Topics include therapy, medication, depression, anxiety & more. Each installment takes the form of an essay or interview.

Our complete list of conversations, including:

Pixelated, the digital, double-blind, lit-inclined author chat

A Bit Contrived, interviews with real authors about improvised books

The Art of Commerce, exploring the intersection of literature and the market

Episode I: An interview with Andy Weir

Published 7/13/15
In this installment, Andy Weir talks about anxiety.

I'm here with Andy Weir, author of The Martian, his debut novel—and soon to be a major motion picture starring Matt Damon and Jessica Chastain. Andy was also part of our series Pixelated with Edan Lepucki. You mentioned to me that you have suffered and do suffer from anxiety problems. Anxiety can take many shapes, and mean very different things to different people. What does anxiety mean to you, and when did yours start?

I've had problems with anxiety my whole life. It's a common issue in my family. Even as a kid, I'd get worried and worked up about stuff that didn't matter. I've had a pretty easy life, no trauma or anything. So I don't think it's a psychological root. I think it's just how I'm wired. 

Basically, I'm a worrier. I will imagine the most bizarre and unlikely scenarios and worry that they might happen. And it leads to a confirmation bias. When unlikely things do happen, I remember it forever. I have an irrational feeling deep down that I'm some kind of nexus for statistical anomalies. 

So when people say "the odds of that happening are astronomically low" my gut reaction is "my whole life has been astronomically unlikely things happening to me". So, despite my deep love of science and rational thought, I still can't overcome my irrational fear that statistics don't apply to me like they do to everyone else. 

So I worry. I worry that I'll die in a plane crash if I fly. I worry about every health problem I have, no matter how minor, because I assume it's cancer until proven otherwise. 

It took control of my life. I was finally able to combat it with therapy and medication and my life has improved significantly. 

What brought you to therapy? Was it a single event or just the feeling that you were done with anxiety? Did you have any prejudice against therapy or medication before you started them?

I tried therapy many times in the past, but (and this is just my own analysis) the science hadn't caught up with my problems yet. When I was in my 20s, the general approach to treating anxiety was to say "suck it up, worrywart" so it always ended up being ineffective. For me, anyway. 

Then my book got published and became a huge success. You'd think that would make me happy, but actually it just played into my irrational belief that abnormal probability follows me around. The complete change in my life that ensued, including leaving my day job and going full-time on writing, was difficult for me. I was at extremely heightened anxiety pretty much all the time. 

NASA invited me to Houston for four days of VIP tours. And I really, *really* wanted to go. But it was in Houston. That's a four-hour flight from where I life, and a 30+ hour train ride. I decided I had to fly. 

So I got therapy. Again. I was dubious at first, because I've had so many failures in the past. But I was happy to discover they do things very differently now. I saw two doctors. One for therapy, and another for meds. They put me on Sertraline for long-term anxiety treatment. It took weeks to start having an effect but it definitely worked. 

Then there was the problem of the sheer, blinding panic I get when I'm on a plane. I knew a general anti-anxiety med wouldn't work. I also knew from previous attempts at flight that Xanax, Lorezepam, and Clonopin didn't work. So this time my doctor had me take Valium. 

And it did the trick. I didn't like being on the plane. I was uncomfortable and nervous. But not sheer, blinding terror like in the past. 

I'm curious how you mean by "they do things differently". What things in particular were useful to you?

On the topic of medication, there's a stigma against them, especially for people in creative fields, because it might "cut your edge". Was this a concern for you? Did you find any truth to it?

Well, twenty years ago or so when I sought help for anxiety, they were only interested in therapy. There was a plenty of phrma treatments for *depression* but not for anxiety. At least, not the treatment that I ended up with. 

Therapy always ended up being relaxation exercises, meditation, breathing control, etc. It helped a tiny bit, but only a tiny bit. It was like throwing a bucket of water on a forest fire. 

What really made a difference was the Zoloft (Sertraline). It's not a magical cure-all or anything and every case is different. But for me, my life quality went up significantly once it started kicking in. There's no epiphany moment where things get better. I just slowly got less anxious over time and started to feel normal more often. 

Also, there's a strong resistance in the psych community against prescribing short-term meds like Valium. With good reason, people get addicted to them easily and abuse them. I understand that, but I only take it for flights, which happen once or twice a year. 

I felt frustrated having to "work my way up" through ineffective medications until I got to short-term relief that actually works. It's like when you call tech support for a software problem and you have to go through thirty stupid questions like "is your computer plugged in" before you can get to the meat of the problem.

Stigma: I don't feel any stigma about it. I understand that others do. It's private information, of course. But I'm not embarrassed to have treatment.

I am embarrassed and sometimes ashamed that I have the problem in the first place. Everyone else seems to be able to keep their shit together without needing special help and I feel bad that I can't do the same.

But that's insecurity about my own personality, not any sort of embarrassment about seeking treatment.

I assume you feel Zoloft hasn't affected your creative output in any way? How about your relationships—do you feel your anxiety got in the way in any manner, and that your treatment helped that, or was it always strictly an internal battle?

Ah right, I forgot to answer that question earlier. Zoloft has such a subtle effect I can't honestly tell if it's affected my creativity at all. I don't think so, though.

My anxiety has definitely gotten in the way of relationships. I haven't been able to have or maintain a long-term romantic relationship, ever. I've never had a relationship last longer than 6 months. I still haven't gotten past that; it's a big hurdle for me. The Zoloft may help there, but I honestly haven't even tried to address it.

I find it incredibly interesting that you conflate the good anomalies and the bad anomalies; you are the "nexus for statistical anomalies", as you put it. I think there's something there about the inherent condition of being a writer. On some level, if you're a creator, you must have the confidence in your unique voice and perspective, and the feeling that only you could make your art. But that sort of confidence has an underside, it's naturally a very lonely proposition. Have you ever connected with another artist over the issue, or spoken to someone going through something very similar? Do you find your artistic role models as having similar dispositions (as much as you can know)?

I haven't connected with any other writers on a close enough level to have that kind of conversation with them. I don't really know the personal lives of my role models. I'm more interested in their bodies of work.

Do you feel as though the underlying biological facts that contribute to your anxiety have also been a requisite for you to be able to produce the work you have? Just from The Martian and your episode of Pixelated, I know you know a lot about 'how things work', and can balance that well with seeing the forest for the trees. I might make the connection that this attention to detail, and to putting things together in a metaphysical way, might make up the components of your anxiety—but I'm not you. Do you think I'm off base here?

I don't know. It may have contributed in a way. Being a worrywart gives me an attention to detail that I might not otherwise have. But that's still there. I still come up with the same worries as before the meds. They just don't bother me as much.

If you could give yourself advice about your anxiety when you were, say, twenty-five, what would it be?

I would tell younger me to seek help and be persistent. To ask about pharmaceuticals that might help. One of the biggest challenges for me was hopelessness. I didn't think there was any way I could actually change, and didn't believe meds would have any effect. I assumed the anxiety was a core component of my personality, not a physiological problem.

One last question: if there's one stigma associated with anxiety or mental health in general that you'd like to put away, what would it be?

The main problem is the belief that seeking help means you're a failure. If other people want to consider it strange that you need help, that doesn't matter. Your medical privacy is assured by the system. There's no reason they ever need to find out. But to anyone who has a problem: YOU have to understand that seeking help is okay and you have to be willing to accept it.