Are we born anxious?

A NYT magazine cover story makes the case that we are. So why has my experience with anxiety been so different?

By Judy Berman

Published October 5, 2009 1:06PM (EDT)

Anxiety came at me like a speeding locomotive, threatening to flatten me entirely if I didn't manage to untie myself from the tracks. It was a few months after I graduated from college. Circumstances -- a small, ugly, shared apartment; a minor health scare; the sense of aimlessness resulting from the realization that the career I'd long coveted wasn't for me -- had conspired to make me feel trapped in my own life. I began waking up in cold sweats in the middle of the night, or lying awake for hours when sleep wouldn't come. Then there was the hypochondria: Every tiny bruise or stomachache seemed to herald some vague but terminal illness. Approximately once a month, I had a panic attack.

A year earlier, I had been a wide-eyed, carefree undergraduate, getting into all kinds of fun trouble and looking forward to going out into the world and making something of myself. I didn't realize that "something" would turn out to be an angsty ball of nerves.

But perhaps I should have seen that train coming. In a fascinating New York Times Magazine cover story, Robin Marantz Henig explores the evidence psychologists are finding to support the hypothesis that anxiety -- which affects twice as many women as men -- is an inborn trait that leaves a "neurological fingerprint." She profiles Jerome Kagan, a Harvard professor whose ongoing study of a cohort of babies has led to the conclusion that "some of us ... are born anxious -- or, more accurately, born predisposed to be anxious." In his research, which began in 1989 with a group of 4-month-olds, he found that highly reactive babies -- the type of infants "who essentially fell apart when exposed to anything new" --  are much more likely to grow into anxious adults. These children's trajectory looked something like this:

At age 4, children who had been high-reactive were four times as likely to be behaviorally inhibited as those who had been low-reactive. By age 7, almost half of the jittery babies had developed symptoms of anxiety — fear of thunder or dogs or darkness, extreme shyness in the classroom or playground — compared with just 10 percent of the more easygoing ones. About one in five of the high-reactive babies were consistently inhibited and fearful at every visit up to the age of 7.

Yet some high-reactive babies seemed to shake their anxiety as they grew up. "By adolescence, the rate of anxiety in Kagan's study subjects declined overall, including in the high-risk group," writes Henig. "At 15, about two-thirds of those who had been high-reactors in infancy behaved pretty much like everyone else." She uses the example of Mary, now 21 and studying at Harvard, who appears to have channeled her anxiety into a talent for ballet, a "dutiful" attitude toward schoolwork and a commitment to good behavior: "I don't stray from the rules too much," she tells Henig. "But it's natural for me -- I never felt troubled about it."

Still, a calm demeanor and school or work success don't always mean that anxiety has been "cured." Rather, Henig describes "a kind of sub-rosa anxiety, a secret stash of worries that continue to plague a subset of high-reactive people no matter how well they function outwardly. They cannot outrun their own natures; consciously or unconsciously, they remain the same uneasy people they were when they were little." Although they may be well-adjusted adolescents, earning good grades and making a lot of friends, they tend to become tense before exams or other major events. Kagan describes this as "the difference between persona (the outer-directed personality) and anima (the inner-directed thoughts and feelings). The persona can be controlled," he says, "but the anima often cannot."

Henig goes on to describe the debate surrounding the real-world value of lab experiments that measure anxiety responses and draw some conclusions about why so many high-reactive babies avoid becoming anxious adults. One study, for example, found that "the best fit for high-strung babies were sensitive mothers, who met their fearful children on their own terms and interacted with them in a way that was accepting and supportive without being intrusive." (Strangely, few psychologists seem to be studying the effects of fathers' reactions on high-reactive children.)

Since my anxiety seemed to follow the opposite trajectory -- emerging out of nowhere, rather than improving over time -- I didn't find much to identify with until near the end of the piece. Henig interviews Susan Engel, of Williams College, who is writing a book about temperament, on the ways she and her eldest son handle their anxiety. "The way we deal with it is that we both get everything done in lots of time," says Engel. "We can't stand the anxiety of a looming deadline; we're so worried about being late that we do it five days early." For my entire life, I've been the same way -- and when classmates or co-workers have told me they're jealous of my efficiency or work ethic, I've always said the same thing: "It's not really a choice. I kind of have to do this, or I wouldn't sleep at night."

By the time I finished the article, I had come to the realization that I must have been a high-reactive baby, and that a combination of good parenting and strong adaptive skills had kept my anxiety at bay for two decades. But on the phone with my father (also a compulsive finisher of tasks) last night, I couldn't help asking what I had been like as a baby. Was I finicky? Hostile to or fearful of new stimuli? Nope. As he remembers it, I was happy and welcoming, friendly to strangers and quick to seek out new experiences. My biography doesn't quite fit with Kagan's findings about how high-reactives behave as teenagers either. It seems they tend to "avoid the traditional hazards of adolescence," growing up "to be the Felix Ungers of the world ... clearing a safe, neat path for the Oscar Madisons." I was not that kind of adolescent, to put it mildly.

In the years since my initial crisis, I've learned to treat my anxiety like a chronic, non-fatal illness: Never a big proponent of psychiatric medication, I keep my symptoms in check through a combination of major changes (finding a new career, moving out of that depressing apartment) and lifestyle adjustments (exercise, vitamins, making sure I get a reasonable amount of sleep). Still, worry has become a part of my personality. For me, anxiety may have been more of an inborn capacity, a switch that only difficult circumstances could flip, than an innate trait, evident from birth.

I say this not to poke a tiny hole in Kagan's groundbreaking research or Henig's illuminating article, but to highlight perhaps the most significant observation in the entire story:

There may well be hundreds of different temperaments, and these studies have investigated only two — the most stable and most amenable to measurement, but still just two. If it were as simple as saying that a high-reactive infant will become a behaviorally inhibited child who will become an anxious adult, all the scientific work on temperament would amount to little more than charting horoscopes.

Just before the end of the piece, Henig explains what she means when she says "the link between neurology and behavior is complicated": "While a Sylvia Plath almost certainly won't grow up to be a Bill Clinton, she can either grow up to be anxious and suicidal, or simply a poet. Temperament is important, but life intervenes."

Judy Berman

Judy Berman is a writer and editor in Brooklyn. She is a regular contributor to Salon's Broadsheet.

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