The Whitt Review

Anxiety and tension seem to abound in our modern culture and the current trend is to escape the unpleasantness of its impact. But when has life ever been exempt from stress? In the long run, is it desirable that a population be ever free from tension? Should there be a pill for every mood and occasion?

–From a December 1956 report by the New York Academy of Medicine

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Odds are that you or a loved one falls somewhere on the anxiety spectrum. Maybe a specific action like flying makes travel less than enjoyable, or a holiday cocktail party packed with small talk gives you jitters. Fortunately, most specific anxiety disorders are manageable. And some anxiety, especially in early life, is instrumental in helping us develop into adults that are capable of overcoming adversity. But what do medical professionals mean when they diagnose someone with “anxiety”, and how do they synthesize decades of experience to craft and implement treatment regimens? More importantly, what triggers the crossover from normal human angst to chronic anxiety so severe that the workings of daily life become practically impossible?

 

I won’t leave you in suspense regarding my opinion about this book. You should buy “My Age of Anxiety” now and put it at the top of your reading stack. From the start, author Scott Stossel exhibits a rare level of honesty that underpins the entire book. He shares painful details of his mental health struggles, from panic attacks as a child to anxiety-induced irritable bowel syndrome as an adult. Your heart sinks with every story he tells, your list of questions growing page by page. He opens up his life not for sympathy or praise, but as a way of showing how debilitating chronic anxiety can be. It’s obvious in his writing that this book served as therapy, a way for him to map his experience against the medical community’s ever-changing knowledge about mental health.

 

And from my perspective, only one thing is certain about how medical professionals view anxiety – their understanding is constantly changing. Hardly a week goes by without a major news outlet producing an article or story about anxiety’s impact on our relationships, productivity, and livelihoods. Much of the recent coverage has attempted to explain the Venn diagram that includes anxiety and depression. Where does one end and the other begin? Mr. Stossel connects them without equivocation, even suggesting that they are one and the same, with overlapping symptoms, diagnoses and treatments. One basis for his argument is the way the two are treated pharmacologically, with numerous medications prescribed for both anxiety and depression. So, are patients anxious with mild depression?  Or depressed and with mild anxiety? Maybe depranxious? 

 

For several chapters, he takes a deep dive into the history of psychopharmacology, from Freud’s support for cocaine as a viable therapy to the widespread prescription of MAOI medications today. Starting with the introduction of the first anti-anxiety drugs in the 1950s, he makes one trend clear:

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Every time new drug therapies come along, they raise the question of where the line between anxiety as psychiatric disorder and anxiety as a normal problem of living should get drawn. We see this again and again throughout the history of pharmacology: the rise of tranquilizers is followed by an increase in anxiety diagnoses; the rise of antidepressants is followed by an increase in the rate of depression.

 

An interesting trend certainly, and one that mirrors the introduction of new medications for numerous health problems. But as someone who has struggled for years with varying levels of anxiety, I can assure you that it’s real and disruptive. The rise in new medications probably has influenced the rate of diagnosis by medical professionals, but that doesn’t discount the very real impact that chronic anxiety has on the afflicted. Anxiety shines a spotlight on you at the worst possible time, elevating your worst character traits to center stage in the epic play called Life. Like many people, I’ve taken different steps to tackle the problem. Some have been successful and some have not. I’ve studied the potential causes, both genetic and environmental. But at the end of the day, the only thing I’m sure of is that I’m simply a highly functioning anxious person.

 

After finishing “My Age of Anxiety”, I backed away from the book for several weeks before sitting down to write this review. I struggled with how to express my opinion, because Mr. Stossel doesn’t lead you to an easy conclusion. Frankly, I wanted more. I was frustrated that 400 plus pages left me with more questions than answers. But as I looked back through my margin notes, I slowly came to understand that Mr. Stossel’s story is my story and your story. He didn’t write a book about anxiety, depression, or mental illness. He wrote a book about the human experience. His only escape from the daily struggles of chronic anxiety was to dig in and learn – about himself, his condition, his family, his therapists, his medications, his world. Isn’t that what we all try to do every day - to better understand ourselves and our place?

  

As he states in an early chapter, “to grapple with and understand anxiety is, in some sense, to grapple with and understand the human condition”. I think this sums up the book perfectly. We worry because we plan for the future. And we plan for the future because we are human. So, I guess only one thing is certain.

 

To worry is to live.