My age of anxiety : fear, hope, dread, and the search for peace of mind

410 Pages·2013·1.89 MB·English

by  Stossel

THIS IS A BORZOI BOOK
PUBLISHED BY ALFRED A. KNOPF
Copyright © 2013 by Scott Stossel All rights reserved.
Published in the United States by Alfred A. Knopf, a division of Random House LLC, New York,
and in Canada by Random House of Canada Limited, Toronto, Penguin Random House
Companies.
www.aaknopf.com
Knopf, Borzoi Books, and the colophon are registered trademarks of Random House LLC.
Library of Congress Cataloging-in-Publication Data
Stossel, Scott.
My age of anxiety: fear, hope, dread, and the search for peace of mind / Scott Stossel.—First
edition.
pages cm
Includes bibliographical references.
ISBN 978-0-307-26987-4 (hardcover)
eBook ISBN: 978-0-385-35132-4
1. Anxiety. 2. Anxiety—Chemotherapy. 3. Anxiety disorders—Epidemiology. 4. Tranquilizing
drugs—Social aspects.
5. Stossel, Scott—Mental health. I. Title.
RC531.S78 2014
616.85’22—dc23 2013006336
Jacket design by Carol Carson
v3.1
For Maren and Nathaniel—
may you be spared.
Contents
Cover
Title Page
Copyright
Dedication
PART I
The Riddle of Anxiety
ONE The Nature of Anxiety
TWO What Do We Talk About When We Talk About Anxiety?
PART II
A History of My Nervous Stomach
THREE A Rumbling in the Belly
FOUR Performance Anxiety
PART III
Drugs
FIVE “A Sack of Enzymes”
SIX A Brief History of Panic; or, How Drugs Created a New Disorder
SEVEN Medication and the Meaning of Anxiety
PART IV
Nurture Versus Nature
EIGHT Separation Anxiety
NINE Worriers and Warriors: The Genetics of Anxiety
TEN Ages of Anxiety
PART V
Redemption and Resilience
ELEVEN Redemption
TWELVE Resilience
Acknowledgments
Notes
Bibliography
A Note About the Author
Other Books by This Author
PART I
The Riddle of Anxiety
CHAPTER 1
The Nature of Anxiety
And no Grand Inquisitor has in readiness such terrible tortures as has
anxiety, and no spy knows how to attack more artfully the man he
suspects, choosing the instant when he is weakest, nor knows how to lay
traps where he will be caught and ensnared, as anxiety knows how, and
no sharpwitted judge knows how to interrogate, to examine the accused
as anxiety does, which never lets him escape, neither by diversion nor by
noise, neither at work nor at play, neither by day nor by night.
—SØREN KIERKEGAARD, The Concept of Anxiety (1844)
There is no question that the problem of anxiety is a nodal point at
which the most various and important questions converge, a riddle
whose solution would be bound to throw a flood of light on our whole
mental existence.
—SIGMUND FREUD,
Introductory Lectures on PsychoAnalysis (1933)
I have an unfortunate tendency to falter at crucial moments.
For instance, standing at the altar in a church in Vermont, waiting for
my wife-to-be to come down the aisle to marry me, I start to feel
horribly ill. Not just vaguely queasy, but severely nauseated and shaky—
and, most of all, sweaty. The church is hot that day—it’s early July—and
many people are perspiring in their summer suits and sundresses. But
not like I am. As the processional plays, sweat begins to bead on my
forehead and above my upper lip. In wedding photos, you can see me
standing tensely at the altar, a grim half smile on my face, as I watch my
fiancée come down the aisle on the arm of her father: in the photos,
Susanna is glowing; I am glistening. By the time she joins me in the front
of the church, rivulets of sweat are running into my eyes and dripping
down my collar. We turn to face the minister. Behind him are the friends
we have asked to give readings, and I see them looking at me with
manifest concern. What’s wrong with him? I imagine they are thinking. Is
he going to pass out? Merely imagining these thoughts makes me sweat
even more. My best man, standing a few feet behind me, taps me on the
shoulder and hands me a tissue to mop my brow. My friend Cathy,
sitting many rows back in the church, will tell me later that she had a
strong urge to bring me a glass of water; it looked, she said, as if I had
just run a marathon.
The wedding readers’ facial expressions have gone from registering
mild concern to what appears to me to be unconcealed horror: Is he going
to die? I’m beginning to wonder that myself. For I have started to shake.
I don’t mean slight trembling, the sort of subtle tremor that would be
evident only if I were holding a piece of paper—I feel like I’m on the
verge of convulsing. I am concentrating on keeping my legs from flying
out from under me like an epileptic’s and am hoping that my pants are
baggy enough to keep the trembling from being too visible. I’m now
leaning on my almost wife—there is no hiding the trembling from her—
and she is doing her best to hold me up.
The minister is droning on; I have no idea what he’s saying. (I am not,
as they say, present in the moment.) I’m praying for him to hurry up so I
can escape this torment. He pauses and looks down at my betrothed and
me. Seeing me—the sheen of flop sweat, the panic in my eyes—he is
alarmed. “Are you okay?” he mouths silently. Helplessly, I nod that I am.
(Because what would he do if I said that I wasn’t? Clear the church? The
mortification would be unbearable.)
As the minister resumes his sermon, here are three things I am actively
fighting: the shaking of my limbs; the urge to vomit; and
unconsciousness. And this is what I am thinking: Get me out of here.
Why? Because there are nearly three hundred people—friends and
family and colleagues—watching us get married, and I am about to
collapse. I have lost control of my body. This is supposed to be one of
the happiest, most significant moments of my life, and I am miserable. I
worry I will not survive.
As I sweat and swoon and shake, struggling to carry out the wedding
ritual (saying “I do,” putting the rings on, kissing the bride), I am
worrying wretchedly about what everyone (my wife’s parents, her
friends, my colleagues) must be thinking as they look at me: Is he having
second thoughts about getting married? Is this evidence of his essential
weakness? His cowardice? His spousal unsuitability? Any doubt that any
friend of my wife’s had, I fear, is being confirmed. I knew it, I imagine
those friends thinking. This proves he’s not worthy of marrying her. I look
as though I’ve taken a shower with my clothes on. My sweat glands—my
physical frailty, my weak moral fiber—have been revealed to the world.
The unworthiness of my very existence has been exposed.
Mercifully, the ceremony ends. Drenched in sweat, I walk down the
aisle, clinging gratefully to my new wife, and when we get outside the
church, the acute physical symptoms recede. I’m not going to have
convulsions. I’m not going to pass out. But as I stand in the reception
line, and then drink and dance at the reception, I’m pantomiming
happiness. I’m smiling for the camera, shaking hands—and wanting to
die. And why not? I have failed at one of the most elemental of male
jobs: getting married. How have I managed to cock this up, too? For the
next seventy-two hours, I endure a brutal, self-lacerating despair.
Anxiety kills relatively few people, but many more would welcome death
as an alternative to the paralysis and suffering resulting from anxiety in
its severe forms.
—DAVID H. BARLOW, Anxiety and Its Disorders (2004)
My wedding was not the first time I’d broken down, nor was it the
last. At the birth of our first child, the nurses had to briefly stop
ministering to my wife, who was in the throes of labor, to attend to me
as I turned pale and keeled over. I’ve frozen, mortifyingly, onstage at
public lectures and presentations, and on several occasions I have been
compelled to run offstage. I’ve abandoned dates, walked out of exams,
and had breakdowns during job interviews, on plane flights, train trips,
and car rides, and simply walking down the street. On ordinary days,
doing ordinary things—reading a book, lying in bed, talking on the
phone, sitting in a meeting, playing tennis—I have thousands of times
been stricken by a pervasive sense of existential dread and been beset by
nausea, vertigo, shaking, and a panoply of other physical symptoms. In
these instances, I have sometimes been convinced that death, or
something somehow worse, was imminent.
Even when not actively afflicted by such acute episodes, I am buffeted
by worry: about my health and my family members’ health; about
finances; about work; about the rattle in my car and the dripping in my
basement; about the encroachment of old age and the inevitability of
death; about everything and nothing. Sometimes this worry gets
transmuted into low-grade physical discomfort—stomachaches,
headaches, dizziness, pains in my arms and legs—or a general malaise,
as though I have mononucleosis or the flu. At various times, I have
developed anxiety-induced difficulties breathing, swallowing, even
walking; these difficulties then become obsessions, consuming all of my
thinking.
I also suffer from a number of specific fears or phobias. To name a
few: enclosed spaces (claustrophobia); heights (acrophobia); fainting
(asthenophobia); being trapped far from home (a species of
agoraphobia); germs (bacillophobia); cheese (turophobia); speaking in
public (a subcategory of social phobia); flying (aerophobia); vomiting
(emetophobia); and, naturally, vomiting on airplanes (aeronausiphobia).
When I was a child and my mother was attending law school at night,
I spent evenings at home with a babysitter, abjectly terrified that my
parents had died in a car crash or had abandoned me (the clinical term
for this is “separation anxiety”); by age seven I had worn grooves in the
carpet of my bedroom with my relentless pacing, trying to will my
parents to come home. During first grade, I spent nearly every afternoon
for months in the school nurse’s office, sick with psychosomatic
headaches, begging to go home; by third grade, stomachaches had
replaced headaches, but my daily trudge to the infirmary remained the
same. During high school, I would purposely lose tennis and squash
matches to escape the agony of anxiety that competitive situations
would provoke in me. On the one—the only one—date I had in high
school, when the young lady leaned in for a kiss during a romantic
moment (we were outside, gazing at constellations through her
telescope), I was overcome by anxiety and had to pull away for fear that
I would vomit. My embarrassment was such that I stopped returning her