by Daniel Smith
Kierkegaard was right: To be human is to be anxious. But that’s just the starting point. The next and most important step is learning how to discipline your anxiety without smothering it completely. Without, in fact, wanting to smother it.
• • •
There are two types of anxiety sufferers: stiflers and chaotics.
Stiflers are those who work on the principle that if they hold as still, silent, and clenched as possible they will be able to cut the anxiety off from its energy sources, the way you cinch off the valve on a radiator. It isn’t hard to spot a stifler. They tend to look haunted and sleepless, like combat veterans, and they are more likely to chain smoke and pour themselves a drink within five minutes of getting home from work.
Chaotics, by contrast, work on no principle whatsoever. Although chaotics are sometimes stiflers when alone, around people, and especially in tense interpersonal situations, they are brought into a state of such high psychological pressure that all the valves pop open of their own accord, everything is released in a geyser of physicality and verbiage, and what you get is a kind of shimmery, barely stable equilibrium between internal and external states, like in those rudimentary cartoons where the outlines of the characters continuously squiggle and undulate. Sometimes the behavior of chaotics is interpreted by laymen as emotional honesty, but it’s almost always involuntary. Chaotics are merely stiflers with weak grips.
When I went off to college, I wanted very much to be a stifler. Partly this was because of pride. To go crying to your mother right after you’ve had sex for the first time is sufficiently humiliating that it fosters a need to maintain composure at similar points in the future. Partly, however, it was because going off to college isn’t just a journey into dread-inducing freedom. It is also a journey into a sudden, stultifying constriction of one’s personal space—which is to say, the opposite of freedom. This is what makes college so precarious a transition for your less robust types. It’s an anxiety double whammy: In the existential sense, college radically expands life’s possibilities; but in the nitty-gritty, flesh-and-bone sense, college throws you into cramped living quarters with people you have never met and share no genetic affiliation with but whom you have no choice not only to endure but also to shower with, brush your teeth alongside, and defecate three feet away from. After close to two decades of cohabiting exclusively with parents and siblings, this shift can cause a fair amount of psychological friction. This is particularly true because in freshman dormitories it is something of an imperative to present yourself as poised and confident even if you are in fact bilious, angst-ridden, and actively decompensating. In this way, the dorms are not unlike army barracks, right down to the bunk beds, the thin mattresses, and the young men weeping quietly into their pillows.
It became clear very early on that, in these conditions, I didn’t have what it takes to be a stifler. I tried. How I tried! In those first weeks away my circumoral muscles got a serious workout, what with me grinning anytime anyone so much as breathed in my direction. The grin was a reflex, like a startled cat extending its claws. I didn’t realize how disturbing it must have come off to my new classmates until late one night I tried it out in the mirror. I looked like Charles Manson at a parole hearing. My other efforts presumably didn’t come off much better. There was, for example, my voice. I did my best to pitch it somewhere short of screamingly hysterical but I could never pull it off. The problem was that the thicket of muscles that connect the head to the shoulders were, in my case, perpetually clenched—a condition that, had I weighed more than 120 pounds at the time, might have made me look like a villain on the pro wrestling circuit, playing to the crowd. Instead I looked and sounded like an enormously ugly girl at a Justin Bieber concert.
Then there was the coughing. I coughed a lot. It was a mid-level cough, volume-wise, halfway between a throat-clear and a deep-phlegm extraction, and I peppered my conversation with it liberally. I did this in order to beat back the sensation that I was about to projectile weep onto whomever I was talking to. This sensation welled up in me especially when I had to talk to professors, and it was deeply unsettling, because I took it for granted that in calculating final grades a professor could only be swayed negatively by the fact that he’d been wept on. The coughing helped.
But not for long. By the end of my fourth week at school round-the-clock anxiety and the addled half-sleep that comes with it had eaten so thoroughly into my defenses that only the most violent fits were able to keep the tears at bay. There was simply nowhere to escape to. At home when I was anxious I could count on two places in which I was free to freak out as extravagantly as I wanted: my bedroom and the bathroom. Even in high school the bathroom was usually available for a quick nervous breakdown, because by then improved security had driven the smokers outside, across the property line. In the dormitory bathroom, I discovered, it was almost impossible to find the solitude a real anxiety attack demands.
Three times, out of a sort of neurotic muscle memory, I hurried down the hallway from my room to find a stall in which I could take my head in my hands and let loose with whatever high-order grunting or moaning might, when the paroxysm had run its course, result in an hour or two of calm. The first time I found a barrel-chested sophomore in lacrosse shorts vomiting energetically into (or mostly into) the middle of a long line of sinks. When he noticed me standing there (the cough) he stared at me briefly with wet deer eyes and said, by way of explanation, “Tequila.” The second time the bathroom was being used for the same purpose, but now by a long-haired freshman who was naked save for a pair of tight turquoise underwear. The third time the sophomore was back, although this time he didn’t notice me because he was unconscious. From the looks of it he had passed out in medias vomitus, slumped in a position that one would think it would be impossible to remain unconscious in no matter one’s blood-alcohol level: his knees on the tile, his arms dangling at his side, and his chin resting on the lip of the sink. I took one look and hurried back to bed.
• • •
All of my weep-sorties to the bathroom happened in the morning, at anxiety’s worst, and what the sight of my debauched hallmates suggested to me was not the simple, obvious fact that college students sometimes drink to excess and that drinking to excess isn’t terribly good for the body. What it suggested, rather, was that drinking to excess was the comparatively smart way to go. We were similar, lacrosse-shorts and turquoise-underpants and I. We all felt the urge to expel the poisons within us. We had all rushed to the bathroom. What divided us was what preceded that urge. They had presumably felt pleasure before their collapses. Their nausea followed joy, and so had a sort of built-in redemption. My nausea followed nausea, and so was redeemed by nothing. I’d botched the equation. It was supposed to go PLEASURENAUSEADISCHARGE. Mine went NAUSEADISCHARGENAUSEA. What I saw when I looked at lacrosse-shorts and turquoise-underpants wasn’t just a couple of puke-stained underclassmen but young men whose presence was explicitly intended to make it clear to me that my emotional life was untenable and self-destructive. They may have looked like schmucks, huddled there sickly, but the message they delivered was that I was the schmuck, for I didn’t even know to have a little fun before the pain. And who doesn’t know that?
My roommates delivered much the same indictment. Tom and Sanjay, of central Massachusetts and New Delhi, respectively, were not the sort to chase the pleasures of the flesh. In those first weeks, the majority were rushing into a haze of keg beer and bong hits and chopped-up Ritalin tablets. Not Tom and Sanjay. Would that they had, so that I could have been left alone with my anxiety rather than having to endure their unnerving equanimity hour after hour. They were geniuses of equanimity, those two. Tom, I could at least rationalize, had training in this respect. Tow-headed and rangy, he was a boarding-school veteran, and had the boarding-school veteran’s nonchalance down pat. On move-in day he ambled into our room carrying an economy-sized bar of Toblerone, took a look around at the drab bureaus and the barren bunk beds and nodded dispass
ionately, as if he were thinking, “I’ve seen better, but it’ll have to do.” Me he regarded with a more quizzical air. He must have encountered that look in the eyes of classmates before—that first-day terror—but his attitude still suggested, in those first weeks, that it was his peculiar fate to have to live for nine months in close quarters with a Woody Allen protagonist.
Sanjay regarded me with the same wary skepticism. This really hurt, because of all people Sanjay should have been my comrade in dread and homesickness. Six thousand miles from home, unaccustomed to the strange ways of the American teenager, mandated at pain of disinheritance to achieve his way into a top medical school, Sanjay should have been paralyzed by anxiety. We should have been up on our bunks trading pills like they were baseball cards. Instead Sanjay eyed me suspiciously, as if he were afraid I might walk across the room and collapse into his arms. Sanjay’s presence exuded the worst message of all. To me his poise said, “I’ve got it way worse than you and I’m managing just fine.”
Or perhaps he didn’t see a thing, for one night on his way back from brushing his teeth he stooped to pluck a small white something off the carpet. “What is this?” he asked no one in particular.
It was one of my Xanax tablets. My mother had sent me to school with a small supply. It must have fallen out of the container as I fumbled with the cap one dreadful night.
“I don’t know,” I said.
“It’s a pill of some sort, I believe.”
“Yes,” I said. “It’s a pill of some sort.”
He paused to think for a second. “Is it your pill, Dan?”
“No,” I said. “Not mine. I don’t take pills.”
He examined it, turning it over in his palm. “I wonder how it got here.” Then: “Are you certain it isn’t yours?”
“Let me take a look.”
He handed it over, and I made a good show of scrutinizing the pill for signs of ownership.
“Oh,” I said. “Oh, right. Yes, it is mine. I totally forgot. Yeah, it’s mine.”
“But you said—”
“I completely forgot. It’s mine. Thanks.”
“What is it?”
“It’s a . . . vitamin. It’s one of my vitamins.”
“A vitamin? What is it for?”
“My heart,” I said, and climbed into bed.
8.
the diagnosis
It wasn’t very long ago that homesickness was considered a legitimate psychological disorder. The French called it maladie du pays, the Spanish el mal de corazón, the Germans Heimweh. The English called it “the Swiss disease,” because they thought the Swiss were sissies. Homesickness was a serious problem, particularly in the military; people actually died from it. In 1770, in his journal of Captain Cook’s first voyage, Joseph Banks reported that the sailors “were now pretty far gone with the longing for home which the Physicians have gone so far as to esteem a disease under the name of Nostalgia.” In a paper titled “History of a remarkable Case of Nostalgia affecting a native of Wales, and occurring in Britain,” the doctor Robert Hamilton wrote,
In the year 1781, while I lay in barracks at Tin mouth in the north of England, a recruit who had lately joined the regiment, . . . was returned in sick list, with a message from his captain, requesting I would take him into the hospital. He had only been a few months a soldier; was young, handsome, and well-made for the service; but a melancholy hung over his countenance, and wanness preyed on his cheeks. He complained of a universal weakness, but no fixed pain; a noise in his ears, and giddiness of his head. . . . As there were little obvious symptoms of fever, I did not well know what to make of the case. . . . Some weeks passed with little alteration . . . excepting that he was evidently become more meager. He scarcely took any nourishment. . . . He was put on a course of strengthening medicines; wine was allowed him. All proved ineffectual. He had now been in the hospital three months, and was quite emaciated, and like one in the last stage of consumption. . . . On making my morning visit, and inquiring, as usual, of his rest at the nurse, she happened to mention the strong notions he had got in his head, she said, of home, and of his friends. What he was able to speak was constantly on this topic. This I had never heard of before. . . . He had talked in the same style, it seems, less or more, ever since he came into the hospital. I went immediately up to him, and introduced the subject; and from the alacrity with which he resumed it I found it a theme which much affected him. He asked me, with earnestness, if I would let him go home. I pointed out to him how unfit he was, from his weakness to undertake such a journey till once he was better; but promised him, assuredly, without farther hesitation, that as soon as he was able he should have six weeks to go home. He revived at the very thought of it. . . . His appetite soon mended; and I saw, in less than a week, evident signs of recovery.
The Russians weren’t so kind to their homesick as the English. When Russian soldiers were afflicted by widespread nostalgia on their way into Germany in 1733, the general in charge threatened that “the first to fall sick will be buried alive.” During the American Civil War, the Grand Army of the Republic recorded 5,547 cases of nostalgia, seventy-four of which proved fatal. This was almost two hundred years after the diagnosis was coined, by a Swiss doctor named Johannes Hofer. The first case Hofer reported was that of a fragile young man who’d traveled sixty miles from home. The young man had gone off to college.
• • •
About a month into my college career I began to call my mother in hysterics from a pay phone bolted to the brick façade of the student center. By that time, the possibility that one could die of homesickness seemed very real. Being away at college felt like a kind of living death—an exile. The exile was of course from childhood, and it was permanent. There would hereafter be visits home, vacations, holidays. But if all went according to plan, this was it. This was adulthood, Month 1.
“I don’t want to be here,” I wailed. “I hate it. It’s terrible. I can’t go anywhere. I can’t concentrate. I can’t think straight. There’s nowhere to go, there’s nowhere to be alone. I don’t know what to do.”
It was the old anxiety incantation: I I I I I I I. The phone I called home from, every day, sometimes two or three times a day, was tucked into a niche in the façade, but not so well tucked that it was out of hearing shot of the students parading sunnily past on their way to check their e-mail or buy french fries. But that didn’t matter anymore. By now the mental pressure had grown so intense that I was willing to risk exposure if it meant the chance of some relief. Specifically, I was after instruction. That’s the second part of the anxiety incantation: Tell me what to do! Tell me what to do! What should I do?
My mother is one of those unlucky women who lives by the maxim, “A mother is only as happy as her least happy child.” But to her credit, she never revealed the slightest distress. For the first time in my life I became the beneficiary of the demeanor she reserves for her clients.
“Breathe,” she said. She said it over and over again. It was her tireless mantra. “Breathe, Daniel. You have to breathe. If you breathe, if you breathe the way I will tell you how to breathe, you’ll feel better. I promise you that.”
The pledge was not unfamiliar. My mother is the Billy Graham of therapeutic breathing. Many years ago, she had little rectangular signs made with the word BREATHE printed on them in flowery epigraphical type, to display in her office. She owns dozens of sheets of neon-orange BREATHE stickers that she distributes to anyone in need. Growing up, one was posted on our refrigerator and another on the wall just beneath the kitchen telephone, at eye level. They were meant to remind my mother that whenever she felt unsteady, whenever the old anxiety feeling came back, she should sit down, close her eyes, and—
And what? What was this process by which the beast was to be neutralized? What alternate states of consciousness or bodily contortions did it require? I had never before asked, and when my mother had tried to tell me I hadn’t listened. I listened now, and I was incredulous, for the change in br
eathing my mother preached was, when you got down to it, minuscule.
“Go,” she said. “Find a quiet place to sit.”
“But there isn’t a place to sit.”
“Of course there is. I’ve been there. It’s a college campus. There are tons of places to sit.”
“No, there aren’t. The place is overrun. There are people everywhere. It’s an infestation!”
“The library,” she said. “Go to the library.”
“But there are loads of people in the library! That’s where they keep the computers.”
“Then try another floor. Go to the basement.”
I did as she said. In the periodicals room I found a wool-knit lounge chair with a heavy wooden frame and heaved it in front of a window overlooking a copse of trees at the base of a steep hill.
“The secret is to breathe much lower than you’re breathing,” my mother said. “When you’re anxious you breathe too high in the chest. You want to breathe lower, in your belly. You want to be able to feel your belly rise and fall. When you sit, put your hand on your belly and feel it rise and fall as you breathe. Breathe slowly. First breathe in through your nose. Count to four as you breathe. Then breathe out as you count to six. Close your eyes. Breathe. Keep your hand on your belly. In through your nose, four, out through your mouth, six. In through your nose, four, out through your mouth, six. In through your nose, four, out through your mouth, six . . .”