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Summer 2008 | Vol 11 No 4

Review

Anxiety – Yours and mine

Diana Ballon

Athough it’s called A Brief History of Anxiety, Patricia Pearson’s book tackles the subject in an encyclopedic way. She draws creatively on the work of historians, philosophers, anthropologists, theologians and poets – and her own experiences as an investigative journalist, crime reporter and fiction writer – to depict anxiety through the ages. Along with 40 million adult Americans in any given year, Pearson suffers from what Keats described as “wakeful anguish.”

Pearson is generous in exposing her own struggles within a more widespread, collective anxiety in Western culture. Her writing is often lyrical, so much so that we can feel her inner turmoil. Pearson’s sensibility, her acute sensitivity to fear and the uncertain – elements of the world that we all live with and that make life excruciating when we live them too acutely – is what makes this book so successful. She captures the angst and silence that often greet us in the throes of anxiety, when depression and anxiety collude. Despite her success as a professional writer, she also lives with “a pervading sense of doom.”

A Brief History of Anxiety (Yours and Mine) is an ambitious work. While not only looking at our experiences of anxiety historically, Pearson also describes her family’s legacy of anxiety, her own “nervous breakdown” following a difficult breakup, her stint as a TV crime reporter in New York, anxiety in childhood, the prevalence of anxiety across cultures, anxiety in the workplace and the use of antidepressants to treat anxiety. But at times the book takes on too much.

This is no more true than in the chapter on antidepressants. Pearson draws from leading “activist psychiatrists” – David Healy, Joseph Glenmullen and Peter Breggin –and from online consumer chat groups to speak about the often underreported effects of antidepressant withdrawal. She speculates about the potentially devastating side-effects of these medications, including a possible risk of diabetes. But is there research to back up these claims?

For the anxious readers among us, Pearson’s cautionary notes on antidepressants may only leave us, well, more anxious. While I think we all know about possible withdrawal effects, particularly with certain types of antidepressants, the severity of withdrawal symptoms merits greater exposure, as does a discussion of how to discern when someone is experiencing withdrawal effects and when they are experiencing a return of the symptoms the drug was intended to treat.

Pearson writes that “[a]nxiety is treatable with pills, and is no longer respected as a meaningful signifier of a culture caught and flailing in arrested development.” But can’t both be true? Can’t we take antidepressants to treat anxiety, while recognizing that our culture is contributing to our demise? My greatest difficulty with this section is not what Pearson has written, but what she has omitted. Psychotropic drugs have transformed many people’s lives, enabling them to hold down jobs, maintain relationships and enjoy simple pleasures, such as being able to concentrate on a good novel. For many people, life is so tormented that they are willing to risk reduced sexual pleasure, weight gain, a dulling of mood and the uncertain potential long-term effects of these drugs to make life bearable. These drugs may also prevent some individuals from sinking into a depression that can lead to suicide. Ultimately, people need to make their own decisions about what amount of pain is tolerable and how best to combat it. The disquieting truth about antidepressants is that we simply don’t know for sure what amount or type is best or for how long.

While this grey area of antidepressant use is absent, the book succeeds whole-heartedly and compassionately in depicting other shades of grey as we struggle to live amidst life’s uncertainties – a recommended read for people with anxiety, those trying to escape its ravages and the professionals working hard to treat it.

A Brief History of Anxiety (Yours and Mine). Patricia Pearson. Random House, Toronto, 2008, 208 pp., $29.95.

Diana Ballon is an editor at the Centre for Addiction and Mental Health in Toronto.