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Friday, Jul 10, 2009
America is the most anxious country on the planet. So will I ever learn to live with my fear, racing heart and disaster scenarios?
By Meredith Maran
Read more: Paranoia, Psychology, Antidepressants, Anxiety, Psychiatry, Life
June 12, 2008 | I'm sitting at my desk, pretending to work. I dial my wife's cellphone. Again. She doesn't answer. Again.
Katrine's out of town, and we had a plan to talk two hours ago. Eleven years into blissful domestic partnership with a certified Anxious Person (A.P.), Katrine knows all too well the price of violating such a plan. I glance at the clock for the 23rd time in the past 127 -- make that 129 -- minutes. I'm not imagining this. Something's wrong.
My mouth goes dry. My heart starts pounding. Good thing I took that Managing Your Anxiety class when my anxiety suddenly, inexplicably, peaked last winter. If I hadn't learned to "interrupt my automatic thinking" and "substitute coping statements," I'd be freaking out right now.
I close my eyes and take a deep "settling breath": in-in-in through the nose, out -- whoosh! -- through the mouth. I check my voice mail, in case I missed Katrine's call. "You have no new messages," the robo-voice says. Who needs new messages, I think. I have plenty of old ones. Whatever can go wrong, will. Good news is bad news's way of catching you off-guard.
The phone rings in my hand. "My cell ran out of juice," Katrine says, "and I couldn't get to my charger."
She waits for me to say what she, or any other normal person would say -- words in a language I do not speak. Instead I burst into tears. "I thought you were dead!" I wail.
Not for nothing do I make my living writing stories. The darkest ones with the unhappiest endings -- those are the ones I save for myself. As a journalist and an anxious person, I'm driven to know why. So I decide to embark on a little investigation of trepidation, agitation, consternation and palpitations.
The first thing I learn: As the New Age gurus say, I am so not alone. Misery loves company, but anxiety draws a crowd. Turns out that anxiety disorder -- a spectrum that includes panic, obsessive-compulsive disorder, post-traumatic stress, phobias and the catch-all, generalized anxiety disorder -- is now the most prevalent mental health problem in the world.
Like Burger Kings and Botox clinics, A.D. is disproportionately prevalent in the U.S. According to the most recent World Mental Health Survey, Americans are the most anxious humans on earth. Forty million of us -- that's 28.8 percent -- suffer from the ailment that the National Institutes of Mental Health defines as "an excessive, irrational dread of everyday situations"; William James called "a horrible dread at the pit of my stomach"; and Anaïs Nin called "love's greatest killer."
I call Dr. Leslie Rokoske, a psychiatrist at the Ross Center for Anxiety and Related Disorders in Washington, D.C., and ask her why. "It's the pace of life," she says. "Everyone's very stressed out, trying to keep up." Rokoske adds that she and her colleagues have noted an, um, surge in anxiety in response to 9/11 and the war in Iraq. "We had an attack on our own country, which is a collective trauma," she says. "And now we've got our military coming back with head trauma and PTSD."
But some people (me) seem unable to handle that anxiety as well as others (Katrine). "There's a definite linkage between genetics and anxiety disorders," Rokoske says. "Nine out of 10 of our anxious patients have a family history of anxiety."
I'm doomed, I say, recalling the nights I fell asleep as a child, listening to my father pacing the floor.
"Anxiety is a good thing to have in a dangerous situation," Rokoske says soothingly. "It's the original caveman fight-or-flight response. When the adrenal gland senses danger, it sets off neurotransmitters in the brain -- cortisol, norepinephrine, serotonin -- to help the body cope."
Turns out, my fellow Americans are high on cortisol. We're nine times more likely to be anxious than the Chinese laborers who assemble our children's toys, whose working and living conditions would make us run screaming for a Xanax IV. And 94.4 percent of Mexicans -- bone-crushing poverty and barbed-wire borders notwithstanding -- have never experienced a major episode of anxiety or depression. But move a Mexicano north of the border, according to a study in the December 2004 National Institutes of Health News, and his mental health will deteriorate faster than you can say "Campesinos sí, NAFTA no."
To find out why, I call on Patricia Pearson -- novelist, anxious person and author of "A Brief History of Anxiety (Yours and Mine)." The book is a genre-busting page turner: a portrait of Pearson's lifelong struggle with anxiety, melded with a journalistic investigation of what ails her, and me and us. "Mexicans have stronger family ties, deeper connections to their community, greater involvement in collective rituals through their churches and unions and schools," Pearson tells me. "And there's less onus on the individual in Mexico to achieve material success."
So, I muse aloud, if I invite my adult kids to move back into their old rooms, join my local pagan coven and take the iPhone off my must-have list, Katrine will stop calling me "psycho" and start calling me "honey" again?
Pearson laughs. "We live in one of the most anxiety-provoking cultures on the planet," she says. "That's why we have this neurotic need to be plugged into our iPhones all the time."
Pearson had her first anxiety attack at age 7. Now, at 44, she's still doing things like stocking her basement with cases of freeze-dried vegetables to prepare for the next flu pandemic. I ask what she does, besides shopping online at Survival Acres, to keep her demons at bay. Her answer is a page from my Managing Your Anxiety workbook. "I do cognitive behavioral therapy to help me recognize patterns of behavior that made my anxiety worse," she says. "I spend time with my family and friends. And, with great reluctance, I get my butt to the gym."
I'm on the Managing Your Anxiety drill, too, but I don't know whether it's my modified behavior, or the little yellow pill I take each night, that's improved what passes for my equilibrium.
"We've constructed this narrative of ourselves as purely biological beings," Pearson explains. "If we're anxious, we have a chemical imbalance, which can be treated with chemicals. That's a very limiting tale to tell about our lives. We need to know ourselves, rather than simply swallowing capsules of 'Pain Begone.'"
Suddenly I'm awash in the feeling I get when one of those glowing earth mothers starts describing her transcendent home birth, and I hitch my jeans up to hide my Caesarean scar. "Pain Begone is my new best friend," I confess.
"Drugs can be helpful," Pearson allows. "But in my case they never resolved the underlying issues."
How retro, I think. How quaint. Who can afford to care about underlying issues anymore? Not my $450-a-month HMO, that's for sure.
Off the couch
The perfect high
