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We risk over-diagnosing anxiety. There’s another way to look at it

The intense focus on our emotions and internal mental states without considering what is causing them can have problematic side effects

Rather than fearing anxiety, Rory McIlroy harnessed it to help him win the 2025 Masters. Photograph: Richard Heathcote/Getty Images
Rather than fearing anxiety, Rory McIlroy harnessed it to help him win the 2025 Masters. Photograph: Richard Heathcote/Getty Images

Something quite shocking has happened in the last 20 years.

In the 20th century, survey after survey identified a hump of unhappiness in the mortgage-burdened and career-stressed middle-aged. The young and the old, in contrast, were as happy as sandboys. But suddenly, all that has changed. Now research finds that the young are as miserable – in some studies more miserable – than their middle-aged parents, uncles and aunts.

A major UCD study of 10,000 people aged 12 to 25 in 2019 found 22 per cent reported experiencing severe anxiety. Researchers at the Royal College of Surgeons found more than a quarter of school-aged adolescents described their mental health as “bad” or “very bad” in 2021.

The hump has changed to a ski slope, as one researcher put it. Only oldies are happy.

Why has this happened? We don’t know for sure and social media use – constant comparison, doomscrolling, cyberbullying – almost certainly play a part. In a world of escalating geopolitical conflicts, Donald Trump’s threats against Greenland, the rich getting richer and leaving the young house-less behind them, and now AI uncertainties shadowing almost every potential career, it would, in some ways, be a wonder if anxiety wasn’t increasing.

Psychologist Jonathan Haidt, author of The Anxious Generation, has fingered another factor at play. This was a progressive decline in the amount of time that young people spent out of the home, playing freely and unsupervised.

If you are over 40, chances are you roamed relatively freely as a young teenager. Under 40? Your leisure time was probably more orchestrated and adult-controlled.

We know teenagers who have a Saturday job on average become more emotionally robust and confident adults than those who did not have one. They are thrown on to their own resources and no longer protected – in the worst cases coddled – by over-anxious parents. In the adult working world, they rub against the rough edges of human interactions: they make mistakes and suffer the consequences; they get bored; they feel out of their depth and have to deal with it. A Saturday job is not a requirement to become an emotionally resilient, confident young adult, of course. But what is a likely precursor is the confidence that develops from doing things in the face of difficulties and in spite of anxiety.

And confidence is the greatest antidote to anxiety.

There is another way of looking at anxiety – as an opportunity to build resilience. That is not to diminish the distress of those experiencing anxiety as a disorder, but for many of us, it is simply a part of life – not always something to be feared, but an opportunity to build resilience.

Consider this. If I have a racing heart, dry mouth, sweaty hands and twisting stomach, what emotion am I having? Anxiety may be what springs to mind, but in fact these are also the symptoms of anger and excitement. So here’s the puzzle: if I feel exactly the same symptoms for these two opposite emotions – anxiety and excitement – how do I know what emotion I’m experiencing?

The answer is simple: by context. If you are about to watch Ireland play France in the opening match of the Six Nations, then you might label them as excitement (an emotion in this case quickly followed by disappointment). But in a dark house alone at night, the emotion becomes fear. These symptoms just prepare you for action.

This primitive arousal system is neutral about what that action should be: it doesn’t care whether you are running away, throwing a punch or celebrating a great try.

One of the worst things about anxiety is fear of fear – anxiety about anxiety. That is why, when we pathologise routine experiences of anxiety that are part of everyday life, we risk feeding the problem. Some anxiety is unavoidable and it can be an opportunity to build resilience. Left to their own devices, emotions are usually self-limiting. But when we focus our attention on them, they linger. Anxiety, in particular, can increase when we start to notice the fight-or-flight symptoms and worry they will surge.

Our world is rightly much more aware now of the psychological stresses that most of us experience from time to time. Awareness is positive. It is certainly an advance from the “pull yourself together” approach that I grew up with. But this intense focus on our emotions and internal mental states without considering what is causing them may have some problematic side effects.

One such potential side effect – a particular problem with the over-diagnosis we see on social media – is the attaching of a label to oneself. When you say “I have anxiety” and see it as a “thing” that afflicts you, that can undermine your sense of control. If you change your perception of the threat, your thoughts about it and your actions towards it, the anxiety will change too.

Clinical psychologists and cognitive behaviour therapists know this and can offer help to deal with anxiety. But the scale of the problem is now so great that there will never be enough therapists to deal with the ski slope of unhappiness that researchers have identified. And anyway, do we really want thousands of Irish children, teenagers and adults to be submitting themselves en masse to individual therapy? Should we not be reserving precious therapist skills for the most severe and needy cases?

Happiness and mental wellbeing require a balance between two things: a focus on action in the external world on the one hand, and introspection in the internal world on the other. Too much time on our own, scrolling on phones or brooding over Facebook likes tends to turn us inward. If we focus our attention too much and too long on our emotions and internal world, we risk incubating vicious cycles of anxiety and unhappiness.

Anxiety’s evolutionary purpose is to protect us from threat. The consequence of that is avoidance. In some contexts, that may be useful, but anxiety makes us do less stuff.

There is a better way to think about it. Emotions such as anxiety, anger – and excitement – are a form of energy. Rory McIlroy famously welcomed his early double-bogey at the Masters – he embraced this “failure” and harnessed the autonomic nervous system energy it caused to help him go on to win the tournament. Rather than fearing his anxiety, he harnessed it.

How a sports psychologist helped Rory McIlroy live with the raging doubts and secure career Grand SlamOpens in new window ]

Anxiety is not pleasant and for some it is debilitating and needs professional help to be overcome. But for many of us, it can be if not a friend, maybe an edgy acquaintance who gets us out the door with our minds focused on challenge in the external world rather than imagined threats inside our heads.

Prof Ian Robertson is a neuropsychologist and author of How Confidence Works and The Winner Effect