Monday, March 3, 2014

My Age of Anxiety by Scott Stossel

This is what the outside looks like at sales conference.
Sometimes it's better not to look since you'll be in a
conference room all day, all week. 
I just spent a week in Florida with my publishing colleagues for our semi-annual sales conference, which is...not exactly my idea of work heaven. On the one hand, many of us are scattered around the country and never see each other in person except at conference, so it has the feel of a family reunion. On the other, it's a week of forced socializing with people you're forced to talk to when you are secretly thinking that gnawing off your own arm might be more pleasant, so it...has the feel of a family reunion. The good: seeing my pals, hearing about upcoming books, and engaging with presenters know how to pump up a crowd of book nerds with sneak peek movie trailers, cheerleading speeches about the state of the business, and author visits. The bad: lousy food, a packed schedule, occasionally assigned seating, and the dreaded cocktail hour before each dinner. Imagine a five day schedule that has about four hours of free time between 8:30 am and 9 pm (that's four hours in the entire week, total), and then remember that this is a group of book nerds and probably 80% suffer at least a little social anxiety. We all flew into Florida, and I'd guess that 50% are anxious about flying. You're expected to talk during meetings, so let's just give the group a nice 95% total for those suffering from performance anxiety. You're in a hotel and you're not going outside anytime soon, so there's the claustrophobia for some. Also: public toilet usage, and one of my (least) favorite things ever, the Potty Talkers. If I'm trying to pee with a line of acquaintances out the door waiting on one of the four stalls in the women's restroom that has the row of doors that doesn't latch properly, I absolutely do not want to talk about the upcoming Ken Burns documentary about the Roosevelts. When people ask me about sales conference, I think first of being anxious.

Recently I read Scott Stossel's book My Age of Anxiety, an exploration of the history of a mental disorder and Stossel's personal relationship to it. Anxiety is now the most commonly diagnosed mental disorder in the US, and anxiety medications are the bestselling drugs ever. I have no doubt that there were quite a few prescriptions for Xanax and Klonopin and other drugs packed in luggage for our sales conference. But what's the deal with anxiety? Did you know that it was barely even recognized as a condition only a few decades ago? How did we get to a point where so many people are so clearly panicky?

Stossel, the editor of The Atlantic Monthly, has suffered from anxiety his entire life, as have many members of his family going back generations. He was the kid who cried every day of elementary school, the one who threw tennis matches just to get off the court faster, and his fear of vomiting is epic. He's tried many, many combinations of pills, and booze, and pills and booze, and has spent pretty much his whole life with therapists in an attempt to control his panic, fear, and dread. Trying to wrap his head around the condition that has dictated his life for so long, Stossel learned everything he could about anxiety and wrote a book.

Here are some fun tidbits:
  • Anxiety could be genetic. There are specific genes now attached to people with anxiety disorders that can be plotted, and frequently anxious parents will have anxious children (even when they are trying to protect their children from the conditions they suffer). 
  • Generalized Anxiety Disorder, the broad DSM V (the bible of psychiatric disorders that the docs use to diagnose people) category for people with anxiety, was created after it was discovered that certain medications alleviate panic, so in a sense, the drug created the disease. That's not to say that people weren't anxious before, but they didn't have a diagnosed disorder. They were shy or depressed or "a little off." 
  • Anxiety has been around forever, and one famous sufferer was Charles Darwin, who hated leaving home, sailing on the ocean, and enclosed spaces. After Darwin completed in famous voyage on the Beagle, he mostly stayed home for the rest of his life. Scientists now look at anxiety as an evolutionary adaptability that helped early people survive when they had more to fear than Zorro attacking in the middle of the night. 
  • Millions of people take SSRI's, selective serotonin reuptake inhibitors, the class of drugs that includes Prozac, Paxil, Zoloft, Celexa, etc. The drugs are among the most prescribed ever, but scientists aren't exactly sure how--and even if--they work. The brain is a complicated organ. Nonetheless, millions of people have seen some improvement on the drugs and flipping channels any night of the week will reinforce that we live in the age of psychopharmacology. 
Scott Stossel appeared on The Colbert Report.
He's afraid of cheese, among other things. 

My Age of Anxiety isn't a book with easy solutions to your twitchy issues, but it doesn't try to be that. This book is one man's account of a lifetime of anxiety and everything he learned about the condition, laid out clearly for a non-scientific audience, and with some levity. Stossel's attempt to overcome his fear of vomiting with exposure therapy--basically his therapist getting him to ingest Ipecac--is tragic comedy. Reading the book didn't make the cacophony of cocktail hour chit chat and crowds any easier for me at sales conference, but it did provide perspective. And if anything, people are resilient. Stossel survives in spite of his phobias and has a good job, and as far as I know, I wasn't fired at sales conference. 

Here's Scott Stossel's interview on the Colbert Report.

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