Review and Ruminations: Scott Stossel’s “My Age of Anxiety”

Roughly once a year, I find a book that is, for lack of a more descriptive term, me. In previous years, I’ve bestowed that ambiguous crown upon Henry Emmons’ The Chemistry of Calm and Susan Cain’s Quiet. The early favorite for 2014 is Scott Stossel’s My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind. At once a probing and visceral read, Stossel balances a deep and thorough history of anxiety’s origins and manifestations, with his own struggles and presentations with the disease.

And yes, it is a disease. Our present immediate and information-dense age is far from the first to be seen as “creating” anxiety in its citizens. Such accusations have been cast upon the “modern age” since the Industrial Revolution (no, seriously, it’s in the book). But the fact of the matter is, irrespective of documented percentage (which, for the record, sits at roughly 25% in the United States), “humans have always and ever been anxious; some relatively fixed proportion have always been more anxious than others.” And while in many ways this is exclusively Scott’s story, it in other ways belongs to all of those extra-anxious folks. So what do I have to share with you all- some who might be anxious, and many who are not?

First off, don’t freak out. Odds are, in our own way, we’re doing it already. People with anxiety are not to be feared, consciously avoided, or cast aside. Despite what you may be assuming or understanding is a lack of control of our feelings, many suffering from anxiety are, paradoxically, in fairly good control of ourselves. Scott writes in detail about his pre-public speaking ritual to prevent panic onstage. It would likely horrify many counseling and medical professionals, but it shows a level of awareness of his triggers that many don’t think to associate with individuals dealing with mental illness. But when we are in control, we have our rituals, aids, and talismans that keep us that way.

We don’t always look the same. One of the most resonant things Scott writes in the book, for me, is his description of himself while living with anxiety:

As psychopathologies go, mine has been –so far– relatively quiet […] I am, as they say in the clinical literature, “high functioning” for someone with an anxiety disorder or mental illness; I’m usually quite good at hiding it. More than a few people, some who 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.”

I’ve been told many times when I confess to panic or debilitating agitation that I appear otherwise calm. And, to be honest, that facade takes a lot of work. Stories of family members, friends, or media portrayals of anxiety lead lots of people to believe that they know what to look for when seeking out people with mental illness. In the most extreme cases, you might. But awareness months (such as Mental Health Awareness Month, observed each May) aren’t observed for things you can see easily. They’re designed to encourage you to look a little closer. Anxiety’s like that sometimes. No ripples on the surface today? Look under the water. Ask questions. You might be surprised by the ferocity of the paddling that you find beneath the surface.

We don’t know where it comes from. Stossel spends a great deal of My Age of Anxiety following anxiety’s diagnosis history, in some cases pairing it with his own family’s history of at-times debilitating anxiety and panic. He considers brain science that provides clues to what neurotransmitters play a role in creating anxiety. He considers with equal trust behavioral studies that explore what role familial relationships and various forms of therapy play in ameliorating anxiety. He’s been to a number of therapists over the years who have placed responsibility in varying proportions on a combination of the two. But ultimately, we don’t know where anxiety comes from. And if you ask someone why they’re anxious, know that your question could potentially feed the problem. Poet W.H. Auden was among the first to make a clear association between anxiety and uncertainty. We’re anxious because we don’t know: we don’t know we’re at our best, what people think of us, if we’re forgetting something, if we have enough time in the day, if we have enough time existentially…and preoccupation with these things and more weighs on us heavily. Despite being an illness, for many with anxiety, that’s our normal. It just is.

But you can help. To this point, Scott and I seem to have written about anxiety as though its an inevitability. And maybe it is. Maybe it’s something that those with it, are stuck with. However, that doesn’t mean that we’re imprisoned by it. For some, medication and therapy can help. In my case, I’ve been lucky to be much improved by controlled diet and a more natural regimen of supplements. And many studies are showing that anxiety is often paired with extremely admirable traits- thorough and meticulous work styles, conscientiousness, high IQ, creativity, and thoughtful leadership. Praise these traits wherever you may find them, among anxious people or not. I will warn you, and Scott does allude to this in his final chapter, that anxious individuals will instinctively brush off this praise, having compiled ample evidence to the contrary in their own heads. That’s all the more reason for you to voice objections to the potentially damaging inner dialogue- the anxious need to hear it.

Scott talks near the end of his book about the role that resilience can play in helping the anxious cope. Those looking to support anxious family, colleagues, and friends can do their most fruitful work here. Dennis Charney of Mount Sinai identified several (ten, but I’ll abbreviate that list here) critical elements of resilience, including altruism, humor, role models, social supports, and practice in meeting and overcoming challenges. I think you could all guess fairly easily which one I’m most likely to use 🙂

Any way that you can can play a role in creating and sustaining environments with these characteristics- lowering seemingly high stakes with humor, demonstrating tough tasks to reduce nervousness on initial attempts, bring supportive in immediate moments of panic, anxiety, or even uncertainty- can make a world of difference.

And lastly, to return to the paddling analogy from before: if you are invited beneath the water to witness the churning and flailing beneath, be appreciative of the invitation. Recognize the privilege that comes with such a view. And, most importantly, incorporate both the view above water and the one below into your perception of the person. All of us, anxious or not, are more than our struggles. Few demonstrate that better than Scott Stossel. He is much more than an anxious individual; he is a husband, father, editor in chief of The Atlantic, and, in his own right, a wonderful and liberating author.