This is the age of anxiety, the era of the benzodiazepine Xanax - "all jumpy and edgy and short of breath," as New York magazine puts it. Climate change, terrorism, recession - there's something for everyone to worry about, and a medication or a book to go with it. But is anxiety a medical condition or just the new - even not so new - normal?
"Anxiety is a necessary emotion; we need it to perform well," says Dr Natasha Bijlani, a consultant psychiatrist at the Priory in Roehampton, south-west London, "and life is no more dangerous than it ever was. But people's expectations are different - we're more achievement-oriented and we want a quick fix."
A fix such as Xanax (alprazolam)? Hugely popular in the US (48.7 million prescriptions were written for it there last year), it's known as the crack cocaine of benzos. It's similar to Valium but faster-acting and with a much shorter half-life - Valium stays in the system for 20 to 100 hours, Xanax for only six to 12. This is an advantage in some ways - less of a hangover - but accounts for its more addictive qualities. You want more and you want it now.
Anti-anxiety meds are nothing new. Miltown (meprobamate), the first blockbuster tranquilliser, became the toast of Hollywood in the 1950s. Lucille Ball, Tennessee Williams, Aldous Huxley, Norman Mailer and Salvador Dali's wife, Gala, were all fervent fans. Then came the benzos: Librium, followed by the wildly successful Valium, both developed by Leo Sternbach at Roche's plant in Nutley, New Jersey, and approved by the Food and Drug Administration in 1963. Perfect for Cold War angst, more potent than Miltown, Librium and then Valium (developed because of Librium's bitter aftertaste) were also less toxic and sedating and set the way for the "codification of anxiety into medical pathology", as Andrea Tone puts it in The Age of Anxiety: A History of America's Turbulent Affair with Tranquilizers.
Paul Gilbert, professor of clinical psychology at the University of Derby and author of The Compassionate Mind, says that "our cognitive abilities are plumbed into an ancient anxiety system", and that in anxiety disorder, the threat/self-protection system - useful if to avoid being eaten by a lion - seems to be inflamed and easily activated, and that the amygdala, that part of the brain's limbic system that plays a vital role in the regulations of emotions, has become oversensitive. And - no surprise there - it's in the amygdala that the benzos concentrate their soothing, often addictive, magic.
