Behind the Orange Curtain: Depression & Anxiety in Paradise

By: Kyle Kermott, Psy.D.

Even if you’ve never been to Orange County, you probably have some assumptions about what the area is like. Newport Beach and Laguna Beach conjure up images of lavish coastal lifestyles. The noteworthy school systems and low crime-rates make Irvine a prime area for starting and growing a family. Mission San Juan Capistrano, and its fabled annual returning of swallows, is considered “The Jewel of California Missions.” And all of this is to say nothing of Disneyland.

For many, Orange County is thought to be a heavenly destination. Just look at the tagline for Disneyland: “The Happiest Place on Earth.” And yet, in Orange County, hospitalizations for mental health issues have steadily risen year after year since the early 2000’s. Since 2005, rates of depression have increased by 114%. And during the same period, anxiety disorders have nearly doubled as well.

Despite certain assumptions about it being some sort of paradise, the rates of mental illness in Orange County hover around the California and National averages. Which raises the question: How can that be?

Being surrounded by great weather, jobs, outdoor activities, and communities should inoculate someone from mental health issues, shouldn’t it?

It’s human nature to assume that living in a desirable area will have a perceptible, positive effect on one’s mental health. But this just isn’t the case. And the reason it’s not true can be boiled down to an important, but often forgotten, distinction related to human psychology.

For many years, psychoanalytic psychologists have made the useful distinction between one’s internal and external realities. And, imbedded in this distinction, is the understanding that these two realities can, and do, coexist, despite the fact that they very rarely align.

Your internal reality consists of the things you think and feel on a moment-by-moment basis. And the common assumption is that if you change your external reality (where you live, what you do for work, what you own), your internal reality will similarly change. It makes perfect sense to think that if you move from the brutal winters in the Midwest to the Gold Coast, that you will feel happier and more satisfied in life. But we have found that external changes very rarely change one’s internal environment.

Research on happiness has consistently shown that, when faced with trying to change their internal reality, people repeatedly focus their efforts on altering their external world. And, over and over, research has shown that these efforts don’t work. Moving to the perfect neighborhood, getting the new gadget, landing the powerful job, leasing the luxury car…We dream about these things based on the hope that they will change our internal sense of ourselves.

Research calls this the “hedonic treadmill” because chasing after things to make you feel better only leads to needing more and more. Maybe the next thing will do it. It hasn’t worked yet, but if I get this one thing, then that will finally be the answer. Over and over again. Moving, but getting nowhere – like being on a treadmill.

The results are clear: people mistakenly focus on their external worlds when it’s their internal ones that need attention.

Oftentimes, someone goes to therapy and says something along these lines: “I’m unhappy, but I don’t know why. On paper my life looks great, but I’m still not satisfied.” Unfortunately, it’s a common misconception in Orange County – and, indeed, throughout the world – that if someone’s life looks good on the outside, then they must feel good on the inside.

But it’s important to realize that this is hardly ever the case. This realization honors the truth that our external reality does not dictate our internal reality. And this is true for good and bad things. Just like a wonderful external reality doesn’t make someone happy, horrible external circumstances don’t condemn someone to unhappiness.

For various reasons, someone “who has everything” can still feel sadness, anger, anxiety, depression, stress, etc. And sometimes nothing in the outside world can change these things. But that’s okay. It’s okay because once someone honors their internal reality, and begins to address it, then change is actually possible. The foundation for our internal reality is laid down in our childhood, and it develops year after year, through our experiences in relationships, school, work, etc. And, many times, this reality develops incongruently to our external circumstances.

But through the appropriate therapy work with a psychologist, one can effectively change their internal realities – often permanently.

So the take-home message is a simple one. If you find yourself feeling or thinking things that are troubling to you, don’t look to the external world to change those things. No amount of that type of change will give you what you are looking for. Even if you lived in “The Happiest Place on Earth” you can still feel depressed or anxious. It’s not the external world that’s important, but the internal one.

If you want to feel better, direct your efforts to the source of your difficulties. And that is what you carry around inside of you.

Kyle Kermott, Psy.D. is a Clinical Psychologist practicing in Irvine, and serving the surrounding areas of Newport Beach, Costa Mesa, Tustin, and Orange County. As a therapist, he specializes in therapy for depression and anxiety.