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

by Scott Stossel

  2 Meta-analyses of genetic studies: See, for instance, Hettema et al., “A Review and Meta-Analysis of the Genetic Epidemiology of Anxiety Disorders,” The American Journal of Psychiatry 158, no. 10 (2001) 1568–78.

  3 one of the largest-scale studies: Giovanni Salum, “Anxiety ‘Density’ in Families Predicts Disorders in Children” (presentation at ADAA conference, March 28, 2011).

  4 “We believe that most of the children”: quoted in Restak, Poe’s Heart, 64; see also Kagan, Unstable Ideas, 161-163.

  5 Kagan and his colleagues took brain scans: These studies are described in Robin Marantz Henig, “Understanding the Anxious Mind,” The New York Times Magazine, September 29, 2009.

  6 Mice whose Grp gene: See, for instance, Gleb P. Shumyatsky et al., “Identification of a Signaling Network in Lateral Nucleus of Amygdala Important for Inhibiting Memory Specifically Related to Learned Fear,” Cell 111, no. 6 (2002): 905–18.

  7 Mice whose stathmin gene: See, for instance, Gleb P. Shumyatsky et al., “Stathmin, a Gene Enriched in the Amygdala, Controls Both Learned and Innate Fear,” Cell 123, no. 4 (2005): 697–709.

  8 In one study of children: Smoller et al., “Influence of RGS2 on Anxiety-Related Temperament, Personality, and Brain Function,” Archives of General Psychiatry 65, no. 3 (2008): 298–308.

  9 Another study, of 744 college students: Cited in Smoller et al., “Genetics of Anxiety Disorders: The Complex Road from DSM to DNA,” Depression and Anxiety 26, no. 11 (2009): 965–75.

  10 A third study revealed: Leygraf et al., “RGS2 Gene Polymorphisms as Modulators of Anxiety in Humans,” Journal of Neural Transmission 113, no. 12 (2006): 1921–25.

  11 A fourth study, of 607 people: Koenen et al., “RGS2 and Generalized Anxiety Disorder in an Epidemiologic Sample of Hurrican-Exposed Adults,” Depression and Anxiety 26, no. 4 (2009): 309–15.

  12 Lauren McGrath, a researcher: “Unique Study Identifies Gene Associated with Anxious Phenotypes,” Medscape News, March 29, 2011.

  13 “talent for creative dance performance”: R. Bachner-Melman et al., “AVPR1a and SLC6A4 Gene Polymorphisms Are Associated with Creative Dance Performance,” PLoS Genetics 1, no. 3 (2005): e42.

  14 tend to have a harder time: See, for instance, “Catechol O-methyltransferase Val158met Genotype and Neural Mechanisms Related to Affective Arousal and Regulation,” Archives of General Psychiatry 63, no. 12 (2006): 1,396. Also, Montag et al., “COMT Genetic Variation Affects Fear Processing: Psychophysiological Evidence,” Behavioral Neuroscience 122, no. 4 (1008): 901.

  15 One study, conducted by investigators: Enoch et al., “Genetic Origins of Anxiety in Women: A Role for a Functional Catechol-o-methyltransferase Polymorphism,” Psychiatric Genetics 13, no. 1 (2003): 33–41.

  16 Another study, conducted among both: Armbruster et al., “Variation in Genes Involved in Dopamine Clearance Influence the Startle Response in Older Adults,” Journal of Neural Transmission 118, no. 9 (2011): 1281–92.

  17 David Goldman, the chief of human neurogenetics: See, for instance, Stein et al., “Warriors versus Worriers: The Role of COMT Gene Variants,” CNS Spectrums 11, no. 10 (2006): 745–48. Also, “Finding the ‘Worrier-Warrior’ Gene,” Philadelphia Inquirer, June 2, 2003.

  18 These different evolutionary strategies: Cited in Stein and Walker, Triumph over Shyness, 21.

  19 Starting in the mid-1990s: For instance, Lesch, et al., “Association of Anxiety-Related Traits with a Polymorphism in the Serotonin Transporter Gene Regulatory Region,” Science 274, no. 5292 (1996): 1527–31. Also, Hariri, Ahmad R., et al., “Serotonin Transporter Genetic Variation and the Response of the Human Amygdala.” Science 297, no. 5580 (2002): 400–403. (For a good, non-technical overview of this research, see Dobbs, “The Science of Success,” The Atlantic, December 2009.)

  20 Ressler found that the variant: Charles F. Gillespie et al., “Risk and Resilience: Genetic and Environmental Influences on Development of the Stress Response,” Depression and Anxiety 26, no. 11 (2009): 984–92. See also Rebekah G. Bradley et al., “Influence of Child Abuse on Adult Depression: Moderation by the Corticotropin-Releasing Hormone Receptor Gene,” Archives of General Psychiatry 65, no. 2 (2008): 190; Kerry J. Ressler et al., “Polymorphisms in CRHR1 and the Serotonin Transporter Loci: Genex Genex Environment Interactions on Depressive Symptoms,” American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics 153, no. 3 (2010): 812–24.

  21 Variations in this gene: Ibid. See also Elisabeth B. Binder et al., “Association of FKBP5 Polymorphisms and Childhood Abuse with Risk of Posttraumatic Stress Disorder Symptoms in Adults,” The Journal of the American Medical Association 299, no. 11 (2008): 1291–305; Divya Mehta et al., “Using Polymorphisms in FKBP5 to Define Biologically Distinct Subtypes of Posttraumatic Stress Disorder: Evidence from Endocrine and Gene Expression Studies,” Archives of General Psychiatry (2011): archgenpsychiatry-2011.

  22 A 2005 study at San Diego State University: Stein, Murray B., Margaret Daniele Fallin, Nicholas J. Schork, and Joel Gelernter. “COMT Polymorphisms and Anxiety-related Personality Traits.” Neuropsychopharmacology 30, no. 11 (2005): 2092–2102.

  23 In the 1970s, Martin Seligman: Martin E. P. Seligman, “Phobias and Preparedness,” Behavior Therapy 2, no. 3 (1971): 307–20.

  24 monkeys could not easily acquire fears: Susan Mineka and Arne Öhman, “Born to Fear: Non-associative Vs. Associative Factors in the Etiology of Phobias,” Behaviour Research and Therapy 40, no. 2 (2002): 173–84.

  25 This is evidence, Öhman argues: Öhman and Mineka, “Fears, Phobias, and Preparedness: Toward an Evolved Module of Fear and Fear Learning,” Psychological Review 108, no. 3 (2001): 483.

  CHAPTER 10: AGES OF ANXIETY

  1 “the brain-workers in almost every household”: Beard, A Practical Treatise, 1.

  2 “In the older countries”: A. D. Rockwell, “Some Causes and Characteristics of Neurasthenia,” New York Medical Journal 58 (1893): 590.

  3 “American nervousness is the product”: Beard, American Nervousness, 176.

  4 “The Greeks were certainly civilized”: Ibid., 96.

  5 “modern, and originally American”: Ibid., vii–viii.

  6 “When civilization, plus these five factors”: Ibid., 96.

  7 The crucial concept in all these explanations: See, for instance, Micale, Hysterical Men, 23.

  8 “I begin with the head and brain”: Beard, Practical Treatise, 15.

  9 “destroyed or made miserable”: Quoted in Micale, Hysterical Men, 35.

  10 “a veritable social plague”: Quoted in Micale, Hysterical Men, 35.

  11 “One of my patients tells me”: Ibid., 53.

  12 “One of my cases”: Ibid., 54.

  13 “One man was so afraid”: Ibid., 60.

  14 neurasthenia had permeated deep: For a detailed exploration of this, see Lutz, American Nervousness; Schuster, Neurasthenic Nation.

  15 “overstressed nation”: American Psychological Association, Stress in America, 2010.

  16 increased from 13.4 million to 16.2 million: IMS Health Data, National Disease & Therapeutic Index, Diagnosis Visits, 2002–2006.

  17 More Americans seek medical treatment: Ibid.

  18 A study published in the American Psychologist: Swindle et al., “Responses to Nervous Breakdowns in America over a 40-year period,” American Psychologist 55, no. 7 (2000): 740.

  19 Twice as many people reported: Goodwin, Renee D., “The Prevalence of Panic Attacks in the United States: 1980 to 1995,” Journal of Clinical Epidemiology 55, no. 9 (2003): 914–16.

  20 the average college student in the 1990s: Twenge, Generation Me, 107.

  21 “The average high school kid today”: “How Big a Problem is Anxiety?” Psychology Today, April 30, 2008.

  22 A World Health Organization survey: Kessler et al., “Lifetime Prevalence and Age-of-Onset Distributions of Mental Disorders in the World Health Organization’s World Mental Health Survey Initiative,” World Psychiatry 6, no. 3 (207): 168.
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  23 Statistics from the National Health Service: “Anxiety Disorders Have Soared Since Credit Crunch,” The Telegraph, January 1, 2012.

  24 “culture of fear”: Mental Health Foundation, Facing the Fear, April 2009.

  25 the odds in favor of damnation: LeGoff, Medieval Civilization, 325.

  26 “The major problem for Americans”: Slater, Pursuit of Loneliness, 24.

  27 “the paradox of choice”: Schwartz, Paradox of Choice, 2, 43.

  28 “From the moment of birth”: Fromm, Escape from Freedom, 41.

  29 “First of all a feeling”: Tillich, Protestant Era, 245.

  30 “Fascism was like a jail”: Quoted in May, Meaning of Anxiety, 12.

  31 “It has filled the”: The New York Times, February 1, 1948.

  32 “people grasp at political authoritarianism”: May, Meaning of Anxiety, 12.

  33 “for 99 percent of human history”: Sapolsky’s discussion of this appears in Zebras, 378–83.

  34 excessive timidity, caution, and concern: Kagan, What Is Emotion?, 14.

  35 “Competitive individualism militates against”: May, Meaning of Anxiety, 191.

  36 “troubles herself with every thing”: Hunter and Macalpine, Three Hundred Years of Psychiatry, 116.

  37 “Intolerance of uncertainty appears to be”: Michel J. Dugas, Mark H. Freeston, and Robert Ladouceur, “Intolerance of Uncertainty and Problem Orientation in Worry,” Cognitive Therapy and Research 21, no. 6 (1997): 593–606.

  38 a 31 percent increase: Scott Baker, Nicholas Bloom, and Steven Davis, “Measuring Economic Policy Uncertainty” (Chicago Booth Research Paper 13-02, 2013).

  39 “nervous complaints prevail at the present day”: Quoted in Oppenheim, “Shattered Nerves,” 14.

  40 “At the beginning of the nineteenth century”: Quoted in Micale, Hysterical Men, 81.

  41 “atrocious and frightful symptoms”: Cheyne, The English Malady, xxx.

  42 “Other men get their knowledge”: Burton, Anatomy, BOOK I, 34.

  43 “I write of melancholy”: Ibid., 21.

  44 “Many lamentable effects this fear causeth”: Ibid., 261.

  45 “Many men are so amazed”: Ibid.

  46 “There is no greater cause”: Ibid., 21.

  47 “If men would attempt no more”: Ibid., 50.

  48 “In our day we still see”: May, Meaning of Anxiety, xiv.

  CHAPTER 11: REDEMPTION

  1 Eliot was, Kagan observes: Kagan has made this observation in numerous places.

  2 “saturated with the vocabulary”: Micale, Hysterical Men, 214.

  3 “whether among all those Scholars”: Quoted in Ibid.

  4 Dean Simonton, a psychologist: Simonton, “Are Genius and Madness Related? Comtemporary Answers to an Ancient Question,” Psychiatric Times 22, no. 7 (2005): 21–23. See also “The Case for Pessimism,” Businessweek, August 13, 2004.

  5 But his early letters reveal otherwise: Letters quoted here are from Masson, Complete Letters.

  6 “They’re compulsive, they don’t make errors”: Quoted in Robin Marantz Henig, “Understanding the Anxious Mind,” The New York Times Magazine, September 29, 2009.

  7 A 2012 study by psychiatrists: Nicholas A. Turiano et al., “Big 5 Personality Traits and Interleukin-6: Evidence for ‘Healthy Neuroticism’ in a US Population Sample,” Brain, Behavior, and Immunity (2012).

  8 A 2013 study in the Academy of Management Journal: Corrine Bendersky and Neha Parikh Shah, “The Downfall of Extroverts and the Rise of Neurotics: The Dynamic Process of Status Allocation in Task Groups, Academy of Management Journal,” AMJ-2011-0316.R3.

  9 “I would staff it with more neurotics and fewer extroverts”: “Leadership Tip: Hire the Quiet Neurotic, Not the Impressive Extrovert,” Forbes, April 11, 2013.

  10 In 2005, researchers at the University of Wales: Adam M. Perkins and Philip J. Corr, “Can Worriers Be Winners? The Association Between Worrying and Job Performance,” Personality and Individual Differences 38, no. 1 (2005): 25–31.

  11 high IQ scores correlated with high levels: Jeremy D. Coplan et al., “The Relationship Between Intelligence and Anxiety: An Association with Subcortical White Matter Metabolism,” Frontiers in Evolutionary Neuroscience 3 (2012).

  12 a certain interpersonal obtuseness: See Winifred Gallagher, “How We Become What We Are,” The Atlantic, September 1994.

  13 But recent studies on rhesus monkeys: Stephen J. Suomi, “Risk, Resilience, and Gene-Environment Interplay in Primates,” Journal of the Canadian Academy of Child and Adolescent Psychiatry 20, no. 4 (November 2011): 289–97.

  CHAPTER 12: RESILIENCE

  1 the constant berating by Johnson’s superego: Bate, Samuel Johnson, 117–27.

  2 The ten critical psychological elements: Charney, “The Psychobiology of Resilience to Extreme Stress: Implications for the Treatment and Prevention of Anxiety Disorders,” keynote address at ADAA conference, March 23, 2006.

  3 the work of the cognitive psychologist: See, for instance, Albert Bandura, “Self-Efficacy: Toward a Unifying Theory of Behavioral Change,” Psychological Review 84, 191–215; Albert Bandura, “The Assessment and Predictive Generality of Self-Percepts of Efficacy,” Journal of Behavior Therapy and Experimental Psychiatry 13, 195–99.

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