Medicating The Human Condition, Ctd

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In an interview, Scott Stossel discusses his new book, My Age of Anxiety. Why he doesn’t appear outwardly anxious:

Some people say that in stressful situations I can seem unflappable, and I think that’s partly because I’m always kind of internally flapped. And so … when there’s actually something real to be concerned about, it’s actually less anxiety-provoking than these irrational things. It’s also fairly typical … of certain kinds of anxiety-disorder sufferers, particularly people with panic disorder, [they] are exceptionally good at hiding it. They’re able to convey an impression of competence, calmness and confidence, which is maybe substantially real … but there’s an internal fear. … The gap between that and this façade where people see you as competent and effective — you’re always afraid of being exposed, which is in itself anxiety-producing.

One of my more recent therapists calls this phenomenon impression management. Impression management is not only a symptom of anxiety, because you’re worried about being exposed, but it’s also a cause because you’re constantly worried that the house of cards that is your outward image … is going to come crashing down.

Louis Menand takes issue with the book:

“My Age of Anxiety” is not a memoir. Stossel tells us things about his parents, his marriage, and his children, but only things that are relevant to what he calls, after a famous remark of Freud’s, “the ‘riddle’ of anxiety.” The same is true of what he tells us about himself. He appears simply as a sufferer. Most of his book is a scholarly exploration of the history of anxiety and a journalistic account of the present state of medical knowledge. It’s intelligent, interesting, and well written, but the subject of anxiety is a mess, and the book, intentionally or not, is an accurate representation of its subject.

It doesn’t solve the riddle, either, but that’s not Stossel’s fault. It’s because anxiety of the kind he is afflicted with is not a riddle. It’s an illness. There is therefore nothing, except in the medical sense, to solve. That’s not what Stossel wants to believe, though. He has an idea that more is at stake. He thinks that there is a metaphysics of anxiety. “To grapple with and understand anxiety,” he says, “is, in some sense, to grapple with and understand the human condition.”

But he nevertheless praises Stossel:

He is an honest guide. He is committed to thinking through the philosophical, scientific, and human implications of a mood that appears to be universal (though people who live in underdeveloped countries seem to be less anxious) and that has attracted the attention of writers from Aristotle and Robert Burton (the seventeenth-century author of “The Anatomy of Melancholy”) to Søren Kierkegaard and William James. One of the best things about him is that he’s generally agnostic toward the theories and treatments he examines. He sees the possibilities in everything.

George Scialabba thinks Stossel lets capitalism off too easily:

Late in the book, buried in a footnote, a few sentences speculate that “life in a capitalist economy produces anxiety and uneasiness [and] can be psychologically corrosive. . . . Perhaps the human organism is not equipped to live life as society”—“society,” really?—“has lately designed it—a harsh zero-sum competition where the only gains to be had are at the expense of someone else, where ‘neurotic competition’ has displaced solidarity and cooperation.” That’s it. He devotes more space to the etymology of panic (the slightly crazy god Pan) and the physiology of blushing.

Previous Dish on Stossel’s new book here here.

Medicating The Human Condition

Scott Stossel recounts his efforts to cure his crippling anxiety:

Some drugs have helped a little, for finite periods of time. Thorazine (an antipsychotic that used to be referred to as a “major tranquilizer”) and imipramine (a tricyclic antidepressant) combined to help keep me out of the psychiatric hospital in the early 1980s, when I was in middle school and ravaged by anxiety. Desipramine, another tricyclic, got me through my early 20s. Paxil (a selective serotonin reuptake inhibitor, or SSRI) gave me about six months of significantly reduced anxiety in my late 20s before the fear broke through again. A double scotch plus a Xanax and a Dramamine can sometimes, when administered before takeoff, make flying tolerable. And two double scotches, when administered in quick enough succession, can obscure existential dread, making it seem fuzzier and further away. But none of these treatments has fundamentally reduced the underlying anxiety that seems hardwired into my body and woven into my soul and that at times makes my life a misery.

My assortment of neuroses may be idiosyncratic, but my general condition is hardly unique.

Anxiety and its associated disorders represent the most common form of officially classified mental illness in the United States today, more common even than depression and other mood disorders. According to the National Institute of Mental Health, some 40 million American adults, about one in six, are suffering from some kind of anxiety disorder at any given time; based on the most recent data from the Department of Health and Human Services, their treatment accounts for more than a quarter of all spending on mental-health care. Recent epidemiological data suggest that one in four of us can expect to be stricken by debilitating anxiety at some point in our lifetime. And it is debilitating: studies have compared the psychic and physical impairment tied to living with an anxiety disorder with the impairment tied to living with diabetes—both conditions are usually manageable, sometimes fatal, and always a pain to deal with. In 2012, Americans filled nearly 50 million prescriptions for just one antianxiety drug: alprazolam, the generic name for Xanax.