The Conversation

Responses and reverberations

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Surviving Anxiety

In the January/February cover story, Scott Stossel, the editor of The Atlantic, shared his personal struggle with anxiety, and offered a glimpse into the history and science of the disorder.

Staring the anxiety demon in the face has been very scary, which is why it’s such a relief to read an article like this, knowing that it will help chip away at the very dark stigma that is attached to silent, elephant-in-the-room diseases like anxiety and depression.

Joel Weierman
Portland, Ore.

At times I was nodding like crazy, then laughing with tears running down my cheeks. I felt like the author knew me! He gives me hope that we can lead successful lives in spite of, and maybe because of, our anxiety.

R Lukas
TheAtlantic.com comment

I feel like I have waited my entire life for Scott Stossel’s article. There has been no real progress at all in removing the deep shame that is attached to any kind of mental illness. “Crazy” people are blamed for their condition, despite all evidence to the contrary. It takes a rare sort of courage to “come out” and divulge the nitty-gritty details of the inner workings of a brain dominated by the dictates of mental illness. Mr. Stossel so wonderfully validates those of us who have to be the Great Pretenders in life, constantly covering our tracks so we can be seen as normal. He is correct. Anxiety is regarded as a weakness; therefore, weak people are less worthy. Except Mr. Stossel proves otherwise.

Kelly Aanrud
Amherst Junction, Wis.

Scott Stossel makes the often-repeated observation that historical evidence suggests anxiety—and, by extension, a lot of other mental illnesses—can be allied to artistic and creative genius. As a person who has suffered from many of the afflictions he describes, and has the pill bottles to prove it, I’d love to believe this, if only to be in exalted company. But this has always seemed kind of dubious to me. How do we know that history isn’t also full of charwomen and mule drivers and accountants who suffered, but whose lives were just so nondescript that nobody noticed?

Tracy Thompson
Bowie, Md.

The cover line—“I’ve tried therapy, drugs, and booze. Here’s what helps”—is just sensationalism. Unless The Atlantic and Mr. Stossel are endorsing the mixing of prescription drugs and alcohol on a trial-and-error basis, nowhere in this piece is there any mention of or advice on “what helps.”

Kevin D’Amato
Riverhead, N.Y.

Scott Stossel’s article is much needed to help people know that they are not alone. I am a psychiatrist and have specialized in treating anxiety for 30 years. I am always amazed at how alone someone feels when he or she comes in for treatment. Patients have no idea that millions suffer from anxiety. Scott’s willingness to share his personal experiences is brave, and his understanding of anxiety is extremely accurate. There are parts of anxiety that are quite hardwired into the fight-or-flight system. The devastation to a person’s self-esteem can be incredibly damaging. I have spent years listening to people and learning from them about what seems to help, and I have seen that what comes first is knowing anxiety is something you “have” but is not something you “are.”

Overcoming anxiety takes tenacious determination and courage. It is not easy, but I have seen many take on the fight and win. You cannot manage anxiety by hiding from it, you cannot kill it, and you cannot medicate or meditate it away.

I sincerely hope that through Scott’s willingness to share his personal experiences, many others will see that there is hope for them.

Charles R. Cobb, M.D.
Tulsa, Okla.

Living With Anxiety: Reader Responses

After Scott Stossel shared his story, the magazine and the author heard from hundreds of readers who shared their own stories, by turns funny, poignant, and heartrending. Some of those stories are included here; to read many more, visit theatlantic.com/anxiety.

If we had a drink together one evening, you would notice that I have the perplexing habit of taking my pulse the way a runner might at the end of a race (two fingers at the neck, under the jaw on my right side), even though I am seated on a stool with a scotch in my hand, not crossing a finish line and clutching a small paper cup of water. I do this because I fear I’m not getting the oxygen necessary to keep my frail human machine going. I’ve been convinced of my own slow suffocation for at least the past decade, and the steady beat of blood beneath my fingers makes me feel relaxed. It is reassurance that I’m still alive.

J. W. Garrity
Massachusetts

I am plagued by endless questions, swept up in a whirlwind of self-doubt: Are mass-produced, made-in-China toy figurines an indication of my shameless consumerism? Have I perpetuated gender stereotypes by providing my daughter with an abundance of tutus, primarily of the pink variety? Am I promoting unhealthy eating habits by allowing the occasional sugary snack to win out over carrot sticks? The anxiety began with the birth of my daughter. And now, as she attends preschool and the playdates are in full swing, my nerves are entirely fraught. Now my parenting choices are on display for all to see. Now I find myself tackling a bizarre set of proportions every Saturday morning: What is the ideal ratio of Cinderella to Sid the Science Kid? Of tiaras to doctor kits? Of cookies to cucumbers? I haven’t come up with any solutions yet, but that doesn’t stop me from staying up all Friday night searching for answers.

Eimile Green
Toledo, Ohio

If you have never had a panic attack, the best way I can describe it is to compare it to that crazy rush of adrenaline you get when you’re on a roller coaster, during those few seconds right before the ride transitions from the slow, creaky climb to sudden free fall. Your limbs tingle a little, and your stomach knots up in anticipation, only to be released in a matter of seconds. That feeling is intense, and for most people, it’s exhilarating because it is temporary. You’ve only tricked your body into reacting with fear.

With a panic attack, that primal, physical reaction of fear is constant. There is no relief, no sense of exhilaration. Your blood pressure rises, causing your heart to beat a mile a minute; your limbs go numb. Your stomach starts sinking, only there is no bottom for it to hit. So it keeps sinking, and sinking, and sinking. Every physiological alarm your body has for fear is firing at once, and your mind becomes consumed by a panic that defies all logic.But worst of all, even though you know your body is playing a trick on your mind, your mind is trapped inside a fun house with no exit, and you have no idea when the ride will be over.

Cindy Au
Brooklyn, N.Y.

How I make important phone calls:

1. Write down whatever I have to say.

2. Practice over and over.

3. Call the number.

4. Hang up as soon as someone answers—I wasn’t ready, or I jumbled up my words.

5. Wait an hour or so and hope I don’t get the same person.

6. Wait some more because I was not ready an hour ago.

7. Call again (I may go through steps 3 through 6 again).

Alvinette
Sacramento, Calif.

The only exercise that ever worked for me was to write down everything I could possibly fear. The list varied from having a bug in my shoe while driving to nuclear war. As I read the list, I laughed so hard because it all looked so silly. It helped me see how ludicrous it all was—until the next day, when I shook out my shoes before driving again.

I should mention that I have good reason to check my shoes. Once, when I was working at a local radio station, while on the air I discovered a dead cricket in my shoe. I tried to maintain a calm, composed voice while flipping the shoe off so hard it hit the back wall. So this is a case of It happened to me before. It might happen again. To this day I’m relieved I didn’t notice it while driving. I would have wrecked for sure.

Renee
Massachusetts

Imagine each stressor as a blanket. The day-to-day stress is just a sheet, covering you as you lie in bed. Most people sleep with a blanket or sheet each night. This is nothing new; it’s comfortable and normal. Then you get a flat tire. Add a blanket. Then your job is in jeopardy because a grant may not be renewed. Add a fleece throw. Your child is sick. Add two duvets. You start to feel the pressure. You have to take off the covers one at a time to stay comfortable—to help you breathe. To save you from sweaty, sleepless nights. Imagine this, but your bedroom is 98 degrees at all times. Like a hot, humid Miami day (without the cool beaches and strong drinks). Now add the blankets back on.

This is what life is like for me. Once all the blankets are on, everything becomes a nightmare: Chewing noises from my husband. The sound of a keyboard clicking. The way the air blows on my face. The sound of a fork on teeth. My chest feels tight. Every time, I’m convinced I’m having a heart attack. This is what life is like with anxiety.

Marie
Tallahassee, Fla.

Reader Prescriptions

In response to Scott Stossel’s January/ February cover story about living with anxiety, many hundreds of readers proposed remedies for anxiety. Some of the more common recommendations included: 

cut out caffeine
cut out gluten
cut out refined sugar
cut out all grains, dairy, wheat
pharmaceutical-grade probiotics
Vitamin B supplements
Vitamin D supplements
magnesium supplements
fish oil
get treated for hypoglycemia
attachment therapy
NMDA antagonists (like etamine)
betablockers
regular exercise
yoga
sex
mindfulness meditation
insight meditation
daily gratitude exercises
marijuana
LSD
ayahuasca
traditional Chinese medicine
get more sunlight
prismatic lenses
hypnotism
deep breathing
read Essential Spirituality, by Roger Walsh
read The Denial of Death, by Ernest Becker
read the works of Claire Weekes (Hope and Help for Your NervesPeace From Nervous Suffering)
Toastmasters
put faith in God (or some other higher power)
neurofeedback
gene analysis
transcranial magnetic stimulation
cognitive-behavioral therapy
Meridian Tapping (a k a Emotional Freedom Technique)
psychoanalysis to deal with rage against your mother
Intensive Short-Term Dynamic Psychotherapy
get a grip

HOW TO ESCAPE THE COMMUNITY-COLLEGE TRAP

In the January/February issue, Ann Hulbert described the deficiencies of community colleges, where nearly half of all undergraduates are enrolled. She also highlighted an innovative new program, asap, that seeks to remedy the system.

As a high-school teacher, I advised many students not to attend a community college. I would tell them that community college is right for some people, but not for everyone. The “some people” I was talking about were those students who had avoided challenging courses in high school. Many of those folks spend two semesters or more enrolled in remediation courses, paying tuition for work they could have completed in high school.

Hulbert writes, “The existing postsecondary educational hierarchy could hardly be more perverse.” I could not agree more. Those unmotivated and underprepared students who graduated from the high school where I taught went on to the local community college, enrolled in the required remediation courses, and were “in college.” That phrase has taken on new meaning in Florida, where I taught for 30 years. Beginning in 2007, most of the community colleges there were “converted” to state colleges. Same school, same bricks and mortar, but now Edison Community College, for example, is Edison State College. Same in Georgia: Gainesville Junior College became Gainesville State College, and is now part of the University of North Georgia.

The American education system is desperately in need of modernization. Until the “public servants” responsible for making the laws and regulations governing our citizens (are community-college students second-class citizens?) consult and listen to people who have knowledge about what goes on in our schools, America will not be an “opportunity society.”

Frank Lock
Gainesville, Ga.

As an adjunct professor at a community college, and one who teaches remedial English composition, I can relate to Ann Hulbert’s spot-on piece. The students I have seen come through my classrooms over eight semesters are very much like Hulbert’s protagonist, Daquan McGee: their past experiences handicap them from imagining themselves succeeding in school. Massive open online courses, or MOOCs, and other innovations that require a high degree of initiative and perseverance tend to fail this population. I appreciated Hulbert’s running subtext that what’s right for the privileged is also right for the underprivileged, and that structure, support, and face-to-face instruction are what will make the difference for the community-college population. Students who have committed to their success, and who have tangible support systems, either within or outside of their two-year-college campuses, are so much more likely to see themselves earning their associate’s degree. Once students can see themselves holding that diploma, the goal becomes achievable.

Matthew Ratz
North Potomac, Md.

The ASAP program will cost colleges $3,900 per student. Community colleges can’t afford that. In fact, many community colleges have success rates well above 60 percent if we count as successes those students who transfer to a four-year school before they finish their community-college program. There are at least three dozen such community colleges. Hulbert should visit these schools and tell us why they are so successful.

Henry E. Klugh, Ph.D.
Professor Emeritus, Alma College
Traverse City, Mich.

ANN HULBERT REPLIES:

Given the dismally low graduation rates at American community colleges, Henry Klugh is absolutely right that we should take our lessons wherever we can find them. Counting transfer students as success stories is a recent and welcome development, but shouldn’t distract from the urgent problems. Even by that more inclusive measure, only 3 percent of the country’s community colleges can boast of ushering more than 60 percent of their students on to degrees.

CORRECTIONS

Scott Stossel’s January/February cover story said that the SSRI antidepressants used to treat gorillas in a Boston zoo reportedly didn’t help the gorillas. In fact, they did: a combination of SSRIs and benzodiazepines seemed to effectively cure the gorillas of anxiety and depression—and the same drugs mitigated the symptoms of anxious primates at other zoos as well.

“John Kerry Will Not Be Denied,” by David Rohde (December), said that on April 22, 1971, the secretary of state became the first Vietnam veteran to testify before Congress. However, on April 20, 1971, the Vietnam veteran Larry Rottmann testified before the House of Representatives.

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This article available online at:

http://www.theatlantic.com/magazine/archive/2014/04/the-conversation/358637/