UC Press Blog

by Allen L. Tran, author of A LIFE OF WORRY: POLITICS, MENTAL HEALTH, AND VIETNAM'S AGE OF ANXIETY

The Vietnam War, as it is known throughout the world except for Vietnam, is a turning point in the history of psychiatry. The experiences and advocacy efforts of American veterans in Vietnam led to the creation of the diagnosis of post-traumatic stress disorder (PTSD). However, the mental health effects of the war on Vietnamese combatants and civilians remains largely unexamined. Would they experience trauma in a similar way to their American counterparts, or would a different experience of what they still refer to as the American War yield a different set of symptoms, diagnoses, and treatments for war-related mental health problems?

When I first began to answer these questions for my dissertation research in Vietnam, I quickly realized that I was asking the wrong questions. After all, most of the people I met in Ho Chi Minh City (formerly Saigon) were uninterested in dwelling on the past. In just a single generation, Vietnam went from being one of the world’s poorest countries to boasting the second fastest growing economy in the world. Signs of economic progress were everywhere, and a sense of optimism was palpable. By and large, Ho Chi Minh City residents were focused on the future and only brought up recent history to compare it to the present moment. According to many of them, now that the country is modernizing so quickly, they have far more things to worry about than they did in the past. In other words, the Vietnamese are more anxious than ever before.

The first time I heard this story about Vietnam’s age of anxiety, I was skeptical. Shouldn’t people become less anxious as they got wealthier? However, as more and more people told me this account, I knew I had found a new line of questioning to follow. Rather than simply dismiss these claims as a self-congratulatory story that Ho Chi Minh City’s middle class like to tell themselves about themselves, I wanted to know how different objects of worry can come to define a moment in time. After all, who, what, and how we fear makes us who we are. In Vietnam, bombing raids, famine, and deprivation are thankfully not much on people’s minds anymore. For many young people who were born long after the war and its immediate aftermath, the biggest source of concern now lies within: they do not know what they want or understand why they are the way they are. People may marvel at the speed of progress, but these changes–even for the good–can be difficult to handle.

My book, A Life of Worry, looks at the anxieties that take on a life of their own among the rising middle class in Ho Chi Minh City. How much worry a person can or should endure is at the heart of ongoing debates about what defines a good life, a moral person, and the intersection of these two things. Psychiatric clinics, pharmacies, and counseling centers have become the epicenter of intense controversies over the new meaning of worry and how people respond to a supposed epidemic of anxiety disorders. From an anthropological perspective, however, the new age of anxiety in Vietnam is less the result of an increased amount of stress and worry in everyday life than a redefinition of anxiety. People in Vietnam increasingly look to Western psychiatry and psychotherapy to soothe their troubled minds, but in the process of broadening their perspectives on mental health they must also re-examine their own assumptions about themselves and their loved ones. Is anxiety an unavoidable fact of life that you learn to endure as a responsible adult, a sign that you care–maybe too much!–about other people, or a symptom of a disorder that could be medically treated? (Spoiler alert: it’s all of the above.) They get a lot more than they bargained for. 

Although my project moved away from its initial focus on PTSD, the Vietnam-US War was often the elephant in the room. Throughout my observations of and interactions with psychiatrists, therapists, patients, and their families, the war and its scale of unimaginable suffering loomed large as an unspoken but conspicuous part of conversations about mental health. How did people endure, survive, and maybe even overcome the country’s traumatic history? And why are so many people today so anxious? Like me, Ho Chi Minh City residents are still trying to make sense of the war and its emotional fallouts.