Then and Now

In 1987 I started my psychiatry residency. Since then, they have changed the Diagnostic and Statistic Manual three times and it still does not seem to be keeping up with how fast the world is changing around me.

I one saw lots of “lethargic” depressions. Slow and sleepy “ain’t got no energy” depressions. “I feel like a human blob” kind of depressions.

Now most of them turn out to be Type II (“adult onset”) sugar diabetes or the thyroid just stopped working for some creative reason.

Now, even when people qualify for a diagnosis of some sort of depression, they come in complaining “I got anxiety.” Not “nervous”, or any sort of synonym. Just “Anxiety.”

My ninth grade prep school English teacher, a tall and thin dark-haired woman whom I did not believe to serve any significant function in human society, would often shake her head and say, “I guess W.H. Auden was right. We are in the “Age of Anxiety.” Despite my queries she never said what it meant. (I warned you she served no ostensible function in human society.)

I looked it up then, and again more recently, and I do believe we are still, only even more so, in “The Age of Anxiety.”

The Manchester Guardian (which I love) did a nice job of summarizing its confused reception of this masterwork on both sides of the Atlantic. Although the New York Times did a good job as well.

Basically, it was a poem of book length. This ploy has been used from Homer’s Iliad to any (sold through serialization) work by Charles Dickens. As I remember, Bleak House was awfully long and, well, “Bleak.” and he got paid by the word.

So whenever a poet writes something very long, he surely is more important and probably he is richer, if he gets paid by the word.

This is one of the things I read in high school when I could have my mother of blessed memory drop me off at either the Widener Library at Harvard, or the Boston Public Library.

I can’t remember which, because it was a less than memorable experience. I never finished it.

T. S. Eliot thought it was his “best work to date” and the New York Times seems to have thought it was a dismal failure. It got a Pulitzer Prize and yours truly thought it could best be summarized as a “pain in the neck.”

The gist of it is that four people with American jobs and British names are drinking in an American bar in New York. Everybody is nervous because World War Two is about to break out.

They can dance a little and/or pass out but they must not be doing a good job of having sex, because they pass out far too easily.

Ooh boy, are they all anxious.

I have no idea why they all speak to each other in iambic tetrameter, except that they seemed to have used this meter in British literature that was so old they didn’t bother studying it in prep school.

Personally, I think their communal anxiety had something to do with feeling there was going to be a war breaking out, so everybody was going to kill each other.

Today my husband and I drove home in an Uber driven by a 74 year old aerospace engineer who had been, as I understood, forced into retirement because they don’t need him to design fuselages anymore. I am sure that they will invent faster and more effective ways for people to kill each other (probably, in a more untraceable manner) but he will not be able to learn to do this fast enough to have a career.

I think the reason people are having this “Age of Anxiety” is that technology is changing too fast, When I see some of my older patients I may actually become proud of myself for “working” my own computer and phone. They subscribe to a model of planned obsolescence that makes their inability to deal with technology acceptable. To my model of aging, it is NOT acceptable. I cannot feel as comfortable with my phone as my younger patients.

I owe any technological facilities to my husband, who is more than a husband to me in so many ways; too many to describe here.

Charles Darwin decided a while ago it was unlikely that the human race would get much further by evolution alone. The overwhelming majority of “normal” psychiatrists are treating anxiety with benzodiazepines, which are addictive and depressive and give short term relief.

Nobody seems to have realized let alone admitted that anxiety is, for most folks on the 21st century, not a short term problem’ but decided, a long term problem–and one that is not going away sometime soon.

Right now I do use a few natural substances to treat it, although I depend on EFT (teaching people their own acupuncture meridians), questioning and learning about the advantages and limitations of faith, and using the basic principles of cognition and intelligence (I lend them mine) to get through life.