The XX Factor

Why Is the New York Times Scared of Anxiety Disorders?

Do not speak to me of such things

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Agh, stomachaches are the worst. You forget how miserable they are until you get one and can’t fathom what karmic tripwire you stumbled over to deserve all the pain. The most dismal kind descend out of nowhere, sending you mentally scrolling through your most recent meals, all the potentially contaminated surfaces you’ve touched…or maybe the pangs arrive, like clockwork, before big tests or speeches. Either way, stomachaches and anxiety are no strangers to each other. The latest proof of their acquaintance comes courtesy of the New York Times, which reported Monday on a possible link between chronic stomachaches in childhood and anxiety disorders in adulthood. Writes Catherine Saint Louis:

Researchers at Vanderbilt University tracked 332 children with recurring stomachaches that could not be traced to a physical cause — so-called functional abdominal pain — comparing them as they reached young adulthood with 147 children who had never had such stomachaches.

About half the teenagers and young adults who had had functional abdominal pain as children developed an anxiety disorder at some point, compared with 20 percent of the control group, the researchers found. The vulnerability to anxiety persisted into adulthood even if the pain had disappeared, although the risk was highest if the pain continued.

The piece goes on to quote one of the study’s authors, Lynn S. Walker, saying that most people assume the physical pain caused the emotional distress. Walker doesn’t quite buy it: “We found even if the pain went away, these adolescents and young adults still have anxiety,” she said. Sure, early abdominal ordeals might leave psychic scars, sowing the seeds of a mental disorder later in life. But there is another, even more obvious explanation for the research results: Anxiety could be causing the stomachaches.

The New York Times article carefully tiptoes around this interpretation, refusing to utter it outright and including plenty of hedge-y quotes. We hear from Miranda van Tilburg, an associate professor of medicine at the University of North Carolina School of Medicine, who “[cautions] parents against leaping to the conclusion that a child’s unexplained stomach pain is ‘all anxiety based, because we don’t know that.’”

“The take-away message should be you should not be afraid, if your doctor talks to you about anxiety in your child, to seek help from a mental health professional, because it could help your child feel better,” Dr. van Tilburg said.

Such a referral is “not an admission that that’s what’s causing the pain,” she said. “It’s just an admission that anxiety is linked to the pain.”

Don’t be afraid! You aren’t “admitting” anything by taking your kid to a psychiatrist. There’s probably another explanation. Why all the tap dancing here, as if a pre-existing anxiety disorder were somehow unmentionable, or something to be ashamed of? Is it really more reassuring to think a mysterious physical ailment is paining little Stuart than to contemplate the idea that he struggles with anxiety?  

Monday’s NYT piece is not the only recent story to propose an overlap between physical and emotional anguish. But James Hamblin’s column for The Atlantic, “What’s Tylenol Doing to Our Minds?,” is refreshingly straightforward. Hamblin discusses a study implying that Tylenol—a painkiller previously shown to ease the sting of social rejection—also blunts existential despair. Test subjects who took two Tylenol were less likely to make harsh moral judgments after watching a disconcerting video than those who received placebos. (Researchers have found that people experiencing Nietzschean angst tend to cling to austere ethical codes, in the hopes of reorienting themselves.) The piece accepts that mental and physical pain systems are interlaced—that a prick of worry and a headache can light up the same neural pathways. It accepts that the headache isn’t always primary. And implicit in that acceptance (which sounds far better than an “admission,” don’t you think?) is the idea that a psychic twinge is just as legitimate as a physical one, rather than something one must skirt around or apologize for.