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Anxiety is a normal and essential part of life. It acts as a motivator. It is a function of the ancient need for vigilance, an evolutionary ‘must have’. As a part of the full spectrum of our lives we feel anxious much of the time. We worry about our children, about having to gave a talk in public, about a job interview. Wemay have lef the house then worry that we have not locked doors and windows, or that we have left the oven on.

However, anxiety goes beyond the normal range for millions of people. Anxiety is one of the commonest mental health conditions. Depression often accompanies anxiety. Anxiety is not simply a ‘mental’ state: it affects, and is affected by, the body and all its organs. . A hangover – which is a temporary illness – often brings severe anxiety to join its unwelcome symptoms. Severe anxiety, apprehension of doom or death, accompanies some heart attacks.

Among clinical anxiety orders is included a diagnosis of generalised anxiety disorder, a chronic unease and state of worry. Anxiety can directly affect the body with digestive disorders, ‘butterflies in the stomach’, irregular heart beat. A very intense and unpleasant experience of anxiety is in panic attacks. In panic disorders one may feel that one is about to die, that something dreadful is about to happen, even that one is abou to die. Obsessive compulsive disorder is classed as a severe anxiety disorder.

There is no neat line between ‘ordinary’ and ‘clinical’ anxiety. Mental ‘disorders’ are best seen as extremes on a spectrum of normal human experience, exremes which have a significant impact upon quality of life and funcioning. Such extremes are treated by medication, counselling and ‘talking therapies’ such as cognitive behavioural therapy.

Some people are more anxious than others because of their constitution, the genetic factors: they are in higher states of arousal, classically the condition of introverts who are uncomfortable with too much social interaction; shyness is a form of anxiety. Others are made anxious by experience. Adverse childhood experience is a key factor: abuse, inadequate parenting, trauma in a young child who lacks all the adult defences may scar permanently. Such childhood experiences can lead to a range of other problems later in life including addiction.

One of the commonest reasons for addiction taking root is given by the self-medication hypothesis. This essential states that a mood of distress such as anxiety is found to be relieved by a substance or behaviour such as gambling. Not all addiction follows this course, but where it does, recovery must take account of the underlying factors.

There are other ways of looking at anxiety than through  medical or therapeutic perspectives. For instance, it’s interesting to note that the word itself has its roots in the same Latin word which means anger, and that Latin root itself came from a meaning of choking or strangling. Anger itself is one of our basic emotions, a response to danger which is often immediate and without thought. It’s not hard to feel how some forms of anxiety are experienced as an angry turmoil. Anger is strongly related to fear. Anxiety has been likened to fear ‘without an object’, a vague but very uneasy feeling of fear that something very dangerous but ubknown is very near. When a person is anxious, having no object to be fearful of, they may ease their anxiety by turning it into fear of a specific object. Hatred and social evils such as racism are related to this process wherein a deeply anxious, fearful person projects anger towards an object.

In those many parts of the world where chronic absolute poverty, starvation, war and other horrors exist, everyday life is largely fearful of specifics. Where is the next mouthful of food coming from? Will the soldiers come tonight? But in rich nations here basic material needs are largely satisfied, for many who have everything there remains a deep underlying unease. hen all the material needs are satisfied what is the person left with? Many people prosper and live satisfying lives; many with similar material security do not. A chronic anxiety fills the days. The poet W.H.Auden coined the term ‘The Age of Anxiety’ for a long poem in the 1930s.

The sense of this sort of anxiety – unexplained fear – is accompanied by a sense of emptiness. The experience can be one of racing thoughts all going nowhere, restlessness, inability to be at peace with oneself and the world. One reason that such unease occurs in rich countries is that we have the luxury or horror of facing fundamental human problems. We spend a lot of mental energy, for instance, pushing down the fact that not only are we going to die but e may die in the next moment. We learn to block feelings of dread when people close to us suffer and die. Alone, we seek distractions to stop thinking deeply. Much – much more! – has been written around such cheerful points by philosophers and others, but the essential point is that everyone faces these questions or, more commonly, refuses to face them.

Addicts are no different. When you label someone an addict you often disguise the fact that they are as much a human being as anyone else. If you label someone a doctor, you can forget that more importantly they are a human being. In some ways people who are addicts are extreme examples of individuals who have sought and found a means of escaping a world that is ultimately meaningless. The world escaped from is full of anxiety, suffering, death – and the hard, hard work of getting along with other people (‘Hell is other people,’ the philosopher Sartre wrote). The addictive moment, when an addict engages with the drink or the gambling machine, is also an escape from time. Time is the demon at the heart of anxiety. It is the fear that the future, the next hour, the next minute, the next second will bring something overwhelmingly dreadful. The worst anxiety is Dread.

Starting in the United States, the phrase ‘the machine zone’ was employed to refer to the unique state of being between gambling machine and user. The zone is a time one more than a place one, or rather a timeless zone. All the Dread and anxiety associated with time dissolves. The ‘zone’ is a double whammy. It removes the deep negative anxiety of time and provides a positive experience of intense power, independence from the flow of time, and something akin to those ecstatic moments produced by drugs and some religious rites. The latter themselves may be deemed a form of addiction. To a lesser extent, the ‘ordinary punter’ may escape anxiety by shopping, bargain hunting, social media, internet addiction, hoarding, proud housekeeping, fooball, reading, climbing, exercise, over-eating… Addiction seen this way is an extreme example, a very harmful one, of ordinary human behaviour. Most people have a range of distractions, some healthy and some not, but addicts centre their lives around one major objec of desire.

The wealth of modern rich economies is built less on coal and steel than on consumer products. Businesses that provide these products to a large extent reach the need of customers to chase distractions from the pressures of life, and to fill what would otherwise be a terrible emptiness. Business practice is as much a reflection as a driver of culture, its own practice dependent upon and informed by the culture(s) we all live in. Some business, however, also sets out to exploit vulnerable consumers, and this can be seen in financial products including respectable high street names credit offers. The worst cases are exorbitant interest fees for loans and cheating old people of their savings and homes. In he case of gambling and drinks industries it appears that those most vulnerable to harm are exploited. Cheap high strength alcohol is made available for pocket money prices.

Moving towards a conclusion now, i can be argued that states like anxiety and depression are common experiences and we seek ways to escape them. Some ways are relativelt harmless but addiction brings with it not only severe life and health problems but an increase in both anxiety and depression. Addictive engagement seems to bring about a quick way of switching moods very quickly, that switch is the attraction. This isn’t the case for everybody: addiction is a complex condition dependent on many factors peculiar to the individual. But it’s certainly true that many people have felt ‘lost’, anxious, depressed, unable to concentrate as thoughts race. These feelings are not uncommon in society as a whole. Many who are a long way from clinical anxiety and addiction nevertheless live a life permeated by unease, a vague pervading anxiety. In the case of full blown addiction, this unease is intensely powerful and negative, and the only sure ‘way out’ seems to be the ‘fix’ which will lead, of course, to deeper anxiety, guilt, shame, all the impossible attributes of feeling helpless, powerless in the drive to do the one thing one desperately does not want to do.

Those of us who have known addiction or are struggling with it may acknowledge that we have not learned the coping strategies of facing everyday unease. The psychiatrist Sigmund Freud said that his therapy was designed simply to move people from ‘neurosis’ to ‘common unhappiness’. Even the happiest, most contented people have periods and episodes of unhappiness and unease, but they have found positive things in life against the negative background – family, music, donkey racing, clmbing, music, reading, exercise, volunteering, whatever. Recovered or recovering addicts lapse often because the negative unease persists, and perhaps it’s here that medication or other therapies are most important. But when people do recover they don’t become saints or bundles of joy: they slowly come to terms with the anxiety and unease that is part of the package that all humans have to live with to be alive.