Writing About Anxiety

Before reading this post, may I please ask that you read Helen’s superb post on Anxiety and writing, to which this is my long-winded response, which I didn’t want to clutter up Helen’s comments section. Helen’s bravery in writing about a condition that I know so many suffer in abject silence is immense, so I hope my rambling below also proves useful to somebody.

I could begin this post by writing, “I suffer from GAD (generalised anxiety disorder),” or even “I suffer from depression.” Both would be medically correct. The former term is a more recent diagnostic category for a form of affliction that the medical establishment didn’t officially recognise as recently as fifty years ago. Both labels fall under the purview of mental health, and by extension, the pharmaceutical industry.

As is my nature when I want information I turn to books. That’s no surprise to you if you’ve followed my blog for even a short while. If you search long enough, there is a body of writing on what we presently call anxiety, going back as far as the earliest written medical texts of Hippocrates and Galen, and, of course, through to the present ubiquitous neuroscientists.

You might correctly detect a note of skepticism. With a passion, I loathe the labels anxiety and depression. I question their categorisation as mental illness, but I’ll come back to that. Labels function as shared referents during a diagnosis or discussion, but in this case, they function to categorise such a broad range of symptoms as to become practically meaningless. I should also make clear that I am deeply suspicious of the medico-pharmaceutical industry, which, though it undoubtedly employs very many caring people, is as corrupted as every other sphere touched by the bottomless pockets of transnational corporations and their political lickspittles.

Political rant (almost) over (although we all understand, of course, that everything is political), though I will just point out clear evidence in the US that self-reported anxiety and depression has increased tenfold since the industry started dispensing SSRIs to tens of millions of Americans (including children), and that countless clinical studies have demonstrated that SSRIs have “no clinically meaningful advantage over a placebo.” (British Medical Journal)

I have suffered from anxiety (and depression as I see them as intrinsically linked) for about fifteen years. During this period I’ve run a medium-sized company with myriads of conflicting demands. Both my anxiety and depression are mild enough to be undetectable to the people that I work with, and I have learnt a range of behaviours to cover them up. Neither my family nor closest friends knew I suffered from anxiety until I told them two years ago. Unsurprisingly they were upset that I had not shared this burden earlier. I say this only to show that my anxiety is undetectable (unless you know what to look for), but its effect is both physically and psychologically debilitating (I also believe life-shortening). But I have spoken to people whose anxiety and depression (I prefer the term panic to anxiety, which seems to more accurately (and honestly) reflect its manifestation) incapacitates them for weeks, months, and in some cases lifetimes.

What has been utterly fascinating since the autumn of 2011 when I decided to discuss this with firstly my family, then friends, is the sheer scale of concealment of anxiety and depression. Labelling these afflictions, whose effects and coping mechanisms are so diverse and personal, as mental illness, I believe, drives them below ground. But, and I recognise this is a stretch, if fifty percent of a population suffers from a condition, at one time or another, and has done so for millions of years, its prevalence surely requires us to rethink how we label, contemplate and, of course, treat the many symptoms that get thrown into the broad categories of anxiety and depression. If you think fifty percent is an exaggeration, then my circle of family and friends clearly represent a particularly afflicted bunch because the percentage of people that have admitted suffering from symptoms of anxiety, at one time or another, is much, much higher.

My coping mechanism, and believe me I have tried several, keeps panic attacks out of mind most of the time. This works today and has done for the last six months. It may not continue to work. But I have more hope than at any time in the last two or three years. My panic attacks were always at the mild end of my understanding of the spectrum, the fear of a panic attack was usually greater, for me, than its corporeality. The practise that made the difference for me was Autogenic training (AT) (if you’d like details of my London Autogenic therapist, please email me), which I’ve enhanced with my new practise of Hatha yoga.

You’ll be relieved to know that I will get back to the normal subject of my blog, the books I’m reading, if and when my monkey mind can calm down long enough to enable me to stop flitting between books like a thirsty mosquito. I agree with Helen that I’d really like to see this topic discussed more freely as I think its the only genuine way we can develop short or long term remedies beyond the grasp of the medico-pharmaceutical industry.

19 thoughts on “Writing About Anxiety

  1. Anthony, we all know that there are so many of us, but still, percentage is kind of impersonal, it is difficult to identify with numbers – even if is 50% …
    So I would just like to thank you for personifying the reality. It means a lot!

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    • Thank you, Sigrun, for commenting. I think that whatever the official numbers, they are underreported. I worry about such personal posts out of a concern not to be seen as wallowing in personal troubles/emotions (the whole TMI thing). But I took a lead from Helen that if talking about anxiety openly can lift the ever-present feeling of personal shame and alleviate the strain of suffering in silence, then a single post seems forgivable.

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  2. This is a great response to Helen’s post, Anthony — and thanks for pointing me to it. Anxiety’s been a significant issue for me too and it definitely feeds into the way — and indeed preferences — for what I read and write. I’m lucky, for the moment, to actually have the small funding and and an ever diminishing amount of time to investigate a microcosm of these issues in a PhD. I very much appreciate your honesty and the great work you do on this blog.

    best

    jen

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    • Thanks for your comments, jen, I appreciate them very much. I must admit I had given very little thought to how anxiety may have shaped my reading preferences over the last fifteen years, but will do so now. It is a fascinating line of enquiry, not only in thinking of my own tastes, but also of those writers, painters and philosophers that struggled with anxiety.

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  3. How can anyone live in today’s world and not be anxious at times? It is part of our sensitivity, those who question and are open to the world at large will at some point feel anxious. To feel ease all of the time as opposed to ill at ease sometimes, would to me, show some almost inhuman traits. Of course there are those who manage it well and those who mask it well, but it is there, in varying degrees at different times for us all. In manageable amounts, it drives us forward, it is an anticipation, energy and excitement.

    It is considered in the world of mental health (my daily world) to be part of depression. Rating scales are used to measure and monitor the degree. Anxiolytics/Anti depressants are often prescribed, but it is common for me to see people who have severe and enduring depression/anxiety who feel little relief in spite of them. There are others who feel great relief and whose lives become manageable again. I have great issues with a pharma controlled culture, (don’t get me on to the DSM-5) but I can never be completely anti-meds when I see recovery as I do.

    At worst, in the more extreme cases, it is annihilating, utterly debilitating and can destroy family life, relationships, job prospects, with even the smallest activities of daily living becoming impossible. It can have the shadow of trauma behind it, It can have big self esteem issues and often has the harsh critical voice of the perfectionist. It can manifest with lots of physical symptoms, it can manifest as phobia and OCD. The trap of the anxiety cycle can, for some, result in frequent suicidal ideation and in its worse case scenario suicide.

    In lesser degrees Helen Mclory’s description of generalised anxiety disorder (GAD) as a snipping weasel type creature seems appropriate. My own anxiety, like others, arrives often for good reason. it can be accumulative, it has hooks and hooks onto things, remove those things and it will hook onto other things. Other times it will show up for no obvious reason and set up temporary home in the gut. It likes the gut. It does lots of snipping there.

    CBT and anxiety management programmes can help, graded exposures for phobias and varying types of relaxation techniques, physical activity and meditation for GAD. I am a huge advocate of Mindfulness. I use it myself and in my work. It is the SELF KINDNESS and self acceptance I love and the message to just observe thoughts and feelings and sit with them. Battling with them just perpetuates the anxiety cycle. Being open and talking about it helps and should be encouraged to a degree, but sometimes he constant rumination can increase feelings of agitation. I think with depression and anxiety on the increase, we need to look much harder at the causes. What is going on in our society now to cause this increase? I have many of my own theories I won’t go into here, but to go back to Helen’s thoughts about writing as a helpful aid to anxiety is important. I believe we are becoming less creative. We are doing beings and being absorbed by creative activity, be it writing, painting, sewing etc is a vital part of our well being. Leisure time is less frequently spent doing these kinds of activities, they are their own type of meditation. Something important in us is lost without them.
    Being open and honest about our human vulnerabilities and normalising a whole range of human emotion can only be a enlightening and positive thing.

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    • I’m so pleased that you took time to comment as you have, sisika, particularly as someone who works in the field of mental health. I’ve many thoughts after reading your reply, some initial thoughts below.

      How can anyone live in today’s world and not be anxious at times?

      I am wary about that question for the same reason that I dislike the term anxiety. To reduce the affliction of fearing and having panic attacks to a word that we tend to use these days as a synonym for worry is equivalent to those people that think depression means you are feeling a bit sad. (Neither of which you are doing I hasten to add.) Of course anxiety is a normal response to the outrageously deranged world we have lived in since when, the 1930’s? By now, the state of being anxious can be considered a normal adaptive response.

      I also agree that moderate anxiety drives us forward to whatever extent we think we need to be driven forward. I am equally wary of the twentieth century addiction for performance management, it is all a little Totalitarian for my taste.

      The issue of medicating anxiety (and depression) I find genuinely incomprehensible. As in any area influenced by the medico-pharmaceutical industry, I am sure there are treatments that are efficacious, but like Groucho Marx’s “I don’t care to belong to any club that will have me as a member,” I am unable to place my trust in those within the establishment, and so chose the “prefer not to” line when it comes to medication. I am unconvinced that anxiety is a medical illness (Hippocrates, Aristotle and the entire medico-pharmaceutical industry). It could just as easily be viewed, as it has at various times, as a philosophical problem (Plato, Spinoza), a psychological problem (Freud and his disciples), a spiritual condition (Kierkegaard), or a cultural condition, as your opening question suggests (Auden, Camus, Sartre).

      Your comments on Mindfulness are very useful. I’m sure that is critically important and I shall try to incorporate that into my own practise.

      Thanks again.

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  4. Thanks, Anthony. I couldn’t agree more about the industry, and also have a circle of familiars, if you will, that would indicate quite a high incidence rate. As far as the frequency and/or duration of the “episodes” as it is so often described — there is, I have to believe, a sizeable population as effectively hiding a lifelong experience, that is, a pretty severe episode from birth until death. Some of the skillful masking ends at that death, not always coincidentally, of course, though I also suspect, based upon personal experience so far, that many don’t have “the courage” to end it, by whatever means that would be.

    I thank you for this post, though I have to admit that I was initially slightly disappointed at the angle of the subject matter; I thought it (and Helen’s) would be more about the “writing about it” part of it.

    I can see that I need to write about it, because nothing in my lifetime that I have read on the subject has quite nailed the experience.

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    • Thanks, davidly, for your comment. Until reading the final part of Helen’s post I hadn’t thought much about what effect living with panic attacks has had on my reading and writing. It is very intriguing.

      I hope you write about it somewhere that we can read it.

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        • Apologies on behalf on Blogger, Anthony. Yes, Giramondo publishes some extraordinary writers but I’m not sure how savvy it is re partnerships overseas. I don’t really know how readers can keep up, for instance, with Castro or Murnane or Wright without having to order books the slow over-the-oceans and probably very expensive way.

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  5. Helen’s thoughts on anxiety and modernism were interesting, though I think modernism better reflects the reality of the world than realist fiction regardless of one’s psychology.

    I had a period of depression (though not anxiety as such) when younger. As I don’t have it now, and don’t fancy having it back, it’s not something I speak about at any length including here. It’s something I prefer not to remember too clearly, for reasons you’ll probably understand but which I’d hesitate to explain further since that would of itself necessitate thinking about it.

    I share your doubts regarding medicalisation. There’s a risk we can medicalise what is merely part of human experience, part of the diversity of who we are. Children treated for the disease of being children.

    The test for me is not can we label a thing or can we identify related neurochemical states, but does it interfere with that person’s life as they wish to live it? If so then we should as a society try to help. If not, we should not. Obviously it gets more complex than that, but it’s a better place to start than by a cultural definition of normal backed by chemicals.

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    • Thanks for your comments, Max. There is for me a balance between acknowledging that I am afflicted by anxiety and depression, which has a therapeutic element (and is hopefully of some use to others), and talking with great self-absorption about one’s affliction, which, as you suggest, can act as a trigger for further illness.

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  6. Panic. Anxiety. Although not diagnosed with such, I’m certain I have them in some amount. It’s weird, when once I drove boldly, unthinkingly, down the German autobahn, I am now no longer “able” to navigate the highways around Chicago. Just one small instance of my emotion getting the better of me. Thank you for writing of this, for being so honest.

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    • Thank you for commenting, Bellezza, I appreciate it. I share your apprehensiveness about highways (motorways), but given an opportunity I am happy to race motorbikes around a track, which seems contradictory.

      However, given that 1.3 million people die on the world’s roads every year, and that this is roughly comparable with the number of deaths from lung disease, it doesn’t seem too irrational to have the same anxiety from driving on motorways that I might have if I was smoking 10-20 cigarettes a day.

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  7. Thanks for writing about this, Anthony. I don’t think it constitutes ‘too much information’ and, in fact, I applaud and appreciate your willingness to openly discuss such a stigmatized issue. I agree there should be more frank and open talk about ‘mental health’ outside of the expected places, where it might stimulate others to think and learn more about it.

    I’ve struggled with ‘depression’ for all of my adult life and ‘anxiety’ from late childhood. Fortunately, I’ve managed to avoid taking pharmaceuticals and will continue to do so, for I’ve seen and heard of too many lives shattered by their effects. I don’t agree with labeling or the biomedical model of looking at mental health. I believe our bodies and minds react to trauma, and that there are as many different types and degrees of trauma as there are ways of reacting to it. Similarly, I think there are myriad ways to recover, in the short and long term, without the use of chemicals. Writing certainly helps me, as does reading, though there are times when neither feels possible. I’m glad to hear you’ve found some ways that have worked for you.

    I was cheered at the beginning of this year by a small (and rare) victory in the long war against the pharmaceutical industry. New research at Johns Hopkins showed that meditation can relieve symptoms of ‘anxiety’ and ‘depression’, in a study that also controlled for placebo effect. While this comes as no surprise to some of us, it’s my hope that studies like these published in high-profile medical journals will continue to catch the eyes of those working in the mental health field and help to reduce their reliance on prescribing drugs.

    (Reading Helen’s post and yours also made me think in a more focused way about some of the patterns in my own reading habits, so thanks for that, too.)

    —Sean

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    • It is of no surprise that meditation is efficacious, the autogenic training I practise is a variant of meditation. The might of the pharmaceutical industry is considerable, and I do wonder to what extent unstoppable. It is a lot to expect mental health specialists to go against the grain.

      Thanks very much, Sean, for your comments.

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  8. I’ve left the bulk of my response in Helen’s comment section – so I actually won’t re-write everything I’ve written there. But I’m very glad you wrote your own post on this. And I’m fascinated by how my own anxieties and sensitivities influence my reading. I would definitely say that this is what draws me to modernist (and some post-modernist) writers – I think its the combined hypersensitivity to zeitgeist AND intimacy that I find so compelling, writers who are influenced not just by the strictly personal but who cannot escape feeling oppressed at the same time by all that is happening in the world around them. I don’t think I’m explaining that as well as I’d like to, but you may know what I mean.

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    • Since reading Helen’s post I’ve been thinking about this a lot, and think that I can detect a shift in my reading taste that correlates with my experience of panic attacks. Of course I could be rationalising to fit a personal narrative so I won’t make too much of it. Now I look at the writers I consider my personal favourites I can see a pattern that definitely fits your description.

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