“Sam” is my oldest friend. Growing up, I watched her go through long, painful bouts of depression and anxiety. She had difficulty getting motivated to do anything, didn’t sleep well or slept too much, and was chronically late to everything. And as the years passed, she displayed stronger and stronger signs of anxiety: insomnia (“Sleep at night? Ha!”), IBS (“I felt like I had to go to the bathroom all the time”), social phobias (“I would allot myself 15 minutes to stay at any social gathering to not get overwhelmed”) that turned into borderline agoraphobia (“I would spend whole weeks inside my apartment sometimes”), and obsessively overthinking everything. Nothing she did was ever good enough for her; she constantly berated herself over the smallest things.
I empathized with her. I didn’t, however, really understand the breadth of Sam’s anxiety (or anxiety in general) until I read My Age of Anxiety, Scott Stossel’s book about his copious attempts to understand and navigate his own struggle with anxiety and (many) phobias.
Stossel seems, in every sense, to be successful at life: he is the current editor of The Atlantic, has two books under his belt, has a very supportive family, and comes from a well-to-do background. He looks like a nice, put-together guy in the photo on the jacket of the book. But then you read about the lengths he’s gone to manage his lifelong anxiety and you want to tear your hair out and cry at his misfortune. He’s a wreck. And sadly, he’s always been a wreck. But he’s an interesting and articulate one at that. Intertwining scientific research, psychology, history, social theory, and (very) personal stories, Stossel attempts to uncover the roots of anxiety, presenting extremely compelling arguments for the two most powerful sides of the debate: psychopharmacology and cognitive-behavioral therapy, both in which he’s had extensive experience with.
Stossel starts off with a litany of therapies he’s tried: psychotherapy, family therapy, group therapy, cognitive-behavioral therapy (CBT), rational emotive therapy (RET), acceptance and commitment therapy (ACT), role-playing, interoceptive exposure therapy; the list goes on. The medications-list is even longer: Thorazine, Paxil, Celexa, Cymbalta, Serax, Valium, Librium, Xanax, Wellbutrin, Nardil…You get the picture. He’s somewhat of an expert both as a patient and a writer who has researched the topic through and through. My Age of Anxiety is fascinating, whizzing through a comprehensive history of anxiety to highlight defining moments of the birth of the ideas of anxiety and how it has evolved into what it is today. We learn that Charles Darwin suffered horribly from it, which debilitated him for months at a time. So did Freud, who used cocaine to ease his nerves. Stossel goes on to explain the emergence of pharmacology and how barbiturates, sedatives, and MAOIs came into the picture when gin and cocaine ceased to work for people. It’s incredible how drugs like Miltown changed psychology in the 20th century and even our culture, from the advent of the concept of the “neurotic housewife” to inspiring Aldous Huxley’s Brave New World. Anxiety seemed to change the world.
According to the latest figures from the National Institute of Mental Health, about forty million Americans, or about 18 percent of the population, currently suffer from a clinical anxiety disorder.
Although many argue that anxiety has a basis in biology, others see it as a problem of our ultra-modern-too-many-choices-quickly-changing world, and Stossel pursues answers to explain what it is and where it comes from. Is it biological or psychological? He has reason and strong evidence for both.
Importantly, Stossel also poses philosophical questions about how to combat anxiety. He points out that the DSM (Diagnostic and Statistical Manual of Mental Disorders) has grown from 100 to 494 pages and from 182-265 diagnoses between the second (1968) and third editions (1980) of its publication—is this a result of the emergence and awareness of new symptoms, or just clever BigPharma marketing? And how patients are diagnosed is of great concern. The debate between pharmacologists and cognitive-behavioral therapists is long-standing. For pharmacologists, the brain is wired incorrectly and can only be “fixed” with medication. Therapists believe that anxiety is a psychological disorder and can be managed through various cognitive and behavioral therapies, not to mention that the brain can also be “rewired” through the process of therapy. The former’s criticisms include dependency and addiction to medication and prescription-happy psychiatrists. Of course, there are many people who really need and benefit from medication. But are there other, less intrusive methods people can try in the effort to manage their anxiety?
Stossel leads us to believe that he’s tried everything to regulate his anxiety, including “alternative therapies” like yoga, meditation, hypnosis, massage therapy and acupuncture, but hardly gives them more attention in the book than the time it takes to assume downward dog. He mentions these practices as if they are an afterthought and doesn’t discuss them, nor disclose his experiences or the research that’s been done to substantiate them.
Earlier this year, Science Daily cited research by Madhav Goyal, M.D., M.P.H., on the benefits of meditation. An assistant professor at the Johns Hopkins University School of Medicine, he states, “In our study, meditation appeared to provide as much relief from some anxiety and depression symptoms as what other studies have found from antidepressants.” These patients did not typically have full-blown anxiety or depression.
Goyal and his colleagues found that “mindfulness meditation” — a form of Buddhist self-awareness designed to focus precise, nonjudgmental attention to the moment at hand — also showed promise for alleviating some pain symptoms as well as stress. To conduct their review, the investigators focused on 47 clinical trials performed through June 2013 among 3,515 participants, which involved meditation for various mental and physical health issues, including depression, anxiety, stress, and insomnia. They found moderate evidence of improvement in symptoms of anxiety, depression and pain after participants underwent an eight-week training program in mindfulness meditation. To be fair, if it didn’t work for Stossel, perhaps it’s because he suffers more acutely.
Of course, meditation may not work for everyone. But neither will medication or traditional talk therapy. My friend Sam recalls going to therapy for seven years trying cognitive, group and Gestalt therapies without any positive effects. A psychiatrist finally suggested medication but, “I was scared of the side effects and that it would dull my personality, which I heard it did to other people.” A mental health agency strongly suggested she go to an Al-Anon meeting after learning that she was in a relationship with an alcoholic. It changed her life.
Sam has been going to seven Twelve-step Programs over the course of 14 years now and they’ve transformed her psychologically, and even physically. Al-Anon (friends and family of alcoholics), DA (Debtor’s Anonymous), and SLAA (Sex and Love Addicts Anonymous) are just a few they attend either in person or by phone on a weekly basis. She eventually left her toxic relationship and began to take care of herself emotionally and physically (because even showering was challenging sometimes). “With therapists, I was able to hide and avoid my issues,” she tells me, “But meetings are a more authentic exchange. There’s no authority figure; we’re equals who share the same issues (if not worse) and have gone through similar things.” She went on to tell me that meetings help to combat her anxiety with immediate effects; for her, pathologies are mostly a problem of the spirit, not merely psychology or brain chemistry. For Sam, Twelve-step Programs address the soul, something neither medication nor psychology do for her. For “12 Steppers,” when the spirit heals, the physical parts (including thought processes) change.
For Stossel, writing My Age of Anxiety is his mission toward the seemingly impossible: to cure his hellish anxiety. With captivating stories and often hilarious footnotes, I have a better understanding of this facet of life, both within myself and in others—for I, too, experience strong waves of anxiety sometimes, as do many of my friends and family. I’ve never properly gone to a therapist (at least for very long) and have never, ever considered medication (I don’t even like to take Tylenol). Instead, I practice yoga, which does wonders to alleviate my psyche when it’s full of unrest. When yoga isn’t available, I write in my journal about anything and everything that comes to mind, and the process of privately letting things go on paper is extremely therapeutic for me. So does having good sex or taking a brisk walk around the neighborhood. The point is, one method may or might not work for you, but trying different, alternative, or a combination of methods may change your life.
I can’t be sure that Scott Stossel really tried everything to cure himself, but My Age of Anxiety thoughtfully recounts some of his countless, unbelievable experiments. Even though you want to shake him wildly at times to relieve his intense anxiety attacks, you can’t help but want to give him a hug as well.