I HAVE SINCE come to learn that I am not the only person prone to crippling bouts of angst. In fact, far from it.
An estimated 40 million American adults suffer from clinical anxiety—a category that includes panic attacks as well as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD) and social anxiety, according to the Anxiety and Depression Association of America, an advocacy group based in Silver Spring, Maryland.
While low-grade anxiety is normal (it can even be productive), there’s a threshold above which the mindset becomes disabling. Clinical anxiety is defined by the National Institute of Mental Health (NIMH) as anxiety that goes beyond temporary worry or fear, gets worse over time and interferes with things like job performance, schoolwork and relationships. Nearly one-third of Americans will experience anxiety on this level at some point in their lives. It’s the most prevalent psychiatric issue in society today.
And yet, it’s largely invisible. “Most people with anxiety never tell anyone about it,” says James Ballenger, a Charleston, South Carolina-based psychiatrist who is widely regarded as an authority on the disorder.
(His pioneering research in the 1970s contributed to anxiety’s eventual addition to the DSM, or Diagnostic and Statistical Manual of Mental Disorders, essentially the bible of the American Psychiatric Association, in 1980.) Only a third of people who suffer from anxiety will ever seek treatment for it, according to NIMH.
Men, in particular, tend to keep their silence, viewing an admission of anxiety as a sign of weakness, observes clinical psychologist Rolando Diaz, who practices in Arlington. “People, especially men, feel like they should be able to figure it out on their own,” he says. “Out of context, anxiety is open to a lot of interpretation. People who don’t have anxiety don’t understand why people who do [have it] can’t deal with it. But anxiety disorder has a very emotional component—it’s hard to separate out thoughts that are reasonable from what’s unreasonable.”
This was certainly true for Thomas (not his real name), 44, a married father of two in Arlington. “Something changed in me when I had kids,” he says. “My stress levels went through the roof.”
Thomas told no one about the crushing feelings of responsibility and dread that seemed to suffocate him—whether the challenge was keeping his kids entertained for the day or providing for his family and paying the mortgage. “I would be at a work lunch,” he says, “and I’d get this overwhelming sense of discomfort and panic out of nowhere. My heart would start racing, and I would think, I have to get out of here. I’d walk around the block and count to 100 and wonder if this was ever going to go away.”
Rather than seeking help immediately, Thomas turned to alcohol to take the edge off. “I was too macho,” he says. “I wasn’t doing the right things, and I didn’t want to tell anyone about it. Every night was happy hour. My recycling bin was ridiculous. It got really bad for me.”
After a few years, he finally broached the issue with his doctor, resolved to stop drinking and turned to AA for support. Thomas has since relaxed his expectations of himself and focuses on staying present in the moment. He recently began exploring meditation. “Once I owned up to the way I was feeling and allowed for the possibility that not everything was going to get done on time or in the way that I wanted it,” he says, “things started to get better.”