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Age of Anxiety

America seems to be in the midst of a full-blown panic attack. Is there anything we can do about it?

Authors have many images to describe distorted mental states, but that of a glass enclosure, which warps vision and sound, is among the most common. In his searing essay on the loss of his daughter, Aleksandar Hemon uses the metaphor of an aquarium to describe the detached sensations caused by profound grief. Sylvia Plath’s titular bell jar is her symbol for the airless perceptions of suicidal depression. The intercession of glass between human sight and the world is present even in the New Testament, when, in 1 Corinthians, we are told that earthly life is seen “through a glass, darkly.” In a heavenly future, no glazier’s hand will intercede before the face of God.

Anxiety, too, can have this distorting, glassy quality. When I had my first panic attack, in Russia in the summer of 2010, the entire world shrank to the size of my frantically pulsing aorta. I could feel nothing beyond the hammering in my wrists and neck, the freezing sweat that burst out on my forehead, the swishing thrum in my ears. I called emergency services from my host family’s couch in Kazan. Russian EMTs pronounced that an impromptu EKG had shown me to be in perfect condition, and gave me a decoction of “herbs” to drink. At dawn I nodded into uneasy sleep. For the next week, smoke from forest fires igniting all around Russia descended on the city, and my heart intermittently skittered in my chest like a rat. Each time it did I thought I was going to die, although death, unaccountably, never came.

When I came back from Russia to my family’s home in New Jersey, I was a small being hobbled by fear. In the ensuing years I have experienced these moments of pure compression—the universe eaten alive by dread, consisting only of me and my own death—with some frequency. Other passengers on the subway are reduced to shadows, the rattle of the train a faint echo of my own deafening heartbeat, and the glass-haze of terror blots out light.

Explaining a panic attack is a little like explaining an explosion: You can talk about adrenaline, as you can talk about a flurry of reactive particles clashing until they burn. You can talk about the fight-or-flight reaction and the symptoms—sweating, rapid heartbeat, trembling, the overwhelming urge to escape. But you cannot truly convey a swelling balloon of heat, a concussion in the air, the lancing pain of shrapnel, in words. You cannot convey the pure concussive terror of a panic attack in words either, the sense that all your bones are thrumming a bad, insistent chord. I have tried to explain why I must leave the restaurant, why I must have an aisle seat at the show, why sometimes my throat seizes so powerfully I can’t even drink water. Some friends and family members understand; others don’t; and I hide my phobias when I can. The rest of the time, I live within the ringing glass walls of my own panic.

These days, I am an anxious woman in an anxious country. According to studies by the National Institute of Mental Health, nearly 20 percent of Americans experience an anxiety disorder in a given year; over 30 percent experience an anxiety disorder over the course of their lifetimes. And the rate is rising: The American Psychiatric Association, in a May study drawing from a survey of 1,000 American adults, diagnosed a statistically significant increase in national anxiety since 2017.

Why does the present moment evoke such an efflorescence of nerves? It’s tempting to point the finger at Donald Trump, but he is the preeminent symptom of our age of anxiety, not its principal cause. Historic forces have driven the country to fear as it never has before. From the boundless optimism of a cornfed post-war empire, cheerfully jingoistic and fat in the coffers, the nation has awoken to a twenty-first century hangover, a long, jittery ride past militant triumphalism and economic overconfidence into endless war and endless uncertainty. America has dealt with internal paroxysms of terror before, but perhaps none as gaudy and loathsome as our own. If anxiety is a way to understand the fix we’re in, perhaps understanding anxiety can show us a way out.

It’s difficult to pinpoint a cause for so amorphous a phenomenon as anxiety, although some have tried. There are derisive takes that ascribe a skyrocketing rate of debilitating anxiety among younger workers to helicopter parenting and concomitant thin-skinned fragility. A Newsweek article pointed to debt, decreasing homeownership, and lower employment rates as more tangible stressors among millennials. The Geriatric Mental Health Foundation notes that “common fears about aging can lead to anxiety”—fear of falling, of isolation, of dependence, of degeneration. And for adults in middle age, the stresses of financially supporting grown children while also caring for aging parents can lead to anxiety, depression, and reduced overall health.

These generationally distinct stressors arise against a background of overall financial precarity endemic to American workers: 78 percent of full-time workers live paycheck to paycheck, while 71 percent face some measure of debt. Wages haven’t budged in decades; the country’s blood pressure keeps rising instead. The phenomenon that swept Trump into office was dubbed “economic anxiety,” a term that has become a winking euphemism for media timidity about addressing white racism. But that doesn’t mean the bills are getting paid.

This jittery national mood has given rise to what Rebecca Jennings at Vox has dubbed “anxiety consumerism”—the rise of a plethora of products, from fidget spinners to essential-oil sprays—meant to salve restless minds into calm. Based primarily on Google search volume, the investment publication Seeking Alpha wrote in November that sales of weighted blankets, a product initially developed for people with autism and PTSD, would be a major driver of sales on Black Friday 2018, given high demand for the product. An explosion of products featuring cannabidiol, or CBD, a non-psychotropic marijuana-derived product whose proponents say induces calm, has made itself ubiquitous in everything from dog treats to bath salts. Quoted in The New York Times, a CBD start-up founder compared the effects of the compound to “a warm bath, melting the tension away.”

While soothing an ailing psyche with retail—perhaps in lieu, or circumvention, of a profoundly dysfunctional health care system—is quintessentially American, the consequences of our national anxiety don’t stop at our wallets. In recent years our politics has become a politics of primal fear.

For more than a month, the functions of government ground to a partial halt over construction of a wall between the United States and its southern neighbors. The premise of the shutdown—and the promise of the wall—was that the United States was under imminent threat from migrants proceeding northward. Incendiary rhetoric promulgated by Fox News, its chief devotee the president, and sundry members of the Republican Party would have you believe that a human wave is washing up at our southern border in incomprehensible numbers, bringing disease and murder in its wake.

The midterm elections turned into a bitter contest over the threat represented by a column of migrants wending their way slowly northward. When some arrived at the border, they were tear-gassed en masse by a Border Patrol whose reinforcements included a deployment of thousands of U.S. soldiers, the largest deployment of troops during peacetime in a century. The much-vaunted wall, we are told, would keep these criminal disease-bearers away from American citizens. The wall was always central to the promise of the Trump presidency—the idea that Mexicans are “bringing crime” was the premise of his campaign announcement in 2015—and after two years of being stymied by Congress he has now declared a national emergency to build the wall unilaterally.

As inhabitants of a ludicrously well-defended empire, one that gobbles billions yearly for its stratospheric defense budgets, it’s preposterous to imagine that dozens, hundreds, or even thousands of economic or situational migrants would pose a serious threat. Yet through the distorted lens of anxiety, where a single missed breath can feel like the onset of suffocation, even the smallest breach may seem catastrophic. So we imagine a communal bell jar, enclosing us all, an impenetrable but transparent border sealed off from the menace of human ruin.

Anxiety disorder tends to fixate on specific objects: a shadow in a room; a loud noise in the street; the memory of a strained social interaction; the prospect of going outside. The migrant caravan was undoubtedly such a fixation, a specter from the south; the wall, its counterpart, a panacea better than a Xanax, a cure-all for the nation’s many ills. The politics of stoking fear, then suggesting a militarized solution, isn’t new, but it is playing out in its most lurid forms these days. If George W. Bush exploited post-9/11 fears about terrorism and WMDs to invade Iraq, Trump has conjured a threat out of a ragged group of some of the world’s most desperate people. The state of the union, it seems, is scared as hell.

But not all fear is the distorted, excessive fear of anxiety disorder, beavering away over negligible or imagined ills. Some is the entirely justified fear of what is fearsome: struggle, deprivation, dying. In the APA study, people of color reported significantly higher anxiety than Caucasians, in an environment of rising, strident racism. Following an extended fight in the states and in Congress over America’s tattered safety net, adults without health insurance reported a significantly higher overall stress level than those with insurance. The single largest area of increase in anxiety surrounded questions related to finances—the fear of a bank balance driven into the red due to an illness or a layoff.

Generalized anxiety disorder, per the DSM-5, has a maddeningly self-contradictory list of symptoms: It gives rise to both restlessness and fatigue; both lapsed concentration and profound tension of the muscles. In this conflicted state, the mind and body team up to deprive the sufferer of sleep, and to induce irritability. Our body politic seems to suffer from a similar ailment: crouched defensively against threats real and imagined, yet unfocused by the endless distractions of the news cycle. We’re restless for the next big story and fatigued of it already when it arrives. Sleepless and enraged, we pace through our days under the choleric guidance of a president whose only two emotions seem to be smugness and wrath.

Eight years after my initial diagnosis with a panic disorder, I have made a kind of fitful progress towards peace, managing my condition, more or less, with medication and cognitive-behavioral therapy. Lately, I have been working on mindfulness: the separation of troubled thoughts from self, the gathering of breath, the practicing of exercises meant to induce tranquility. It’s slow, difficult work, shot through with setbacks, like a recent evening in which I became so convinced I would choke on a plate of dumplings that I threw them violently away from me, spilling ponzu sauce all over the floor. I wasn’t killed by dumplings, and I quickly cleaned up the dark, sticky patch on my floor. I took a few deep breaths, and resolved to continue the work of trying to fix my broken psyche, piece by piece—causes uncovered, wounds dressed, breathing ragged, then rhythmic.

Emerging from the ludicrous and fearful dream of this era will be a long and painful process. Doing so won’t be merely a matter of finding the right drug (or wall, or candidate, or party doctrine) to slow the nation’s pulse. It’s clear that comforting a troubled populace involves more than offering soothing words, or still worse, provocative, terror-fueled solutions to falsely magnified problems. Any attempt to rescue America from its deep-worn rut of fear must involve an attempt to address the conditions that give rise to that terror. The slow, unglamorous work of unknotting ourselves from fear is something we all have to work towards: through electoral politics, of course, and involvement in the great civic project of this nation.

But the anxious body is one prone to excess, spilling adrenaline thoughtlessly into overburdened veins. Fear is our ailment—the grinding, weary work of insecurity, the grim, false fears of a racial invasion. Overcoming fear will require more than good policies and projects. It will require a new understanding of ourselves and our country, a kind of mindfulness about who we are, really, now that the swagger has gone. It will require addressing this nation’s pathologies at the root: its failures, its crimes, its self-defeating myths. And it will require a measure of courage to break the heavy glass that seals us in, and breathe deeply in a cool new wind.