Nothing to Do but Embrace the Dread Alice James, the celebrated diarist and doted-upon sister of Henry and William, received a diagnosis of terminal breast cancer in 1891. She could not have been more delighted. Alice was 42, and her life had been crippled by a series of mysterious ailments: nausea, vertigo, cramps, spasms, fainting spells, fleeting paralyses. For years at a time she was a nervous invalid, staggering, as she put it, under a "monstrous mass of subjective sensations." After more than two decades of this vague but unremitting suffering, the solidity of the lump in her breast and the finality of her prognosis filled Alice with "enormous relief." No one would choose, she wrote, "such an ugly and gruesome method of progression down the dark Valley of the Shadow of Death ... but we shall gird up our loins and the blessed peace of the end will have no shadow cast upon it." The blessed peace of the end. For nearly 20 years now anxiety has been a powerful, often determining force in my own life, and the longer I live with the experience, the more this sadly exultant phrase strikes me as emblematic of one of the great dangers of the anxious life. I don't mean the danger of wishing oneself dead, although at anxiety's heights suicide can, indeed, have a terrible appeal. I mean the more subtle and insidious danger of wishing anxiety dead. I mean the hunger, which invariably comes over the anxiety sufferer, for a definitive conclusion to the sensation: a bright line, a capping off, a total defusing of the anxious charge. I mean the desperate allure of the endpoint. In a way, the desire to be rid of anxiety is neither unique nor difficult to understand. Like any other affliction, psychiatric or strictly physical, anxiety hurts. It is uncomfortable. If you suffer from emphysema, you will wish to be able to breathe unimpeded. If you suffer from eczema, you will wish for clear skin. And if you suffer from anxiety, you will wish for a mind that does not spin every slightest situation into catastrophe - a mind that approaches everyday life with poise, reason and equanimity. Why wouldn't you want such a thing? Why shouldn't a person's ideal be the very absence or opposite of that which torments him? It's only natural. With anxiety, however, there are two glitches to this desire. The first is that anxiety is not the kind of affliction that can be eradicated. This is because anxiety is not merely or essentially psychiatric. Even when it swells to the level of a disorder, it remains first and foremost an emotion, universally felt and necessary for survival, not to mention for a full experience of human life. Toss aside the bath water of anxiety and you will also be tossing aside excitement, motivation, vigilance, ambition, exuberance and inspiration, to name just several of the inevitable sacrifices. Get rid of anxiety? Even if you could - and you can't - why would you want to? The second glitch is more complex and has to do with the nature of anxiety itself, which for all its attendant discomforts and daily horrors has at its heart a vital truth, even a transcendent wisdom. This truth - which, confusingly enough, doubles as the source of anxiety's pain - is of the essential uncertainty and perilousness of human life. Its fragility and evanescence. Anxiety emphasizes these aspects of existence with an almost evangelical fervor. It hisses them, hour by hour, minute by minute, into the sufferer's ear. "Anything can happen at any time," anxiety says. There is no sure thing. Everything you hold dear is at risk, everything is vulnerable. It can all slip through your fingers. And of course this is right. It is undeniably right, as every practical philosophy from Buddhism to existentialism acknowledges. That is why anxiety continues for many to carry a frisson of superiority. Last year I published a book about my difficulties with acute anxiety, and it is the rare public appearance in which someone does not ask me, "Do you think there is a relationship between anxiety and intelligence?" I always answer, jokingly, "I think there is a relationship between anxiety and genius!" In fact, I do not think there is a relationship between anxiety and intelligence. Anxiety, like the most effective parasite, is indiscriminate in its choice of host. It plagues the ignorant and dimwitted as well as the brilliant and clever. But its message, of contingency, of risk, of skepticism, of flux: that is never dumb. Anxiety's message can never be waved away. And yet that - waving away - is precisely what the anxiety sufferer is always trying to do to anxiety's message. Tortured as he is by the truth of uncertainty, he develops an adversarial relationship to that truth. He loathes it. He fights it. He refuses it. He wants it dead, silent, gone. He wants it to end. This is where the danger creeps in, for there is no surer way to compound anxiety's power than to reject it outright - to yearn, as Alice James did, for something concrete to counter anxiety's relentless ambiguity. I've gone this way. I've gone this way for years at a time, hoping beyond reason for some panacea - the right job, the right partner, the right city, the right therapist, the right home, the right friend - to snap my constitution into stable order. And I can tell you that the search is worse than useless. Like the ropes that tighten around your wrists the more you struggle, the discomfort and confusion of anxiety deepen the more you try to elude them. The harder you fight, the farther you fall. Not even modern pharmacology, in my experience, has the power to arrest this pattern. I've taken the drugs and still take them. They are useful. They have shaved the peaks off my anxiety - or, to flip the metaphor, they have served as a net in anxiety's well, protecting me from plummeting into the full depths. They have turned crippling anxiety into chronic anxiety. Beyond that, they have effected no miracles. Through a decade of dutiful pill-swallowing, my anxiety has survived and sometimes flourished, tailing me through periods of good fortune and bad, weighting my life, complicating and even damaging the relationships with the people I love, and most profoundly, my relationship with life itself. By now I have met and corresponded with hundreds of people who struggle with anxiety - enough to conclude that my own experience, while maybe not the rule, is certainly representative. Enough to know, also, the terrible despair that accompanies the condition. Tortured by an uncertainty that manufactures its own nourishing desperation, what is the anxiety sufferer to do? Is there any way out? Or is the sufferer fated, like Alice James, to find relief only in the "blessed peace" of the end? I have also lived with anxiety long enough to conclude that James had a point. The value and necessity of anxiety mean that it will persist until the last breath. It is impossible to extinguish, no matter the level at which it affects you. If you are one of those unlucky souls whom anxiety affects profoundly, however, you might just be able to find relief, and even redemption, in this very impossibility. For what is the message that everything is fluid but its own solid fact? What is the relentlessness of uncertainty but something about which you can always be certain? And what other choice do you have? The wisdom is already ringing in your ears. You might as well listen. You might as well submit. It won't get you out, but it will without a doubt get you through. This is the final installment of Anxiety. Share your thoughts about the article in the comments section. We will feature a selection of them in a post next week. Daniel Smith is the author of "Monkey Mind: A Memoir of Anxiety." He teaches English at the College of New Rochelle and writes about anxiety at his Web site, The Monkey Mind Chronicles.