletes as egomaniacs who don't take the sport as seriously as the fans do, but this is something that rips them apart inside. When Chuck Knoblauch throws a ball into the stands, it gets replayed on SportsCenter over and over and over again. It takes a lot of mental jujitsu to come back from something like that. Another reason why many athletes have so much trouble regrouping is that there's still a real shrink barrier in sports. This is a culture that says you must be mentally tough to succeed, and I think a lot of players see therapy as an admission of defeat.

You're a self-proclaimed worrywart. So how did writing this book affect your understanding of your own anxieties?

When I started writing this book, I secretly thought that I would fix everything, eliminate my anxieties and become a master of fear. After a bit of research, I quickly realized that you can't eradicate fear and that there is no magic bullet for anxiety. Writing a book was hard enough, but writing one that taps into some of your deepest, darkest emotions was probably the hardest thing I've ever had to do. Ultimately, however, I wouldn't trade the insight I gathered while working on this project for anything. It won't prevent me from wrestling with my anxieties for years to come, but it was a good step in the right direction.

Jacob Sugarman

You can follow Jacob Sugarman on twitter @jakesugarman.

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