My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind
by Scott Stossel
Knopf, 2014

Stossel, editor of the Atlantic magazine, comes out in My Age of Anxiety as a lifelong sufferer of anxiety disorders. In this sprawling exploration of his private torment, he shares personal anecdotes that might be scenes from a sitcom. As his wife is in labor with their first child, Stossel, overcome by anxiety, faints by her side. As a houseguest at Hyannis Port, he flees from an overflowing toilet (a result of his nervous stomach) wearing only a sewage-soaked towel and bumps into John F. Kennedy, Jr.

In Stossel's mind, these are more than passing embarrassments, but rather evidence of his tenuous value as a human being. “I feel I am living on the razor's edge between success and failure, adulation and humiliation—between justifying my existence and revealing my unworthiness to be alive,” he writes.

One in seven Americans has an anxiety disorder, making it the most common officially classified mental illness. Stossel's is a textbook case of anxiety pathology, from a specific phobia at age six (fear of vomiting), to social phobia at age 11, to panic disorder in his late teens and, later, to agoraphobia and depression.

In an effort to understand his condition, Stossel surveys the latest science behind anxiety and finds many leads but few definitive answers. An overactive amygdala, low serotonin and dopamine levels, early childhood experiences and a handful of genes have been implicated, but none consigns a person to unhealthy anxiety. He discovers, for instance, that he has a variant of the SERT gene that some studies have linked to higher rates of anxiety disorders but only when combined with life stress.

The ancient Greeks debated whether anxiety was a medical illness (Hippocrates) or philosophical disharmony (Plato), a division still seen between today's psychopharmacologists and cognitive-behavior therapists. With the advent of new drugs in the 1950s, however, anxiety was increasingly advertised as a biological glitch to be repaired. Stossel chronicles the fascinating, often haphazard, development of antianxiety medications, noting that “every time new drug therapies come along, they raise the question of where the line between anxiety as psychiatric disorder and anxiety as a normal problem of living should get drawn.”

Decades of medication and therapy have offered Stossel only partial relief, and this book is his way of making peace with a problem he may never leave behind. He carefully—you might even say anxiously—considers his subject from all angles. His exhaustive research spills over into lengthy footnotes, and occasionally the book feels scattered and searching. Even in the last chapter, “Resilience,” he does not sound hopeful; he has found more questions than answers—but he has survived yet again.