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

by Scott Stossel

  25 “Hi, I’m Miltown Berle”: Restak, Poe’s Heart, 187.

  26 a $100,000 Miltown art installation: Tone, Age of Anxiety, 76.

  27 “For the first time in history”: Restak, Poe’s Heart, 187.

  28 “be of markedly greater import”: Testimony of Nathan S. Kline, False and Misleading Advertisements (Prescription Tranquilizing Drugs): Hearings Before a Subcommittee of the Committee on Government Operations, 4.

  29 Kline told a journalist: “Soothing, but Not for Businessmen,” BusinessWeek, March 10, 1956.

  30 By 1960, some 75 percent: Tone, Age of Anxiety, 90.

  31 “tense, anxious, Mediterranean-type patients”: Shorter, History of Psychiatry, 248.

  32 “the insulin of the nervous”: Shorter, Before Prozac, 49.

  33 “This stuff is so good”: Valenstein, Blaming the Brain, 27.

  34 “the most dramatic breakthrough”: Tone, Age of Anxiety, 80.

  35 “No one in their right mind”: Valenstein, Blaming the Brain, 27.

  36 may have precipitated Wallace’s downward spiral: See, for instance, D. T. Max, “The Unfinished,” The New Yorker, March 9, 2009.

  37 “was the first cure”: Kline, From Sad to Glad, 122.

  38 the “sparks” and the “soups”: Valenstein, Blaming the Brain, 60–62.

  39 “When I was an undergraduate student”: Quoted in Abbott, Alison, “Neuroscience: The Molecular Wake-up Call,” Nature 447, no. 7143 (2007): 368–70.

  40 Gaddum took LSD: Shorter, Before Prozac, 69.

  41 to give reserpine to every single one: Valenstein, Blaming the Brain, 69–70.

  42 administering reserpine to rabbits: Healy, Creation of Psychopharmacology, 106, 205–6.

  43 Brodie’s 1955 paper: Alfred Pletscher, Parkhurst A. Shore, and Bernard B. Brodie, “Serotonin Release as a Possible Mechanism of Reserpine Action,” Science 122, no. 3165 (1955): 374–75.

  44 built a bridge from neurochemistry to behavior: Healy, Antidepressant Era, 148.

  45 In one of its first advertisements: Shorter, Before Prozac, 52.

  46 “Not infrequently the cure is complete”: Roland Kuhn, “The Treatment of Depressive States with G 22355 (Imipramine Hydrochloride),” The American Journal of Psychiatry 115, no. 5 (1958): 459–64.

  47 another accident of history: Healy, Antidepressant Era, 52, 58; Barondes, Better Than Prozac, 31–32; Shorter, Before Prozac, 61.

  48 “These drugs seemed like magic to me”: Shorter, Before Prozac, 62.

  49 In 1965, he published an article: Joseph J. Schildkraut, “The Catecholamine Hypothesis of Affective Disorders: A Review of Supporting Evidence,” The American Journal of Psychiatry 122, no. 5 (1965): 509–22.

  CHAPTER 6: A BRIEF HISTORY OF PANIC

  1 “The anxiety he felt landing”: Sheehan, Anxiety Disease, 37.

  2 “We assumed it would be”: Donald F. Klein, “Commentary by a Clinical Scientist in Psychopharmacological Research,” Journal of Child and Adolescent Psychopharmacology 17, no. 3 (2007): 284–87.

  3 significant or complete remission of their anxiety: Donald F. Klein, “Anxiety Reconceptualized,” Comprehensive Psychiatry 21, no. 6 (1980): 411.

  4 “The predominant American psychiatric theory”: Quoted in Kramer, Listening to Prozac, 80.

  5 an initial report on imipramine: Donald F. Klein and Max Fink, “Psychiatric Reaction Patterns to Imipramine,” The American Journal of Psychiatry 119, no. 5 (1962): 432–38.

  6 “like the proverbial lead balloon”: Quoted in Kramer, Listening to Prozac, 84.

  7 Subsequent articles over the next several years: Donald F. Klein, “Delineation of Two Drug-Responsive Anxiety Syndromes,” Psychopharmacology 5, no. 6 (1964): 397–408; Klein and Oaks, “Importance of Psychiatric Diagnosis in Prediction of Clinical Drug Effects,” Archives of General Psychiatry 16, no. 1 (1967): 118.

  8 “the reaction of the individual’s ego”: Quoted in Kramer, Listening to Prozac, 84.

  9 “It is hard to recall”: Kramer, Listening to Prozac, 77.

  10 An advertisement for an October 1956 public talk: Tone, The Age of Anxiety, 111.

  11 “In this manner we were able”: Shorter, History of Psychiatry, 105.

  12 Actually, one exception here was astrologers: MacDonald, Mystical Bedlam, 13–35.

  13 “It is the task of the APA”: Caplan, They Say You’re Crazy, 234.

  14 “a book of tentatively assembled agreements”: Kutchins and Kirk, Making Us Crazy, 28.

  15 “As the wine flowed”: David Sheehan, “Rethinking Generalized Anxiety Disorder and Depression” (remarks at a meeting of the Anxiety Disorders of America Association, Savannah, Ga., March 7, 2008).

  16 “Invent a new tranquilizer”: The account of Sternbach’s discoveries is drawn from, among other sources, Baenninger et al., Good Chemistry, 65–78; Tone, Age of Anxiety, 120–40.

  17 “We thought that the expected negative result”: Leo Sternbach, “The Discovery of Librium,” Agents and Actions 2 (1972): 193–96.

  18 tamed a wild lynx with Librium: Smith, Small Comfort, 74.

  19 “The Drug That Tames Tigers”: Quoted in Davenport-Hines, Pursuit of Oblivion, 327.

  20 “slightly soft in the knees”: Tone, Age of Anxiety, 130.

  21 88 percent of those with “free-floating anxiety”: Joseph M. Tobin and Nolan D. C. Lewis, “New Psychotherapeutic Agent, Chlordiazepoxide Use in Treatment of Anxiety States and Related Symptoms,” The Journal of the American Medical Association 174, no. 10 (1960): 1242–49.

  22 “the most significant advance to date”: Harry H. Farb, “Experience with Librium in Clinical Psychiatry,” Diseases of the Nervous System 21 (1960): 27.

  23 “the treatment of common anxieties”: Shorter, Before Prozac, 100.

  24 Librium had the same range: M. Marinker, “The Doctor’s Role in Prescribing,” The Journal of the Royal College of General Practitioners 23, supp. 2 (1973): 26.

  25 Valium became the first drug: Restak, Poe’s Heart, 191.

  26 one in every five women: Valenstein, Blaming the Brain, 56.

  27 18 percent of all American physicians: George E. Vaillant, Jane R. Brighton, and Charles McArthur, “Physicians’ Use of Mood-Altering Drugs: A 20-Year Follow-up Report.” The New England Journal of Medicine (1970).

  28 “It is ten years since Librium”: Quoted in Smith, Small Comfort, 113.

  29 “Whether the increase”: Hollister, Clinical Use of Psychotherapeutic Drugs,111.

  30 “One must consider the broader implications”: D. Jacobs, “The Psychoactive Drug Thing: Coping or Cop Out?,” Journal of Drug Issues 1 (1971): 264–68.

  31 “35, single and psychoneurotic”: See, for instance, The American Journal of Psychiatry 126 (1970): 1696. The advertisement also ran in the Archives of General Psychiatry.

  32 “the arrival of the millennium”: Quoted in Smith, Small Comfort, 91.

  33 “Valium, Librium, and other drugs”: Quoted in Whitaker, Anatomy of an Epidemic, 137.

  34 the brains of people who took tranquilizers: M. H. Lader, M. Ron, and H. Petursson, “Computed Axial Brain Tomography in Long-Term Benzodiazepine Users,” Psychological Medicine 14, no. 1 (1984): 203–6. For additional overview, see “Brain Damage from Benzodiazepines,” Psychology Today, November 18, 2010.

  CHAPTER 7: MEDICATION AND THE MEANING OF ANXIETY

  1 By 2002, according to one estimate: M. N. Stagnitti, Trends in Antidepressant Use by the U.S. Civilian Non-institutionalized Population, 1997 and 2002, Statistical Brief 76 (Rockville, Md.: Agency for Healthcare Research and Quality, May 2005).

  2 a 2007 estimate put the number: United Press International, “Study: Psych Drugs Sales Up,” March 28, 2007.

  3 Trace elements of Prozac: See, for instance, “In Our Streams: Prozac and Pesticides,” Time, August 25, 2003; “River Fish Accumulate Human Drugs,” Nature News Service, September 5, 2003; “Frogs, Fish, and Pharmaceuticals: A Troubling Brew,” CNN.com, November 14, 2003; “Prozac in the Water,” Governing 19,
no. 12 (September 2006); “Fish on Prozac Are Violent and Obsessive,” Smithsonian.com, November 12, 2012.

  4 “Considering the benefit and the risk”: Healy, Let Them Eat Prozac, 39.

  5 A series of studies in the 1980s: Breggin, Talking Back to Prozac, 49. See also Healy, Let Them Eat Prozac, 37.

  6 “This”: Shorter, Before Prozac, 172.

  7 In 2006, Einar Hellbom: Einar Hellbom, “Chlorpheniramine, Selective Serotonin-Reuptake Inhibitors (SSRIs) and Over-the-Counter (OTC) Treatment,” Medical Hypotheses 66, no. 4 (2006): 689–90. See also Einar Hellbom and Mats Humble, “Panic Disorder Treated with the Antihistamine Chlorpheniramine,” Annals of Allergy, Asthma, and Immunology 90 (2003): 361.

  8 David Wong, an Eli Lilly biochemist: Healy, Let Them Eat Prozac, 39.

  9 a branding firm had thought: “Eternal Sunshine,” The Observer, May 12, 2007.

  10 “It is now clear”: Quoted in Barber, Comfortably Numb, 55.

  11 “Paxil is truly addictive”: Quoted in Shorter, Before Prozac, 44.

  12 “do not have a clinically meaningful”: Joanna Moncrieff and Irving Kirsch, “Efficacy of Antidepressants in Adults,” British Medical Journal 331, no. 7509 (2005): 155.

  13 “If you’re born around World War I”: Quoted in Barber, Comfortably Numb, 106.

  14 In Iceland, the incidence of depression: Tómas Helgason, Helgi Tómasson, and Tómas Zoega, “Antidepressants and Public Health in Iceland: Time Series Analysis of National Data,” The British Journal of Psychiatry 184, no. 2 (2004): 157–62.

  15 Britain reported 38 million: Joanna Moncrieff and Joceline Pomerleau, “Trends in Sickness Benefits in Great Britain and the Contribution of Mental Disorders,” Journal of Public Health 22, no. 1 (2000): 59–67.

  16 depression tripled in the 1990s: Robert Rosenheck, “The Growth of Psychopharmacology in the 1990s: Evidence-Based Practice or Irrational Exuberance,” International Journal of Law and Psychiatry 28, no. 5 (2005): 467–83.

  17 1,000 percent increase: See, for instance, Healy, Let Them Eat Prozac, 20. See also McHenry, “Ethical Issues in Psychopharmacology,” Journal of Medical Ethics 32 (2006): 405–10.

  18 the worldwide suicide rate has increased: www.who.int.

  19 if a drug makes you feel good: Greenberg, Manufacturing Depression, 193.

  20 “Psychotherapeutically”: Gerald L. Klerman, “A Reaffirmation of the Efficacy of Psychoactive Drugs,” Journal of Drug Issues 1 (1971): 312–19.

  21 “Americans believe tranquilizers are effective”: Dean I. Manheimer et al., “Popular Attitudes and Beliefs About Tranquilizers,” The American Journal of Psychiatry 130, no. 11 (1973): 1246–53.

  22 only 38 percent of Americans: Mental Health America, Attitudinal Survey 2007.

  23 only half had atypical levels of serotonin: Marie Asberg et al., “ ‘Serotonin Depression’—a Biochemical Subgroup Within the Affective Disorders?,” Science 191, no. 4226 (1976): 478–80.

  24 “abandon the simplistic hypothesis”: “CINP Meeting with the Nobels, Montreal, Canada, June 25, 2002: Speaker’s Notes—Dr. Arvid Carlsson,” Collegium Internationale Neuro-Psychopharmacologicum Newsletter (March 2003).

  25 Not long ago, George Ashcroft: L. McHenry, “Ethical Issues in Psychopharmacology,” Journal of Medical Ethics 32, no. 7 (2006): 405–10.

  26 “the evidence does not support”: Valenstein, Blaming the Brain, 96.

  27 “We have hunted for big simple”: Kenneth S. Kendler, “Toward a Philosophical Structure for Psychiatry,” The American Journal of Psychiatry 162, no. 3 (2005): 433–40. For more on the decaying of the serotonin hypothesis, see Jeffrey R. Lacasse and Jonathan Leo, “Serotonin and Depression: A Disconnect Between the Advertisements and the Scientific Literature,” PLoS Medicine 2, no. 12 (2005): e392.

  28 “If man can be reduced”: Tolson, Pilgrim, 129.

  29 “Yours is a mind”: Quoted in Ibid., 191.

  30 His opinion of biological psychiatry: Peter Kramer makes observations along these lines in Listening to Prozac.

  31 “unable to account for the predicament”: This essay is reprinted in Percy’s collection Signposts in a Strange Land.

  32 “We all know perfectly well”: Quoted and discussed in, among other sources, Elie, The Life You Save, 276; Elliott and Chambers, Prozac as a Way of Life, 135.

  CHAPTER 8: SEPARATION ANXIETY

  1 “Fear disorders”: Ron Kessler, “Comorbidity of Anxiety Disorders with Other Physical and Mental Disorders in the National Comorbidity Survey Replication” (presentation at ADAA conference, Savannah, Ga., March 7, 2008).

  2 “Anxiety in children”: Freud, Three Essays.

  3 “souls burning in hell”: Breger, Dream of Undying Fame, 9.

  4 “libido toward matrem had awakened”: Gay, Freud, 11.

  5 “You yourself have seen”: Breger, Freud, 18.

  6 “subject to attacks of anxiety”: Kramer, Freud, 20.

  7 “a universal event in early childhood”: Complete Letters of Freud to Fliess, 272.

  8 “biological factor”: Freud, Problem of Anxiety, 99.

  9 “the human infant is sent”: Ibid.

  10 “loss of love”: Ibid., 119.

  11 “the atrophied remnants of innate preparedness”: Ibid., 117.

  12 “was a very stable background”: Karen, Becoming Attached, 30.

  13 “a sharp, hard, self-centered woman”: Ibid., 31.

  14 “could be seen as an indictment”: Ibid.

  15 “But there is such a thing”: Bowlby, Separation, viii.

  16 “a frightfully vain old woman”: Karen, Becoming Attached, 44.

  17 “an extremely anxious, distressed woman”: Ibid., 45.

  18 “The fact that this poor woman”: Ibid.

  19 When Ainsworth first arrived in Uganda: This account of Ainsworth’s time in Uganda draws heavily on her book Infancy in Uganda and on chapter 11 of Robert Karen’s Becoming Attached.

  20 none of the ambivalently attached children: Karen, Becoming Attached, 180.

  21 Konrad Lorenz’s influential 1935 paper: Konrad Z. Lorenz, “The Companion in the Bird’s World,” The Auk 54, no. 3 (1937): 245–73.

  22 “What’s the use to psychoanalyze a goose?”: Quoted in Karen, Becoming Attached, 107.

  23 calls to “excommunicate” him: Issroff, Winnicott and Bowlby, 121.

  24 published an article in: Harry Frederick Harlow, “The Nature of Love,” American Psychologist (1958): 673–85.

  25 “Thereafter”: Bowlby, Secure Base, 26.

  26 when infant monkeys were separated: See, for instance, Yvette Spencer-Booth and Robert A. Hinde, “Effects of 6 Days Separation from Mother on 18- to 32-Week-Old Rhesus Monkeys,” Animal Behaviour 19, no. 1 (1971): 174–91.

  27 A subsequent paper by Harry Harlow: Harry F. Harlow and Margaret Harlow, “Learning to Love,” American Scientist 54, no. 3 (1966): 244–72.

  28 “initiation of ventral contact”: See, for instance, Stephen J. Suomi, “How Gene-Environment Interactions Can Shape the Development of Socioemotional Regulation in Rhesus Monkeys,” Emotional Regulation and Developmental Health: Infancy and Early Childhood (2002): 5–26.

  29 The idea behind the variable foraging demand: See, for instance, Mathew et al., “Neuroimaging Studies in Nonhuman Primates Reared Under Early Stressful Conditions,” Fear and Anxiety (2004).

  30 he died alcoholic and depressed: See, for instance, Blum, Love at Goon Park.

  31 the amount of licking and grooming: See, for instance, Christian Caldji et al., “Maternal Care During Infancy Regulates the Development of Neural Systems Mediating the Expression of Fearfulness in the Rat,” Proceedings of the National Academy of Sciences 95, no. 9 (1998): 5335–40.

  32 lasting consequences on a primate’s neurochemistry: See, for instance, Jeremy D. Coplan et al., “Variable Foraging Demand Rearing: Sustained Elevations in Cisternal Cerebrospinal Fluid Corticotropin-Releasing Factor Concentrations in Adult Primates,” Biological Psychiatry 50, no. 3 (2001): 200–4.
<
br />   33 There’s even some evidence: See, for instance, Tamashiro, Kellie L. K., “Metabolic Syndrome: Links to Social Stress and Socioeconomic Status,” Annals of the New York Academy of Science 1231, no. 1 (2011): 46–55.

  34 the children and even grandchildren: See, for instance, Joel J. Silverman et al., “Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps,” Journal of Child and Family Studies 8, no. 1 (1999): 71–89.

  35 A recent study published: Maselko et al., “Mother’s Affection at 8 Months Predicts Emotional Distress in Adulthood,” Journal of Epidemiology & Community Health 65, no. 7 (2011): 621–25.

  36 a coping strategy based on “chronic vigilance”: See, for instance, L. Alan Sroufe, “Attachment and Development: A Prospective, Longitudinal Study from Birth to Adulthood,” Attachment and Human Development 7, no. 4 (2005): 349–67.

  37 “Adults with agoraphobia are more likely”: Corine de Ruiter and Marinus H. Van Ijzendoorn, “Agoraphobia and Anxious-Ambivalent Attachment: An Integrative Review,” Journal of Anxiety Disorders 6, no. 4 (1992): 365–81.

  38 “Adults with agoraphobia report”: Dozier et al., “Attachment and Psychopathology in Adulthood,” in Handbook of Attachment, 718–44.

  39 “[Infants with insecure] attachments”: Warren, et al., “Child and Adolescent Anxiety Disorders and Early Attachment,” Journal of the American Academy of Child & Adolescent Psychiatry 36, no. 5 (1997): 637–44.

  40 “Human adults who reported”: Hane, Amie Ashley, and Nathan A. Fox, “Ordinary variations in maternal caregiving influence human infants’ stress reactivity,” Psychological Science 17.6 (2006): 550–556.

  CHAPTER 9: WORRIERS AND WARRIORS

  1 In 2001, Kenneth Kendler: Kenneth S. Kendler et al., “The Genetic Epidemiology of Irrational Fears and Phobias in Men,” Archives of General Psychiatry 58, no. 3 (2001): 257. See also Kenneth S. Kendler, John Myers, and Carol A. Prescott, “The Etiology of Phobias: An Evaluation of the Stress-Diathesis Model,” Archives of General Psychiatry 59, no. 3 (2002): 242.