On Jan. 13, Hawai’ians received a terrifying text: "Ballistic missile threat inbound to Hawai'i. Seek immediate shelter. This is not a drill." The alert was triggered accidentally, but chaos reigned for nearly 38 minutes until a correction was issued. The state’s governor later reported that children sought refuge in manholes, stores closed and denied shelter to terrified customers and cars drove at high speed. Three days later, Japan’s public broadcaster, NHK, mistakenly sent a similar alert warning that North Korea had just fired a missile. A correction was issued in five minutes.
The mishaps further intensified the anxiety of many Americans who were already alarmed by the elevated tensions between the United States and North Korea.
Last November, North Korea tested a missile that experts believe can strike anywhere in the U.S. mainland. The rhetoric between the two nations has escalated as well. Last September, Pyongyang threatened to reduce the United States to "ashes and darkness," while President Donald Trump has promised to deliver "fire and fury" to Kim Jong-un’s regime.
Such nuclear brinksmanship hasn’t been seen since the twilight of the Cold War. For the first time in at least a generation, Americans are confronting not only the possibility of a nuclear attack, but also a 24/7 news cycle transfixed by that possibility.
Last August, a CBS poll found that 72 percent of Americans are uneasy about a possible conflict with North Korea. That same month, the Chicago Council on Global Affairs reported that 75 percent of Americans consider North Korea’s nuclear program a top threat. In perhaps the most dramatic example of simmering panic, the Bulletin of the Atomic Scientists set the Doomsday Clock, which symbolizes the likelihood of global catastrophe, to two minutes to midnight in January. The last time it was this close was in 1953.
While no one knows what the future holds, people’s fears are very real—and the threat appears to be cropping up more often in psychologists' offices. Although there are no hard numbers to report, anecdotally psychologists say they are seeing more anxiety over a possible nuclear showdown.
'Clinically significant anxiety'
People were particularly uneasy in Hawai’i, even before the false alarm. Last December, the state tested its nuclear warning siren system for the first time since the Cold War. The Hawai’ian Islands are about 4,600 miles from North Korea. A nuclear missile would make landfall in 20 minutes and kill an estimated 18,000 civilians. Molly Bahr, a licensed therapist in Honolulu, says that never in her 10-year career has she seen such an increase in the “frequency and intensity of fear and clinically significant anxiety,” even among clients who haven’t previously experienced such symptoms.
Unlike during the nuclear scares of the 1950s, ’60s and ’80s, today’s anxiety ricochets nonstop between cable news, social media and online forums. In an age of breaking news alerts on smartphones, simply being an informed citizen means volunteering oneself for continuous stress. Graham Davey, PhD, an emeritus professor of psychology at the University of Sussex in England who specializes in anxiety disorders, notes that contemporary news consumers are experiencing trauma-like symptoms because of their exposure to broadcasts and breaking news.
“One of the effects that we’ve researched is that exposure to negative news causally influences your own personal worries by making you catastrophize them more,” Davey says. (In a 1997 studyopens in new window, Davey and his colleagues found that people exposed to negative news reported feeling sadder and more anxious after, and they also tended to obsess over their own worries more.)
Internalizing negative news is especially prevalent in the United States, where APA’s 2017 Stress in America survey found that 95 percent of Americans follow the news regularly. One in five Americans, or 20 percent, report that they check their social media constantly, a significant increase over 2016. More than half of those surveyed said that the news causes stress.
Nobody knows the potential long-term psychiatric effects of nuclear anxiety. Clinical studies on the matter are scarce, and because America hasn’t grappled with a serious nuclear adversary in decades, the pathology of this anxiety has yet to be fully documented. Davey suggests that the anxiety is temporary and tied to negative news reports, but when the news is overwhelmingly negative, as many patients feel it is today, anxiety is a chronic response.
Advising patients
Laura Brown, PhD, a psychologist in Seattle, was 10 during the 1962 Cuban Missile Crisis. She believed then that her hometown of Cleveland was a target, so she practiced a prayer ritual and wrote imploring letters to President John F. Kennedy.
“I still remember how frightened I was and how frightened the adults were,” Brown says today. “I was fearful that the world could end at any moment.”
More than a half-century later, Brown once again lives in a city that she believes could be in the crosshairs of a rogue regime. Seattle, one of the most populated metro areas on the West Coast, has strategic value as a nuclear target. It’s near the Whidbey Island and Kitsap naval bases and the Joint Base Lewis-McChord (formerly Fort Lewis and McChord Air Force Base). In addition, Boeing Aviation operates several facilities in the area.
“I’ve never experienced so much discussion from people who are feeling anxious and fearful,” Brown says.
She advises clients to reduce their time online and read news when they’re less likely to feel vulnerable: midafternoon, for example, instead of just before bedtime.
These strategies are the starting point for recommendations of psychologists now counseling an unprecedented influx of patients worried that America is careening toward disaster.
Like Brown, David H. Barlow, PhD, founder of the Center for Anxiety and Related Disorders at Boston University, advises his clients to take “a little vacation” from their iPhones and social media. “It’s unrealistic to think everyone can pull a Thoreau and go off to the woods for a year, but everybody needs a day off,” Barlow says.
He encourages those who are particularly anxious to designate a “worry room” where they can retreat each day at a scheduled time to mentally purge whatever troubles them at that moment. Barlow provides his clients with exercises to interrogate and evaluate their anxieties.
One unexpected offshoot of all of this anxiety has been energetic political activism. Brown notes that people who never before evinced much interest in Washington, D.C., or city hall are suddenly campaigning on behalf of their pet causes. Michael Tompkins, PhD, co-director of the San Francisco Bay Area Center for Cognitive Therapy, encourages his clients to vote, or join grassroots organizations, or donate to worthy causes. These “small influence” behaviors can sometimes be enough to give clients a sense of control over unpredictable events. In addition, he prescribes basic self-care, including exercise, good nutrition, plenty of sleep, and time with family and friends. “We always have something to worry about as a nation,” Tompkins says. “And we will have other things to worry about. Not everyone who worries has an anxiety disorder.”
