Start and finish: Off trail in San Francisco
After nearly two weeks being back in the Bay Area, I no longer felt jarred by the social pressures I confronted every day. I had learned again how to tune out the advertising telling me that my complexion was subpar, to block out the people next to me at coffee shops talking about their next big get-rich-quick startup idea. However, as my own sense of anxiety was fading, I picked up more on the low-level anxiety that seemed to haunt many Bay Area denizens.
In particular, I had a conversation with one acquaintance who had started taking medication for depression and anxiety. When I asked this person about why they felt they needed the medication, he said he often worried, especially about what other people thought and whether he was doing the right thing. I asked him some more questions to try to understand more about how frequent and severe these thoughts were, as these sounded like normal thoughts to me, at least in moderation. The more he described, the more I questioned whether he actually had these doubts more often than the average person, and if they were in fact unhealthy – as trying to eradicate them with medication implied.
To be clear, I do believe there are many cases of depression and anxiety where medication can help people live a happier and healthier life. In addition, I think that it’s up to each individual to decide where the line is between healthy and unhealthy levels of those emotions. That said, the rise in prescription medication for depression and anxiety – a fourfold increase in 20 years – and its prevalence in society (one in 10 Americans take an antidepressant, with whites and women skewing even higher) make me wonder whether we might have turned normal emotions into clinical problems. (Furthering my suspicion that this might be the case – and not, say, that it’s purely that we’re doing a better job of recognizing and treating depression and anxiety – is that the value of the market for these medications is now close to $15 billion and projected to rise to $20 billion by 2020.)
Put another way: Sadness and worry seem to me to be a normal, healthy part of the human condition, and it might be the changing context of our expectations that make it appear as though these emotions are unhealthy. Looking at ground squirrels scatter at the sound of my footsteps or a deer dart after it catches me in the corner of its eye, it’s clear that it’s quite natural for animals to be jumpy. However, I would not call these animals anxious, but rather appropriately alert – they are prey and might be attacked at any point. Of course, if they lived on an island where they had no predators (for example, the Galapagos Islands), their behavior might seem unnecessary. Similarly, when people are labeled as unnecessarily sad or anxious, the implicit assumption is that they don’t have anything to be sad or anxious about. Given that our country occupies a fragile precipice between stability and chaos, when we’ve had a major financial collapse within the past decade (and another likely to come within the next decade), when income disparity is at its greatest in a century (and the power of employers has likewise grown exponentially after the 2008 recession and the ensuing mass unemployment), when we are continually bombarded by messages of panic from our media, I’m not sure this is a fair assumption.
It doesn’t help that our popular culture has come to embrace pollyannaish movements and gurus as a way of providing a bit of hope to a sometimes-bleak existence. For example, schemes like The Secret or the power of positive thinking implore people to visualize goals as a means to achieving success. The mechanism supposedly at work here is that if you will something enough, it will happen. While this might be helpful in limited circumstances, it also implies that people who are not achieving success are simply not willing it enough. This can lead to people doing some pretty dumb things, like burning their feet walking across hot coals. Furthermore, by following this logic, depression and anxiety would be the result of a lack of will – a product of one’s own actions – and little else.
While medication implicitly removes a degree of control over our mental state and positive thinking philosophies claim a simple solution, I’m more attracted to a middle ground like treatment through cognitive-behavioral therapy. With this approach, people are taught to recognize the onset of a bout of adverse emotions then react to those thoughts by rationalizing the concerns and putting them in context (which could also mean accepting them as valid and coming to peace with them). What appeals to me about this is that it rests on the premise that these emotions are reasonable and normal, but gives people the tools to help manage them when those emotions might not be convenient. Unlike both medication and positive thinking gurus, cognitive-behavioral therapy doesn’t view the emotions or the people who have them as the problem – it is the context that is the issue – and the focus is on building confidence and competence.
I’ve found that hiking, in its own way, has been a bit of a therapy for me, building up my confidence in ways that apply more generally to my life. For example, when I encounter a stream with a low flow and it is hard to collect water, I might weave together several leaves and then stick that into the stream to create a makeshift spout. While this is narrowly about the ability to get water in the desert, it also shows me that I can solve problems creatively, even under difficult conditions. Likewise, when I push myself on to finish a tough stretch of miles, it’s not simply a sign of physical fitness, it’s also represents an ability to persevere and prioritize long-term goals over short-term rewards.
Moreover, this confidence is generalizable – if I can learn one skill, I should be able to learn other skills with sufficient time and practice. Armed with this knowledge that I can tackle complex problems – and that there are some problems I just can’t tackle – I find that anxiety and depression are emotions that I rarely feel on the trail. I’m not saying hiking is a panacea for all ills, but maybe getting outside – relying on oneself and navigating difficult challenges in an environment where it’s normal to be a bit wary of surroundings and to be continually reminded of death – could be part of a solution.