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

by Scott Stossel

  36 “I dread going anywhere”: Life and Letters of Charles Darwin, vol. 1, 349.

  37 “I have therefore been compelled”: Darwin, Autobiography, 39.

  38 He installed a mirror: Quammen, Reluctant Mr. Darwin, 62.

  39 In addition to Dr. Chapman’s ice treatment: Sources include Bowlby, Charles Darwin; Colp, To Be an Invalid; Desmond and Moore, Darwin; Browne, The Power of Place; and Quammen, The Reluctant Mr. Darwin; among others.

  40 “a very bad form of vomiting”: Bowlby, Charles Darwin, 300.

  41 “I have been bad”: Ibid., 335.

  42 “I have been very bad”: Ibid., 343.

  43 “strive to suppress their feelings”: Ibid., 11.

  44 “I must tell you”: Ibid., 375.

  45 “Without you, when I feel sick”: Desmond and Moore, Darwin, 358.

  46 “O Mammy I do long”: Bowlby, Charles Darwin, 282.

  CHAPTER 4: PERFORMANCE ANXIETY

  1 Starting when he was thirty: Oppenheim, “Shattered Nerves,” 114.

  2 “To that”: Davenport-Hines, Pursuit of Oblivion, 56.

  3 “mystifying and scandalously sudden retirement”: Quoted in Marshall, Social Phobia, 140.

  4 “They … to whom a public examination”: “Memoir of William Cowper,” Procedings of the American Philosophical Society 97, no. 4 (1953): 359–82.

  5 “My head was reeling”: Gandhi, Autobiography. (I was pointed to this source by chapter 5 of Taylor Clark’s Nerve.)

  6 “Thomas Jefferson, too, had his law career disrupted”: All Jefferson material here is drawn from Joshua Kendall’s American Obsessives, 21.

  7 a career-ending panic attack: Mohr, Gasping for Airtime, 134.

  8 “I had all these panic attacks”: “Hugh Grant: Behind That Smile Lurks a Deadly Serious Film Star,” USA Today, December 17, 2009.

  9 Elfriede Jelinek, the Austrian novelist: “A Gloom of Her Own,” The New York Times Magazine, November 21, 2004.

  10 Sigmund Freud took cocaine to medicate: See, for instance, Kramer, Freud, 42.

  11 The first case study of erythrophobia: Casper, Johann Ludwig, “Biographie d’une idée fixe” (translated into French, 1902), Archives de Neurologie, 13, 270–287.

  12 “It is not a simple act”: Darwin, Expression, 284.

  13 “the soul might have sovereign power”: Burgess, Physiology or Mechanism of Blushing, 49.

  14 Writing in 1901, Paul Hartenberg: Hartenberg, Les timides et la timidité (Félix Alcon, 1901).

  15 The term “social phobia” first appeared: Pierre Janet, Les obsessions et la psychiatrie (Alcan, 1903).

  16 “the socially promoted show of shame”: Ken-Ichiro Okano, “Shame and Social Phobia: A Transcultural Viewpoint,” Bulletin of the Menninger Clinic 58, no. 3 (1994): 323–38.

  17 In 1985, Liebowitz published an article: Michael Liebowitz et al., “Social Phobia,” Archives of General Psychiatry 42, no. 7 (1985): 729–36.

  18 As recently as 1994: “Disorders Made to Order,” Mother Jones, July/August 2002.

  19 One study has found: See Manjula et al., “Social Anxiety Disorder (Social Phobia)—a Review,” International Journal of Pharmacology and Toxicology 2, no. 2 (2012): 55–59.

  20 Studies at the University of Wisconsin: See Davidson et al., “While a Phobic Waits: Regional Brain Electrical and Autonomic Activity in Social Phobias During Anticipation of Public Speaking,” Biological Psychiatry 47 (2000): 85–95.

  21 “When I see anyone anxious”: “On Anxiety,” in Epictetus, Discourses, ch. 13.

  22 Kathryn Zerbe, a psychiatrist: See, for instance, Kathryn J. Zerbe, “Uncharted Waters: Psychodynamic Considerations in the Diagnosis and Treatment of Social Phobia,” Bulletin of the Menninger Clinic 58, no. 2 (1994): A3. See also Capps, Social Phobia, 120–25.

  23 “Highly anxious people read facial expressions”: “Anxious Adults Judge Facial Cues Faster, but Less Accurately,” Science News, July 19, 2006.

  24 “this barometer can cause them”: “Whaddya Mean by That Look?,” Los Angeles Times, July 24, 2006.

  25 Arne Öhman, a Swedish neuroscientist: See, for instance, Arne Öhman, “Face the Beast and Fear the Face: Animal and Social Fears as Prototypes for Evolutionary Analyses of Emotion,” Psychophysiology 23, no. 2 (March 1986): 123–45.

  26 “doing something foolish”: Marshall, Social Phobia, 50.

  27 A National Institute of Mental Health study: K. Blair et al., The American Journal of Psychiatry 165, no. 9 (September 2008): 193–202; K. Blair et al., Archives of General Psychiatry 65, no. 10 (October 2008): 1176–84.

  28 “Generalized-social-phobia-related dysfunction”: K. Blair et al., “Neural Response to Self- and Other Referential Praise and Criticism in Generalized Social Phobia,” Archives of General Psychiatry 65, no. 10 (October 2008): 1176–84.

  29 they are not consciously aware of seeing: For instance, Murray B. Stein et al., “Increased Amygdala Activation to Angry and Contemptuous Faces in Generalized Social Phobia,” Archives of General Psychiatry 59, no. 11 (2002): 1027.

  30 “Unconsciously perceived signals of threat”: Zinbarg et al., “Neural and Behavioral Evidence for Affective Priming from Unconsciously Perceived Emotional Facial Expressions and the Influence of Trait Anxiety,” Journal of Cognitive Neuroscience 20, no. 1 (January 2008): 95–107.

  31 Murray Stein, a psychiatrist: Murray B. Stein, “Neurobiological Perspectives on Social Phobia: From Affiliation to Zoology,” Biological Psychiatry 44, no. 12 (1998): 1277.

  32 the social hierarchies of particular baboon populations: See, for instance, Robert Sapolsky, “Testicular Function, Social Rank and Personality Among Wild Baboons,” Psychoneuroendocrinology 16, no. 4 (1991): 281–93; Robert Sapolsky, “The Endocrine Stress-Response and Social Status in the Wild Baboon,” Hormones and Behavior 16, no. 3 (September 1982): 279–92; Robert Sapolsky, “Stress-Induced Elevation of Testosterone Concentrations in High Ranking Baboons: Role of Catecholamines,” Endocrinology 118 no. 4 (April 1986): 1630.

  33 the happiest-seeming and least stressed monkeys: Gesquiere et al., “Life at the Top: Rank and Stress in Wild Male Baboons,” Science 333, no. 6040 (July 2011): 357–60.

  34 monkeys with enhanced serotonergic function: See, for instance, Raleigh et al., “Serotonergic Mechanisms Promote Dominance Acquisition in Adult Male Vervet Monkeys,” Brain Research 559, no. 2 (1991): 181–90.

  35 altered serotonin function in certain brain regions: For instance, Lanzenberger et al., “Reduced Serotonin-1A Receptor Binding in Social Anxiety Disorder,” Biological Psychiatry 61, no. 9 (May 2007): 1081–89.

  36 Prozac and Paxil can be: See, for instance, van der Linden et al., “The Efficacy of the Selective Serotonin Reuptake Inhibitors for Social Anxiety Disorder (Social Phobia): A Meta-analysis of Randomized Controlled Trials,” International Clinical Psychopharmacology 15, supp. 2 (2000): S15–23; Stein et al., “Serotonin Transporter Gene Promoter Polymorphism Predicts SSRI Response in Generalized Social Anxiety Disorder,” Psychopharmacology 187, no. 1 (July 2006): 68–72.

  37 when nonanxious, nondepressed people take SSRIs: See, for instance, Wai S. Tse and Alyson J. Bond, “Serotonergic Intervention Affects Both Social Dominance and Affiliative Behaviour,” Psychopharmacology, 161 (2002): 324-330

  38 the monkeys that rise the highest: See, for instance, Morgan et al., “Social Dominance in Monkeys: Dopamine D2 Receptors and Cocaine Self-Administration,” Nature Neuroscience 5 (2002): 169–74; Morgan et al., “Predictors of Social Status in Cynomolgus Monkeys (Macaca fascicularis) After Group Formation,” American Journal of Primatology 52, no. 3 (November 2118): 115–31.

  39 people diagnosed with social anxiety disorder: See, for instance, Stein and Stein, “Social Anxiety Disorder,” Lancet 371 (2008): 1115–25.

  40 One 2008 study found that half: Arthur Kummer, Francisco Cardoso, and Antonio L. Teixeira, “Frequency of Social Phobia and Psychometric Properties of the Liebowitz Social Anxiety Scale in Parkinson’s Disease,” Movement Disorders
23, no. 12 (2008): 1739–43.

  41 Multiple recent studies have found: See, for instance, Schneier et al., “Low Dopamine D2 Reception Binding Potential in Social Phobia,” The American Journal of Psychiatry 157 (2000): 457–59.

  42 Murray Stein, among others: Stein, Murray B., “Neurobiological Perspectives on Social Phobia: from Affiliation to Zoology,” Biological Psychiatry 44, no. 12 (1998): 1277–85. See also David H. Skuse and Louise Gallagher, “Dopaminergic-Neuropeptide Interactions in the Social Brain,” Trends in Cognitive Sciences 13, no. 1 (2009): 27–35.

  43 where you fall on the spectrum: See, for instance, Seth J. Gillihan et al., “Association Between Serotonin Transporter Genotype and Extraversion,” Psychiatric Genetics 17, no. 6 (2007): 351–54.

  44 But Robert Sapolsky has found: Sapolsky, “Social Status and Health in Humans and Other Animals,” Annual Review of Anthropology 33 (2004): 393–418.

  45 In the late 1990s, Dirk Hellhammer: Dirk Helmut Hellhammer et al., “Social Hierarchy and Adrenocortical Stress Reactivity in Men,” Psychoneuroendocrinology 22, no. 8 (1997): 643–50.

  46 In 1908, two psychologists: Robert M. Yerkes and John D. Dodson, “The Relation of Strength of Stimulus to Rapidity of Habit-Formation,” The Journal of Comparative Neurology and Psychology 18, no. 5 (1908): 459–82.

  47 Bertoia … “couldn’t hit and sometimes bobbled fielding plays”: Tone, The Age of Anxiety, 113–14.

  48 “like a song that got in my head”: Quoted in Ballard, Beautiful Game, 76.

  49 “disreturnophobia”: “Strikeouts and Psych-Outs,” The New York Times Magazine, July 7, 1991.

  50 The explicit monitoring theory of choking: Sian L. Beilock and Thomas H. Carr, “On the Fragility of Skilled Performance: What Governs Choking Under Pressure?,” Journal of Experimental Psychology: General 130, no. 4 (2001): 701.

  51 Beilock has found that she can: For more on this, see Beilock, Choke.

  52 a neural “traffic jam” of worry: Quoted in Clark, Nerve, 208.

  53 “found himself in such disgrace”: Herodotus, Histories, vol. 4, bk. 7.

  54 inure their soldiers to anxiety: Gabriel, No More Heroes, 104.

  55 and also valerian, a mild tranquilizer: Ibid., 139.

  56 Researchers at Johns Hopkins University: “Stress Detector for Soldiers,” BBC World News, May 29, 2002.

  57 The Anglo-Saxon Chronicle recounts: Cited in Gabriel, No More Heroes, 51.

  58 “at best a constitutionally inferior human being”: Herman, Trauma and Recovery, 21.

  59 A 1914 article: “The Psychology of Panic in War,” American Review of Reviews 50 (October 1914): 629.

  60 “hyperconsiderate professional attitude”: Quoted in Barber, Comfortably Numb, 73.

  61 “because only such a measure would prevent”: Quoted in Bourke, Fear, 219.

  62 “It is now time that our country”: Ibid.

  63 General George Patton of the U.S. Army denied: Shephard, War of Nerves, 219.

  64 dishonorably discharged for cowardice: Jeffrey Gettleman, “Reduced Charges for Soldier Accused of Cowardice in Iraq,” The New York Times, November 7, 2003.

  65 the first person to be formally diagnosed: Jacob Mendes Da Costa, “On Irritable Heart: A Clinical Study of a Form of Functional Cardiac Disorder and Its Consequences,” The American Journal of the Medical Sciences 121, no. 1 (1871): 2–52.

  66 Studies of “self-soiling rates”: Collins, Violence, 46.

  67 A survey of one U.S. combat division: Paul Fussell, “The Real War, 1939–45,” The Atlantic, August 1989.

  68 Another survey of World War II infantrymen: Kaufman, “ ‘Ill Health’ as an Expression of Anxiety in a Combat Unit,” Psychosomatic Medicine 9 (March 1947): 108.

  69 “Hell … all that proves”: Quoted in Clark, Nerve, 234.

  70 “I could feel a twitching”: Manchester, Goodbye, Darkness, 5.

  71 “Now, those who fail to register”: Christopher Hitchens, “The Blair Hitch Project,” Vanity Fair, February 2011.

  72 needed a man “with iron nerve”: Alvarez, Nervousness, 18.

  73 Comprehensive studies conducted during World War II: See, for instance, Grinker and Spiegel, Men Under Stress.

  74 “These people will be able to collect”: Leach, Survival Psychology, 24.

  75 “uncontrolled weeping”: Ibid., 25.

  76 civilians with preexisting neurotic disorders: Janis, Air War, 80.

  77 “Neurotics turned out to be”: Bourke, Fear, 231.

  78 “looking as worried as they have felt”: Felix Brown, “Civilian Psychiatric Air-Raid Casualties,” The Lancet 237, no. 6144 (May 1941): 689.

  79 One fascinating study of stress: V. A. Kral, “Psychiatric Observations Under Severe Chronic Stress,” The American Journal of Psychiatry 108 (1951): 185–92.

  80 “unprecedented in over 30 years”: Kathleen E. Bachynski et al., “Mental Health Risk Factors for Suicides in the US Army, 2007–8,” Injury Prevention 18, no. 6 (2012): 405–12.

  81 more than 10 percent of Afghanistan veterans: Hoge et al., “Mental Health Problems, Use of Mental Health Services, and Attrition from Military Service After Returning from Deployment to Iraq or Afghanistan,” JAMA 259, no. 9 (2006): 1023–32.

  82 army veterans diagnosed with post-traumatic stress disorder: Boscarino, Joseph, “Post-traumatic Stress Disorder and Mortality Among U.S. Army Veterans 30 Years After Military Service,” Annals of Epidemiology 16, no. 4 (2006): 248–56.

  83 the suicide rate reached a ten-year high: “Mike Mullen on Military Veteran Suicide,” Huffington Post, July 2, 2012.

  84 “were some of the greatest”: Charles A. Morgan et al., “Relationship Among Plasma Cortisol, Catecholamines, Neuropeptide Y, and Human Performance During Exposure to Uncontrollable Stress,” Psychosomatic Medicine 63, no. 3 (2001): 412–22.

  85 Some individuals with high NPY: “Intranasal Neuropeptide Y May Offer Therapeutic Potential for Post-traumatic Stress Disorder,” Medical Press, April 23, 2013.

  86 Administering NPY via a nasal spray: Charles A. Morgan III et al., “Trauma Exposure Rather Than Posttraumatic Stress Disorder Is Associated with Reduced Baseline Plasma Neuropeptide-Y Levels,” Biological Psychiatry 54, no. 10 (2003): 1087–91.

  87 Researchers at the University of Michigan: Brian J. Mickey et al., “Emotion Processing, Major Depression, and Functional Genetic Variation of Neuropeptide Y,” Archives of General Psychiatry 68, no. 2 (2011): 158.

  88 with more glucocorticoid receptors: Mirjam van Zuiden et al., “Pre-existing High Glucocorticoid Receptor Number Predicting Development of Posttraumatic Stress Symptoms After Military Deployment,” The American Journal of Psychiatry 168, no. 1 (2011): 89–96.

  89 “[Russell] used to throw up all the time”: George Plimpton, “Sportsman of the Year Bill Russell,” Sports Illustrated, December 23, 1968.

  90 he ordered that the pregame warm-up: See, for instance, John Taylor, The Rivalry: Bill Russell, Wilt Chamberlain, and the Golden Age of Basketball (New York: Random House, 2005).

  91 “one of the great mysteries in the history of sport”: “Lito Sheppard Says Donovan McNabb Threw Up in the Super Bowl,” CBSPhilly, July 8, 2013.

  92 “You must wonder what makes a man”: Gay Talese, “The Loser,” Esquire, March 1964.

  93 Hoping to conquer his anxiety: This section on Pisa in wartime is drawn from Arieti, Parnas.

  CHAPTER 5: “A SACK OF ENZYMES”

  1 Reportedly, it did: “Restless Gorillas,” Boston Globe, September 28, 2003; “Restless and Caged, Gorillas Seek Freedom,” Boston Globe, September 29, 2003.

  2 “In my last serious depression”: Quoted in, among many other places, Kramer, Freud, 33. For more on Freud’s use of cocaine, see Markel, An Anatomy of Addiction.

  3 “I take very small doses”: Davenport-Hines, Pursuit of Oblivion, 154.

  4 It is an irony of medical history: This irony has been noted by Peter Kramer, among others.

  5 they were ingesting alcohol: Tone, Age of Anx
iety, 10.

  6 “a suitable form of alcohol”: Quoted in Shorter, Before Prozac, 15.

  7 The 1899 edition of The Merck Manual: Tone, Age of Anxiety, 10.

  8 “quick-cure nostrums”: Topics of the Times, The New York Times, January 23, 1906.

  9 The Merck Manual was still recommending: Tone, Age of Anxiety, 22.

  10 “more of a menace to society”: Quoted in Tone, Age of Anxiety, 25.

  11 But when Frank Berger: Much of the history of Frank Berger and Miltown in these pages draws heavily from Andrea Tone’s Age of Anxiety, Edward Shorter’s Before Prozac, and Mickey Smith’s Small Comfort.

  12 “The mold is as temperamental”: Quoted in Tone, Age of Anxiety, 34.

  13 “The compound had a quieting effect”: Taylor Manor Hospital, Discoveries in Biological Psychiatry, 122.

  14 “We had about twenty Rhesus”: Quoted in Tone, Age of Anxiety, 43.

  15 “individuals who are pleasantly”: Henry H. Dixon et al., “Clinical Observations on Tolserol in Handling Anxiety Tension States,” The American Journal of the Medical Sciences 220, no. 1 (1950): 23–29.

  16 The New Jersey psychiatrist reported back: Borrus, “Study of Effect of Miltown (2-Methyl-2-n-Propyl-1,3-Propoanediol Dicarbamate) on Psychiatric States,” The Journal of the American Medical Association, April 30, 1955, 1596–98.

  17 The psychiatrist in Florida: Lowell Selling, “Clinical Use of a New Tranquilizing Drug,” The Journal of the American Medical Association, April 30, 1955, 1594–96.

  18 “You are out of your mind”: Quoted in Tone, Age of Anxiety, 52.

  19 Carter Products sold only $7,500: “Onward and Upward with the Arts: Getting There First with Tranquility,” The New Yorker, May 3, 1958.

  20 In December, Americans bought $500,000: Restak, Poe’s Heart, 187.

  21 “If there’s anything this movie business needs”: Quoted in Tone, Age of Anxiety, 57.

  22 Lucille Ball’s assistant kept a supply: Tone, Age of Anxiety, 57.

  23 “Miltowns, liquor, [and] swimming”: Ibid.

  24 The actress Tallulah Bankhead: Ibid., 58.