Review of "A Brief History of Anxiety"

Patricia Pearson's book is a short introduction to the problem of anxiety, mixing up memoir, epidemiology, sociology, literature, philosophy, pharmacology, psychiatry and presenting it with a good deal of humor. Her reading has been wide and deep, but she has used her research judiciously, careful not to overload her readers. I would imagine most people would need and want to read further, as is usually the case, both because Pearson's references are so interesting, and because this is, after all, a 'brief' history.

Anxiety is a common condition, affecting nearly 20% of Americans to a clinically significant degree, and coming out of a World Mental Health Survey in 2002 as the 'most prevalent mental health problem across the globe'. Pearson herself has suffered from generalized anxiety disorder for several years, and she gives us the story of her obsession with pandemic influenza after she came across a government website, pandemicflu.gov, with its warnings and alarming information. She began stockpiling foodstuffs, and worrying about evacuating her family: 'What if I can't fit/ The powdered butter and dehydrated dinners/ Into my Mazda? Along with the dogs and children?' (And if they have to stay in the basement, will she have to put booties on the dogs' feet so they don't bring avian feces into the house?!)

Pearson structures the book around her own experiences, providing just enough detail so she can springboard from the personal to the general smoothly. She discusses childhood fears and how they may be helped or hindered by adult responses. Her time as a crime reporter was too traumatic for her to continue, changing her whole approach to the world as a place of danger.

There is a discussion of anxiety or the lack of it in different cultures, and a general conclusion that community and a belief in something larger than ourselves assists us to cope. Pearson is a believer in the benefits of religion or at least a spiritual life of some sort (and writes scornfully of those prominent atheists who miss the point about these benefits of ritual and meaning).

It is about control and who has it, and the rationality or irrationality of life. She quotes Jung who wrote 'human experience is not entirely rational' and argues that we cannot, in fact, control our lives exactly as we want, and our frantic efforts to do so cause us more pain than is necessary. Her struggle with pharmacological treatments make for sober reading. I would argue that anti-anxiety and anti-depressant medication has its place but agree that our doctors need to educate us, and themselves, more about the risks as well as the benefits.

I recommend this as a vibrant and interesting introduction to the problem of anxiety because Pearson has taken a multi-factorial approach, making it a rich stew, comforting and illuminating and challenging in equal measure. It needs to be remembered that she is writing from the patient's perspective, not as a clinician, and it is a philosophical approach, searching for the meaning of her anxiety, both for herself and the broader community.

© 2009 Sue Bond

Sue Bond has degrees in medicine and literature and a Master of Arts in Creative Writing. She reviews for online and print publications. She lives in Queensland, Australia