Anxiety has afflicted me all my life.

As recently as 1979, neither panic attacks nor panic disorder officially existed.

To grapple with and understand anxiety is, in some sense, to grapple with and understand the human condition.

I had no trouble with strangers finding out about my anxiety. It was my friends and colleagues I was concerned about.

An astonishing portion of my life is built around trying to evade vomiting and preparing for the eventuality that I might.

I've always been interested in intellectual history and in psychology, and anxiety is obviously something that's been a big part of my life.

To some people, I may seem calm. But if you could peer beneath the surface, you would see that I'm like a duck--paddling, paddling, paddling.

Some people say that in stressful situations I can seem unflappable, and I think that's partly because I'm always kind of internally flapped.

During high school, I would purposely lose tennis and squash matches to escape the agony of anxiety that competitive situations would provoke in me.

There's a vast encyclopedia of fears and phobias, and pretty much any object, experience, situation you can think of, there is someone who has a phobia of it.

There's a book that's critical to understanding anxiety, a 17th-century book, 'The Anatomy of Melancholy,' by Robert Burton. I wanted to write something like that.

I am living on the razor's edge between success and failure, adulation and humiliation - between justifying my existence and revealing my unworthiness to be alive.

Hugh Grant, who several times has announced that he was thinking of retiring from acting, has said that he suffers from panic attacks when the cameras start rolling.

My parents were not perfect, but no one's parents are. As childhoods go, mine was pretty comfortable and good in a lot of ways, and yet I still ended up with anxiety.

Many nights, I would begin the evening fueled by caffeine and nicotine, which I needed to propel me out of torpor and hopelessness - only to overshoot into quaking, quivering anxiety.

People who suffer from anxiety are very good at hiding it. That can often be a contributor to the anxiety because the gap between the internal perception and the external impression can feel so large.

Even though my mom herself was anxious, I think she didn't know how to deal with it in her kid, and my dad just had no conception of what this was about, and sort of didn't even want to acknowledge it.

All the textbooks talk about avoidance as a classic hallmark of anxiety disorder. So you need a therapist who is sympathetic and understanding but will also push you to do precisely the things that scare you.

The fear of vomiting, which for me is one of the most original and most acute of my fears, is actually fairly common. Emetophobia, it's called, and by some estimates, it's the fifth most common specific phobia.

To say that my anxiety is reducible to the ions in my amygdala is as limiting as saying that my personality or my soul is reducible to the molecules that make up my brain cells or to the genes that underwrote them.

Generally speaking, the anxiety will pass, which is easy for me to say when I'm not in the middle of an anxiety attack. When you're in the throes of one, it's hard to feel anything other than utter misery and terror.

I wanted to put a human face on anxiety disorders. I thought people who suffer from anxiety might recognize themselves and gain some comfort from my story and for those who don't suffer from anxiety disorders gain some understanding.

Even as economic and political freedoms have advanced enormously and generated huge benefits for humanity, they've also created a great deal of anxiety because every time you have to make a choice, there's anxiety about making the wrong one.

There is an element in which anxiety co-represents with aspects of my personality I wouldnt want to give up. It allows you to have foresight. I may not be as empathetic. Its hard to figure out the difference between pathology and personality.

When I was 5 and my sister was 3, we went on a family trip, and she ate cheese off the floor at an airport. My mother, a germaphobe, got very upset. My sister, of course, got a stomach virus, and ever since then, I have an aversion to cheese.

There is an element in which anxiety co-represents with aspects of my personality I wouldn't want to give up. It allows you to have foresight. I may not be as empathetic. It's hard to figure out the difference between pathology and personality.

There are lots of things, including changing the kind of inner dialog, that can mitigate anxiety. And yes, there are people who have the glass half full and glass half empty, and I'm afraid the glass is going to break and I'll cut myself on the shards.

During first grade, I spent nearly every afternoon for months in the school nurse's office, sick with psychosomatic headaches, begging to go home; by third grade, stomachaches had replaced the headaches, but my daily trudge to the infirmary remained the same.

Carly Simon abandoned the stage for seven years after collapsing from nerves before a concert in Pittsburgh in 1981. When she resumed performing, she would sometimes ask members of her band to spank her before she went onstage, to distract her from her anxiety.

Barbra Streisand developed overwhelming performance anxiety at the height of her career; for 27 years she refused to perform for the general public, appearing live only in private clubs and at charity events, where she presumably believed the pressure on her was less intense.

I have, since the age of about 2, been a twitchy bundle of phobias, fears, and neuroses. And I have, since the age of 10, when I was first taken to a mental hospital for evaluation and then referred to a psychiatrist for treatment, tried in various ways to overcome my anxiety.

One challenge is trying to extend access to more poorly served communities in rural areas and in the inner city. Sometimes you have kids who are suffering from trauma and post-traumatic stress disorder, and they have no way of getting access to the remedies that are available to them.

I don't want to be in a position that could make me vomit, like air travel. I've purloined airsick bags and stuffed them everywhere, just in case I ever feel the need to throw up. I haven't vomited since 1977, but I think about it all the time. I recognize that it's irrational, but I'd rather jump out of a window than vomit.

Somehow, in many of those near-miss instances, I've managed to fight through and continue. But in all these situations, even when they're apparently going well, I feel I am living on the razor's edge between success and failure, adulation and humiliation - between justifying my existence and revealing my unworthiness to be alive.

It is an irony of medical history that even as Freud's later work would make him the progenitor of modern psychodynamic psychotherapy, which is generally premised on the idea that mental illness arises from unconscious psychological conflicts, his papers on cocaine make him one of the fathers of biological psychiatry, which is governed by the notion that mental distress is partly caused by a physical or chemical malfunction that can be treated with drugs.

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