John Brockman - What Should We Be Worried About?

We could try closing the widening worry gap with data. If we could calculate the relative risk of death by snakes, spiders, cars, and guns, we could compare the discrepancy between what we worry about (e.g., spiders) and what statistically causes more deaths (e.g., cars). Then we could try to swap our lower-ranked worry with a higher-ranked worry. We could even sketch the outlines of software that facilitates a better reallocation of worry. (I’m looking at you, mobile-application developers.) If we’re going to worry about something, it might as well actually threaten our existence.

Another option for closing the worry gap involves policy change. Governments undoubtedly collect valuable data on the relative potency of various threats so as to direct their limited resources toward reducing the most pressing dangers. But information alone is not enough; it must motivate behavioral change. Thus, laws (with enforceable sanctions) are sometimes needed to transform this information into action. Unfortunately, in the case of global threats, governments must coordinate their laws. This is not impossible; it has happened in the past, when governments came together to ban chlorofluorocarbons in order to stop atmospheric-ozone depletion. It may happen in the future with respect to carbon sequestration and global climate change. But it requires a massively coordinated and continued effort.

I’m advocating metaworry rather than hyperworry . Hyperworry feeds on itself: Escalating worrying about worrying could fuel a positive-feedback loop, ending in a fearful freeze. Since the brain has limited energy, we should probably view worry as a resource to be conserved and efficiently allocated. Beyond increasing the worry level, metaworry implies redirecting worry based on information. Retuning our ancient worry engines may be difficult, but not impossible. Consider laws requiring the use of seatbelts while driving. What I find miraculous is not that these laws have become mandatory in most U.S. states, nor even that they reduce fatalities as predicted, but rather that the laws now grab me at a visceral level. Twenty-five years ago, I would never have thought twice about driving without a seatbelt. Now, when I can’t buckle my seatbelt I feel uneasy and tense. In a word, I worry—and seek to close the gap.

JOEL GOLD

Psychiatrist; clinical associate professor of psychiatry, NYU Langone Medical Center

Worry in and of itself can be extremely corrosive to our lives. The things we worry about tend to be distinct from those problems that grab our attention, stimulate us, and mobilize us to action. It is useful to recognize a potential or imminent danger and then do something about it; it is quite another matter to ruminate in a state of paralysis. Taking scientific, political, or personal action to address climate change is progressive. Lying sleepless in bed thinking about the melting polar caps does nothing but take a mental and physical toll on the insomniac.

The very word ”worry” connotes passivity and helplessness: We worry about some event in the future and hope it works out. And the question we are posed this year implies that much of how we worry is irrational. I’m confident that many of the responses addressing what we shouldn’t be worrying about will reassure readers because they will be specific and supported by the evidence. “Don’t worry, be happy” bromides are of no use; notice that people who are told to “relax” rarely do.

Moreover, there is a large segment of the population for whom the serenity prayer really doesn’t cut it. They can’t distinguish between the obstacles in life they might actively address, thereby diminishing worry, and those for which there is no salutary behavior and are therefore best put out of mind. These people worry not only about problems that have no solutions but also about circumstances that to others may not seem problems at all. For this group, irrational worry becomes pathological anxiety. I am writing about the tens of millions of Americans who suffer from anxiety disorders.

I currently treat people in my psychiatric practice who are often derisively called “the worried well.” They are most certainly worried, but they are not at all well. No one would question the morbidity associated with the irrational fears of the psychotic patients I once treated at Bellevue Hospital: the fear that they were being poisoned; that thoughts were being inserted into their minds; that they had damned the Earth to Hell. Yet trying to rationally explain away someone’s phobia—aside from the use of structured cognitive behavioral therapy—is no more useful than trying to talk someone out of his delusion.

People with anxiety disorders suffer terribly: The young man with OCD, tormented by disturbing imagery and forced to wash his hands for hours until they bleed; the veteran haunted by flashbacks of combat, literally reexperiencing horrors physically survived; the professional who must drive hundreds of miles for fear of flying; the former star athlete, now trapped, unable to leave her home, fearing she might have another panic attack at the mall or while driving over a bridge. And the numbers are staggering: Anxiety disorders are the most commonly diagnosed psychiatric disorders, afflicting nearly 20 percent of all adult Americans each year and almost 30 percent over the course of their lives. Those suffering from phobias, panic, generalized anxiety disorder, PTSD, and the rest are more likely to be depressed, more prone to substance abuse, and more likely to die younger. And before death arrives, whether sooner or later, enjoyment of life is vitiated by their anxiety. Pleasure and anxiety do not co-occur.

We all want to avoid the biological and social risk factors for anxiety, but for tens of millions of Americans and hundreds of millions worldwide, it is too late. Once morbid anxiety takes hold, only psychotherapy and/or psychopharmacotherapy will suffice. Worry descends upon the worrier like a fever. Without appropriate treatment, that febrile anxiety burns away at the soul. With such treatment, the fever may break. Only then can the worried become well.

DOUGLAS RUSHKOFF

Media theorist; documentarian; author, Present Shock: When Everything Happens Now

We should be worried about the decline of the human nervous system. We should be worried that something—likely environmental but possibly more subtle than that—is hampering our ability to parent new human beings with coherently functioning perceptual apparatuses. We should worry about what this means not just for our society’s economic future but for the future of our collective cognition and awareness as a species.

Consider the rising proportion of our youth who are classified as “special needs.” By current count, one in eighty-eight children has an autism spectrum disorder—and one in fifty-four boys. Eight percent of children between three and seventeen years old have a learning disability. Seven percent have ADHD. And these figures are rising steadily. The vast majority of children with spectrum disorders also suffer from “co-morbidities,” such as anxiety disorder, sensory-processing disorder, intellectual disabilities, and social disorders. These special-needs children will likely need special education and then special care and special caretakers for the rest of their lives. Someone has to pay for this.

Moreover, as the numbers of children affected by these impairments increase, the amount of resources remaining to raise and educate the “neurotypical” members of our communities go down. The more children requiring $100,000 and up of special-needs education each year, the less money remains and the larger the regular classes must become. There are of course many social remedies for these problems, from increased community support and involvement to radical rethinking of education itself. But the less well educated we are, the less prepared we are tackle these issues.