Book Review: On Edge

“Fear ambushes me… I feel fine… And then, a second later, I’m not,” writes Andrea Peterson.

Her new book, On Edge: A Journey Through Anxiety, is an exploration of her life with anxiety, from her first panic attack, to realizing that she had an anxiety disorder, to sorting out the dizzying array of treatments and ultimately discovering for herself what anxiety is and how to live with it.

While it is estimated that one in three Americans will have at least one anxiety disorder in their lifetime, it took Peterson multiple trips to the emergency room, EKG tests, blood tests, CAT scans, MRIs and multiple other suspected conditions before she was finally diagnosed with an anxiety disorder. Part of the reason for this, Peterson discovered, was that depression tends to claim most of the headlines and media attention.

Yet anxiety can be deadly.

“Recent research has found that it is anxiety disorders and other illnesses, like problems with impulse control and addiction that are more likely to lead to suicide attempts,” writes Peterson.

As her anxiety began to spiral out of control, Peterson experienced often confusing neurological symptoms that bewildered her and scared her parents. Like many who suffer from anxiety, Peterson tried to hide her symptoms.

“Trying to hide my terror and appear normal was exhausting so I came up with a cover story. I told my roommates and others that I was recovering from mono, the quintessential college “kissing” disease,” writes Peterson.

As her anxiety continued unabated, Peterson found herself exhausted, in a bone-deep torpor.

Yet, as much as she feared death, Peterson’s feelings of hopelessness – and lack of clear diagnosis – gave way to thoughts of wanting to die.

“I couldn’t see any other way to escape how I felt. The doctors couldn’t help me. Nor could my parents of friends. And I increasingly didn’t feel strong enough to slog through the days and nights,” writes Peterson.

Peterson’s experience is not entirely uncommon. She quotes researchers Dan Grupe and Jack Nitschke:

“A patient with an anxiety disorder probably builds up neural pathways of anxiety just as a concert pianist strengthens neural pathways of musicianship – through hours of daily practice.”

Some of these pathways, Peterson writes, begin very early on. Parents who are overprotective and controlling – micromanaging their child’s every move – send the message to their children that they are not capable.

Anxiety can also follow generational lines. Peterson’s grandmother suffered from severe mental illness, and at one point even tried to burn the house down. Years later, her sister experienced a handful of panic attacks, and fears of highways, bridges and airplanes. While it is difficult to pinpoint just how genetic transmission of anxiety may occur, one of the biggest risk factors, according to Peterson, is being female.

“Women are twice as likely as men to develop one [anxiety disorder] and women’s illness generally last longer, have more severe symptoms, and are more disabling,” writes Peterson.

Treatment, however, is often complicated by the fact that people with anxiety, panic disorders and phobias often wait years before discussing their symptoms with a professional. As she sought help for her own symptoms, Peterson explored an array of therapeutic methods – including cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), yoga, neurofeedback, and even Meetup groups for social anxiety.

While some therapies are more effective than others, Peterson writes that mindfulness, in particular, seems to hold promise. Peterson quotes Stefan Hofmann, a professor of psychology at Boston University who has conducted a large scale study comparing the efficacy of CBT to Kundalini yoga and stress education:

“Mindfulness encourages individuals to stay in the here and now. The present-moment awareness at the heart of mindfulness works directly against the worrisome cognitive tendencies.”

Pharmaceutical medication for anxiety is not a straight forward process either, according to Peterson. While astounding amounts of money are spent marketing new medication to patients, promising to give them their life back, many medications cause almost as many side effects as they are meant to cure. Some, like the benzodiazepines that were implicated in the deaths of Whitney Houston, Heath Ledger, and Anna Nicole Smith, are downright dangerous.

Anxiety also complicates work, relationships, and even everyday decisions. Anxious people are often perfectionists, have trouble with procrastination, are risk-averse, and as they often attempt to conceal their symptoms from others, find themselves also battling isolation and loneliness.

Peterson’s book is not just a story of her own anxiety, but a fascinating look at the neuroscience, genetic and environmental risk factors, research and treatment approaches that often confound the diagnosis of anxiety. While there is no magic bullet for anxiety, what we can learn is that through staying grounded – daily exercise, adequate sleep, good nutrition, and supportive relationships – life with anxiety is possible and within reach.

On Edge: A Journey Through Anxiety
Andrea Peterson
Crown (2017)
Softcover, 258 Pages

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