The Age of Anxiety: A History of America's Turbulent Affair with Tranquilizers

by Andrea Tone

Anxious Americans have increasingly pursued peace of mind through pills and prescriptions. In 2006, the National Institute of Mental Health estimated that 40 million adult Americans suffer from an anxiety disorder in any given year: more than double the number thought to have such a disorder in 2001. Anti-anxiety drugs are a billion-dollar business. Yet as recently as 1955, when the first tranquilizer—Miltown—went on the market, pharmaceutical executives worried that there wouldn’t be interest in anxiety-relief. At mid-century, talk therapy remained the treatment of choice.But Miltown became a sensation—the first psychotropic blockbuster in United States history. By 1957, Americans had filled 36 million prescriptions. Patients seeking made-to-order tranquility emptied drugstores, forcing pharmacists to post signs reading “more Miltown tomorrow.” The drug’s financial success and cultural impact revolutionized perceptions of anxiety and its treatment, inspiring the development of other lifestyle drugs including Valium and Prozac.

In The Age of Anxiety, Andrea Tone draws on a broad array of original sources—manufacturers’ files, FDA reports, letters, government investigations, and interviews with inventors, physicians, patients, and activists—to provide the first comprehensive account of the rise of America’s tranquilizer culture. She transports readers from the bomb shelters of the Cold War to the scientific optimism of the Baby Boomers, to the “just say no” Puritanism of the late 1970s and 1980s.

A vibrant history of America’s long and turbulent affair with tranquilizers, The Age of Anxiety casts new light on what it has meant to seek synthetic solutions to everyday angst.

Genres: History, Psychology, Nonfiction, Medicine, Mental Health, Science, American History

320 pages, Hardcover

First published January 1, 2008

Reviews

[Skostal · Rating 3 out of 5]

Initially this appears to be a very scholarly book on the American view of anxiety and a pharmacological history of tranquilizers. But the book misses on several counts. While the author spends a great deal of time on the women's movement, she never makes the call as to whether she believes women are more prone to anxiety or hysteria, or whether they are legitimately depressed and anxious as a repressed group in society. And she completely misses the importance of the role insurance companies play. Insurers will reimburse for prescription drugs, but often do not cover alternative therapies (talk therapy, relaxation training, yoga, gym memberships, etc.) that go a tremendous distance in relieving anxiety. Also, with the advent of deinstitutionalization, tranquilizers and other drugs allowed people to live outside a structured medical setting. She spends far too much time discussing Miltown, the first tranquilizer to hit the American market, and its cultural effects, and far too little on follow-on drugs. Though heavy with end notes, there is too much about what users wrote in letters to the FDA, and too little from more knowledgeable sources, such as the American Medical Assn and the American College of Neuro-Pyschopharmacology. Relying on the records of others, such as Congressional testimony, live interviews from former surgeon generals, for example, and their hindsight, would have added much.

[Arwen Downs · Rating 5 out of 5]

This was an enlightening book, covering not only the history of the United States' great love of tranquilizers of all kinds, but the development of said drugs and the correspondence of an overwhelming national feeling of anxiety with the rise of tranquilizer use.

In addition, Tone's writing style is entertaining and her objectivity when dealing with such a polarizing subject as psychopharmacology made the book ring true in a way a more damning or effusive book would not.

All-in-all, a perfect nonfiction work for summer vacation!

[Kim Fay · Rating 4 out of 5]

It's been an interesting year, researching anti-anxiety drugs for my new novel. Beating out "Happy Pills in America," "The Age of Anxiety" is the best book I've found so far on Miltown, the precursor to Valium and the granddaddy of all anti-anxiety meds. At one time in the 1950s it was the most prescribed pill in America. I liked this book more than Happy Pills because it was not written in such an academic (dry) manner (even though it is clearly a scholarly, well-researched book). "The Age of Anxiety" explores why America was prime for an anti-anxiety medication explosion in the middle of the twentieth century and how this explosion was fueled by so many different factors: lack of FDA regulation, patients self-dosing, doctors seeing positive results, advertising, a deceptive lack of information about addiction on the part of pharmaceutical companies. Of course, the fun stuff is the social history: Milton Berle used to call himself Uncle Miltown, and it was fashionable to serve Miltinis at parties - martinis with a Miltown rather than an olive. One of the things I liked best about this book is that author Tone doesn't feel the need to damn anti-anxiety medications such as Miltown, Valium and Librium. In fact, she even shows in some instances how a backlash against these drugs was harmful to those who truly needed them.

[Rena Sherwood · Rating 2 out of 5]

I suppose it's only fair that a book about tranquilizers is, in itself, tranquilizing. The small print, the dry tone of voice and the masses of endnotes just adds to the soporific effect. Pull up a pillow, crack open the book and lights out, everybody!



My Mom takes tranquilizers and I wanted to know more about them, which was why I picked this book up from the library in the first place. After reading this book, I'm still wondering about tranquilizers but I know scads about Milton Berle jokes on Miltown, the sexist nature of tranquilizer advertising and that Andrea Tone had a huge crush on the inventor or Miltown.



Sadly, there is hardly anything about Xanax or more modern-day tranks. The emphasis is on advertising, news and magazine articles about tranquilizers from the 1950s to the 1970s. Withdrawal symptoms are hardly talked about and addiction is mentioned but not gone detail nearly as much as how these medications were advertised and why Miltown went belly-up.

[Steven · Rating 4 out of 5]

A nice overview of the development and social history of the new tranquilizers of the 50s and 60s (Miltown, Valium, Librium, Klonopin, etc.) and how they shaped American attitudes towards mental health and the concept of addiction.

Tone does an excellent job of covering the development, personal stories, cultural attitudes, and marketing strategies surrounding these drugs. I appreciate how she was able to smoothly integrate all these approaches into a quite understandable narrative.

Two of her themes are especially notable. First, how these anxiolytic drugs ,once known as aides to the overworked, anxious executive in the 50s and early 60s, morphed into the "mother's little helper" of later decades. Secondly, the changing attitudes toward tranquilizers from essential aides to negotiating hectic modern lives to dangerous addictive mind-numbers.

A great overview.

[Heather · Rating 4 out of 5]

I read this book as research for an article I am writing. I needed a historical perspective on tranquilizers in America. I greatly appreciated Tone's writing, particularly how she placed the prevalence of tranquilizers in a historical context. For example, Miltown, the first commercial tranquilizer, came onto the scene during the Cold War when national anxieties were high. But, she didn't just blame the rise of tranquilizers on global unrest. She also addressed the pharmaceutical industry's financial incentives to market tranquilizers to a large number of people, the political and cultural climate that was at one time in denial that prescription drugs could be addictive, as well as people's demand for drugs "just to feel normal."

I thought it was an interesting read that did not shy from addressing the complexities of the business of anxiety in America.

[Ed · Rating 4 out of 5]

Tone has provided us with a readable and scholarly narrative of the creation of anxiety as a diagnosis and its relationship to the medications used to treat it. In addition to her command of the technical literature she conveys cultural significance of anxiety over the last sixty years with clarity. I especially appreciated the biographical material, based on interviews, on Frank Berger (Miltown) and Leo Sternbach (Librium). Although brief, her descriptions of the place of benzodiazapines in France and Japan highlighted just how culture-bound our reactions to medications are.

[Socraticgadfly · Rating 4 out of 5]

Before Valium, there was Librium. Before that, there was Miltown, the first modern tranquilizer, the first move beyond the old barbiturates.

Tone details America’s love affair with these magic pills which, stereotypes of overworked housewives aside, were first most eagerly adopted by CEOs and other corner suite persons.

There’s no earthshaking findings here, just a good overview of a period in American history.

[Russianwitch · Rating 4 out of 5]

It's an easy read which breaks a difficult subject down to social and economic aspects of the problem painting the general situation and the influences which had the most effect on the "problem".
The language is clear and effective the examples very descriptive.
The book also gives good leads for those who want to examine the culture of tranquilizers in the US further.

[Pat · Rating 3 out of 5]

Thought provoking look at the myriad of treatments for anxiety over decades, how the definition of what constitutes anxiety has changed, the role that politics, consumerism, ethics, women's movement, big Pharma, etc. has played and continues to in the "war on drugs" and society's handling of our collective dis-ease.

[Barry · Rating 4 out of 5]

Andea Tone supplies good insight on past history of Tranquilizers and how the drug companies promoted them

[Ariel · Rating 4 out of 5]

fascinating

[Ilana · Rating 5 out of 5]

Well written, thought provoking and great conversations brought up by this work.

[Rhi · Rating 4 out of 5]

I heard about this book on the podcast /You're wrong about/, and like that show, it is well-researched and engages deeply with the human in small moments that shaped public discourse, perception, and direction of growth.

The book focuses on the beginnings of the minor tranquilizer industry with Miltown, though it does continue through to the 90s. While several other reviews that I scanned past found this a soporific or poor choice, I think that it really does what it intends to do, which is to show the striking of the match: the bright flare of sulfure and potassium chlorate more than the slow oxidation of the stick of wood. I found this first part of the book to me both the most engaging and the most illuminating in terms of US national relationships to both the pharmaceutical industry and mental healthcare.

It is eminently worth the read. The book pulls from diverse primary sources: letters to the FDA, company communications and advertisements, documentation from congressional hearings, etc., as well as being substantially sourced with academic literature.

[Sara · Rating 3 out of 5]

This was an interesting and surprisingly in-depth history of traquilizers in America--and the concomitant rise of the pharmaceutical industry's power in marketing and cultural influence. While I could have done without some of the granular details on how various pharma companies developed meprobamate and benzodiazapines, it was still a good primer on how these things were brought to market. More interesting to me was how the culture and media interpreted the rise and fall of tranquilizers, which Tone details in the final chapters more thoroughly than elsewhere (though I was fascinated by Miltown's cultural cache in the 50s).

[Terry Slaven · Rating 5 out of 5]

This is an exhaustively researched and extremely well-written medical history of the ascendency of pharmaceutical approaches to psychiatry in the United States covering the period from the end of World War Ii through the aftermath of 9/11. One could only wish that the author would update the story and its lessons to cover the period of the COVID pandemic.

[Tamsin Lorraine · Rating 3 out of 5]

Interesting topic but I found the writing style a little heavy

[Autumn · Rating 3 out of 5]

I learned alot about tranquilizers from this book. It really is just a history but she writes well so it is easy to read.

[Chelsea K · Rating 4 out of 5]

3.5 stars.

[Sandra Ross · Rating 5 out of 5]

I read this book as part of the research for a new blog post I've been formulating and writing over the past couple of weeks to discuss the impact of widespread prescription abuse and addiction to, for lack of a better overall, if not at all accurately descriptive, term, mood-altering medications on the probability of eventually developing a lifestyle dementia.

Having never taken any of these kinds of medications myself - they both terrify me and I personally believe that our natural neurological chemical responses were designed to serve as warnings and indicators we have that increasingly (to the point of being overwhelming at times) urge us to stop, leave, or change whatever is causing them - but knowing that they have become ubiquitous in modern life, I still was surprised by this book.

Tone has done her homework. She shows how pharmacology became entrenched in American culture beginning with the development of minor tranquilizers in the 1950's to replace, as a supposedly benign, non-addictive, and safe mood stabilizer, the more dangerous barbiturates (which factored prominently in the deaths of Marilyn Monroe, Judy Garland, and Elvis Presley during their heyday).

Everybody, it seemed, took them and they were publicly and openly endorsed as an essential part of living and achieving the American dream. These medications were cheaper than traditional psychotherapy, achieved almost immediate results (as opposed to the long-term results of the psychologist/patient relationship that psychotherapy by its nature engendered), and seemingly did no harm.

Tone shows how the Cold War era in the United States - and the high anxiety it produced in most Americans - was the perfect environment for the introduction and continued development of prescription tranquilizers (Librium, Valium, Xanax, and Paxil, among many others whose names are commonplace now, are in the class of medications).

With these tranquilizers came the development of Big Pharma as we know it now. These medications were heavily marketed to both doctors and the public with advertising budgets that were huge, "detail people" (pharma sales reps) who courted doctors with money and stuff in exchange for more prescriptions, and, as a result, primary care physicians - who did not (and do not even today) understand the ins and outs of brain chemistry and addiction - replaced psychiatrists as the main prescribers of these brain chemistry-changing drugs.

It was not until the late 1970's and early 1980's that the nefarious dark side of these medications became apparent: when people tried to stop taking them, often cold-turkey, and leaving permanent - and sometimes fatal - damage (physical and neurological) in their wake.

However, despite this, Big Pharma and PCPs continue to promote these medications freely and without hesitation or caution (and they are still big moneymakers for Big Pharma) for a large segment of the American public. It seems that, for all concerned, including consumers, being comfortably numb is more important than preserving the brain and actually living life, navigating with full consciousness through the ups and downs, the good, the bad, and the ugly, and the inevitable stress that being alive brings, and in the process, which can often be very painful, learn and grow into a better version of ourselves.

Personally, I'd far rather endure the pain, no matter how great it is, than to be on perpetual mute and miss what is the actual point of living altogether.