Blessing of panic attacks

Blessing of panic attacks

SINGAPORE - I don't particularly like the fact that I am an anxious person, but after reading The Atlantic magazine editor's account of his lifelong struggle with anxiety disorder, I count my blessings. Scott Stossel, 44, has suffered from phobias, fears, neuroses and panic attacks since he was a child. He has tried all kinds of therapies and drugs and even alcohol, but nothing works.

He has abandoned dates, walked out of examinations and had breakdowns during job interviews, on flights and simply walking down the street.

Being anxious also hurts his stomach and loosens his bowels. He writes: "My stomach hurting and my bowels loosening makes me more anxious, which makes my stomach hurt more and my bowels even looser, and so nearly every trip of significant distance from home ends up the same way: with me scurrying frantically from restroom to restroom on a kind of grand tour of the local latrines.

"For instance, I don't have terribly vivid recollections of the Vatican or the Colosseum or the Italian rail system. I do, however, have detailed memories of the public restrooms in the Vatican and at the Colosseum and in various train stations in the winter of 2002."

He has soiled himself on an airplane and on a date.

As though that is not enough, Stossel struggles too with a pathological fear of vomiting. On the one - and only - date he had in high school, when the girl leaned in for a kiss during a romantic moment, he was overcome by anxiety and had to pull away for fear that he would vomit. His embarrassment was such that he stopped returning her telephone calls.

It has been more than 35 years since he last vomited, but a big portion of his life is still built around trying to evade vomiting and the eventuality that he might throw up. He stashes motion-sickness bags taken from airplanes all over his home and office and car, in case he is suddenly overtaken by the need to vomit. He carries antiemetic medications with him all the time.

As an editor of an influential magazine and an author, he is often asked to give talks and he has worked out a pre-talk regimen that enables him to avoid the weeks of anticipatory misery that the approach of a public speaking engagement would otherwise produce.

Four hours before the event, he will pop his first half milligram of Xanax (a popular tranquiliser). Then just about an hour before he goes to the lecturn, he takes his second half milligram of Xanax and 20 milligrams of Inderal, which is a blood pressure medicine or beta-blocker that dampens the sympathetic nervous system, to keep his physiological responses to the anxious stimulus of standing before a crowd - "the sweating, trembling, nausea, burping, stomach cramps and constriction in the throat and chest" - from overwhelming him.

He washes down those pills with either a shot of scotch or vodka. He needs the alcohol to subdue the residual physio- logical eruptions that the drugs are inadequate to contain.

Even though he is, say, speaking at 9 in the morning, he may sneak away for another quaff just half an hour or 15 minutes before the talk.

As he addresses his unsuspecting audience, he has some Xanax in one pocket and a mini-bar bottle or two of vodka in the other - just in case.

At some level, it is adaptive to be reasonably anxious. But anxiety is produced by both nature and nurture. It is a psychological phenomenon as well as a socio- logical phenomenon.

As Stossel puts it, "in computer terms, it's both a hardware problem (I'm wired badly) and a software problem (I run faulty logic programs that make me think anxious thoughts)".

Yet, for such a bundle of nerves, Stossel is a successful man by standard measures. He is a Harvard graduate, has written for various influential papers and magazines and has published two books, the second of which - My Age Of Anxiety: Fear, Hope, Dread. And The Search For Peace Of Mind - just released last month, has hit the New York Times Bestsellers list. His account of his disorder is based on that book and published in the January-February issue of The Atlantic.

He is also a husband and a father of two. (Naturally, at his wedding, he was on the verge of collapse. And at the birth of his first child, he actually keeled over.)

I asked Dr Calvin Fones, psychiatrist and the former head of the National University of Singapore's department of psychological medicine, if he had come across many cases of such "high-functioning" patients.

He said he had.

"Anxiety can be a two-edged sword. It can paralyse you, but if you can control it and harness its energy, it can make you a better editor, a better doctor or a better lawyer," he said.

"It's like the nuclear bomb. It can be very destructive, but you can also make constructive use of nuclear energy."

Just as Stossel says: "My anxiety remains an unhealed wound that, at times, holds me back and fills me with shame - but it may also be, at the same time, a source of strength and a bestower of certain blessings."

My Age Of Anxiety: Fear, Hope, Dread And The Search For Peace Of Mind by Scott Stossel is available at Books Kinokuniya at $31.95 with GST.

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