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

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A riveting, revelatory, and moving account of the authors struggles with anxiety, and of the history of efforts by scientists, philosophers, and writers to understand the condition
As recently as thirty-five years ago, anxiety did not exist as a diagnostic category. Today, it is the most common form of officially classified mental illness. Scott Stossel gracefully guides us across the terrain of an affliction that is pervasive yet too often misunderstood.
Drawing on his own long-standing battle with anxiety, Stossel presents an astonishing history, at once intimate and authoritative, of the efforts to understand the condition from medical, cultural, philosophical, and experiential perspectives. He ranges from the earliest medical reports of Galen and Hippocrates, through later observations by Robert Burton and Sren Kierkegaard, to the investigations by great nineteenth-century scientists, such as Charles Darwin, William James, and Sigmund Freud, as they began to explore its sources and causes, to the latest research by neuroscientists and geneticists. Stossel reports on famous individuals who struggled with anxiety, as well as on the afflicted generations of his own family. His portrait of anxiety reveals not only the emotions myriad manifestations and the anguish anxiety produces but also the countless psychotherapies, medications, and other (often outlandish) treatments that have been developed to counteract it. Stossel vividly depicts anxietys human tollits crippling impact, its devastating power to paralyzewhile at the same time exploring how those who suffer from it find ways to manage and control it.
My Age of Anxiety is learned and empathetic, humorous and inspirational, offering the reader great insight into the biological, cultural, and environmental factors that contribute to the affliction.

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THIS IS A BORZOI BOOK PUBLISHED BY ALFRED A KNOPF Copyright 2013 by Scott - photo 1
THIS IS A BORZOI BOOK PUBLISHED BY ALFRED A KNOPF Copyright 2013 by Scott - photo 2

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. AnxietyChemotherapy. 3. Anxiety disordersEpidemiology. 4. Tranquilizing drugsSocial aspects.
5. Stossel, ScottMental health. I. Title.
RC 531. S 78 2014
616.8522dc23 2013006336

Jacket design by Carol Carson

v3.1

For Maren and Nathaniel
may you be spared.

Contents
PART I
The Riddle of Anxiety
PART II
A History of My Nervous Stomach
PART III
Drugs
PART IV
Nurture Versus Nature
PART V
Redemption and Resilience
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 - photo 3

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.

SREN 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 Psycho-Analysis (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 shakyand, most of all, sweaty. The church is hot that dayits early Julyand 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 fiance 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. Whats 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? Im beginning to wonder that myself. For I have started to shake. I dont mean slight trembling, the sort of subtle tremor that would be evident only if I were holding a piece of paperI feel like Im on the verge of convulsing. I am concentrating on keeping my legs from flying out from under me like an epileptics and am hoping that my pants are baggy enough to keep the trembling from being too visible. Im now leaning on my almost wifethere is no hiding the trembling from herand she is doing her best to hold me up.

The minister is droning on; I have no idea what hes saying. (I am not, as they say, present in the moment.) Im praying for him to hurry up so I can escape this torment. He pauses and looks down at my betrothed and me. Seeing methe sheen of flop sweat, the panic in my eyeshe is alarmed. Are you okay? he mouths silently. Helplessly, I nod that I am. (Because what would he do if I said that I wasnt? 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 peoplefriends and family and colleagueswatching 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 wifes 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 wifes had, I fear, is being confirmed. I knew it, I imagine those friends thinking. This proves hes not worthy of marrying her. I look as though Ive taken a shower with my clothes on. My sweat glandsmy physical frailty, my weak moral fiberhave 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. Im not going to have convulsions. Im not going to pass out. But as I stand in the reception line, and then drink and dance at the reception, Im pantomiming happiness. Im smiling for the camera, shaking handsand 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 Id 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. Ive frozen, mortifyingly, onstage at public lectures and presentations, and on several occasions I have been compelled to run offstage. Ive 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 thingsreading a book, lying in bed, talking on the phone, sitting in a meeting, playing tennisI 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.

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