Apr/May 2009

Sedation Nation

Choire Sicha


In 1945, the United States had its first atom-bomb test; in 1949, the Soviets blew up one of their own. These events inspired, most immediately, what the newly Americanized W. H. Auden described as “The Age of Anxiety”—and, more recently, Dr. Atomic, the most boring and worthless John Adams opera imaginable. Did anyone relax at all between Auden and Adams? Yes: on drugs.

Now we Americans, as Andrea Tone writes in her own The Age of Anxiety, are more likely to see a doctor for anxiety than for back pain or migraines. Tone is a professor in the Department of Social Studies of Medicine at McGill University. Her excellent book, as a result, reads like half an excellent book. Don’t you wonder whether academics ever think, “Hey, I’ve done all this awesome reporting and research—maybe I should write so as to encourage people to read this”? She could have packaged it after Mark Kurlansky’s Salt or as a Malcolm Gladwell treatise, simply by calling it Downers.

But the college book marketplace is quietly dependable, and academics, despite the ’90s flirtation of queer and feminist theorists with coolness and actual readers, would never dream of having spots on the front table at Barnes & Noble bought for them— or of writing for a large audience. That’s particularly unfortunate, because this book is a strong historical account of the most important topic of our interior lives—and noninterior as well: Tone notes early on that “a cold war political establishment . . . ceaselessly reminded its citizens of the need for collective calm.” That calm came then and comes now in handy pill form.

Miltown was invented in 1950 and went on the market in 1955; by 1956, “an astounding one in twenty Americans had tried it.” Latter-day brand-identity consultants must cringe at its name, but its magic success ushered in our present era of ads that remind us, “Ask your doctor about . . .” The drug was discovered by a socialist-empathizing Czech Jew who had become fascinated by the idea of a new class of sedatives after accidentally relaxing many mice while researching penicillin preservatives. (It was named for Milltown, a sleepy hamlet in New Jersey.) At first, the pertinent experts didn’t even know how to categorize this sort of drug. “The world needs tranquility,” said a psychiatrist to the drug’s inventor, and there you go: the tranquilizer.

The new era of marketing anxiety created anxiety for the marketers. Miltown was licensed to another company, repackaged as Equanil, and rebranded. While Miltown was made famous through a sturdy Hollywood clientele and sketches on The Milton Berle Show, Equanil promoted itself with ads that quoted Macbeth. Miltown’s people fought back, with panache. They commissioned Salvador Dalí to create a quite peristaltic sixty-foot-long walk-through cocoon that apparently conveyed being liberated from anxiety. Aldous Huxley freely trumpeted the drug.

Miltown had plenty of company on the “lifestyle drug” market. In 1954, thorazine was approved for use in the United States. In 1957, Marsilid, the first monoamine oxidase inhibitor, went briefly on the market. In 1960 came the brilliantly named Librium; three years later, Valium made its debut. (The inventor of both, Leo Sternbach—who later created the very delicious Klonopin—received a mere $20,002.) Tone notes that Valium was the most widely prescribed drug in the Western world from 1968 to 1981. Of course, Judy Garland died in 1969, and Jimi Hendrix died in 1970, as did Canned Heat guitarist Alan Wilson, all having taken barbiturates—1970 also being the year the Controlled Substances Act was signed into law.

Along with the explosion in chemical treatments came shifting views of the condition of anxiety—though Tone isn’t always clear on how they originated or why they took hold. In the ’50s, “neurosis was fashionable”—but in the ’70s, anxiety became “a problem to be medicated and concealed.” That changed again, perhaps in the mid-’90s, but the reader is largely left guessing why.

The source material grows exponentially greater as the present day nears, and the book’s narrative and search for bigger meanings become unmanageable. Betty Ford is publicly in rehab in 1978; Xanax appears in 1981, big momma Prozac in 1987. A “well-funded educational and advertising campaign to publicize anxiety disorders” is mounted by any number of outlets, notably Cohn & Wolfe on behalf of GlaxoSmithKline promoting social anxiety disorder and Paxil. Documenting this is Tone’s greatest public service.

But such material comes across disjointedly and therefore makes it hard to figure out where are we now. Despite a brief section on September 11 and recent marketing, the history and meaning of drugs in the ’00s remain vague. What we all know anecdotally to be true is that there’s a mess: millions of Americans, including teens and tweens, parked on drugs, for reasons alternately good and bad, some with and some without a doctor’s clear intention and directive. Some of us are medicated to avoid the horror of existence, which is unfortunately not a medical condition. What social injustices and evils do we tolerate or ignore due to our six decades of heavily prescribed tranquility?

To answer that question would mean treating anxiety as something more than a free-floating cultural signifier. Tone’s book, for all its great reporting and incisive treatment of the origins of the modern neurosis industry, only gestures toward the broader implications of a mass-medicated citizenry. That’s a bit nerve-wracking.

A former editor at the New York Observer, Choire Sicha is a regular contributor to the Los Angeles Times

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