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Mske kan angst ogs vre en styrke

Information | 25.01.2014 | | Sektion: Moderne Tider Side 24 | 1603 ord | Artikelid: e43a4b13 |
Original artikel
Efter hele livet at have forsgt sig med snart sagt en hvilken som helst terapiform, et hvilket som helst
medikament og oceaner af sprut har forfatter og redaktr Scott Stossel givet op og indset, at hans angst
er et livsvilkr. Det har han skrevet blndende erindringsbog om
Lad os sige, at du er en del af publikum, og jeg er p talerstolen. Og jeg har forberedt mig. Fire timer
tidligere har jeg taget et halvt milligram Xanax (hvis jeg venter for lnge gr min ' kamp-eller flugtreaktion' s meget i overdrive, at medicin ikke er nok til at dmpe angsten). For omkring en time siden
har jeg taget yderligere et halvt milligram og mske 20 milligram Inderal.
Jeg har brug for et helt milligram Xanax plus Inderal - en medicin mod forhjet blodtryk eller en
betablokker - for at dmpe det sympatiske nervesystems reaktion og for at holde mine fysiologiske
reaktioner p den flelse af angst jeg har over at st foran et publikum, nede.
Ellers overmander sveden, rysteture, kvalme, bvsen, mavekramper og forsnvring i hals og bryst
mig. Sandsynligvis har jeg skyllet pillerne ned med whisky eller, mere sandsynligt, vodka, hvis lugt er
mere neutral. For selv to Xanax og en Inderal er ikke nok til at berolige mine tanker, der flyver forvirret
rundt, og medicinen kan heller ikke fjerne den trykken, jeg har i bryst og hals, som ofte nr et punkt,
hvor jeg ikke kan tale. Jeg har brug for alkohol til at f reaktionerne ned i tempo, for at undertrykke de
tilbagevrende fysiske reaktioner, som lgemidlerne ikke kan dmpe.
Faktisk har jeg sandsynligvis drukket mit andet glas for mellem 15 og 30 minutter siden, under
forudstning af at jeg har kunnet slippe vk lige fr introduktionen. Jeg har ogs altid nogle Xanax i en
lomme og en miniflaske vodka eller to i den anden lomme. Jeg har vret kendt for at tage en diskret
slurk i sidste jeblik, lige fr jeg gr p scenen, fordi selv da oplever jeg stadig den angst, der giver mig
lyst til at drikke mere. P det tidspunkt er mine hmninger bedvede og min dmmekraft svkket af
spiritus og benzodiazepiner.
Men hvis jeg har formet at ramme the sweet spot - den perfekte kombination af timing og dosering,
hvor den kognitive og psykomotorisk slvende virkning af narkotika og alkohol har nedkmpet min
angst - ja s har jeg det godt oppe p scenen: nervs men ikke elendig, lidt omtget, men stadig i stand
til at tale tydeligt. Ha jeg derimod taget for meget - for meget Xanax eller for meget spiritus - vil jeg
lyde slret og ikke s overbevisende. Og har jeg omvendt ikke selvmedicineret nok, s sveder jeg
voldsomt, mens min stemme bver svagt og min opmrksomhed vender sig indad, eller mere
sandsynligt: S er jeg forsvundet fra scenen, fr jeg over hovedet nede op p den. Helt bogstaveligt..

The Atlantic: Lets say youre sitting in an audience and Im at the lectern. Heres what
Ive likely done to prepare. Four hours or so ago, I took my first half milligram of Xanax.
(Ive learned that if I wait too long to take it, my fight-or-flight response kicks so far into
overdrive that medication is not enough to yank it back.) Then, about an hour ago, I took
my second half milligram of Xanax and perhaps 20 milligrams of Inderal. (I need the
whole milligram of Xanax plus the Inderal, which is a blood-pressure medication, or betablocker, that dampens the response of the sympathetic nervous system, to keep my
physiological responses to the anxious stimulus of standing in front of youthe sweating,
trembling, nausea, burping, stomach cramps, and constriction in my throat and chest
from overwhelming me.) I likely washed those pills down with a shot of scotch or, more
likely, vodka, the odor of which is less detectable on my breath. Even two Xanax and an
Inderal are not enough to calm my racing thoughts and to keep my chest and throat from
constricting to the point where I cannot speak; I need the alcohol to slow things down and
to subdue the residual physiological eruptions that the drugs are inadequate to contain. In
fact, I probably drank my second shotyes, even though I might be speaking to you at,
say, 9 in the morningbetween 15 and 30 minutes ago, assuming the pre-talk
proceedings allowed me a moment to sneak away for a quaff.
If the usual pattern has held, as I stand up here talking to you now, Ive got some Xanax in
one pocket (in case I felt the need to pop another one before being introduced) and a
minibar-size bottle or two of vodka in the other. I have been known to take a discreet lastsecond swig while walking onstagebecause even as Im still experiencing the anxiety
that makes me want to drink more, my inhibition has been lowered, and my judgment
impaired, by the liquor and benzodiazepines Ive already consumed. If Ive managed to hit
the sweet spotthat perfect combination of timing and dosage whereby the cognitive and
psychomotor sedating effect of the drugs and alcohol balances out the physiological
hyperarousal of the anxietythen Im probably doing okay up here: nervous but not
miserable; a little fuzzy but still able to speak clearly; the anxiogenic effects of the
situation (me, speaking in front of people) counteracted by the anxiolytic effects of what
Ive consumed. But if Ive overshot on the medicationtoo much Xanax or liquorI may
seem to be loopy or slurring or otherwise impaired. And if I didnt self-medicate enough?
Well, then, either Im sweating profusely, with my voice quavering weakly and my attention
folding in upon itself, or, more likely, I ran offstage before I got this far. I mean that literally:
Ive frozen, mortifyingly, onstage at public lectures and presentations before, and on
several occasions I have been compelled to bolt from the stage.
Rdselsslagen lige fra babystadiet
Sdan indleder Scott Stossel - chefredaktr p det respekterede ugemagasin The Atlantic - sin nye 416
sider lange bog My Age of Anxiety: Fear, Hope, Dread and the Search for Peace of Mind om den
lammende, altoverskyggende angst, som han har kmpet med hele sit liv.
Og som har styret ham lige s lnge.
Angsten gjorde ham til en overnervs baby, der altid frygtede at vre alene. Som fik ham til at tilbringe
alle sine aftener, da han var mellem fire og seks r i sikker forvisning om, at hans mor - som studerede
jura p aftenskole - aldrig ville komme hjem, men ville d i et biluheld eller forlade ham. Den fik ham til

at tilbringe stort set hele sin tid i grundskolen hos skolesygeplejersken med frst hovedpine og siden
mavepine. Og den har frt til konstant medicinering, siden han var fem.
The Atlantic: Anxiety has afflicted me all my life. When I was a child and my mother was
attending law school at night, I spent evenings at home with a babysitter, abjectly terrified
that my parents had died in a car crash or had abandoned me (the clinical term for this is
separation anxiety); by age 7 I had worn grooves in the carpet of my bedroom with my
relentless pacing, trying to will my parents to come home. During first grade, I spent
nearly every afternoon for months in the school nurses 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.
Stossels angst og forbier, der inkluderer flere diagnoser, end pladsen her tillader at remse op, inkluderer
blandt andet en strk angst for lukkede rum, hjder, at blive fanget langt fra hjemmet, bakterier, ost,
flyvning, opkastning..
The Atlantic: I also suffer from a number of specific fears and phobias, in addition to my
public-speaking phobia. To name a few: enclosed spaces (claustrophobia); heights
(acrophobia); fainting (asthenophobia); being trapped far from home (a species of
agoraphobia); germs (bacillophobia); cheese (turophobia); flying (aerophobia); vomiting
(emetophobia); and, naturally, vomiting while flying (aeronausiphobia).
Han beskriver, hvordan hans var gennembldt af sved, da han skulle giftes, hans ben rystede, s han
mtte lne sig op ad sin brud foran alteret for ikke at kollapse. Ved fdslen af hans frste barn
besvimede han. Hans lille pige har arvet hans skrk for at kaste op uden at vi nogen sinde har talt om
det derhjemme, og uden at hun kender diagnosen..
The Atlantic: My wedding was accompanied by sweating so torrential that it soaked
through my clothes and by shakes so severe that I had to lean on my bride at the altar, so
as not to collapse. At the birth of our first child, the nurses had to briefly stop ministering
to my wife, who was in the throes of labor, to attend to me as I turned pale and keeled
Dden - eller det der er vrre
Han har ogs forladt stvnemder, eksaminer, jobsamtaler, lufthavne, tog og biler I sdanne tilflde
har jeg nogle gange vret overbevist om, at dden eller noget endnu vrre var nrt forestende.
The Atlantic: Ive abandoned dates; walked out of exams; and had breakdowns during
job interviews, plane flights, train trips, and car rides, and simply walking down the street.
Og selv nr jeg ikke er ramt af akut angst, er jeg prget af bekymring: over mit helbred og min families
sundhed, over konomi, arbejde, over at kre galt i bil eller f en vandskade i min klder, over
alderdom og ddens uundgelige komme, over alting og ingenting. En bekymring, der bliver til
mavepine, hovedpine, vejrtrkningsproblemer, synkebesvr, svimmelhed, smerter i arme og ben, der
fles som influenza.

The Atlantic: Even when not actively afflicted by such acute episodes, I am buffeted by
worry: about my health and my family members health; about finances; about work;
about the rattle in my car and the dripping in my basement; about the encroachment of
old age and the inevitability of death; about everything and nothing. Sometimes this worry
gets transmuted into low-grade physical discomfortstomachaches, headaches,
dizziness, pains in my arms and legsor a general malaise, as though I have
mononucleosis or the flu.

Syv r gammel havde han slidt riller i sit tppe i sovevrelset ved at pace rundt derinde; i gymnasiet
tabte han med vilje, nr han spillede tennis, for at slippe for konkurrencesituationer, der ville
fremprovokere angst.
Den eneste date, han havde i gymnasiet, endte brat, da den unge dame lnede sig ind for at kysse
ham, men hvor han uheldigvis blev overvldet af angst og trak sig vk af frygt for, at han ville kaste op
p den udkrne. Jeg var s forlegen, at jeg holdt op med at svare p hendes telefonopkald.
The Atlantic: by age 7 I had worn grooves in the carpet of my bedroom with my
relentless pacing, trying to will my parents to come home.

During high school, I would purposely lose tennis and squash matches to escape the
agony of anxiety that competitive situations would provoke in me. On the onethe only
date I had in high school, when the young lady leaned in for a kiss during a romantic
moment (we were outside, gazing at constellations through her telescope), I was
overcome by anxiety and had to pull away for fear that I would vomit. My embarrassment
was such that I stopped returning her phone calls.
Han har prvet det meste inden for behandling. Individuel psykoterapi gennem 30 r, familieterapi,
gruppeterapi, kognitiv adfrdsterapi, rationel flelsesladet adfrdsterapi, accept-og engagement-terapi,
hypnose, meditation, rollespil, massage, bn, akupunktur, yoga, stoisk filosofiog lydbnd han, havde
bestilt fra reklamer, jeg havde set sent om natten p tv. Og tonsvis af medicin: Thorazin, Imipramine,
Desipramin, Chlorpheniramin, Nardil, BuSpar, Prozac, Zoloft, Paxil, Wellbutri, Effexor, Celexa, Lexapro,
Cymbalta, Serax, Perikum, Zolpidem, Valium, Xanax, Rivotril - kombineret med storforbrug af l, vin,
gin, bourbon, vodka og whisky.
Men som han skriver: Og hvad virkede? Intet af det.
The Atlantic: Heres what Ive tried: individual psychotherapy (three decades of it), family
therapy, group therapy, cognitive-behavioral therapy, rational emotive behavior therapy,
acceptance and commitment therapy, hypnosis, meditation, role-playing, interoceptive
exposure therapy, in vivo exposure therapy, self-help workbooks, massage therapy,
prayer, acupuncture, yoga, Stoic philosophy, and audiotapes I ordered off a late-night TV
And medication. Lots of medication. Thorazine. Imipramine. Desipramine.
Chlorpheniramine. Nardil. BuSpar. Prozac. Zoloft. Paxil. Wellbutrin. Effexor. Celexa.

Lexapro. Cymbalta. Luvox. Trazodone. Levoxyl. Inderal. Tranxene. Serax. Centrax. St.
Johns wort. Zolpidem. Valium. Librium. Ativan. Xanax. Klonopin.
Also: beer, wine, gin, bourbon, vodka, and scotch.
Heres whats worked: nothing.
Hvilket ikke er helt sandt. Visse af lgemidlerne har hjulpet ham i kortere tid, nogle op til et halvt r ad
gangen. Men intet har fundamentalt reduceret den underliggende angst, der synes vvet ind i min
krop og sjl og til tider gr mit liv en elendighed.
The Atlantic: Actually, thats not entirely true. Some drugs have helped a little, for finite
periods of time.

But none of these treatments has fundamentally reduced the underlying anxiety that
seems hardwired into my body and woven into my soul and that at times makes my life a
Intet melodrama
Det, der gr Stossels bog til en fabelagtig fortlling, er, at angsten ikke har forhindret ham i i dag at
blive chefredaktr p et af USA's mest respekterede medier. Han er velfungerende og formr at skjule
sin tilstand meget af tiden. Og at arbejde. Hans liv er, som han ogs medgiver, fuldkommen
udramatisk. Der forekommmer hverken melodrama eller psykopater. Man kan ikke lave hverken film
eller bger om det. Og han overlever.
The Atlantic: My life has, thankfully, lacked great tragedy or melodrama.

Robert Downey Jr. will not be starring in the movie of my life.

I am, as they say in the clinical literature, high functioning for someone with an anxiety
disorder or other mental illness; Im usually quite good at hiding it.
Han kaster heller ikke op. Som han noterer: Det er i skrivende stund 35 r, to mneder, fire dage, 23
timer og 34 minutter siden, jeg kastede op sidst. Hvilket betyder, at mere end 83 procent af mine dage
p jorden er get, siden jeg sidst kastede op en tidlig aften, 7. marts, 1977, da jeg var syv r gammel.
The Atlantic: I struggle with emetophobia, a pathological fear of vomiting, but its been a
while since I last vomited. More than a while, actually: as I type this, its been, to be
precise, 35 years, two months, four days, 23 hours, and 34 minutes. Meaning that more
than 83 percent of my days on Earth have transpired in the time since I last threw up,
during the early evening of March 7, 1977, when I was 7 years old.
Men det betyder ikke, at han er holdt op med at bekymre sig: Jeg bruger vel omkring 60 procent af min
vgne tid p at holde je med de ting, jeg er bange for. Jeg undgr hospitaler og offentlige toiletter, jeg
er besat af at vaske mine hnder og meget opmrksom p, hvor alt, hvad jeg spiser, kommer fra. Det

er relativt almindeligt. Han gr imidlertid skridtet videre. Han hamstrer sm poser beregnet til opkast,
og han altid medicin mod maveonder p sig.
The Atlantic: What this means is that I have spent, by rough calculation, at least 60
percent of my waking life thinking about and worrying about something that I have spent
zero percent of the past three-plus decades doing. This is irrational.
And yet, an astonishing portion of my life is built around trying to evade vomiting and
preparing for the eventuality that I might throw up. Some of my behavior is standard
germophobic stuff: avoiding hospitals and public restrooms, giving wide berth to sick
people, obsessively washing my hands, paying careful attention to the provenance of
everything I eat.
But other behavior is more extreme, given the statistical unlikelihood of my vomiting at
any given moment. I stash motion-sickness bags, purloined from airplanes, all over my
home and office and car in case Im suddenly overtaken by the need to vomit. I carry
Pepto-Bismol and Dramamine and other antiemetic medications with me at all times.
Og som en generel overvgning af fjenden p forhnd, har jeg altid et detaljeret mentalt og opdateret
kort med mig over globale forekomster af norovirus (den mest almindelige stamme af mavevirus) og
andre former for gastroenteritis. Jeg bruger internettet til at spore udbrud i USA og rundt om i verden.
Jeg kan til enhver tid fortlle dig, prcis hvilke plejehjem i New Zealand, krydstogtskibe i Middelhavet,
eller grundskoler i Virginia, der kmper med udbrud..
The Atlantic: Like a general monitoring the enemys advance, I keep a detailed mental
map of recorded incidences of norovirus (the most common strain of stomach virus) and
other forms of gastroenteritis, using the Internet to track outbreaks in the United States
and around the world. Such is the nature of my obsession that I can tell you at any given
moment exactly which nursing homes in New Zealand, cruise ships in the Mediterranean,
and elementary schools in Virginia are contending with outbreaks.
Angst er en folkesygdom Ikke desto mindre er budskabet
Ikke desto mindre er budskabet om, at man kan bde overleve og leve et godt liv med angst vigtigt. For
som Stossel skriver, s er angst og de dermed tilknyttede lidelser den mest udbredte officielt
klassificerede psykiske sygdom i USA i dag. Angst er mere almindeligt end depression og andre
affektive sindslidelser.
Iflge National Institute of Mental Health og det amerikanske sundhedsministerium vil omkring 40
millioner voksne amerikanere - eller en ud af seks - p et tidspunkt af deres liv lide af en eller anden
form for angst. Og en ud af fire kan forvente p et tidspunkt at blive ramt af invaliderende angst.
I 2012 blev der skrevet 50 millioner recepter p bare en bestemt angstdmpende medicin alprazolam,
det generiske navn for Xanax.
The Atlantic: Anxiety and its associated disorders represent the most common form of
officially classified mental illness in the United States today, more common even than
depression and other mood disorders. According to the National Institute of Mental

Health, some 40 million American adults, about one in six, are suffering from some kind
of anxiety disorder at any given time; based on the most recent data from the Department
of Health and Human Services, their treatment accounts for more than a quarter of all
spending on mental-health care. Recent epidemiological data suggest that one in four of
us can expect to be stricken by debilitating anxiety at some point in our lifetime. And it is
debilitating: studies have compared the psychic and physical impairment tied to living with
an anxiety disorder with the impairment tied to living with diabetesboth conditions are
usually manageable, sometimes fatal, and always a pain to deal with. In 2012, Americans
filled nearly 50 million prescriptions for just one antianxiety drug: alprazolam, the generic
name for Xanax.
Konklusionen p bogen er interessant. Som Stossel skriver: Angst han vre uudholdeligt. Men mske
er det ogs en gave. Mske er angsten en essentiel del af, hvem jeg er. ' Jeg hader at du er angst' siger
min hustru til mig, ' og jeg hader, at du bliver s ulykkelig af angsten. Men hvad nu, hvis det, jeg elsker
ved dig, er forbundet med din angst? Hvad nu hvis du bliver rask og det viser sig, at du ender som et
totalt fjols.' Mske har hun ret. Min angst er forblevet et bldende sr, som af og til holder mig tilbage og
fylder mig med skam - men mske er det ogs, samtidig, en styrke, en ressource, der mske kan vre
forbundet med en vis velsignelse."
The Atlantic: Ive come to understand that my own nervous disposition is perhaps an
essential part of my beingand not just in ways that are bad. I hate your anxiety, my
wife once said, and I hate that it makes you unhappy. But what if there are things that I
love about you that are connected to your anxiety?
What if, she asked, getting to the heart of the matter, youre cured of your anxiety and
you become a total jerk?
I suspect I might.

My anxiety can be intolerable. But it is also, maybe, a giftor at least the other side of a
coin I ought to think twice about before trading in. As often as anxiety has held me back
prevented me from traveling, or from seizing opportunities or taking certain risksit has
also unquestionably spurred me forward.
anra@information. dk.
Jeg bruger vel omkring 60 procent af min vgne tid p at holde je med de ting, jeg er bange for. Jeg
undgr hospitaler og offentlige toiletter, jeg er besat af at vaske mine hnder og meget opmrksom p
oprindelsen af alt, hvad jeg spiser SCOTT STOSSEL.
Fakta: Scott Stossel
My Age of Anxiety Fear, Hope, Dread and the Search for Peace of Mind.
416 sider. 17,68 dollar.

The Atlantic: