Andy Warhol Was a Hoarder (29 page)

Ultimately, it was Darwin's work—primarily his writing of
On the Origin of Species
—that occupied most of his time and his worry. In 1844, Darwin completed a 189-page draft of his theory, with instructions for Emma to publish it if he died. But 14 years later, when Alfred Russel Wallace's correspondence arrived at his doorstep, Darwin still had not finalized his work. The cause for “Darwin's delay,” as it has been dubbed, has been scrutinized and debated for years. He was of course busy with his marriage, his children (seven out of ten would survive into adulthood), and other major writing projects, including a five-volume collection documenting the plant and animal specimens he had collected during the
Beagle
voyage, and four reports on the diversity of barnacles. He also needed time to analyze everything, from the breeding habits of pigeons to the variation among strawberries and pears. And he wanted to be right. Well aware of half-baked speculations about evolution that had already been published, including an account by his grandfather Erasmus, Darwin's account needed to be as tight as an Anchor Bend knot.

There is little doubt that Darwin struggled with feelings of anxiety about publishing his theory, especially early on. Known to be a modest and affable man who hated both controversy and the public spotlight, he knew that his proposition that the earth's creatures were not uniquely designed by a higher power, but had instead evolved and adapted over time, would outrage the most pious members of society, upending centuries of religious belief about divine creation. Darwin had lost much of his own religious faith after the death of his daughter, Annie, in 1851, but his wife was a devout Christian; publishing could upset not only the greater
masses but his most loyal supporter at home. His theory, he wrote to a friend, amounted to “confessing a murder.”

It was competition that would finally push Darwin to publish his work. Charles Lyell, who had received Darwin's letter with Alfred Russel Wallace's correspondence, presented both scientists' theories jointly at a scientific meeting in July 1858—one month after Wallace's initial communication had arrived. It was a respectable solution that received surprisingly little notice and gave Darwin time to move forward honorably. Over the next year, he worked tirelessly to finalize his 500-page account. He also felt sick. As far back as 1838, Darwin had drawn a connection between his brain and his gut, writing that “I find the noddle & the stomach are antagonistic powers, and that it is a great deal more easy to think too much in a day, than to think too little.” Now, as he raced to the finish line in 1859, Darwin again attributed his physical distress to the strain of completing his “abstract,” as he called it, and he longed for it all to be over. “I have been extra bad of late, with the old severe vomiting rather often & much distressing swimming of the head,” he wrote to Fox. “My abstract is the cause, I believe of the main part of the ills to which my flesh is heir to.”

T
HERE IS A CRITICAL DIFFERENCE BETWEEN
fear and anxiety. Fear is like a guest who shows up without warning and leaves quickly; anxiety unpacks its suitcase, settles into your brain, and overstays its welcome. The difference comes down to real and imagined threats. Fear is a necessary part of our evolutionary makeup—a hardwired reaction to danger that compels us to run from a stampede of elephants or a tsunami and gives us the energy to do so. Our stress hormones spike, our hearts pump faster, our blood
pressure increases. Anxiety, which causes some of the same physiological symptoms, is all about perceived hazards, not ones that are actually staring us in the face.

Scientists have pinpointed the circuitry for fear in a cluster of neurons called the amygdala, located deep inside the brain. Studies have revealed that a damaged or missing amygdala changes the way an animal responds to peril. Rats with an impaired amygdala will hang out with a sedated cat—an animal they'd normally flee from—and even nibble its ear. Healthy monkeys placed in close proximity to a snake, real or fake, will withdraw, avoid eye contact, and take their time reaching for tempting food situated near the reptile, be it M&M's, Froot Loops, or cocktail peanuts (we
are
related!). Monkeys whose amygdalas have been surgically removed, by contrast, act uninhibited; they go after the treats quickly, despite the possible risk, and even show curiosity about an animal they would otherwise evade.

Human studies are equally intriguing. Several years ago, researchers tried to evoke fear in a patient whose amygdala was destroyed by a rare congenital disorder. They took the patient, known as SM, to a spooky Halloween tour at the Waverly Hills Sanatorium, formerly a tuberculosis infirmary in Louisville, Kentucky, which was said to be haunted by dead patients and medical staff. As other adult members of the group screamed with fright, SM smiled and laughed at the monsters that jumped out to scare her. She even startled one of them by poking him in the head. Later, she reported feeling great excitement—as if she were riding a roller coaster—but zero fear.

The scientists showed SM movie clips from horror films, including
The Shining
and
The Silence of the Lambs
; she found them entertaining, not terrifying. And even though she said she hated snakes and spiders, SM showed no apprehension when taken to an exotic
pet store, where she displayed an unusual compulsion to touch the animals, reporting that it was “so cool” to hold a slithering snake and feel its darting tongue. Her curiosity was so great, says Justin Feinstein, the study's lead author and a clinical neuropsychologist at the Laureate Institute for Brain Research in Tulsa, Oklahoma, that a store employee had to stop her from touching a tarantula so that she didn't get bitten.

It is well established that the amygdala acts as a warning system for external threats. Scanning the horizon like a searchlight, it sends chemical signals to other parts of the brain when danger is spotted. But as scientists unravel the science of fear, they are discovering that the amygdala's role is far more complex than originally imagined. It isn't, it turns out, the be-all and end-all of fear. This became clear recently when Feinstein and his colleagues put SM up to a different kind of challenge. Given her prior reactions, the scientists expected SM to respond without apprehension when they put a mask over her nose and asked her to inhale oxygen laced with carbon dioxide, a standard laboratory fear test. To the researchers' surprise, SM gasped for air, ripped off her mask, and had a full-blown panic attack. Her reaction turned out to be far more intense than most of the control subjects with fully functioning amygdalas; they had trouble breathing, but less than a quarter of them reacted with panic.

Feinstein's interpretation of these findings is that when a threat emerges
inside
the body—you breathe in bad air or feel pain in your heart—the primitive brain stem, not the amygdala, takes over. Not only that, when the amygdala is working as it should be, it may actually serve to damp down anxiety rather than ramp it up. This seems to be corroborated in other studies, which have found that people who suffer from panic attacks have a significant amount of atrophy in their amygdalas. If a damaged amygdala fails
to inhibit panic, Feinstein explains, the brain might overreact to things that aren't really that dangerous—a bridge or a crowd of people—and trigger a series of panic attacks that ultimately leads to a condition known as agoraphobia, an avoidance of places and circumstances where panic might occur.

Just as allergies manifest in different ways—hives, rashes, watery eyes, sneezing—anxiety disorders can appear in multiple guises, often in the same individual. The
DSM
lists 11 types of anxiety disorders, including panic disorder and agoraphobia as well as selective mutism (anxiety so severe a child cannot speak in school or other social settings) and the more common generalized anxiety disorder (pervasive and chronic worry about a variety of everyday issues). Today, Darwin's aversion to blood would likely fall into the category of a specific phobia; other common phobias include a fear of spiders, heights, and flying. Darwin was also apprehensive about public speaking, a classic feature of what is now classified as social anxiety disorder and characterized by extreme worry about being scrutinized and humiliated. In a letter to his son Willy, Darwin wrote that when he was required to read papers as secretary of the Geological Society, “I was so nervous at first, I somehow could see nothing all around me, but the paper, & I felt as if my body was gone, & only my head left.” At another time, he noted that speaking for just a few minutes at a scientific society meeting “brought on 24 hours [of] vomiting.”

In a report published in the
Journal of the American Medical Association
in 1997, two medical doctors concluded that Darwin suffered from panic disorder, an anxiety disorder marked by recurrent panic attacks. These attacks are characterized by a sudden onset of fear accompanied by severe physical symptoms that can erupt unexpectedly. Darwin experienced a range of features associated with panic disorder, the researchers wrote, including palpitations,
shortness of breath (which he described as “air fatigues”), crying, insomnia, abdominal distress, and feelings of imminent death. In the midst of a panic attack, it is not uncommon for people to worry that they are having a heart attack and are likely to die. The doctors also described Darwin's own accounts from his health journals—waking during the night feeling fearful and experiencing “swimming of the head,” trembling hands, and “attacks of sickness”—as experiences consistent with the condition. Darwin's illness “followed a waxing and waning course typical of the disorder,” the authors wrote. “His attacks caused him great distress and interfered with his work and social life.”

The doctors theorized that Darwin also suffered from agoraphobia, a Greek and Latin term that translates as “fear of open spaces.” The two conditions are often linked (until recently they fell under one diagnosis in the
DSM
), because people who have repeated panic attacks tend to avoid the places and situations that made them fearful in the first place—a bridge, a crowded theater, an elevator, or being alone. In Darwin's case, he actively shied away from public appearances, scientific meetings, and social interaction, because participating in these activities had a deleterious effect on his health. Soon after their marriage in 1839, Charles and Emma moved from London to Downe, where Darwin put stringent limitations on the time he spent out of his home. “During the first part of our residence we went a little into society, and received a few friends here; but my health almost always suffered from the excitement, violent shivering and vomiting attacks being thus brought on,” he later reflected in his autobiography. Darwin did communicate actively with family, friends, and scientists by exchanging some 15,000 letters, but his preference was to stay physically close to home with his wife by his side. “I dread going anywhere, on account of my stomach so easily failing under any excitement,” he
wrote to his cousin in 1852. His life was comfortable, he told Fox, but “it is the life of a hermit.” Even a major conference held to debate
On the Origin of Species
was too much for him. He wrote a note saying he couldn't attend because of stomach pain.

A series of landmark studies suggest that key features of anxiety, which runs in families, are detectable in the earliest days of life. In 1989, Harvard psychologist Jerome Kagan launched a long-term study in which he observed how a group of four-month-old babies responded to unfamiliar people and toys. Some of the babies remained calm and relatively unfazed, but about 20 percent had strong reactions—they cried, they pumped their arms and legs, they arched their backs. Kagan and his colleagues followed those babies for two decades and discovered that the highly reactive infants were more likely to be shy, cautious, and anxious children and adults.

Baby Darwin might have made an interesting research subject. In his youth, he exhibited physical symptoms—trembling, chills, shivering, and intestinal upset—in response to both pleasant and unpleasant events, according to Colp, the Columbia psychiatrist. He left a dog show early after seeing one of the animals react to its owner's reprimand, telling a friend, “I can't stand this any longer; how those poor dogs must have been licked.” After shooting his first bird, Darwin later recalled, his hands were trembling so much with excitement that he could barely reload his gun. Listening to music prompted such intense enjoyment “so that my backbone would sometimes shiver,” he wrote in his autobiography. Like the highly reactive babies in the Harvard study, Darwin responded to stimuli in a very physical way and may have been primed for anxiety from an early age.

He would have been in excellent company today. Anxiety disorders are the most ubiquitous of mental health conditions, affecting
some 40 million Americans. We live at a time when it's easy to become nerve-racked by the minute choices that freedom affords us (not just should I buy organic milk, but what
brand
should I buy?), by the economy, by terrorism, by the mobile devices that interfere with our sleep. Inner peace is clearly hard to come by, as confirmed by how many people are desperately trying to find it. Guess what ranks as the top psychiatric medication prescribed in the country? The anti-anxiety drug alprazolam, which goes by the brand name Xanax. In 2012 alone, 49 million prescriptions were written.