‘Coming Out’ as Anxious

When I was 10, I was diagnosed with a collection of anxiety disorders. For the next three and a half decades, I hid my condition from those around me. I concocted elaborate explanations for the absences caused by my therapy appointments. I kept my medications out of sight. I generally did everything I could to project an aura of competence and confidence that was often at odds with the vulnerability, and sometimes the terror, that I felt.

Then I decided to write a book about anxiety. The dilemma: Should I reveal anything about my own struggles? Would I hurt myself professionally by doing so? Embarrass myself? Worsen my anxiety?

My psychotherapist, Dr. W., understood my concerns. But he suggested gently, on many occasions, that revealing my anxiety would perhaps dissipate the shame I associated with it. Doing so might prove therapeutic, even liberating. “You’ve been keeping your anxiety a secret for years, right?” he would ask. “How’s that working out for you?”

He had a point. I was still terribly anxious, and often unhappy.

But I would retort that at least I was gainfully employed and not a laughingstock or an object of unwanted pity. Concealing my anxiety was in some sense working for me.

Dr. W. would counter that by sharing what I had gone through, perhaps I could provide solace to some of the millions of other people who suffer from clinical anxiety. Perhaps I could even, as he put it, “write yourself to health.”

In the end, I decided, with considerable apprehension, to go ahead and reveal my own anxiety in the book. It’s now been a year since my book was published. Did “coming out” help?

The short answer is: a little bit, yes. The longer answer is … well, let me tell you a story.

My most longstanding anxiety is emetophobia, the pathological fear of vomiting. I had, at the time of my book’s publication, gone some 37 years without throwing up. Given my history, the odds of my vomiting at any given moment are rather low. I know this rationally, and yet a good part of my life is still given over to worrying that I will — and moreover that I will do so at the most inopportune time.

In August, I accompanied my boss to interview Bill Clinton for the magazine we work for. My role was merely as an appendage — to provide moral support to my boss, who would conduct the interview, and to the magazine’s creative director, who would be helping to superintend a photo shoot. Still, I was looking forward to sitting in.

But as the taxi to the interview site lurched its way through traffic in the August heat, I began to feel queasy. As I walked into the building where the interview was to take place, my nausea increased, which caused my anxiety to deepen, in the usual vicious cycle of heightening physiological and emotional distress, triggering my typical internal dialogue: Do I have a virus? Food poisoning?

Relax, I told myself. It’s just anxiety.

But what if it’s not? Oh, god: I’m going to throw up, and my non-vomiting streak is going to end — and it’s going to end, as of course it would have to, right in front of, or on top of, the former president of the United States.

I tried to tell myself that wouldn’t be the end of the world. After all, Mr. Clinton’s predecessor in the White House, George H.W. Bush, once threw up on the prime minister of Japan. But such attempts at self-reassurance tend to be futile once my anxiety engages full throttle.

You’re just anxious and a little carsick, I told myself, retreating to the men’s room, where I gulped a Xanax. Hurry up, Xanax, work!

Returning to the office, I was told that Mr. Clinton was finally on his way, and I suddenly became quite certain I was going to be sick — probably just as he arrived. After 37 years of not vomiting, my streak was going to end by barfing on the erstwhile leader of the free world, and then getting shot. (In my anxiety-driven thought process, I’d concluded that my vomiting would be interpreted by the Secret Service as evidence of hostile intention.)

Bolting from the building, I crossed the street to a hotel bar where, surrounded by chatty conference attendees wearing lanyards, I gulped an emergency vodka. Within minutes, as the Xanax and alcohol kicked in, my nausea dissipated. I felt well enough to return to the office. My hope was that I’d get back in time. No such luck. Mr. Clinton was in an inner room of the suite, the interview already underway.

“Where’d you go?” the magazine’s creative director asked. I told him, as I would later tell my boss, that I’d had to field a phone call from an angry author, which was a partial truth — I’d fielded such a call earlier in the day.

So, no, publishing a book about anxiety has not cured me of it.

But in important ways, publishing the book has been a kind of deliverance. During the promotional tour for my previous book, in 2004, I lived in terror of having to run off a stage, or run out of a live TV broadcast, because of a panic attack, thereby embarrassing myself and revealing my anxiety to the world. But now, having pre-emptively announced my anxiety, if I were forced to run offstage I could always yell out, “Sorry, please refer to Chapter 4!”

I had the equivalent of a get-out-of-public-appearances-free card: You signed up an anxious guy for an event, what’d you expect? This helped relax me.

More broadly, I revealed my anxiety and … the world didn’t end. Did friends and colleagues talk about me behind my back? Maybe. Probably. (O.K., definitely.) But for the most part people didn’t seem to treat me any differently — and to the extent that they did, it was to express sympathy or empathy and even admiration for my “bravery” in revealing my vulnerability. (This always struck me as odd because I was being brave only in revealing my lack of bravery, which is a cheap sort of bravery indeed.)

Many people — friends, colleagues, strangers — came forward to share their own stories of anxiety, and to say that my publicly revealing my anxiety somehow made them feel more hopeful, or less alone, and sometimes less anxious. This made me feel good, though I found it ironic that my writing about my anxiety seemed to reduce other people’s anxiety more than it did my own.

I’m still anxious. I still have bad episodes. I remain (lightly, for the most part) medicated. But Dr. W. was right: Coming out as anxious has helped. It has been a relief not always to have to do “impression management,” as Dr. W. calls it. I don’t — or don’t always, anyway — feel a desperate compulsion to hide the anxiety that sometimes overtakes me.

After years of wanting to be known for the equanimity that I (mostly) managed to project to the world despite my inner churnings, I’ve embraced, albeit uneasily, my place in the nervous flock. I don’t know exactly where we’re going together, but I draw solace from our shared membership in the fellowship of the anxious. Together, perhaps, we can shuffle forward — two steps forward, one step back — toward resilience and even serenity.

Scott Stossel, the editor of The Atlantic magazine, is the author of “My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind.”