My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind Hardcover - 2014

Excerpt

Some eighty years ago, Freud proposed that anxiety was "a riddle whose solution would be bound to throw a flood of light on our whole mental existence." Unlocking the mysteries of anxiety, he believed, would go far in helping us to unravel the mysteries of the mind: consciousness, the self, identity, intellect, imagination, creativity — not to mention pain, suffering, hope, and regret. To grapple with and understand anxiety is, in some sense, to grapple with and understand the human condition.

The differences in how various cultures and eras have perceived and understood anxiety can tell us a lot about those cultures and eras. Why did the ancient Greeks of the Hippocratic school see anxiety mainly as a medical condition, while Enlightenment philosophers saw it as an intellectual problem? Why did the early existentialists see anxiety as a spiritual condition, while Gilded Age doctors saw it as a specifically Anglo-Saxon stress response — a response that they believed spared Catholic societies — to the Industrial Revolution? Why did the early Freudians see anxiety as a psychological condition emanating from sexual inhibition, whereas our own age tends to see it, once again, as a medical and neurochemical condition, a problem of malfunctioning biomechanics?

Do these shifting interpretations represent the forward march of progress and science? Or simply the changing, and often cyclical, ways in which cultures work? What does it say about the societies in question that Americans showing up in emergency rooms with panic attacks tend to believe they're having heart attacks, whereas Japanese tend to be afraid they're going to faint? Are the Iranians who complain of what they call "heart distress" suffering what Western psychiatrists would call panic attacks? Are the ataques de nervios experienced by South Americans simply panic attacks with a Latino inflection — or are they, as modern researchers now believe, a distinct cultural and medical syndrome? Why do drug treatments for anxiety that work so well on Americans and the French seem not to work effectively on the Chinese?

As fascinating and multifarious as these cultural idiosyncrasies are, the underlying consistency of experience across time and cultures speaks to the universality of anxiety as a human trait. Even filtered through the distinctive cultural practices and beliefs of the Greenland Inuit a hundred years ago, the syndrome the Inuit called "kayak angst" (those afflicted by it were afraid to go out seal hunting alone) appears to be little different from what we today call agoraphobia. In Hippocrates's ancient writings can be found clinical descriptions of pathological anxiety that sound quite modern. One of his patients was terrified of cats (simple phobia, which today would be coded 300.29 for insurance purposes, according to the classifications of the fifth edition of the Diagnostic and Statistical Manual, the DSM-V) and another of nightfall; a third, Hippocrates reported, was "beset by terror" whenever he heard a flute; a fourth could not walk alongside "even the shallowest ditch," though he had no problem walking inside the ditch — evidence of what we would today call acrophobia, the fear of heights. Hippocrates also describes a patient suffering what would likely be called, in modern diagnostic terminology, panic disorder with agoraphobia (DSM-V code 300.22): the condition, as Hippocrates described it, "usually attacks abroad, if a person is travelling a lonely road somewhere, and fear seizes him." The syndromes described by Hippocrates are recognizably the same clinical phenomena described in the latest issues of the Archives of General Psychiatry and Bulletin of the Menninger Clinic.

Their similarities bridge the yawning gap of millennia and circumstances that separate them, providing a sense of how, for all the differences in culture and setting, the physiologically anxious aspects of human experience may be universal.

In this book, I have set out to explore the "riddle" of anxiety. I am not a doctor, a psychologist, a sociologist, or a historian of science — any one of whom would bring more scholarly authority to a treatise on anxiety than I do. This is a work of synthesis and reportage, yoking together explorations of the idea of anxiety from history, literature, philosophy, religion, popular culture, and the latest scientific research — all of that woven through something about which I can, alas, claim extensive expertise: my own experience with anxiety. Examining the depths of my own neuroses may seem the height of narcissism (and studies do show that self-preoccupation tends to be tied to anxiety), but it's an exercise with worthy antecedents. In 1621, the Oxford scholar Robert Burton published his canonical The Anatomy of Melancholy, a staggering thirteen-hundred-page work of synthesis, whose torrents of scholarly exegesis only partially obscure what it really is: a massive litany of anxious, depressive complaint. In 1733, George Cheyne, a prominent London physician and one of the most influential psychological thinkers of the eighteenth century, published The English Malady, which includes the forty-page chapter "The Case of the Author" (dedicated to "my fellow sufferers"), in which he reports in minute detail on his neuroses (including "Fright, Anxiety, Dread, and Terror" and "a melancholy Fright and Panick, where my Reason was of no Use to me") and physical symptoms (including "a sudden violent Head-ach," "extream Sickness in my Stomach," and "a constant Colick, and an ill Taste and Savour in my Mouth") over the years. More recently, the intellectual odysseys of Charles Darwin, Sigmund Freud, and William James were powerfully driven by their curiosity about, and the desire to find relief from, their own anxious suffering. Freud used his acute train phobia and his hypochondria, among other things, to construct his theory of psychoanalysis; Darwin was effectively housebound by stress-related illnesses after the voyage of the Beagle — he spent years in pursuit of relief from his anxiety, visiting spas and, on the advice of one doctor, encasing himself in ice. James tried to keep his phobias hidden from the public but was often quietly terrified. "I awoke morning after morning with a horrible dread in the pit of my stomach and with a sense of insecurity of life that I never knew before," he wrote in 1902 of the onset of his anxiety. "For months, I was unable to go out in the dark alone."

Unlike Darwin, Freud, and James, I'm not out to adumbrate a whole new theory of mind or of human nature. Rather, this book is motivated by a quest to understand, and to find relief from or redemption in, anxious suffering. This quest has taken me both backward, into history, and forward, to the frontiers of modern scientific research. I have spent much of the past eight years reading through hundreds of thousands of the pages that have been written about anxiety over the last three thousand years.

My life has, thankfully, lacked great tragedy or melodrama. I haven't served any jail time. I haven't been to rehab. I haven't assaulted anyone or carried out a suicide attempt. I haven't woken up naked in the middle of a field, sojourned in a crack house, or been fired from a job for erratic behavior. As psychopathologies go, mine has been — so far, most of the time, to outward appearances — quiet. Robert Downey Jr. will not be starring in the movie of my life. I am, as they say in the clinical literature, "high functioning" for someone with an anxiety disorder or a mental illness; I'm usually quite good at hiding it. More than a few people, some of whom think they know me quite well, have remarked that they are struck that I, who can seem so even-keeled and imperturbable, would choose to write a book about anxiety. I smile gently while churning inside and thinking about what I've learned is a signature characteristic of the phobic personality: "the need and ability" — as described in the self-help book Your Phobia — "to present a relatively placid, untroubled appearance to others, while suffering extreme distress on the inside." *

To some people, I may seem calm. But if you could peer beneath the surface, you would see that I'm like a duck — paddling, paddling, paddling.

* "For many, many people who have anxiety disorders — particularly agoraphobia and panic disorder — people would be surprised to find out that they have problems with anxiety because they seem so'together' and in control," says Paul Foxman, a psychologist who heads the Center for Anxiety Disorders in Burlington, Vermont. "They seem to be comfortable, but there's a disconnection between the public self and the private self."

Media reviews

Kirkus (starred review)
“In this captivating and intimate book, the editor of the Atlantic spares no detail about his lifelong struggle with anxiety and contextualizes his personal experience within the history of anxiety’s perception and treatment….Stossel deftly explores a variety of treatments and their risks and successes, providing unique insight as both a journalist (whose priority is impartial investigation) and sufferer (whose imperative is to feel well). Throughout, the author’s beautiful prose and careful research combine to make this book informative, thoughtful and fun to read. Powerful, eye-opening and funny. Pitch perfect in his storytelling, Stossel reminds us that, in many important ways, to be anxious is to be human.”

Booklist (starred review)
“Tying together notions about anxiety culled from history, philosophy, religion, sports, and literature with current neuropsychiatric research and his extensive personal experience, Stossel’s book is more than an astounding autobiography, more than an atlas of anxiety. His deft handling of a delicate topic and frustrating illness highlights the existential dread, embarrassment, and desperation associated with severe anxiety yet allows room for resiliency, hope, transcendence. Absolutely fearless writing.”

Daniel Akst, The Wall Street Journal
“Excessive anxiety, it turns out, is like most things that beset humans: partly nature and partly nurture. And it may even have its virtues. Worriers tend to be conscientious, sensitive to others and detail-oriented. These can be useful traits in many aspects of life: in marriage, say, and in the workplace. They appear to be useful in an author as well, judging by Mr. Stossel's achievement in "My Age of Anxiety."...In dissecting his own acute case, along with the disorder that afflicts him, he offers a degree of understanding to the rest of us—along with a modicum of comfort and even hope to those who must trudge through life chronically anxious despite their seeming good fortune.”

The New York Times
“Ambitious and bravely intimate…A thrilling intellectual chase.”

Jen Chaney, The Washington Post
“By combining such unfiltered honesty with deep reporting, Stossel has delivered an enlightening, empowering read. But all of his disclosures serve a higher purpose, too. His candor about his sense of unrest—as well as his gnawing, conflicted feelings about admitting to it—serve as the foundation for his investigation into the panic and apprehension that afflict millions of Americans….The word ‘brave’ tends to get thrown around pretty cavalierly in our culture, but given the frankness of this book, there’s no other appropriate word for what Stossel does here. It’s brave, and, as Dr. W. suggests, potentially therapeutic for individuals other than the writer himself. I can personally attest to that.”

Steve Danziger, Open Letters Monthly
“The most accurate representation of the anxiety sufferer’s mindset that I’ve ever come across….I suspect that much will be made of Stossel’s bravery, but praise should be given to his literary achievement and the arrival of a substantial, if challenging, voice capable of elucidating the 130 year history of “magic” pharmaceuticals….The book is a startling achievement.”

Kimberly Marlowe Hartnett, The Seattle Times
“Scott Stossel’s new book on his lifelong struggle with severe anxiety is outstanding in the fullest sense of the word. ‘My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind’ is both conspicuous and superior within its genre. Stossel, who also wrote a fine biography of Sargent Shriver, brings his dogged fact-digging skills to this work, which is peppered with humor and humility, remarkably balanced—and generous to the point of philanthropy with his deeply personal, hard-won knowledge. Plus, the man is a lovely writer.”

David Adam, Nature
“Books exploring personal experiences of mental illness tend to be either over-wrought accounts of personal trauma that shed little light on the world beyond the author’s nose, or the more detached observations of scientists and medics. It is rare to find works that bridge these objectives, which is one reason that the writer Andrew Solomon achieved such success with The Noonday Demon….Stossel’s book deserves a place on this higher shelf.”

Matt Price, Newsday
“‘My Age of Anxiety’” is a brave—and quite possibly perverse—book, one that will leave you squirming and fascinated in equal measure….There is much pain here, but humor, too….Without meaning to, Stossel has written a self-help manual. There is no miracle cure for anxiety, he suggests—we can manage our fears and worries, even if we can never quite tame them.”

Matthew Gilbert, The Boston Globe
“On the one hand, the book is astonishingly thorough and lucidly written. It’s a fascinating look at that linchpin of the human condition—the primitive fight-or-flight response—and how it resides in our psyches in a time of IEDs and SSRIs. Rare will be the reader who doesn’t spot him or herself somewhere in Stossel’s sweeping analysis, as he digs into parenting styles, performance stress, talk therapy, medication, depression, fear of flying, blushing, you name it. On the other hand, you have to wonder if “My Age of Anxiety” is so good, so copiously reported and completist, in large part thanks to Stossel’s harsh expectations of himself....His perpetual agony has become our reading pleasure.”

Publishers Weekly
“Stossel's journey through his own life is unsparing, darkly funny (a nervous stomach tends to flare up at the worst times, like in front of JFK Jr.), but above all, hopeful. As with many sufferers, Stossel's quest to find relief is unfinished, but his book relays a masterful understanding of the condition he and millions of others endure.”

Tablet
“Amazingly candid and compassionate…A comprehensive study of anxiety—how people saw it in the past, how scientists and psychologists understand it today, and what if anything can be done to cure it.”

Bookforum
“Enthralling...an extraordinary literary performance....It is also—I hope I don't sound like a publicist—extremely useful....In an age inundated by memoirs and psychic self-help books, My Age of Anxiety is the rare memoir that tells an entirely compelling story, and the rare self-help book that really helps. You, and many thousands of readers along with you, will laugh until you cry.”

Amy Bloom, O Magazine
“Scott Stossel’s erudite, heartfelt, and occasionally darkly funny meld of memoir, cultural history, and science, feels excruciatingly relevant….Stossel, the editor of The Atlantic, is a wry, if distressed, chronicler of his own history and that of psychopharmacology. It’s been a long and in many ways frightening journey for him. Still, near the end of the book, in a chapter titled ‘Redemption,’ Stossel attempts to see the upside of anxiety—the links between it and creativity, productivity, morality. His therapist advises him to give himself more credit for being resilient, and it seems he does. He concludes with hope that ‘admitting my shame and fear to the world’ will ultimately be ‘empowering and anxiety reducing.’ We hope so, too.”

Sherryl Connelly, New York Daily News
“The editor of the Atlantic magazine, Stossel has suffered from debilitating anxiety and phobias since childhood. With humor, insight and intense research, he sheds light on the disorder that is believed to affect one in seven Americans. From a historical overview to a review of current treatments in a book laced with fascinating personal anecdotes, Stossel delivers authentic perspective on such suffering."

Canadian Living
“I don’t like to tell people that they need to read a certain book, who am I to tell you what to do? But today I am breaking that rule because Scott Stossel’s My Age of Anxiety: Fear, hope, dread, and the search for peace of mind is a must-read for anyone who is dealing with anxiety.”

Elle Magazine
“A carefully reported, wryly funny, and admirably honest historical and personal investigation”

Andrew Solomon, author of The Noonday Demon
“Scott Stossel has produced the definitive account of anxiety, weaving together science, history, and autobiography. His writing is evocative and often witty, disarmingly intimate, and wonderfully empathetic. This story has needed to be told, and Stossel tells it with edgy frankness.”

Daniel Smith, author of Monkey Mind: A Memoir of Anxiety
“Scott Stossel is a wreck, but he’s a gorgeous wreck: honest, curious, compassionate, and obsessively, almost neurotically, well-informed. He’s gone deep into the history and science of anxiety and produced an invaluable work, full of compelling detail and truly hard-won wisdom. I learned a great deal from this wonderful book.”

Elizabeth Gilbert, author of Eat, Pray, Love: One Woman's Search for Everything Across Italy, India and Indonesia
“Most of us at some point have suffered from anxiety. Some of us have felt it severely; others have felt it often. But an unlucky few—like Scott Stossel—live with minds that are constant storm-tossed seas of dread and shame. It could not have been easy for Stossel to dissect his own anxiety so honestly in this memoir. But he was brave as hell to write it, and I'm glad he did, for he brings to this story depth, intelligence, and perspective that could enlighten untold fellow sufferers for years to come.”

Ben Mezrich, author of the New York Times Bestsellers The Accidental Billionaires and Bringing Down The House
“Fascinating and hugely entertaining, Scott Stossel's My Age of Anxiety is a brilliant look into one of the most prevalent conditions of our time. An intense, incredibly brave narrative tinged with moments of outright hilarity, it's impossible to put down; anyone who has ever suffered even the mildest bout of anxiety is going to be captivated by the author's quest to understand the sometimes twisted workings of his own mind. Without a doubt, Stossel is one of the most screwed up individuals I have ever encountered-and this book is one of the best I have read in years.”

Joshua Wolf Shenk, author of Lincoln's Melancholy
“What adjectives shall I use to describe Scott Stossel's My Age of Anxiety? 'Brave,' certainly. 'Erudite' and 'trenchant' also come quickly to mind. But for those of us who suffer from anxiety—and for families, friends and colleagues—maybe the single most important description is 'useful.' This book is staggeringly, brilliantly, indispensably useful.”

Daniel Gilbert, Edgar Peirce Professor of Psychology, Harvard University, author of the international bestseller Stumbling on Happiness
“A combination of rich intellectual history and emotionally raw memoir, My Age of Anxiety is smart, poignant, and deep. A beautifully written, expertly researched, and unflinchingly honest account of one person’s battle and many people’s war. Highly recommended.”