Capitolo 1
Anxiety: The Price We Pay for Being Human
In a world increasingly defined by uncertainty, Scott Stossel's "My Age of Anxiety" arrives as both confession and cultural history. This deeply personal exploration has resonated with millions, including celebrities like Emma Stone and Stephen Colbert, who have publicly praised its honest portrayal of living with anxiety. Stossel's work stands as one of the most comprehensive examinations of anxiety ever written, combining memoir with scientific, philosophical, and historical perspectives. As anxiety rates continue to climb globally-with the World Health Organization now identifying anxiety disorders as the most prevalent mental health condition worldwide-Stossel's intimate journey through his own nervous mind offers readers something rare: the comfort of knowing they are not alone in their suffering, and the hope that understanding anxiety's complex nature might be the first step toward mastering it.
Capitolo 2
The Riddle of Anxiety: A Personal and Universal Struggle
Anxiety represents one of humanity's most perplexing psychological puzzles-a condition that affects millions yet remains stubbornly resistant to simple explanation. Stossel begins his exploration with raw honesty, describing how he nearly collapsed during his own wedding ceremony from overwhelming anxiety. This personal suffering isn't isolated; it runs through four generations of his family. His great-grandfather ended up in McLean Hospital, his grandfather developed ritualistic behaviors, his mother experienced panic attacks, and his sister tried numerous medications without success.
The question of causation haunts Stossel. Is his anxiety purely genetic? Perhaps trauma played a crucial role-his great-grandparents lost a young child in the 1920s, a devastating event that rippled through generations. His mother might have acquired her anxieties through "modeling" from her worrywart mother, and he in turn learned fearfulness by watching her. Research suggests mothers who experience stress during pregnancy produce more anxious children-like Thomas Hobbes, who wrote "Myself and fear were born twins" after his mother went into premature labor from terror at news of the Spanish Armada.
Stossel wryly describes his anxiety as the product of contradictory cultural inheritances: "a neurotic and histrionic Jewish background suppressed inside a neurotic and repressed WASP sensibility." As he puts it: "I'm like Woody Allen trapped in John Calvin."
Yet anxiety isn't entirely negative. Darwin (who suffered crippling agoraphobia) noted that species that "fear rightly" increase their chances of survival. The Yerkes-Dodson study demonstrated that moderate anxiety actually improves performance in humans and animals. As David Barlow, founder of Boston University's Center for Anxiety and Related Disorders, puts it: "Without anxiety, little would be accomplished. The performance of athletes, entertainers, executives, artisans, and students would suffer; creativity would diminish; crops might not be planted."
Different cultures and eras have perceived anxiety differently-from the ancient Greeks' medical condition to the Enlightenment's intellectual problem, from the existentialists' spiritual condition to our own age's neurochemical disorder. Yet the underlying experience remains remarkably consistent across time and cultures-Hippocrates described patients with recognizable phobias and panic disorders that match modern diagnostic criteria.
Despite appearing calm to many, Stossel describes himself as "constantly churning inside-like a duck: paddling, paddling, paddling." His therapist suggests that revealing his anxiety might lift the burden of shame and reduce isolation. Research confirms that suppressing anxiety actually produces more anxiety. When Stossel began acknowledging his condition, he discovered almost everyone he spoke with was eager to share their own anxiety experiences-suggesting the condition is far more widespread than official statistics indicate.
Capitolo 3
The Mind-Body Connection: When Anxiety Gets Physical
The brain-gut connection has deep historical roots in medicine. Irritable bowel syndrome (IBS), first identified in 1830, has been called everything from "spastic colon" to "windy melancholy." With no definitive organic cause, doctors attribute it to psychological sources-perhaps a hypersensitized awareness of intestinal sensations. Research shows IBS patients report pain at lower thresholds when balloons are inflated in their colons compared to healthy subjects.
This connects to anxiety sensitivity-people with high scores on the Anxiety Sensitivity Index have heightened interoceptive awareness of their bodily functions. This hyperawareness creates a dangerous feedback loop: noticing subtle physiological changes triggers anxiety, intensifying those sensations, leading to panic. Studies show powerful connections between anxiety sensitivity, IBS, worry, and neuroticism.
Historical observations from Aristotle ("Fear brings about diarrhea") to groundbreaking research like William Beaumont's 1833 studies on a hunter with a stomach fistula demonstrated how emotions directly affect digestion. Wolf and Wolff's 1943 work with "Tom," who fed himself through a hole in his abdomen, provided scientific proof that anxiety immediately pales stomach lining and reduces acid secretion.
For Stossel, this creates a vicious cycle-anxiety triggers digestive distress, which increases anxiety. His travels become restroom tours rather than sightseeing expeditions. One particularly mortifying incident occurred at the Kennedy compound in Hyannis Port when a bathroom emergency coincided with a toilet malfunction during a gathering attended by President Clinton, leaving him to escape half-naked past John F. Kennedy Jr.
Stossel's emetophobia-fear of vomiting-creates another vicious cycle where stomach pain causes anxiety, which worsens the stomach pain. This condition found community through online forums like the International Emetophobia Society. Research shows emetophobes have high "somatization vulnerability" and catastrophic interpretations of bodily symptoms, along with an insatiable desire for control.
Charles Darwin suffered decades of debilitating stomach complaints, spending a third of his waking hours either vomiting or bedridden. Though doctors proposed countless diagnoses-from arsenic poisoning to Chagas' disease-careful examination reveals anxiety as the precipitating factor in his worst attacks. Despite traveling worldwide on the Beagle, after returning to England Darwin never left the country again due to his stomach "easily failing under any excitement." He installed mirrors to see guests approaching his home, giving him time to prepare or hide.
Darwin's anxiety severely impacted his work on evolution, with "periodic vomiting" episodes leaving him bedridden for weeks or even years. Any excitement or socializing triggered "violent shivering and vomiting attacks." He tried countless remedies: ice treatments, water cures, exercise, special diets, brandy, chemical concoctions, metal plates strapped to his torso, and "electric chains." Even completing the proofs for On the Origin of Species required working in twenty-minute increments between bouts of stomach distress, with a special lavatory installed behind a curtain in his study for emergency vomiting.
Capitolo 4
When Performance Becomes Paralysis: Social Anxiety's Grip
Burton's observation from 1621 captures perfectly how fear manifests physically when we must perform before others-causing redness, pallor, trembling, sweating, heart palpitations, and even fainting. Even history's greatest orators like Cicero and Demosthenes confessed to trembling before important speeches.
Stossel draws solace from learning about accomplished figures throughout history who struggled with debilitating performance anxiety. Demosthenes was jeered for his anxious stammering before becoming renowned for oratory. Gandhi once froze during his first court case and fled in humiliation. Thomas Jefferson avoided public speaking so severely that he gave only two speeches as President. Others who suffered include Henry James, Vladimir Horowitz (who refused to perform for fifteen years), Barbra Streisand (who stopped performing for money for 27 years), and Nobel laureate Elfriede Jelinek, who couldn't accept her prize in person due to social phobia.
The DSM divides social anxiety disorder into two subtypes: specific (fear of particular circumstances like public speaking) and general (distress in any social context). The cruel irony is that social phobics fear having their anxiety exposed, yet their symptoms-blushing, shaking, stammering-betray them publicly, creating a vicious cycle of increasing anxiety.
Though social anxiety disorder was only officially recognized in 1980, the syndrome has been documented throughout history. In 1901, French psychiatrist Paul Hartenberg described "les timides" who experience racing hearts, chills, hyperventilation, trembling, and mental confusion in social situations-a description remarkably similar to modern diagnostic criteria.
The explosion of social anxiety diagnoses-from zero patients before 1980 to tens of millions within twenty years-has fueled controversy. Critics like Christopher Lane argue that pharmaceutical companies have pathologized ordinary shyness for profit. While marketing certainly played a role in expanding diagnosis, the distress experienced by true social phobics is genuine and intense. Some studies indicate that up to 23 percent of patients diagnosed with social anxiety disorder attempt suicide.
Stossel's own performance anxiety emerged at age eleven during a school play when he suddenly found himself unable to speak while on stage. This traumatic experience opened a trapdoor that transformed all subsequent public performances into torture. Even as a choir member, he'd hide his face behind his score and mouth words silently, fearing he'd vomit if he made any sound.
Performance anxiety manifests in measurable physical symptoms: accelerated heart rate, elevated epinephrine and norepinephrine, decreased gastric motility, and high blood pressure. Studies show socially anxious individuals experience high activation in their right cerebral hemispheres before speaking, interfering with logical processing and verbal abilities.
Social anxiety is deeply intertwined with feelings of shame and perceived inferiority. When Stossel's therapist asked him to imagine a worst-case public speaking scenario, his catastrophic response (humiliation followed by unemployment, divorce, and social ostracism) so alarmed her that she consulted her supervisor. This extreme negativity and poor self-image, coupled with desperate attempts to hide perceived inadequacy, are hallmarks of social phobia.
Capitolo 5
Choking Under Pressure: When Anxiety Sabotages Performance
Stossel's performance anxiety has sabotaged him since childhood. In seventh grade, he deliberately lost a tennis match to escape unbearable anxiety, hitting balls into the net and double-faulting his way to defeat. Though relief came immediately, self-loathing followed just as quickly. This pattern repeated throughout his athletic career, with one notable exception: a perfect 17-0 squash season in tenth grade, achieved with the help of daily Valium. The medication positioned him in the optimal zone described by the Yerkes-Dodson law-enough anxiety to sharpen performance without becoming overwhelming.
As an adult, Stossel continues battling this demon. In a club championship match, he held a commanding lead before anxiety flooded his system. His mouth dried, limbs heavied, and nausea overwhelmed him. He deliberately began losing points, desperate only to escape the court without vomiting. Eventually, he simply conceded the match, mortified and defeated not by his opponent but by his anxiety. He had "choked"-a term whose etymology fittingly derives from the Latin root of "anxiety" (angere, meaning "to choke").
The roster of elite athletes who've spectacularly choked under pressure is extensive. Greg Norman squandered an insurmountable lead at the 1996 Masters, ending in tears. Jana Novotna collapsed five points from winning Wimbledon in 1993. Boxing champion Roberto Duran famously surrendered mid-fight against Sugar Ray Leonard, pleading "No mas" with millions watching. More puzzling are chronic chokers like Nick Anderson, whose missed free throws in the 1995 NBA finals haunted him for life, or Chuck Knoblauch and Steve Sax, second basemen who mysteriously lost the ability to make routine throws to first base.
Cognitive psychology reveals that choking occurs when athletes think too much about their movements. Brain scans show anxious performers experience neural "traffic jams" of worry and self-monitoring, while clutch performers display streamlined neural activity. The more self-conscious you become, the worse you perform-anxiety drives you to do precisely what you most fear.
Is it possible to be simultaneously anxious and effective, cowardly and strong, terrified and heroic? Bill Russell, the legendary Boston Celtics player who won eleven NBA championships, vomited from anxiety before most games-1,128 games between 1956 and 1969. His teammate John Havlicek called this "a welcome sound" because it meant Russell was keyed up for the game. Similarly, Floyd Patterson, the heavyweight boxing champion, carried disguises to his fights in case he wanted to slip away, calling himself "a coward" despite his fierce strength. Most remarkably, Giuseppe Pardo Roques, a Jewish community leader in Pisa, was crippled by animal phobias that prevented him from traveling, yet showed extraordinary courage facing Nazis who ultimately killed him. These cases reveal how anxiety can coexist with-and sometimes even enable-exceptional performance and moral heroism.
Capitolo 6
The Medication Revolution: Treating the Anxious Brain
In anticipation of his first book's release, Stossel found himself caught between competing approaches to anxiety treatment. A Harvard psychopharmacologist insisted his anxiety was a biological illness requiring medication-like insulin for diabetes-while a Stanford cognitive behavioral therapist urged him to stop taking drugs that prevented him truly confronting his anxiety.
Before the FDA began requiring ingredient listings in 1906, popular "nerve remedies" secretly contained alcohol, marijuana, or opium. Heroin was sold over-the-counter until 1914, and the 1899 Merck Manual recommended opium for anxiety treatment. For the first half of the twentieth century, barbiturates dominated the market despite their addictive properties and lethal overdose potential.
The revolutionary tranquilizer meprobamate (Miltown) was discovered entirely by accident when Frank Berger, a Jewish refugee scientist, noticed that a penicillin preservative he'd synthesized had a calming effect on laboratory animals. Despite initial corporate disinterest, Miltown was approved in 1955 and quickly became a cultural phenomenon. Within eighteen months, it was the most prescribed drug in history, with celebrities from Lucille Ball to Tennessee Williams publicly endorsing it.
By 1960, 75% of American doctors were prescribing Miltown, shifting anxiety treatment from psychoanalysts' couches to family doctors' offices. Meanwhile, chlorpromazine (Thorazine) emerged from French research in 1952 when surgeon Henri Laborit noticed it produced remarkable calming effects in surgical patients. When psychiatrists began using it on psychotic patients, the results were astonishing-violent patients calmed down, and some long-term institutionalized patients recovered enough to leave hospitals.
Stossel's own medication journey began with Thorazine in seventh grade, when his anxiety became so severe he refused to go to school. While the medication kept him out of the hospital, it came with significant costs: cognitive fogginess, dehydration, dry mouth, emotional numbness, and tardive dyskinesia (finger twitching). By eighth grade, his condition improved enough to discontinue Thorazine, though he notes he has remained on various psychiatric medications continuously for thirty years since.
The discovery that modified hydrazine compounds could affect mood began when scientists at Hoffmann-La Roche found that isoniazid and iproniazid, initially developed as tuberculosis treatments, had an unexpected side effect: patients became "mildly euphoric," even dancing through hospital hallways. This research intersected with discoveries about MAOIs, which inhibit the enzyme that breaks down serotonin and norepinephrine in synapses. This revelation sparked the pharmaceutical industry's marketing of psychiatric drugs as correctors of "chemical imbalances."
In 1954, Swiss pharmaceutical company Geigy created imipramine by modifying Thorazine's chemical structure. Roland Kuhn discovered it energized patients rather than sedating them, dramatically improving even deeply depressed individuals. Released in Europe as Tofranil in 1958 and America in 1959, it was revolutionary-before Kuhn's 1957 presentation, the concept of an antidepressant didn't exist.
Capitolo 7
The Creation of Panic Disorder: How Drugs Defined Disease
One day while reading emails, Stossel notices he's feeling warm. This awareness spirals into panic as he questions if he's getting sick, having a fever, or worse. Despite knowing the mechanics of panic attacks and having experienced thousands, his internal dialogue battles between rationality ("It's just another panic attack") and catastrophizing ("What if this time it's different?").
The term "panic" derives from Pan, the Greek god of nature who would issue bloodcurdling screams when awakened, causing travelers to drop dead from fright. The experience of panic attacks involves severe physiological and emotional symptoms: palpitations, sweating, shaking, shortness of breath, chest tightness, nausea, dizziness, tingling sensations, and overwhelming feelings of doom. Psychiatrist David Sheehan relates how a World War II veteran who stormed Normandy on D-day claimed his panic attacks were far more terrifying than combat, saying he would "gladly again volunteer to land in Normandy" rather than experience a severe panic attack.
Though approximately eleven million Americans will be diagnosed with panic disorder, the condition didn't officially exist until after 1979. Its emergence as a diagnostic category stems directly from observations about imipramine's effects.
In 1958, psychiatrist Donald Klein at Hillside Hospital began administering the newly available imipramine to psychiatric patients. While many depressed patients improved, Klein was particularly intrigued by fourteen patients whose acute anxiety episodes-characterized by rapid breathing, palpitations, weakness, and feelings of impending death-significantly improved or disappeared completely.
Klein's observations contradicted the prevailing Freudian theory that anxiety stemmed from psychic conflict rather than biology. While Freud had initially considered anxiety neurosis to have biological roots in 1895, he later abandoned this view in favor of psychological explanations. Klein, however, concluded that panic attacks originated in a biological malfunction-a "false suffocation alarm" where defective internal monitors fire even when oxygen levels are normal.
The publication of the DSM-III in 1980 marked a fundamental shift in how we conceptualize mental illness-moving from the dimensional model that prevailed through DSM-II to the categorical model that continues today. Panic disorder was the first psychiatric disease defined primarily by drug response-imipramine cured panic, therefore panic disorder must exist.
The expanding boundaries between normal anxiety and psychiatric disorder raise troubling questions. When Frank Berger advertised Miltown in 1956, it promised relief from conditions like "executive stomach," "boss nerves," and "housewife nerves"-none recognized as psychiatric disorders. This pattern continues: new drug therapies emerge, followed by increases in anxiety and depression diagnoses.
In 1957, Leo Sternbach at Hoffmann-La Roche accidentally invented the first benzodiazepine, chlordiazepoxide (Librium). After FDA approval in 1960, Librium quickly outpaced Miltown in sales, becoming the most prescribed medication on earth. Sternbach later synthesized Valium, which was 2.5 times more potent than Librium and became America's most popular drug from 1969 to 1982. By 1975, one in five American women and one in thirteen men had taken benzodiazepines.
In the late 1970s, Italian neuroscientist Erminio Costa finally discovered how benzodiazepines work: they bind to GABA receptors on neurons, amplifying GABA's inhibitory effects and suppressing central nervous system activity. While glutamate excites neurons, GABA inhibits them, slowing their firing rate. This provides a useful metaphor for understanding anxiety as an overheating engine of rapid neuronal firing that benzodiazepines help slow down.
Capitolo 8
The Meaning Behind the Medicine: Philosophical Questions
In spring 1997, after a difficult year marked by his parents' divorce, job troubles, and romantic woes, Stossel began taking Paxil at his therapist's urging. The effects were remarkable-an initial manic energy boost followed by brightened mood, professional advancement, and freedom from panic attacks for the first time since middle school. But was it really the medication, or just coincidental life improvements?
Prozac exploded into American consciousness with Newsweek's March 1990 cover story, becoming the iconic antidepressant of the late twentieth century and a blockbuster for Eli Lilly. As the first SSRI in America, it soon surpassed Xanax as history's best-selling psychiatric drug. By 2007, an estimated 33 million Americans were taking SSRIs, saturating not just medicine cabinets but also our culture and environment, with trace elements found in frogs, fish, and even drinking water reservoirs.
Despite their popularity, questions about SSRI effectiveness persist. The British Medical Journal concluded these drugs "do not have a clinically meaningful advantage over placebo." Yet Americans consume billions of dollars of SSRIs annually, even as rates of anxiety and depression have increased rather than decreased. Martin Seligman notes depression rates rose from 1% for those born around WWI to 10-15% for those born in the 1960s-a tenfold increase across two generations.
The deeper one investigates anxiety and psychopharmacology, the less clear things become. The serotonin theory of depression is unraveling-early studies found only a quarter of depressed patients were serotonin deficient, with an equal number having higher-than-average levels. Arvid Carlsson, father of the serotonin hypothesis, has urged psychiatry to "abandon the simplistic hypothesis" that disordered emotions result from abnormal neurotransmitter function.
Donald Klein's imipramine experiments reduced anxiety to a biological symptom, draining it of philosophical meaning. Yet philosophers like Kierkegaard and Sartre, along with many psychotherapists, see anxiety not as something to be avoided or medicated but as the truest route to self-discovery. For evolutionary biologists, anxiety evolved to keep us alive by enhancing vigilance. Freud believed anxiety signals threats from within ourselves. Medicating away anxiety instead of listening to what it's trying to tell us risks blocking important signals that something needs to change in our lives.
Novelist Walker Percy grappled with how emotional pain is handled in the age of biological psychiatry. Coming from a family plagued by suicide and depression, Percy initially pursued medicine, believing science would explain melancholy. While recovering from tuberculosis, he underwent a spiritual crisis and conversion to Catholicism after reading Kierkegaard. Percy came to believe that modern depression rates stemmed partly from science's reductionist worldview. In his writings, he argued that psychiatry's biological focus fails to "account for the predicament of modern man" and that anxiety might be "a summons to an authentic existence."
Capitolo 9
The Roots of Anxiety: Nature, Nurture, and Childhood
When did Stossel's anxiety begin? This question leads him to examine his childhood behaviors-from epic tantrums as a toddler to extreme shyness at age three. His parents faced difficult questions: Were his behaviors normal developmental stages or signs of emerging pathology? The pediatrician deemed his tantrums "normal," advising his parents to let him "cry it out." His separation anxiety at nursery school seemed within normal developmental parameters, though his "inhibited temperament" foreshadowed adult neurosis.
Stossel's separation anxiety intensified when he was six, coinciding with his mother starting law school. Each day after school, despite kind babysitters, he would pace his bedroom desperately awaiting his father's return, convinced his parents had died or abandoned him. This nightly ritual of terror lasted for years-watching the clock, staring out windows, experiencing thirty minutes of exquisite agony until hearing the Volkswagen in the driveway.
Freud wrote in 1905 that "Anxiety in children is nothing other than an expression of the fact that they are feeling the loss of the person they love." Separation anxiety has remained a research focus ever since. Decades of studies across multiple disciplines have demonstrated the critical importance of early mother-child bonding in determining lifelong well-being.
John Bowlby, born to an emotionally distant aristocratic family and sent to boarding school at eight, revolutionized understanding of separation anxiety. His early research focused on children separated from mothers through war or illness, finding they displayed acute distress despite having basic needs met. Through the 1940s-50s, he observed that when mothers had "secure attachment" relationships with children-being calm and available but not smothering-the children were calmer, more adventurous, and happier.
Mary Ainsworth, initially drawn to psychology by her own insecurities and distant relationship with her mother, became Bowlby's crucial partner in developing attachment theory. Her "strange situation experiment," where mother-child pairs were observed in unfamiliar settings with strangers entering and mothers leaving, revealed three attachment styles: secure (babies explored confidently with mother present and sought comfort upon reunion), ambivalent (babies became severely distressed at separation and both clung to and hit mothers upon return), and avoidant (babies seemed indifferent to mothers' departures-a defense mechanism for maternal rejection).
Longitudinal studies confirmed that attachment styles predict lifelong psychological health. Securely attached children developed higher self-esteem, better impulse control, greater empathy, stronger "ego resiliency," less anxiety, and more independence than anxiously attached children. These effects persisted for decades: securely attached toddlers became teenagers who easily made friends, while ambivalently attached ones struggled socially.
Harlow's groundbreaking monkey experiments definitively disproved behaviorist theories of attachment. When given a choice between a wire "mother" with food and a cloth "mother" without, infant monkeys overwhelmingly chose the comfort of the cloth surrogate, spending 16-18 hours daily clinging to it. This evidence devastated the behaviorist claim that babies bond with mothers merely because they provide food.
Columbia University researchers developed the variable foraging demand (VFD) paradigm to study how unpredictable maternal availability affects offspring. When monkey mothers faced unpredictably difficult food-gathering conditions, they became "psychologically unavailable" to their infants. Though subtle, these disruptions produced powerful effects-their offspring showed permanently elevated stress hormones even ten years later, hyperreactive anxiety responses, compromised immune function, and social withdrawal.
Capitolo 10
Genes and Anxiety: The Biological Foundations of Fear
Despite careful parenting to avoid transmitting anxiety, Stossel's daughter has developed the same specific emetophobia that both he and his mother share. This pattern of "familial aggregation due to genetic risk" appears throughout his maternal lineage, with multiple relatives suffering from anxiety disorders across generations. Studies show genes account for roughly 30% of vulnerability to anxiety disorders, with having a close relative with generalized anxiety disorder increasing one's risk from 1-in-25 to 1-in-5.
Harvard psychologist Jerome Kagan's sixty years of research shows that 10-20% of infants demonstrate an "inhibited" temperament from birth, with measurable physiological differences including faster heart rates, higher cortisol levels, and greater amygdala activity. These "high-reactive" children maintain these physiological markers throughout life and are more likely to develop clinical anxiety disorders as adults.
Research on anxiety's genetic basis includes the Maudsley strain of "emotionally reactive" rats bred through selective mating, and modern studies where scientists manipulate specific genes in mice to alter anxiety responses. Eric Kandel identified genes controlling fear conditioning (Grp) and innate anxiety levels (stathmin). Human studies by Jordan Smoller found variations in the RGS2 gene correlate with behavioral inhibition, introversion, heightened amygdala response to fearful faces, and vulnerability to anxiety disorders after traumatic events.
The COMT gene has three variants affecting dopamine breakdown in the prefrontal cortex. The met/met variant leaves excess dopamine in synapses, creating "negative emotionality," inflexible attentional focus, and difficulty regulating emotional arousal-traits linked to anxiety disorders. The val/val variant produces less intense negative emotions and reduced behavioral inhibition. David Goldman calls COMT the "worrier-warrior gene," with val/val "warriors" performing better under stress, while met/met "worriers" (25% of the population) excel at evaluating complex environments when not stressed.
Kerry Ressler discovered certain gene variants confer remarkable resilience against anxiety disorders. His research on the CRHR1 gene found that while C/C carriers who suffered childhood abuse were highly likely to develop depression, and C/T carriers showed moderate vulnerability, those with the T/T variant displayed almost complete immunity to depression despite childhood trauma.
Learning he has the val/met COMT variant and anxiety-prone short/short SERT genotype raised philosophical questions about identity and responsibility for Stossel. If anxiety is genetically encoded rather than a character flaw, should this be liberating? Yet attributing personality to genetic luck creates philosophical tensions-the same genetic building blocks that create anxiety also form his entire self.
Stossel's family demonstrates the hereditary nature of anxiety across generations. His great-grandfather Chester Hanford's psychiatric journey reveals striking parallels to his own condition. Despite his accomplished career as Harvard dean, Chester eventually broke down under work pressure in 1947. His records document familiar traits: nervousness, procrastination, obsessive behaviors like hand-washing, self-criticism, and the ability to project outward calm while suffering internally.
Capitolo 11
Finding Meaning in Anxiety: Redemption and Resilience
The author explores anxiety's potential benefits, noting that "worriers are likely to be the most thorough workers and most attentive friends." Research shows conscientious, neurotic people tend to be more reflective, goal-oriented, and organized. Studies reveal that neurotics contribute more than managers predict to group projects, with one researcher stating she would "staff with more neurotics and fewer extroverts" than instinct suggests. Financial managers high in anxiety often make the best money managers when paired with high IQs.
Anxiety also correlates with intelligence-Stossel's therapist notes his anxious patients are typically his smartest ones, particularly lawyers skilled at foreseeing complex scenarios. This connection may be evolutionarily adaptive, as anxious people remain prepared for rare but serious dangers. Stossel's wife even wonders if curing his anxiety might remove qualities she values in him, as his condition likely contributes to his social sensitivity and attentiveness to others' emotions.
Samuel Johnson, the renowned essayist and lexicographer, suffered from "horrible hypochondria" and "perpetual irritation" from age twenty onward. His contemporaries noted his strange tics and twitches (suggesting possible OCD) and agoraphobia. Johnson believed idleness bred anxiety and madness, attempting to combat them through routine and early rising. Though Johnson constantly berated himself for laziness, he was extraordinarily productive-his collected works fill sixteen volumes, not including his famous dictionary.
Modern anxiety research is increasingly focusing on what makes healthy people resistant to developing anxiety disorders. Dennis Charney's studies of Vietnam POWs who didn't develop PTSD identified ten critical elements of resilience: optimism, altruism, having an unshakable moral compass, faith, humor, role models, social supports, willingness to face fears, having meaning in life, and practice overcoming challenges.
During the final month of his book leave, Stossel experienced a "tornadic event" that destroyed his home. As trees crashed through the roof and windows shattered around him, he noticed something remarkable-though his fight-or-flight response was fully activated, he felt less unhappy than during a panic attack. Despite facing genuine physical danger, he found the experience almost exciting, confirming that panic attacks can feel worse than actual life-threatening situations.
The path to mental health requires developing what his therapist calls "self-efficacy"-a concept from cognitive psychologist Albert Bandura about building psychological strength by repeatedly proving one's competence despite feelings of anxiety or vulnerability. Ironically, writing this book forced Stossel to deeply examine his anxiety and weakness, initially reinforcing those feelings. Yet completing the work might demonstrate a form of resilience.
Despite his dependency on medication and genetic predisposition to anxiety, Stossel's therapist reminds him that he's managed to run a magazine, edit cover stories, work on his book, care for his family, and cope with house destruction-all while managing debilitating anxiety. Perhaps finishing and publishing this book-admitting his shame and fear to the world-will ultimately prove empowering and anxiety-reducing. In this way, anxiety might be not just a burden but also a gift-linked to moral sense, planning abilities, and even survival instincts. As Kurt Goldstein wrote, "The capacity to bear anxiety is important for the individual's self-realization and for his conquest of his environment.... Self-actualization occurs only at the price of moving ahead despite such shocks."
