My work suffers, of course. How could it not? I’m sadly not a perfectionist but, rather, an avoider and a regretter. There are periods when I will respond to e-mails at a reasonable pace, and then there’s the e-mail about a potentially lucrative project that I ignored for months. I haven’t even opened it; I don’t know what it says. Since childhood, I’ve had versions of “the packing dream,” in which I am surrounded by clothes strewn chaotically around the room, and I cannot choose what to bring on a trip. I may have enough time to finish packing, or I may already be too late. Whatever the scenario, it’s never one of those dreams about physical impediments, in which you try to move but can’t; the obstacle is always only my own mind, my own incapability, and that is the torment—that I’ve done this to myself. (I have never actually missed a flight.) As for work, I always manage to “get it done,” though I don’t know how. It’s probably a reasonable enough fear of failure—or fear of failing to achieve the impossibly ambitious vision in my mind—that is my obstacle. Even worse is the possibility, floated by sanguine meditators and accepters of things-as-they-are, that I may need the anxiety, and the promise of eventual relief from it, to do anything at all.
What about panic attacks? I’ve never had the kind of panic attack that people mistake for a medical emergency, but sometimes I become very still, sort of unable to move, for, I don’t know, ten to twenty minutes to an hour, and my muscles are sore the next day. There are the usual racing thoughts: love, squandered potential, unlikely vanities, loss of income. Injustices committed against me; chores. Will I get cancer? Knowing that everyone worries they have cancer helps only a little bit. My ultimate anxiety is not that a certain fear will come true. Rather, I experience panic as mostly meta: the horror of being trapped, in this mind-set, for the rest of my life.
Naturally, I am not merely anxious; I am also very sad. The two are, for me, inextricable: I get anxious that I’ll get sad and sad that I’m so anxious. It’s harder to describe the depression, and the fear of it, because fewer physical symptoms are involved. Weeping, that telltale sign of sadness, is usually cathartic, a response to a specific buildup of identifiable issues, and thus not involved in what I can’t help but think of as the true suffering, which recedes and returns, recedes and returns. People often talk about being unable to get out of bed in the morning. What if you can get out of bed—after about an hour and a half of lying awake in it, thinking about how you should get out of bed? What if you can get out of bed but find it beckons you back throughout the day? What if you are, owing to your difficulty sleeping, just tired? Which comes first, exhaustion or depression? Does it matter?
Even knowing that “normal” is a nefarious construct, used to shame and control, there’s something about these symptoms that makes me want to know how many people have them; they mean nothing to me alone because none of them is so unusual as to cause alarm, or even merit comment, and so they might mean anything. Is it really such a big deal? I don’t know where to put the emphasis, how to tell it, and this is particularly disturbing because knowing where to put the emphasis is my vocation, which is also bound up with, I’ll admit, my “sense of self.” “You don’t seem anxious,” friends will say, surprised at my competent narration. This is not the response I want. How competent could it be if no one believes what I’m telling them?
I can shift the blame. As with anything that matters, the language we use to describe “mental illness” is all wrong. Mental illness is “real,” as real as a tumor, but not the same kind of real as a tumor. Its effects are measurable, in blood pressure or hours slept, or noticeable, in weird hand gestures or an erratic mode of speaking, but mental illness has no shape or volume; its size cannot be conveyed through comparisons to fruits and vegetables. It becomes real in the description of its effects, in the naming of everything around it, rather than in attempts to define it, though we have many words and phrases that approach the task. “Disturbance” is funny, and accurate, because it refers both to the internal condition and what it produces: behavior that might unsettle oneself or others. I become “nervous” in small-stakes situations of short or predetermined time frames; “nervousness” no longer describes the anxious disposition, as it did in the past, but the feeling of being anxious about a specific thing that is usually imminent. I’m “neurotic” because I know the basics of psychoanalysis and am a fast-talking big-city professional; I’m “neurasthenic” because I know the word. My mother used to call herself, as well as me, a “worrywart”; to “worry” is to fidget with something in the mind. “Panic” is acute, “attack” is very acute, and a “fit” is a cute version of a “panic attack”; “throwing a fit” is what children do and what adults do when they are “freaking out” while simultaneously making childish demands. Like “freaking out,” “going insane” is applicable as a joke in retrospect, though it became too popular on the Internet and lost its edge, particularly because the sort of people who said it were just the sort who ought to be arguing that the usage stigmatizes people with mental illnesses. I still indulge in “crazy,” which is classic, and permitted, I think, because I am. “Distressed” is the joke version of nervous, though someone “in distress” is being euphemized, as is someone “behaving erratically.” A “crisis” is both intense and prolonged; a “spiral” is a crisis about one issue, characterized by repetitive and catastrophic thinking, and “spiralling” may feature prominently in crises, but in a slightly funny way. I fear having a true “breakdown,” which suggests, to me, among other things, a failure of speech, but I also fantasize about having a true breakdown for the same reason. I am rarely, if ever, “hysterical”; that’s sexist. “Mentally ill” is, of course, insufficient, though when I have seen other people “in crisis” I have thought I actually understand the term. The concept of “mental health,” did you know, comes from Plato, who said that it could be cultivated through the elimination of passion by reason. Today, good mental health means something like the elimination of both passion and reason.
Unless I’m about to appear onstage, in which case I am “nervous,” I describe myself as “anxious” so that people know I’m serious: this is not a passing worry but a constant state, and if I were to seek a medical diagnosis I would get one, handily. The question “Why don’t you?” naturally arises. The answer is that I do not feel it would help, and might even create more problems than it solves. In medicine, the problem of language is a problem of classification; I do not seek a diagnosis, probably, because I do not want to be trapped in a single term. (I hate being trapped, you might have noticed.) Like everyone else’s, my mind dabbles in an array of mental illnesses to create a bespoke product, and I find all the terms I know either ludicrously broad or ludicrously specific. I learned from Scott Stossel’s upsettingly thorough 2014 book, “My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind,” that the term “generalized anxiety disorder” was conceived at a dinner party, in the nineteen-seventies, held among members of a task force working on the DSM-III. According to David Sheehan, a psychiatrist who was there, they were all drunk, wondering how to classify a colleague who “didn’t suffer from panic attacks but who worried all the time . . . just sort of generally anxious.” “For the next thirty years,” Sheehan continues, “the world collected data” on the group’s drunken musing. The point of this anecdote, Stossel establishes, is not to say that generalized anxiety disorder isn’t real but to demonstrate how somewhat arbitrary decisions made by powerful people can shape how we see ourselves. I also don’t mean to suggest that the ideas that we have while drunk are bad—more that drunkenness can give us an admirable economy and frankness, and encourage us to just pick something and go with it, something that some of us, sober, really struggle to do.
An essay like this is supposed to have a narrative. Where does my anxiety come from? Famously, it’s overdetermined. First, my parents: they passed down bad genes, and then they might not have raised me right. To go further I’d have to discuss the ways that they might not have been raised right, and then discuss the ways that they might not have raised me right. Although, like everyone, I have a list of these in the Notes app on my phone, and I update it every few days when a new injustice committed against my past innocence reveals itself, I am hesitant to go down this path, which narrows to a tunnel, which is eventually pitch-dark. The packing dream, a desire to escape my humble origins; the sunburn neurosis, from my mother’s warnings. I am the way I am because my father did this, or my mother didn’t do that. Not a very satisfying conclusion.
What about society? That’s what’s fucked up. In the early two-thousands, a group of academics in Chicago formed a collective called the Feel Tank—an alternative to the think tank, though of course they also opposed “the facile splitting of thinking and feeling.” According to their manifesto, they sought “to understand the economic and the nervous system of contemporary life” by being “interested in the potential for ‘bad feelings’ like hopelessness, apathy, anxiety, fear, numbness, despair and ambivalence to constitute and be constituted as forms of resistance.” One of their early slogans was “Depressed? . . . It might be political.”
Here the concept of normality truly collapses: what is normal—financial precarity, an inability to plan for the future, war—is not good at all. Feel Tank Chicago was established as part of the “affective turn” in the academic humanities, which began in the nineties; this approach to understanding emotions as shaped by power structures has become wildly influential, though it’s not new. For example: the concept of Americanitis, popularized by William James at the end of the nineteenth century, described “the high-strung, nervous, active temperament of the American people,” according to an 1898 issue of the Journal of the American Medical Association. The causes—advances in technology and accompanying pressures of capitalism—were much the same as they are today. Wherever the contemporary occurs, anxiety and depression are seen as natural reactions to it, and performances of profound mental discord in response to the news will be familiar to anyone on social media.
