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‘My Age of Anxiety’ by Scott Stossel

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Reading "My Age of Anxiety," Scott Stossel's first-rate study of anxiety and his candid personal history as an acute sufferer, you may feel conflicted.

On the one hand, the book is astonishingly thorough and lucidly written. It's a fascinating look at that linchpin of the human condition — the primitive fight-or-flight response — and how it resides in our psyches in a time of IEDs and SSRIs. Rare will be the reader who doesn't spot him or herself somewhere in Stossel's sweeping analysis, as he digs into parenting styles, performance stress, talk therapy, medication, depression, fear of flying, blushing, you name it.

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On the other hand, you have to wonder if "My Age of Anxiety" is so good, so copiously reported and completist, in large part thanks to Stossel's harsh expectations of himself, his gnawing terror of being revealed as a fraud. Like our species as a whole, which can adapt positively when triggered by fear, Stossel — who's also the editor of The Atlantic — may well have been driven to this triumph by the excruciating anxiety that has plagued him since childhood. His perpetual agony has become our reading pleasure.

And it is agony, that's for sure. "My Age of Anxiety" comes at the torments of anxiety from every imaginable angle. It's an epic piece of synthesis, as Stossel gathers relevant material from history, pop culture, psychology, science, philosophy, religion, and literature, where he found his title in W.H. Auden's 1947 book-length poem "The Age of Anxiety." He seems to have run a net across the libraries of the world to capture every little fact and big question about his subject, then found the most strategic place to drop them in the narrative.

You may well begin the book not quite grasping the precise meaning of anxiety. For centuries, it has been a vaguely defined phenomenon that, as Stossel explains, has been discussed interchangeably with "hysteria," "worry," "neurasthenia," "vapors," "melancholy," "dread," and "edginess." Even Freud, "anxiety's patron saint," stumbled in clarifying the word and "contradicted himself repeatedly over the course of his career." And some experts believe that anxiety disorders don't truly exist, that they are, as Stossel explains, "invented by the pharmaceutical-industrial complex in order to extract money from patients and insurance companies." But by the end of the book, you'll have a strong belief in and an understanding of everything from separation anxiety to combat trauma.

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You'll also finish with insights into the workings of the brain, technical material that Stossel manages to make engaging. He geeks out on the history of anxiety drugs, showing how scientists have accidentally found psychotropic properties in compounds made for other applications — a tranquilizer from the 1950s called Miltown, for example, whose origins were in the world of penicillin preservatives. Simultaneously, he addresses broader issues associated with drugs — the "pharmaceutical arms race," America's obsession with happiness and workplace advantages, and the Calvinist belief that "if a drug makes you feel good, it must be bad."

Even more than the encyclopedic material, though, Stossel's many personal stories are what give "My Age of Anxiety" its narrative unity and its emotional weight. He tells his humiliating tales with fierce honesty, and they bring as much definition to anxiety as all the hard data on brain chemistry and genetic transmission. It's all here — his early tantrums, his moments of sweat-drenched catastrophizing, his drug-juggling (including Thorazine, desipramine, Paxil, Zoloft, Xanax, and Inderal), his good and less-good therapists, his family history, and his emetophobia, which is a deathly fear of vomiting. Stossel describes trying to beat emetophobia with "exposure therapy" involving ingesting ipecac in the company of a therapist.

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In one of his most vivid accounts, he is staying with the Kennedy family on Cape Cod in the late 1990s to research his first book, "Sarge: The Life and Times of Sargent Shriver." Suddenly he is stricken with a nervous stomach. He just barely makes it to the bathroom off the front hall, but then the plumbing fails and he winds up mopping the floor with his pants. Finally, he dashes upstairs with only a soiled towel around his waist and runs directly into John F. Kennedy Jr., who appears unfazed by Stossel's dishevelment. The story has obvious twinges of comedy, but the dominant mood is pathos. That day, he was caught in one of the fundamental cycles of anxiety, where the fear of an upset stomach leads to an upset stomach.

His confessional tone is remarkably likable, not least of all when he enthusiastically carries a point into one of the book's many footnotes. There are no undercurrents of humble bragging here, no overtones of exhibitionism. He doesn't even really dramatize his struggles so much as straighforwardly lay them out for us. And that makes it easy to feel sympathy, to avoid the more popular reaction of enjoying others' troubles, the schadenfreude effect.

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With self-awareness as his weapon, Stossel tilts bravely into his subject matter, even to the point of looking head-on at the developing anxiety symptoms in his two young children. But there are no big fixes in "My Age of Anxiety," no last-minute transformations; just the lingering hope that knowledge and understanding will ultimately, possibly, lead to empowerment


Matthew Gilbert can be reached at matthew.gilbert@globe.com.