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My Age of Anxiety: Fear, Hope, Dread, and…

My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind (2013)

by Scott Stossel

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My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind is written by Scott Stossel, who lives with generalized anxiety disorder (GAD) as well as several phobias. The book looks at his own experience but also contains extensive research on theoretical perspectives on anxiety and how these have evolved over time, the evolution of diagnostic categories, and the history behind various treatment approaches including the development and marketing of anxiolytic drugs. While it offers wide-ranging information, at times it struck me as a bit excessive.

Stossel looked at the question of nature versus nurture, both of which play a role. Temperament is thought to be innate, there is certainly evidence of a genetic element to anxiety disorders, and parenting styles are also believed to have an impact. The development of phobias in childhood is a predisposing factor for the development of adult psychopathology. For the author, who has a strong family history, the cause is likely a combination of a heaping helping of all of these. He admits that judges himself for being anxious, and worries that “resorting to drugs to mitigate these problems both proves and intensifies my moral weakness.” He has done many years of psychotherapy, including Freudian-style psychodynamic and cognitive behavioural, and tried various medications, “but none of these treatments have fundamentally reduced the underlying anxiety that seems woven into my soul and hardwired into my body and that at times makes my life a misery.”

It was clear from an early age that the author had an anxious temperament, beginning with frequent temper tantrums as a toddler. He experienced significant separation anxiety, which intensified at age 6, coinciding with his mother starting night school. He began experiencing emetophobia (fear of vomiting) around the same time, and this worsened in grade 7 after he overheard a teacher describing vomiting due to food poisoning. Grade 7 was also when he had to attend a new school, which resulted in daily battles and social withdrawal, and at that time he was put on medications (chlorpromazine and imipramine).

Stossel’s mother was highly over-protective and over-involved, but he writes that she deliberately withheld affection in the hope that might prevent anxiety similar to what she herself had experienced as a child. She physically dressed him until age 9 or 10, picked out his clothes every night until age 15, ran baths for him while he was in high school, and didn’t allow him to walk anywhere that streets might be too busy to cross or neighbourhoods might be dangerous. As I read the chapter that covered this I freely admit I judged, thinking no wonder this kid had problems.

It has been shown that people with IBS (irritable bowel syndrome) and/or panic disorder are more physically reactive to stress and tend to convert emotional distress to physical symptoms. The author describes significant physical symptoms with his anxiety, particularly gastrointestinal symptoms, which then feeds into his emetophobia. As an adult, a therapist had attempted to do exposure therapy using ipecac to make him vomit. The ipecac was ineffective, and the experience only contributed further to the emetophobia.

The book covers the history of various types of medications used for anxiety, including opium, barbiturates, and benzodiazepines. When chlordiazepoxide became the first benzodiazepine on the market in the United States in the 1960’s, it quickly became the most prescribed drug in the country. Medication use for anxiety increased even further with the introduction of the SSRIs (selective serotonin reuptake inhibitors). The author observed that “the explosion of SSRI prescriptions has caused a drastic expansion in the definitions of depression and anxiety disorder (as well as more widespread acceptance of using depression and anxiety as excuses for skipping work), which in turn caused the number of people given these diagnoses to increase.”

The book covers an array of research studies that have been conducted on anxiety as well as a wide range of relevant theories, from Freud who thought anxiety was the basis of all mental illness to attachment theories to Klein’s false suffocation alarm theory of panic attacks. Societal views on anxiety over time are also discussed, including American General George Patton’s belief in World War II that in order to prevent the contagion of “combat exhaustion” from spreading it should be punishable by death.

At 401 pages including footnotes, this book isn’t a quick light read. It took me over three months in fits and starts to read it, in part because my concentration wasn’t always up to it. It’s jam packed full of information, so it’s a lot more to absorb than just a first-person account of mental illness. I think what I appreciated the most about it was how it forced me to reflect on and question my own ideas and judgments. It’s well-researched, and I would say it’s a good choice for anyone who’s looking for a broader historical view to help contextualize their own experience as the author does in this book. ( )
  MH_at_home | Jun 29, 2018 |
What better guide to the world of anxiety than a person who lives with anxiety every single day? Scott Stossel draws on his own decades-long experience with anxiety, panic attacks, and various phobias as he explains the history of how anxiety came to be recognized and classified as a mental health condition. He discusses the various lenses through which treatment is provided (is anxiety a sign of neurosis or repressed feelings, or is it the result of chemical imbalances in the brain?). He highlights the writings of noteworthy historical personages who could be said to have anxiety as we know it today: Darwin, Samuel Johnson, even Freud himself. Along the way, Stossel writes candidly and bravely about his (at-times-horrific) panic attacks and visits to various psychiatrists and the pharmacist’s shop of drugs he’s been prescribed over the years.

Overall, this was a fascinating book. I respected his candour and ability to write down what must have been terrifying experiences for him, and some of his comments about anxiety had me nodding in recognition. The only part where my attention really wandered was the section talking about the various prescription drugs developed and marketed over the years; not necessarily the actual development and marketing, but more the part where he explained what receptors they acted upon and how they differed from other drugs. And he was probably simplifying things, too.

I highly recommend this if you’re curious about what it’s like to live with anxiety or if you are interested in psychological memoirs or mental health issues. ( )
  rabbitprincess | Aug 6, 2017 |
In an age when we spend billions of dollars on psychotropic drugs, the title of this book drew me in. The author himself has lived with crippling anxiety since childhood and his history, along with personal anecdotes, treatments, and therapies are included in the book (often amusingly), along with a vast amount of research into anxiety disorders. Nature vs nurture and genetics is covered along with the history of the disorder and how the definition has changed over the years. Some of the most interesting parts of the book are when Stossel talks about famous people who have struggled with crippling anxiety (Freud, Darwin….). The author’s sometimes amusing (and sometimes heartbreaking) personal experiences are sprinkled throughout the book, making what can sometimes be a bit technical more interesting.

This is not a self-help book, so those looking for definitive answers would be disappointed, but it can offer comfort and insight. This would be an interesting read for someone who has anxiety. And for those who don’t, it will lead to a better understanding of those who do.

I admit I skimmed some of the denser statistical information. Also, the vast amount of footnotes, most of which contained fascinating information, should have been incorporated into the body of the book. But all in all, the author's wry humor and interesting presentation of the material makes this a good read. ( )
  janb37 | Feb 13, 2017 |
Interesting that a few of my friends liked this book so much. I didn't particular care for the author's own story, harrowing and sad as it was, and think that there are more compelling treatments of psychopharmaceuticals, attachment theory, etc. Perhaps I've spent too much time with in both genres to have really enjoyed this one. ( )
  benjaminsiegel | Jul 30, 2016 |
Scott Stossel is an anxious human.

He is quite possibly the most anxious human I’ve ever had the good fortune of “meeting,” if you can call it that. Scott has multiple, extreme phobias: in particular, vomiting, flying, and public speaking. He suffers terrible anxiety-induced digestive problems. He has had too many panic attacks to count. And he has been on almost every antidepressant and anti-anxiety medication in existence.

My anxiety, much like Scott’s, began when I was a child. However, my anxiety, unlike Scott’s, is not (save a few months here and there) debilitating. I had no idea that one could suffer from anxiety to the degree that Scott does.

My Age of Anxiety is, largely, a history and examination of the phenomenon of anxiety. It covers the gamut: famous historical sufferers, medication, phobias, diagnosis, treatment, conjectured physiological and psychological causes. So if you’re not into reading what is essentially a textbook about anxiety, you might not like this. (I found it extremely interesting–and it is incredibly well written.)

If you’re on the edge about this book, consider picking it up at least to read the highly detailed anecdotes about Scott’s experiences with anxiety, including the time he overflowed a toilet while staying in a house with the Kennedys, his wedding-induced panic attack at the altar, and his disastrous attempt to conquer his fear of vomiting. They were hilarious–he does a great job of making light of what were clearly terrible, traumatizing situations for him.

I enjoyed My Age of Anxiety, and I think anyone with an interest in anxiety or personal experience with it would learn quite a bit from reading this tome. ( )
  blackrabbit89 | May 7, 2016 |
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By combining such unfiltered honesty with deep reporting, Stossel has delivered an enlightening, empowering read. But all of his disclosures serve a higher purpose, too. His candor about his sense of unrest — as well as his gnawing, conflicted feelings about admitting to it — serve as the foundation for his investigation into the panic and apprehension that afflict millions of Americans.
added by melmore | editWashington Post, Jen Chaney (Jan 31, 2014)
His new book, “My Age of Anxiety,” uses his experience as a guide through the disorder, tracing its legacy in thought and culture. He seeks to understand what anxiety is and what it means; he probes the condition’s ambiguities. The result is ambitious, and bravely intimate: a ruminative book that often breaks into a thrilling intellectual chase.
added by melmore | editNew York Times, Nathan Heller (Jan 23, 2014)
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The author recounts his lifelong battle with anxiety, showing the many manifestations of the disorder as well as the countless treatments that have been developed to counteract it, and provides a history of the efforts to understand this common form of mental illness.… (more)

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