New Yorkers' seven most
commonanxieties, illustrated

We talked to more than a dozen New York mental health
professionals to find out what their clients fear most.

Most New Yorkers find their palms sweaty and hearts racing from time to time. From the careening taxis ignoring the pedestrian’s right of way and the suffocating crowds of the subways to the daunting challenges of work, dating and making friends in the big city, the sources of anxiety are seemingly endless in New York. Considering this, we were curious as to which parts of city life caused the most sleepless nights for New Yorkers. Was it stepping onto a germ-infested train? Nagging thoughts of whether our ex swiped left on Tinder? Or something more threatening, like crime or terrorism? We consulted with more than a dozen of New York’s mental health professionals to find out what their clients feel most anxious about. While not strictly scientific, our survey offers insight into the most common anxieties of New Yorkers who are in therapy. Here’s what their therapists, psychiatrists, and counselors had to say:

Daniel Shaffer

Illustrator

1. Transportation

Let’s face it, riding the subway isn’t exactly a walk in the park, and nearly all of the respondents to the Hopes & Fears inquiry said their patients felt anxiety about taking public transit in New York. Psychotherapist Nicole Matusow, LMSW, says, “Being touched by strangers in close proximity, or witnessing two strangers arguing about who bumped who first, can be enough for some people to begin associating mass transit with symptoms of anxiety.” Dr. Jessica Hirsh Weiss, PhD, says she’s helped patients overcome transportation anxiety with gradual exposure, sometimes “even riding the train with them and coaching them through the process.”

2. Relationships

Putting yourself out there to find a mate is emotionally risky anywhere in the world and New York’s mental health professionals, including psychotherapist David Perkins, LCSW, report that relationships are a common source of anxiety for their patients. Psychotherapist Sharon K. O’Connor, LCSW, says that her patients express anxiety about much of the dating process, especially finding a partner in time to have children. Mental health counselor Rachel Pauker, LMHC, believes that dating woes are exacerbated by large cities, where a career may be a higher priority than getting married. “We are told we should find a partner and a home,” she says. “But people in New York are trying to figure out what they want, which causes anxiety if it’s different than what they’re told they should want.”

3. Health

People worldwide worry about their health and longevity, as well as that of their partners and children. Mental health professionals report that they’re seeing an increasing rate of anxiety over illness in New York patients. Counselor Pauker says that health-related anxieties are now impacting her younger patients, such as women in their 20s who may have experienced an irregular pap smear. Available for use by the city’s 8.4 million people, New York’s public spaces also spark germ-related anxieties in patients, according to expressive art psychotherapist Melissa R. Giuttari, MA, LMHC. To cope, Dr. Kore Nissenson-Glied, PhD, suggests looking at what you have control over and “taking care of your health, going to doctors’ appointments, getting good sleep, nutrition, and exercise.”

4. Socializing

Social anxiety expands on relationship anxiety to include all sorts of group situations and judgment from those around us. Psychotherapist Simone Kornfeld, LCSW, says that social anxiety is related to the basic human need to be loved and be accepted. Dr. Robert Schachter says some of his clients seek treatment for overwhelming fears of being perceived negatively, which can impact the ability to form meaningful friendships and a supportive social network. New Yorkers, in particular, are susceptible to social anxiety, according to some local mental health experts. Walking the streets of the city causes anxiety in some of Matusow’s patients, who wonder, “How am I seen by the endless anonymous people who I pass daily?” while status disparity is an acute aspect of New York life that affects relationships. “Affluence and high-achieving professionals are prevalent,” says therapist Roxanne Wolanczyk, LCSW. “For some, this causes anxiety about how others perceive them.” Compounded by the difficulties of developing meaningful social connections, feelings of isolation or loneliness tend to accompany social anxiety, according to O’Connor.

5. Being alone

It’s a tad ironic that people who reside in a crowded city, surrounded by others all the time, actually experience lots of anxiety about being alone for the long term. But it makes sense—not only are relationship and social anxiety prevalent reasons why fear of ending up alone is so common, the busy, hectic way of life in New York further limits our abilities to find lifelong partners, friendships, and communities. Therapist Rachel Roos Pokorney, LCSW, says, “NYC is a very career-driven city. Sometimes, people don’t always understand the difficulty people here can have in balancing professional and personal life.” “To cope with this,” counselor Lauren Rigney, LMHC, “you can become more mindful. Increasing mindfulness means focusing on what change you can affect right now, in this moment. You cannot change the past and you cannot predict the future; those are two places anxiety manifests itself. You can only affect the present time. Understanding this concept and learning to use it multiple times a day can help take your heightened anxiety and bring it into a healthy range.”

6. Career

Many ambitious people move to New York City to follow their dreams and pursue a successful career. The idea that we might fail at this goal, despite how much energy we give it, creates a heightened sense of anxiety around work in general. Rigney says careers are her patients’ second most common source of anxiety, behind the related fear of failure. “Fear of failure encompasses a lot of issues without [patients] always knowing it, such as losing a job and not having enough money to survive in an expensive city,” she says. The vast career opportunities available in the city are both a draw and source of anxiety for New York patients, according to O’Connor, who says, “There may be more choices, which can be overwhelming, and the competition and pressure to succeed can be much more intense [than elsewhere].”

7. Finances

The cost to live in the Big Apple is notoriously high, which makes finances another major source of concern for New Yorkers, according to mental health professionals. Rigney says, “With many families living month to month, it does not take much to miss a rent payment, need to skip a meal, or sacrifice a long-term financial plan for a crisis moment. These nagging thoughts can cause so much anxiety in individuals that the fear of failing at a single given task takes on bigger stakes.” Dr. Kim Bernstein, PhD, LP, says that financial woes, especially those related to the increasing cost of housing in New York, are actually part of a larger anxiety. “More fundamentally, what we’re talking about is people’s sense of security—their feeling of having a home. And in this demanding and manic city, for a great many people, that source of stability and containment is under continual threat of being taken away.”

THANKS TO OUR EXPERTS: Nicole Matusow, LMSW, Dr. Kore Nissenson-Glied, PhD, Lauren Rigney, LMHC, Dr. Jessica Hirsh Weiss, David Perkins, LCSW, Sharon K. O’Connor, LCSW, Rachel Pauker, LMHC, Melissa R. Giuttari, MA, LMHC, Simone Kornfeld, LCSW, Dr. Robert Schachter, Roxanne Wolanczyk, LCSW, Dr. Kim Bernstein, PhD, LP, Rachel Roos Pokorney, LCSW

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