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

by Scott Stossel

Johnson’s journal entries, you will have noted, span more than forty years—from his twenties until his early seventies—and it is hard to know which is more affecting: the futility of his efforts to shake off sloth and to rise early or his earnest commitment to continuing to try despite his knowledge of that futility. (As he wrote in his journal on June 1, 1770, “Every Man naturally persuades himself that he can keep his resolutions, nor is he convinced of his imbecility but by length of time and frequency of experiment.”) Walter Jackson Bate, Johnson’s greatest modern biographer, first compiled many of these entries in the 1970s, when psychobiography in the Freudian mode was in vogue. Bate suggested that these entries—and Johnson’s continuing exhortations to improve himself generally—were evidence of a superego that was too perfectionistic in its demands, and he argued that the constant berating by Johnson’s superego, along with the low self-esteem that naturally accompanied it, accounted for Johnson’s “depressive anxiety” and his many psychosomatic symptoms. For Johnson, the “danger” of indolence was that, as his friend Arthur Murphy noted, “his spirits, not employed abroad, turned inward with hostility against himself. His reflections on his own life and conduct were always severe; and, wishing to be immaculate, he destroyed his own peace by unnecessary scruples.” When Johnson surveyed his life, Murphy wrote, “he discovered nothing but a barren waste of time, with some disorders of body, and disturbances of mind, very near to madness. His life, he says, from his earliest youth, was wasted in a morning bed; and his reigning sin was a general sluggishness, to which he was always inclined, and, in part of his life, almost compelled, by morbid melancholy and weariness of mind.” In this striving for perfection in order that he might think well of himself, Johnson exhibits the classic traits of what Karen Horney, the influential Freudian psychoanalyst, called the neurotic personality. According to Bate, Johnson’s writing, “which often anticipates … modern psychiatry,” was concerned with “how much of the misery of mankind comes from the inability of individuals to think well of themselves, and how much envy and other evils spring from this.” As Johnson himself put it, his strong interest in biography as a literary form—his work includes The Lives of the Poets and other biographical sketches—was motivated by an interest not so much in understanding how a man “was made happy” or how “he lost the favour of his prince” but in understanding “how he became discontented with himself.”

  But here’s an instructive fact: As unhappy with himself as he was, and as frequently as he berated himself for his lassitude and for lying in bed until two, Johnson was enormously productive. Johnson, despite churning out essays for money (“no man but a blockhead” would ever do otherwise, as he famously said), was no mere hack. Some of his writings—his protonovel Rasselas, his poem The Vanity of Human Wishes, the best of his essays—are fixtures of the Western canon. The Works of Samuel Johnson occupies sixteen thick volumes on my shelf—and that’s not even including the work for which he is most famous, the massive dictionary he compiled. Clearly, Johnson’s self-assessments of skillfulness and accomplishment were at odds with the reality—which, modern clinical research has shown, is often the case in people of melancholy disposition.†

  In his persistent efforts toward self-improvement, and in keeping up his great writerly productivity in the face of emotional torment, Johnson exhibited a form of resilience—a trait that modern psychology is increasingly finding to be a powerful bulwark against anxiety and depression. Anxiety research, which has traditionally focused on what’s wrong with pathologically anxious people, is focusing more and more on what makes healthy people resistant to developing anxiety disorders and other clinical conditions. Dennis Charney, a professor of psychiatry and neuroscience at the Ichan School of Medicine at Mount Sinai, has studied American prisoners of war in Vietnam who did not, despite the traumas they endured, become depressed or develop PTSD. A number of studies by Charney and others have found that the qualities of resilience and acceptance were what allowed these POWs to ward off the clinical anxiety and psychological breakdown that afflicted many others. The ten critical psychological elements and characteristics of resilience that Charney has identified are optimism, altruism, having a moral compass or set of beliefs that cannot be shattered, faith and spirituality, humor, having a role model, social supports, facing fear (or leaving one’s comfort zone), having a mission or meaning in life, and practice in meeting and overcoming challenges. Separate research has suggested that resilience is associated with an abundance of the brain chemical neuropeptide Y—and while it’s unclear which way the causation goes (does a resilient temperament produce NPY in the brain, or does NPY in the brain produce a resilient temperament, or is it, most likely, a combination of both?), some evidence suggests NPY levels have a strong genetic component.‡

  I lament to Dr. W. that, based on thirty years of futile effort so far, my prospects for achieving a recovery from anxiety sufficiently transcendent to provide an uplifting ending to this book seem dismal. I talk to him about the emerging research on resilience, which is fascinating and hopeful—but then I note, as I’ve done before, that I don’t feel very resilient. In fact, I say, I’ve now got tangible proof that I’m genetically predisposed to be not resilient: I’m biologically hardwired, at a cellular level, to be anxious and pessimistic and nonresilient.

  “This is why I keep telling you I hate all the modern emphasis on the genetics and neurobiology of mental illness,” he says. “It hardens the notion that the mind is a fixed and immutable structure, when in fact it can change throughout the life course.”

  I tell him that I know all that. And I know, furthermore, that gene expression is affected by environmental factors and that, in any event, reducing a human being to either genes or environment is absurdly reductionist.

  And yet I still don’t feel much capacity for resilience.

  “You’re more resilient than you know,” he says. “You’re always saying ‘I can’t handle this’ or ‘I can’t handle that.’ Yet you handle a lot for someone with anxiety—you handle a lot, period. Just think about what you’ve had to deal with while trying to complete your book.”

  As my deadline for delivering this book crept paralyzingly closer, I took a part-time leave from my day job as a magazine editor so I could focus on writing. This decision was not without risk: advertising my dispensability at a company that had been downsizing, in an industry (print journalism) that was radically contracting and possibly dying, and in an economy that was the worst since the Great Depression was hardly the best way to maximize my job security. But increasingly panicked that I was going to miss my deadline and have to plunge my family into bankruptcy, I calculated that the leave was a necessary gamble. My hope was that the time freed up by going on temporary leave, combined with the pressure of the looming deadline, would create the conditions necessary for a spasm of productivity.

  That didn’t happen. This did:

  The very day that my leave was to begin, my heretofore healthy wife fell ill with a mysterious and protracted ailment that led to multiple doctor’s appointments (internists, allergists, immunologists, endocrinologists) and a series of inconclusive diagnoses (lupus, rheumatoid arthritis, Hashimoto’s thyroiditis, Graves’ disease, and others). A few days after that, my completely law-abiding wife was charged (wrongly and absurdly; it’s a long story) with a felony that required thousands of dollars in legal expenses and several trips to court to combat. Around this same time, my mother’s second husband left her for another woman, and they (my mother and my soon-to-be ex-stepfather) began divorce proceedings that I feared would leave her impoverished. My father’s start-up company, which I had hoped would help fund my kids’ college education, lost its funding and folded. And so as I sat at my computer day after day on my ostensible book leave, I spent less time writing than I did worrying about my wife’s health and compulsively checking our dwindling bank balances as money flowed out much faster than it was flowing in.

  And then one early morning in August—the final month o
f my leave—I awoke to crashing thunder and a driving rain. Suddenly branches and stones started pummeling my bedroom window. As I leapt from bed and ran from the room, the window exploded inward. (My wife and kids were out of town.) I made for the basement, passing the kitchen just as the ceiling caved in—a tree had fallen on the roof. Cabinets were ripped from the walls and pitched to the floor. Light fixtures dropped from above and dangled in the air, suspended by sizzling wires. A swath of insulation unfurled from what remained of the ceiling, hanging there like a panting tongue. Shingles rained from above, splattering onto the linoleum. Rain poured through the gaping hole in the roof.

  I ran through the living room just as another tree toppled onto the house. All four windows in the room shattered at once, glass flying everywhere. Dozens of trees were falling, some of them pulled up by their roots, others split in two about eighty feet up from the ground.

  I scrambled down the stairs, intending to take refuge underground. But when I got to the basement, three inches of water already covered the ground, and the level was rising fast. I stood on the bottom step, thoughts racing, wondering what was going on (hurricane? nuclear attack? earthquake? tornado? alien invasion?)§ and trying to figure out what to do.

  Standing there in my boxer shorts, I became conscious of the thunderous pounding of my heart. My mouth was dry, my breathing was quick, my muscles were tense, my heart was racing, adrenaline was coursing through my bloodstream—my fight-or-flight response was fully activated. As I felt my heart thudding, it occurred to me that my physical sensations were like those of a panic attack or an episode of phobic terror. But even though the danger now was so much more real than during a panic attack, even though I was aware that I might get hurt or even (who knows?) die as the roof caved in and giant trees tumbled, I was less unhappy than I would be during a panic attack. I was scared, yes, but I was marveling at Nature’s force, her ability to tear down my seemingly solid house around me and to knock down scores of big trees. It was actually sort of … exciting. A panic attack is worse.‖

  The next several weeks were spent dealing with insurance claims and disaster recovery technicians and real estate agents and movers—and not at all working on my book. As the precious days of my dwindling leave ticked away, I again found myself in an excruciating bind. If I didn’t go back to work, I feared, I would lose my job; if I did go back to work, I’d probably miss my book deadline (and maybe lose my job anyway). Worse still would be to finally receive the external confirmation of my inner conviction all these years: that I am a failure—weak, dependent, anxious, shameful.

  “Scott!” Dr. W. said when I was going on in this fashion. “Are you listening to yourself? You’ve already written one book. You’re supporting a family. You have a job.”

  Later that day he e-mailed me:

  As I was writing my notes today after we met, it occurred to me that you need to better internalize positive feedback.… Your capabilities are far from the picture of inadequacy that you carry around in your head. Please try and absorb.

  I wrote back:

  I’ll try to absorb these comments—but I immediately discount or back away or rationalize them.

  He responded:

  Scott, the automatic response is to discount positive feedback. That is why it is so difficult to change. But the beginning of that process is a pushback against the negative juggernaut.

  Trying is all anyone can ask.

  The irony, of course, is that, as Dr. W. keeps telling me, the route to mental health and freedom from anxiety is to deepen my sense of what he calls, drawing on the work of the cognitive psychologist Albert Bandura, self-efficacy. (Bandura believed that repeatedly proving to oneself one’s competence and ability to master situations, and doing so in spite of feelings of anxiety, depression, or vulnerability, builds up self-confidence and psychological strength that can provide a bulwark against anxiety and depression.) Yet writing this book has required me to wallow in my shame, anxiety, and weakness so that I can properly capture and convey them—an experience that has only reinforced how deep and long-standing my anxiety and vulnerability are. Of course, I suppose that even as writing this book has intensified my sense of shame, anxiety, and weakness and has accentuated those feelings of “helpless dependency” that, according to the psychiatrists at McLean Hospital, did in my great-grandfather, it has also helped me appreciate that my efforts to withstand their corrosive effect provide some evidence that I have the resources to overcome them. Maybe by tunneling into my anxiety for this book I can also tunnel out the other side. Not that I can escape my anxiety or be cured of it. But in finishing this book, albeit a book that dwells at great length on my helplessness and inefficacy, maybe I am demonstrating a form of efficacy, perseverance, productivity—and, yes, resilience.

  Maybe I am not, for that matter—despite my dependency on medication, despite my flirtations with institutionalization, despite the genotype of pathology handed down to me by my ancestors, despite the vulnerability and what sometimes feels like the unbearable physical and emotional agony of my anxiety—as weak as I think I am. Consider the opening sentence of this book: “I have an unfortunate tendency to falter at crucial moments.” That statement feels true to me. (“The neurotic,” Karen Horney writes in The Neurotic Personality of Our Time, “tenaciously insists on being weak.”) And yet, as Dr. W. is always pointing out, I did survive my wedding and have managed (so far) to remain productive and gainfully employed for more than twenty years despite often debilitating anxiety.

  “Scott,” he says. “Over the last few years, you’ve run a magazine and edited many of its cover stories, worked on your book, taken care of your family, and coped with the destruction of your house and with the normal vicissitudes and challenges of life.” I point out that I’ve managed all this only with the help of (sometimes heavy) medication—and that anything I’ve accomplished has been accompanied by constant worry and frequent panic and has been punctuated by moments of near-complete breakdown that leave me always at risk of being exposed for the anxious weakling that I am.

  “You have a handicap—anxiety disorder,” he says. “Yet you manage it and, I would say, even thrive despite it. I still think we can cure you of it. But in the meantime, you need to recognize that, given what you’re up against, you’ve accomplished a lot. You need to give yourself more credit.”

  Maybe finishing this book and publishing it—and, yes, admitting my shame and fear to the world—will be empowering and anxiety reducing.

  I suppose I’ll find out soon enough.

  * * *

  * Recent research on sleep cycles suggests that difficulty in rising early is not (entirely) a character failing but rather a biologically hardwired trait: some people’s circadian rhythms make them what researchers call “morning doves,” leaping easily out of bed in the morning and fading at night, whereas other people are “night owls,” productively burning the midnight oil and unable to get out of bed in the morning.

  † Actually, an intriguing body of research has found that clinically depressed people tend to be more accurate in their self-assessments than healthy people, suggesting that an ample quotient of self-delusion—of thinking you’re better or more competent than you in fact are—is useful for good mental health and professional success.

  ‡ As we saw in chapter 9, the research of Jerome Kagan, Kerry Ressler, and others suggests that genes play a large role in determining one’s innate levels of nervousness and resilience.

  § It was, my insurance company would later conclude, “a tornadic event.”

  ‖ As if to confirm that, two nights later I woke up with a stomachache, which instantly triggered miserable body-quaking panic that had me desperately gulping vodka and Xanax and Dramamine in headlong pursuit of unconsciousness—probably putting myself at more risk of death than the house-destroying storm did.

  Acknowledgments

  This book might not exist if Kathryn Lewis had not, unbeknownst to me, shown an e-mail with my inchoate thoughts to
Sarah Chalfant of the Wylie Agency—and it would almost certainly not exist if Sarah had not then tracked me down and spurred me, patiently but relentlessly, to produce an actual proposal. Scott Moyers, during his stint at the Wylie Agency, held my hand through some dark times, providing both wisdom and invaluable practical advice. Andrew Wylie is as legend has him: a great and fearsome agent—you want him on your side. No one is a greater champion of writers than Andrew.

  Marty Asher, a sympathetic editor, immediately grasped what I was trying to do, and his enthusiasm for the book brought it to Knopf. Marty’s warmth and his many kindnesses sustained the book (and me) through some difficult stretches.

  I owe Sonny Mehta triply: first for signing off on Marty’s original acquisition of the book; second for his patience as the writing dragged on; and third for assigning the manuscript to Dan Frank for editing. Dan’s ministrations made this book so much better. I have worked as an editor for twenty years, so I like to think I know good editing when I encounter it: Dan is a brilliant editor and a kind man. Amy Schroeder helped untangle my prose. Jill Verrillo, Gabrielle Brooks, Jonathan Lazzara, and Betsy Sallee, among others, make it a pleasure to be a Knopf author.

  I am grateful for fellowships at the Yaddo and MacDowell colonies, which gave me time and space to work.

  Lots of people contributed ideas, steered me to useful sources, or provided support in other ways: Anne Connell, Meehan Crist, Kathy Crutcher, Toby Lester, Joy de Menil, Nancy Milford, Cullen Murphy, Justine Rosenthal, Alex Starr, and Graeme Wood. Alane Mason, Jill Kneerim, and Paul Elie all provided helpful early feedback on the book proposal before it was fully formed. Alies Muskin, executive director at the Anxiety and Depression Association of America, was generous with her time and her Rolodex.

  My brother-in-law, Jake Pueschel, provided valuable research assistance, tracking down hundreds of scholarly articles for me and, more essentially, helped me to process and interpret my genetic data. Jake’s parents, my mother- and father-in-law Barbara and Kris Pueschel, provided both child care and moral support—and tolerated my too-frequent absences from family events while I raced to meet deadlines.