Born To Rue: Why Some People May Be Hard-Wired For AnxietyS

In a fascinating New York Times Magazine piece on the causes of anxiety, Robin Marantz Henig writes that some people "are just born worriers, their brains forever anticipating the dropping of some dreaded other shoe." People, that is, like me.

The article focuses on several longitudinal studies by psychologist Jerome Kagan and his colleagues. Kagan has found that some babies (about 20% of his simple) are "high-reactive," meaning they kick, writhe, or fuss in response to new stimuli. These babies are more likely to grow into anxious, inhibited, or shy children, and as teens and young adults exhibit differences in brain structure and function. The differences include hypersensitivity in the amygdala, a part of the brain responsible for dealing with danger and new situations. Kagan's research suggests that some people are wired from birth to be more anxious than others.

Henig mentions one subject, known as Baby 19, who in a 1989 experiment "was distressed by novelty - new sounds, new voices, new toys, new smells - and showed it by flailing her legs, arching her back and crying." In a 2004 interview, when she was 15, Baby 19 enumerated in her worries thus:

When I don't quite know what to do and it's really frustrating and I feel really uncomfortable, especially if other people around me know what they're doing. I'm always thinking, Should I go here? Should I go there? Am I in someone's way? ... I worry about things like getting projects done... I think, Will I get it done? How am I going to do it? ... If I'm going to be in a big crowd, it makes me nervous about what I'm going to do and say and what other people are going to do and say. How I'm going to deal with the world when I'm grown. Or if I'm going to sort of do anything that really means anything.

Not all of Kagan's "high-reactive" subjects were this visibly agitated. By adolescence, most of the kids who had feared new things were "getting good grades, going to parties, making friends." But, Henig writes,

There exists a kind of sub-rosa anxiety, a secret stash of worries that continue to plague a subset of high-reactive people no matter how well they function outwardly. They cannot quite outrun their own natures: consciously or unconsciously, they remain the same uneasy people they were when they were little.

At this point, she seems like she's writing from inside my brain. I'm not sure if I was a "high-reactive" baby, though the way my parents shudder when they talk about my infancy makes me think something was off. I wasn't a conventionally shy child either, but I was terrified of things like death, ghosts, lizards in the bedroom (don't ask), and being disliked. By thirteen, I was convinced I had a mysterious illness that was making my hair fall out (I didn't), and my separation anxiety was so severe that I once spent an entire visit to a friend's house pacing, waiting for my parents to come pick me up. But by high school, I kind of had a handle on things. Therapy helped my separation anxiety, and though I still pretty much thought I was dying all the time, I was able to go out, make friends, and have fun. Which is basically where I am today.

As I've said before, people who've just met me tend to describe me as calm. I don't freak out about work, and being with friends usually makes me forget my anxieties, so I rarely seem outwardly upset. But like Baby 19, I have a laundry list of worries coursing through my head on any given day: Do I have swine flu? Could I be pregnant (this one actually started long before I was sexually active — if I had an immaculate conception, I would not only have to raise a child but also convert to Christianity)? Is this cut on my finger going to give me gangrene? Did I offend someone? Did I say something weird? Am I weird?

If the foregoing list is any indication, the answer to the last question is yes. But if Kagan's research is accurate, there are many more people who are "forever anticipating the dropping of some dreaded other shoe." This shoe metaphor is especially apt, given that I tend to become especially anxious after something good happens to me, as though I deserve something bad to even it out. But as I've become aware of this tendency, I find it has less power over me, and I'm able to laugh at myself a little as I start to come down with promotion-related meningitis.

Henig discusses different parenting approaches to dealing with high reactive children, but says, "the best outcome, however it happens, is to rear a child who learns to wrestle his demons on his own." She quotes a 13-year-old subject of Kagan's, who wrote,

Inner struggles pulled at me for years until I was able to just let go and calm myself. For example, when I first heard about the anthrax in Washington, I began to have an upset stomach. I realized it was simply because of my anxiety that I was feeling sick. As soon as I realized that, the stomachache went away. Because I now understand my predisposition toward anxiety, I can talk myself out of simple fears.

Henig writes that, "there are many adults, anxious or not, who can't control their own interior monologues as well as this boy can" — and I'm not quite there yet. I'm still capable of losing sleep over the aforementioned gangrenous finger, and I tend to practice a kind of worry exceptionalism — my past worries may have been irrational, I tell myself, but this one is real. I remain a supporter of SSRI treatment, because it's the only thing that ever really shut up my constant interior hypochondrialogue — but a cautious one, because the side effects eventually made me quit. Nowadays what helps the most is absorbing work (which Henig mentions), being social, and, oddly, reading and writing about anxiety.

Some have complained that contemporary psychological research, especially insofar as it focuses on brain scan and controlled experiment, is cold and unhelpful to the individual sufferer. But for me, there's something immensely calming in finding out about the possible defects in my brain. It provides me with a narrative — I'm feeling this way because I was a high-reactive infant and I now have an oversensitive amygdala. This narrative is obviously imperfect — Henig mentions, for instance, that we're not sure about the connection between amygdala activity and the subjective experience of anxiety — but I like that it locates the source of my anxiety in my brain and not in my parents (who, for the record, always tried everything to help me feel better), or, most frightening of all, in the world. I'm aware that we live in anxiety-producing times (Henig duly mentions the recession), but for me, all times are anxiety-producing, and I like to be reminded that my anxiety really comes not from the outside world, but from inside me. It means I have the power to do something about it — even if I'm not sure what that something is.

Understanding the Anxious Mind [NY Times Magazine]