The Anxiety Tax

Elena is sixteen. She cannot sleep.

Not tonight specifically, though tonight is bad. She lies in the dark in her bedroom at Sarah’s house, Margaret’s granddaughter in a room decorated with remnants of childhood she has not yet replaced. The glow-in-the-dark stars on her ceiling, applied when she was eight, cast their faint green light on a person they no longer describe. She is awake at 1:40 a.m. on a school night and she does not know why, exactly, except that her body will not stop humming.

She scrolled her phone until Sarah took it at eleven. Before the screen went dark she had read an article titled “Which Jobs Will AI Eliminate by 2030?” followed by an article titled “Why AI Will Create More Jobs Than It Destroys” followed by a thread in which people her parents’ age argued about whether learning to code was still worth it, whether college was still worth it, whether anything she might do in the next six years of preparation would connect to anything on the other side.

Elena is not diagnosable. She does not have an anxiety disorder. Her school counselor, whom she saw once and did not return to, told her that some worry about the future is normal and that she should try breathing exercises. The breathing exercises did not address the problem, which is not that Elena’s breathing is wrong but that her perception is correct. The world she is preparing to enter is genuinely uncertain in ways that no previous generation of sixteen-year-olds has faced at this speed and scale, and her body is responding to that genuine uncertainty with a stress response calibrated by evolution for environments where threats were immediate, physical, and resolvable.

Elena’s anxiety is not a malfunction. It is her body’s correct response to an environment of ambient, unresolvable threat. And that correct response is destroying her health.

What the Body Does

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Bruce McEwen spent decades studying what happens to a body under sustained stress. Not acute stress, the kind that spikes adrenaline and resolves when the threat passes, but chronic stress, the kind that never fully resolves because the threat never fully passes. He called the cumulative cost of this sustained activation “allostatic load”: the wear and tear on the body’s regulatory systems from being kept at alert status indefinitely.

The mechanisms are well documented. Cortisol, the primary stress hormone, is designed for short deployment. It mobilizes energy, sharpens attention, suppresses non-essential functions like immune response and digestion. In acute stress, cortisol surges and then subsides. In chronic stress, cortisol becomes baseline. The system that was designed to sprint is forced to run a marathon.

The consequences accumulate. Sustained cortisol suppresses immune function, making the body more vulnerable to infection and slower to heal. It promotes visceral fat storage, increasing cardiovascular risk. It impairs the hippocampus, degrading memory and learning. It elevates inflammatory markers, contributing to a cascade of chronic conditions from diabetes to depression. The body, running at emergency speed indefinitely, begins to consume itself.

This is not speculative biology. It is established physiology with decades of empirical support. What is new is not the mechanism. What is new is the scale of the stressor.

Elena’s cortisol is not elevated because of a specific threat she could name, address, and resolve. It is elevated because she inhabits an information environment that presents the future as simultaneously catastrophic and unprecedented, that offers no consensus about what is happening or what to do about it, and that refreshes this uncertainty continuously through feeds she cannot fully avoid even when her mother takes her phone at eleven. The threat is ambient. It has no location. It has no resolution. Her body does not know how to stand down from a threat that is everywhere and nowhere, that is not a predator or a storm or an enemy but a condition of the civilization she was born into.

Allostatic load is what happens when the alarm never turns off. Not because it is broken. Because the alarm is right.

The Rationality Problem

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The clinical framework for anxiety disorders distinguishes between rational and irrational anxiety. Irrational anxiety responds to threats that are exaggerated, misperceived, or imagined. It is treated by correcting the perception: cognitive behavioral therapy helps patients recognize that the feared outcome is unlikely, that the threat is manageable, that the catastrophic interpretation is distorted.

Elena’s anxiety does not fit this framework, because Elena’s perception is not distorted.

She perceives that AI is transforming the labor market in ways that may eliminate career paths she is currently preparing for. This is accurate. She perceives that adults, including experts, disagree fundamentally about the severity and timeline of this transformation. This is also accurate. She perceives that the skills she is developing in school may or may not be relevant to the economy she enters in six years, and that no one can tell her with confidence which skills will matter. This is accurate too.

Her body’s stress response is proportionate to the signal. The problem is not that the signal is false. The problem is that a true signal of sustained, unresolvable uncertainty produces a physiological response that the body cannot sustain without damage. Evolution did not design the stress system for threats that last years. It designed the stress system for threats that last minutes, possibly hours. The mismatch between the duration of the stressor and the duration the stress response was designed to sustain is what produces the damage.

You cannot treat rational anxiety by correcting the perception. The perception is correct. You can only treat it by changing the environment. And the environment is not changing in reassuring directions.

This is the specific cruelty of the moment. Elena’s therapist, if she had one, could not honestly tell her that her fears are exaggerated. Her school counselor cannot honestly say that the career paths she imagines will exist. Her mother, Sarah, cannot honestly promise that the world will stabilize before Elena enters it. The adults in Elena’s life are themselves uncertain, themselves anxious, themselves unable to offer the reassurance that would, if it were true, resolve the stress response that is eroding her health.

Jean Twenge has documented the generational data. Anxiety, depression, and self-harm among adolescents have risen sharply since the early 2010s. The causes are debated. Smartphones, social media, academic pressure, political polarization, climate anxiety, each has its advocates. But beneath the specific causes is a structural condition that Twenge’s data reveals without fully naming: this generation perceives the future as more uncertain than any generation in modern memory, and this perception is not wrong.

Three Bodies

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Elena is sixteen and her cortisol is chronically elevated because the future is uncertain.

James is twenty-three and his cortisol is chronically elevated because the present is insufficient. Part 52 described his empty ledger, the career that generates income but not identity, the work that employs him without needing him. James does not lie awake at night the way Elena does. His anxiety manifests differently: a low-grade irritability, a difficulty concentrating that he attributes to screen habits, a tendency to overdrink on weekends that he calls socializing. His last physical showed elevated blood pressure. His doctor suggested exercise and stress reduction. James exercises. The stress does not reduce, because the stress is not coming from inside James. It is coming from the structural condition of being unnecessary in a system that still requires his attendance.

Margaret is seventy-two and her body carries the allostatic load of decades. Not from AI specifically, which arrived late in her life, but from the accumulation of stressors that McEwen documented across a lifetime: the years of managing a household on a librarian’s salary, the worry about Sarah’s marriage, the physical demands of aging, the bereavement when her husband died, and now the ambient anxiety of a world that has changed faster than her capacity to understand it. Margaret’s blood pressure is managed with medication. Her knee pain is managed with ibuprofen and avoidance. Her sleep, fragmented and insufficient, is managed with an over-the-counter antihistamine that her doctor would prefer she not take but that is better than the alternative of lying awake.

Margaret’s body is not responding to a single stressor. It is carrying the cumulative cost of a lifetime of stress responses, each individually adaptive, collectively destructive. McEwen’s research showed that allostatic load is not merely additive. It is compounding. Each stressor degrades the body’s capacity to recover from subsequent stressors. The system that was worn thin by decades of manageable stress becomes fragile in the face of new stress. Margaret’s health is not bad because she is old. It is bad because her body has been paying the anxiety tax for fifty years, and the principal compounds.

Three people. Three ages. Three versions of the same mechanism. The body responds correctly to genuine threat, and the correct response, sustained beyond its design parameters, becomes the damage.

The Meaning Disease

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Part 52 referenced Case and Deaton’s documentation of deaths of despair in deindustrialized American communities. The opioid epidemic, the suicides, the alcoholic liver disease. These deaths concentrated not among the poorest but among those who had lost economic function: people whose communities had organized around industries that no longer existed, whose identities had been built on work that no longer needed them.

Case and Deaton’s crucial insight was that these were not poverty diseases. The communities where deaths of despair concentrated were not, by global standards, impoverished. They had housing, food, television, automobiles. What they lacked was meaning. The answer to “what am I for?” had collapsed, and the body followed where the answer had gone.

Part 28 of this series traced the same mechanism through the lens of belonging. Frankl’s observation from the camps: those who found meaning survived, those who lost it perished. Durkheim’s sociology of suicide: when social integration weakens, self-destruction rises. The belonging gap, the loneliness epidemic, the collapse of close friendship, the attenuation of the social bonds that give life its structure and its point.

Now combine the economic displacement of Part 52 with the belonging erosion of Part 28 and add the ambient uncertainty that Elena embodies, and you see not a crisis but a convergence. The meaning wound, the belonging gap, and the anxiety tax are not three separate problems. They are three manifestations of a single structural condition: the speed of change has exceeded the capacity of human bodies and human institutions to adapt.

Deaths of despair were a preview. Not because the AI transition will replicate deindustrialization exactly, but because the underlying mechanism, the severing of the connection between effort and meaning, operates at any scale. What happened to Appalachian coal towns is now happening, in distributed and less visible form, to knowledge workers, creative professionals, administrative staff, and sixteen-year-olds trying to imagine a future that no adult can describe with confidence.

The Political Consequence

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Anxious populations are politically volatile. This is not a partisan observation. It is a documented pattern across cultures and time periods. When structural uncertainty deepens, the political market for certainty expands.

Hannah Arendt studied the conditions that produced totalitarianism and identified a precondition that economics alone does not explain: atomization. The breakdown of social bonds, professional identity, community membership, the intermediate institutions that stand between the individual and the state. When these dissolve, the individual is left exposed, unmediated, available for mobilization by movements that offer belonging and certainty as substitutes for what has been lost.

The leader who says “I alone can fix it” is not offering a policy. That leader is offering an answer to the question that structural uncertainty poses: Is anyone in charge? Does anyone know what is happening? Can anyone make it stop? The specifics of the answer matter less than the fact that an answer is being offered. Certainty itself becomes the product, and the demand for that product grows as the supply of genuine certainty diminishes.

This dynamic operates independently of left-right political alignment. Authoritarian populism draws from both sides of the spectrum, promising certainty to people who have been told by responsible authorities that certainty is not available, that the situation is complex, that the future is uncertain. These responsible authorities are correct. And their correctness is politically unsustainable, because the human body and the human psyche cannot inhabit sustained uncertainty without seeking resolution, and if resolution is not available through understanding it will be sought through submission.

The anxiety tax is not just physiological. It is political. A population that cannot sleep is a population that cannot deliberate. A population that cannot deliberate is a population that cannot self-govern. A population that cannot self-govern is a population available to anyone who offers to govern for it.

The Doom Loop

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Trace the cycle.

Structural uncertainty about AI’s impact on work, identity, and social organization produces widespread anxiety. The anxiety is rational. It is physiologically damaging. It is politically destabilizing.

The political destabilization produces policy paralysis. Leaders who acknowledge uncertainty cannot offer the certainty that anxious populations demand. Leaders who offer certainty cannot deliver it. The gap between what is promised and what is possible produces cynicism and disengagement. The institutions designed to mediate between citizens and their collective challenges, legislatures, regulatory bodies, public agencies, lose legitimacy.

The loss of institutional legitimacy deepens the structural uncertainty. If the institutions cannot respond, who will? If the leaders cannot deliver, what is the plan? The absence of institutional response confirms the anxiety that produced the institutional crisis, and the cycle accelerates.

Each revolution of the loop degrades the capacity to exit it. Institutional capacity is eroded by each cycle of politicization and paralysis. Public trust, once lost, is expensive to rebuild. The cognitive function of the population, degraded by chronic allostatic load, reduces the collective capacity for the complex thinking that the situation demands.

The doom loop is not a prediction. It is a description of a mechanism already operating. The question is not whether it will engage. The question is whether it can be interrupted.

The Crisis Within the Crisis

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Healthcare systems, already strained, face a behavioral health emergency that their architecture was not designed to address.

The standard treatment model for anxiety is individual: identify the patient, diagnose the condition, prescribe the intervention. Cognitive behavioral therapy. Medication. Lifestyle modification. These work for anxiety that originates in individual cognition, in distorted perceptions or maladaptive patterns that can be corrected through clinical intervention.

They do not work, or work only partially, for anxiety that originates in the environment. You can teach Elena breathing exercises. You cannot breathe away the labor market. You can prescribe James an SSRI. You cannot medicate away the structural condition of being unnecessary. You can manage Margaret’s blood pressure. You cannot manage away fifty years of accumulated allostatic load.

The treatment for environmental stressors is to change the environment. But the environment is a global technological transformation operating at a pace that exceeds institutional response capacity. No therapist can prescribe that. No healthcare system can deliver it.

What healthcare systems can do, and will be asked to do, is manage the downstream consequences of a stressor they cannot address: the insomnia, the depression, the substance use, the cardiovascular disease, the autoimmune conditions, the early mortality. They will treat these as individual conditions because individual treatment is what healthcare systems do. The structural cause will remain untreated because it is not a medical problem. It is a civilizational one.

The cost is not just suffering, though the suffering is real. Chronic stress reduces cognitive function, workplace productivity, immune response, and life expectancy. An anxious population is a less productive, less healthy, less innovative, and more expensive population. The anxiety about economic disruption is itself economically disruptive. The worry about meaning loss is itself a loss of meaning. The tax pays itself.

What Elena Knows

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Elena knows something that the adults in her life are reluctant to say plainly. She knows that the reassurances are uncertain. She knows that “technology always creates more jobs” is a historical observation, not a guarantee. She knows that her mother’s generation had a different relationship to the future, one in which preparation was more reliably connected to outcome, in which effort more predictably produced result.

She does not resent this. She is not angry in the way that political narratives would predict. She is something harder to organize around than anger: she is tired. Tired at sixteen, in the way that allostatic load makes people tired, not from exertion but from the sustained activation of systems designed for short-term deployment. Her fatigue is not laziness. It is the metabolic cost of a correct perception sustained past the body’s capacity to sustain it.

Margaret recognizes something in Elena’s fatigue that she cannot quite name. It resembles what she felt in the years after her husband died, when the future contracted and the days lost their forward momentum. Margaret’s grief resolved, slowly, into a life that found new structure through the garden, through Sarah and the grandchildren, through the rhythms of a retirement that was smaller than her working life but not empty. She wants to tell Elena that it will resolve. She is not sure she can say so honestly.

James recognizes Elena’s insomnia because he has his own version: not sleeplessness but the restless dissatisfaction of a person whose days do not add up to anything he can point to with pride. James and Elena are experiencing the same structural condition at different life stages, one at the beginning of a career that may not materialize, the other in the early years of a career that has already hollowed out. They are both paying the anxiety tax. They are both paying it with their bodies.

What would it take to turn off the alarm?

Not reassurance. Reassurance addresses the perception, and the perception is accurate. Not medication. Medication addresses the symptom, and the symptom is adaptive. Not therapy alone, though therapy helps. The alarm is not malfunctioning. It is responding to a real signal.

It would take a world in which the signal changed. In which the future became legible enough for a sixteen-year-old to plan for it without the plan feeling like a guess. In which effort connected to outcome reliably enough for a twenty-three-year-old to build a career rather than perform one. In which the institutions designed to manage collective challenges were trusted enough to manage this one.

We are not in that world. The question, which Part 55 will try to sit with honestly, is whether we can build it from inside the one we have.

This is Part 54 of The Approximate Mind, a series examining how AI might serve human flourishing rather than human extraction. Part 53 traced the mechanisms that lock AI-mediated economic optimization in place once established. This article examines what the structural uncertainty of the AI transition does to human bodies, human politics, and human capacity to respond to the very transformation producing the anxiety.