By Lynda Goetz
Pexels - Stress Kindel Media
It is almost certainly true to say that for the majority of the population in the developed world, living conditions and ‘quality of life’ have never been better. Looking at this from a historical perspective, there is little doubt that, for most of us, our material living conditions are far higher than they have ever been. The hierarchies of the past are being broken down. On the whole the expectation of the majority is that they should be able to earn a reasonable wage, without working unreasonably long hours, to provide for their families; to not only put food on the table and a roof of some sort over their head, but also to go on holidays and enjoy up-to-date technologies and fashions. Leaving aside the inadequacies and the complaints, education and healthcare in most of the developed world are universal. Why then is ‘anxiety’ the children’s word of the year and why are so many adults (as well as children) suffering from stress and other mental health issues? Leaving aside for now the immediate effects of the pandemic, what is it about our modern world that makes this such a widespread problem?
Is it perhaps just a matter of semantics? The word ‘stress’ as a verb was originally associated with emphasis; and as a verb and a noun with physics and engineering, relating to pressure or tension on a material object. It was first used in a medical or psychological sense less than a hundred years ago in the 1930s by endocrinologist Hans Selye. Time magazine published an interesting article in 1983 entitled Can We Cope? (which I found as a link from a brief article more recently in 2016 about Dr Selye). It is clear that whilst Dr Selye may have coined the use of the term in a medical sense, the damage done by ‘stress’ to the human body is absolutely not a vague feeling, nor simply the application of a word from another scientific field to the field of medicine, but a measurable effect, which can have physical as well as mental repercussions.
What about ‘anxiety’? Life has always had its worries, but when did natural anxiety spill over into ‘anxiety disorders’? Mind, the mental health charity, lists nine different kinds of “commonly diagnosed anxiety disorders” on its website under the subject, but it appears harder to find much about the history of such classifications. In the Unites States however, the National Center for Biological Information (NCBI) does have several papers addressing the subject. Contrary to some impressions, the existence of anxiety disorders may not simply be a modern problem. In an article written in 2015, and appearing in the PMC (PubMed Central, the US National Library of Medicines’ digital archives) French doctor, Marc-Antoine Crocq MD, writes about the History of Anxiety from Hippocrates to DSM (Diagnostic and Statistical Manual of Mental Disorders). For those interested in semantics and terminology as well as psychology, his article is fascinating and suggests that whilst the Greeks and Romans may have had some understanding of what we call anxiety disorders, and even used similar terminology, “there was an interval of centuries when the concept of anxiety as an illness appeared to have disappeared from written records”.
As knowledge and classification of psychiatric and mental health disorders has developed and evolved the approach to and treatment of different conditions has been refined. DSM-5, first published in 2013 by the American Psychiatric Association, has refined classifications. However, here in the UK there is no separate psychiatric classification and the National Health Service uses the World Health Organisation’s International Classification of Diseases (ICD). What seems very apparent is that whilst the ability of doctors and scientists to treat physical illness and physical damage has advanced in leaps and bounds over the last couple of centuries, understanding of mental issues has much further to go before humans can claim to be able to treat many problems of mental health. Apparently, according to Dr Crocq, “Ancient Greek and Latin authors reported cases of pathological anxiety, and identified them as medical disorders. The therapeutic techniques suggested by ancient Stoic and Epicurean philosophers would not seem out of place in today's textbooks of cognitive psychotherapy”.
In May 2018, after a survey showed that 74% of the UK population considered that they had felt overwhelmed by stress at some point during the previous year, Dr Jay Watts wrote in The Independent that the problem was the “brutal” and “hostile” world in which we are living; that lifestyle tips were “the opium of the people” and that the “levelling of society” was the only solution. Whether or not one agrees with her views, it is hard not to connect the vicissitudes of modern life with the apparent increase in the number of people suffering from some form of mental health problem. The ‘human condition’ has always been complex and the complexity seems to increase decade by decade or even year by year as the population increases, living conditions become more crowded and our reliance on technology and all things material grows exponentially. Fewer and fewer, at least in the West, have the comfort of religion to fall back on.
We have more choice now than ever before; choice not just in terms of retail purchases, but in important and significant lifestyle decisions. We have to make choices about which subjects to study at school. These choices lead in turn to choices about which jobs or careers we can do. When we choose our partners we are no longer limited to those in our village or our parents’ social circle or even those of the opposite sex. We can choose whether or not to have children – without choosing celibacy - see my article Selfish or not? The kids question (only-connect.co.uk). We can choose, within certain limitations, where in the world we wish to live. Most of these choices were not available to the majority until relatively recently. Choices were constrained by geography, social class and education, or rather lack of it. Although a few managed to escape the confines of the place and family into which they were born, for the majority there was not a choice, simply the need to fit into the strata of society and location of their birth. Resignation and acceptance of the role Fate had dealt was often the only policy. Religions claimed to provide answers – often in the form of promises about an afterlife, but religions rarely offered choices. The freedom we now have is in a way a part of the modern problem.
Freedom to choose has, for many, led to anxiety and stress. Am I making the right choice? Did I make the right choice? Will I make the right choice? How does my life look to others? How does it compare to the lives of others? Many no longer have the small certain structures of family and local life to support them. Families are often broken and cities can be lonely places. The State, whilst it may try to control and to ‘nanny’, cannot really be expected to nurture. As more and more people have the education and the leisure to think, more and more become distressed by the ‘human condition’ which has exercised writers and philosophers over the centuries. People become polarised in their views and the stresses of modern living becomes exacerbated.
The answers to the problem remain elusive. That the problems have probably existed as long as Man began to develop thought and speech are almost undeniable. That there is an increase in the numbers suffering from stress, anxiety and related mental health issues in the modern world is equally undeniable. Hannah Arendt in her book The Human Condition*, first published in 1958 (which I have to confess I have not read), whilst generally viewed as brilliant, apparently offered no solutions. On the other hand, Australian biologist Jeremy Griffith, in an interview - The Human Condition Solved - in which he discusses his book Freedom: the End of the Human Condition, absolutely considers that he has the answer to the problem. He posits it lies in the battle between “instinct and intellect”.
I suspect it will be some time before the answers to the problems of being human are resolved, but in the meantime, perhaps someone might point out to all those strutting autocratic regimes around the world of “the pressing need to create a gentler, fairer environment, less hostile to our basic needs to feel connected, valued and safe” as Dr Watts concludes in her article for the Independent. By the time that happens, we may not, if Elon Musk** and others have their way, be entirely human at all.
**Neuralink, the company he co-founded is, along with rivals, Science Corp and Synchron, attempting brain computer interfacing.