I’ve hinted in multiple social media posts that I have an anxiety disorder. I’ve posted pithy phrases and click-worthy internet articles that talk about how people who suffer from anxiety see and view the world, but it’s all been at a safe distance.
Let me tell you my story.
I attended graduate school shortly after getting married. I was teaching ten contact hours (Organic Chemistry Lecture plus two labs), taking nine hours of graduate courses (full time for a grad student in Chemistry), and researching as much as possible for a brand new advisor. (Translation: out to make a name for herself and demanding high outputs of research/publishable work.)
I was on a trip to Oklahoma with my ex, when I suddenly felt as though I was having a heart attack. I couldn’t breathe. My heart was pounding. I had flop sweats. I had Sarah rush me to the nearest doc-in-a-box, and they transported me to a hospital. Heart disease runs on both sides of my family, so even though I was just twenty-five, it was reasonable to assume I might be having an issue.
After a tense night in the hospital where I was telemetered like a space shuttle, they found nothing wrong. Quite the opposite, in fact–I was extremely healthy. The ER doc gave me a diagnosis of “panic attack” and suggested I seek counseling and pharmaceutical help.
For nearly a year after that, I refused. I thought it was all in my head. I worried about the stigma that came with it. I worried that I would lose my “edge” and that medication would dull me or change my personality.
I finally sought help when I sat in my research lab (computational chemistry) and went nearly catatonic after completing an exam. I couldn’t move. It was like I had completely locked up–the biological equivalent of a blue screen of death. I finally managed to pull myself together and schedule an appointment with a family physician who dealt with issues similar to mine in his practice.
I started with a low dose of Lexapro, an SSRI, and after I acclimated to the medicine, it did seem to help. My lows weren’t as low. I was never “high” or manic; I was constantly in a state of fight-or-flight until my brain had enough and shut down. I had consistent break-through anxiety, even with the treatment.
I did this for years, wearing a mask of inauthenticity. At times, my anxiety and the corresponding depression would come out, and it would be ugly. I was so full of bile and self-hatred that it hurt those around me to hear it. Nothing I did was right; nothing I did could ever meet this false standard of perfection to which I held myself. Facts didn’t matter though; I told myself I was a failure because I had to chemically modify my brain chemistry to function at an acceptable level.
I tried counseling with a wonderful therapist for a couple of years. I got somewhat better, but I never really learned to be comfortable with me. You see, I have this nagging train of thought. Because thoughts for me can’t exist without context, sometimes they sound like my mom; sometimes they sound like my ex-wife. Sometimes they sound like a friend, and sometimes I can’t tell who it sounds like. Regardless, this voice continually tells me how inadequate I am. It tells me that people don’t really want to be with me, and that I have nothing to offer anyone.
Fear builds when you’re constantly having this in your head.
I thought I had finally defeated this thought life, but what I found is that it had grown more insidious. Where I used to swear at myself and call myself names, where I used to internalize all the bullying and slights that I endured as a child/teenager, I found myself replacing it with fear-based decision making.
I resumed my counseling (with the same therapist), and began to really work on me. It’s funny, for a while, I still worked on the wrong things. I had a recipe for a wonderful cake, and I spent all my time on the frosting. I still was working on the outside–honing my skills at wearing a new mask, because my other one had failed so spectacularly.
I feared an outcome, so I made decisions to avoid the outcome. I was feeding this monster that I had built for myself with every bad decision. Each new decision made the monster grow into greater and greater kaiju-sized proportions. I finally couldn’t deal with it anymore. I had been lying to myself for so long that I didn’t know how to deal authentically with myself, but I knew I had to try.
I’m still trying. I’ve added another medicine to my regimen. I exercise (not as well lately) like a fiend, I eat fairly well, my weight is under control. I meditate some and should do more.
It’s taken me thirteen years of managing this disease to learn that I can’t afford to lie to myself. “That’s obvious,” you might say. Yeah. It is. And yet, when you’re in fight-or-flight all the time, you make shit up to get through it. You plan for contingencies; you expect the worst. If it comes true, well then you were justified in your planning. And the one time out of ten that the worst actually does come to pass eclipses the nine times that it did not.
It’s also taken me thirteen years to realize the impact that this disease has on the people around me. You can’t constantly ask people to defend themselves against irrational fears without it taking a toll on them. You can’t continually demand/plead for authentic affirmation–if it’s coerced, then its not real. Doing these things to assuage the moment-to-moment fear and depression is like a band-aid for a concussion. Yeah, the band-aid is vaguely a medical intervention, but it isn’t really going to help in the long term. You have to put in the work on yourself to justify someone’s investment in you. I hate to put it in those terms, but I’ve learned that most people consider relationships to be transactional. It’s the human experience.
Let’s talk some specifics about the people around us. When a person suffers from anxiety and depression, people in their circle need to realize a couple of critical things:
- You can’t just use a magic switch and change your thought life. In my case, those thoughts are driven by experience, personal trauma, and years of self-teaching. Telling someone that they SHOULDN’T feel that way doesn’t help. I know I shouldn’t feel that way…and yet I do.
- Even those who have done the work of intense therapy and remain steadfast in their commitment to medical treatment will still have days, episodes, and triggers. I’m not talking about the hipster-politically-correct idea of a “trigger word.” I’m talking about situations and circumstances that break through the thin shell of control and pharmacopeia that an anxiety sufferer has managed to establish. These triggers can be inconsistent–a trigger one day, not the next. They can actually be (and often are) unrelated to the stress immediately in front of them. I used to get really nervous as a passenger in cars. I would be with a perfectly capable driver and have a feeling of unrealistic dread.
- Pushing loved ones who suffer from anxiety and depression to fix themselves can do more harm than good. You know something? People who suffer from anxiety and depression don’t want to hurt those they love; they don’t want to be the ones who bring everyone down. They don’t want to have to ask people to defend themselves against irrational fears about the future or the past. They do, in fact, wish that those fears didn’t occur at all!
- I used to think that I could set a timetable to be better. I could meet this goal, this milestone, and at the end, I would have a ribbon cutting ceremony on the new me. That’s bullshit. Fixing yourself takes the time it takes; it moves in fits and starts, and calling attention to the failures and the flaws only makes it worse. (This goes doubly for self-blame.) Corollary: the people around you don’t get to determine the time table, either. If they box you in, demand something that you’re not ready to do, then you need to set your boundaries and hope they realize their error.
- I don’t want to control anyone. What I do want to do is KNOW how things are going to go. What’s the plan? When is the project due? When are we hanging out? What day are we leaving? When is that meeting? Does that meeting have a well-defined agenda? I’m comfortable and secure when I know what the plan is. I don’t have to determine it. I don’t necessarily have to have a say in it. When people refuse to commit to plans, or when they change plans on a whim and offer no apology or excuse, that can ramp up the anxiety in a hurry. And if this is done by someone you love and who should know it as a trigger? It makes it ten times worse.
- Judging and labelling those with anxiety and depression is the quickest way to make them regress. I’ve talked to a couple of people I know and trust who are fighting this disease, and we all agree. Calling behaviors stupid or irrational just tells us something we already know. Respecting our feelings, free of judgement or label, allows us to deal with them. You wouldn’t call a child with a learning disability stupid, would you? You wouldn’t call attention to someone’s prosthetic arm, would you? Hard truth: It’s the same thing. If we feel stupid, if we feel irrational, and if that is affirmed by those around us, it just feeds the voice inside. You justify all the negative things that I’ve been saying to myself for years.
- We know that when we ask a boss or a parent or a lover to affirm us that we shouldn’t need it. We know that we should be able to provide that for ourselves. Imagine it this way: There is an irrational part of you that fears something you hate is going to come to pass. The rational you can’t get to the irrational part, because there is a fortified wall between them–that wall is built brick-by-brick out of fear, self-loathing, feelings of worthlessness, and all the past failures. Sometimes that wall is insurmountable. We just can’t do it without help. Corollary: If we have to ask for it all the time, we’re not doing the necessary work.
- If we’re in a particularly difficult season of our lives, we need people to be patient and loving and nurturing as we try to work on our selves. As long as we’re willing to put in the work, we need those people who love and care for us to be patient with our bullshit. (And yes, most of the time, we know it is bullshit. It doesn’t change the very real feelings behind it.) Corollary: If we’re not willing to put in the work, we can’t expect those around us to, either.
- I can’t be perfect, but I can be good enough…and that’s okay.
- When a person feels worthless or deals with negative self talk, the best thing someone can do is show intentionality. This can be anything–a hug, a cup of coffee, a random kiss, a package in the mail, being fully present in a moment with someone. We crave intentionality, because the part of us that most
people have that can self-soothe is broken. Everyone I’ve talked to who suffers or has suffered from this agrees–we do our best, and sometimes it’s just not enough. Plus, intentionality is just a good way to interact with people, even if they don’t have anxiety or depression.
- People with anxiety see through words. We’re great at lying to ourselves and wearing masks. We will look at how you act, what you make a priority, and how you treat us when we’re at our lowest. “I’m here for you,” or “I love you,” means nothing to us if it isn’t matched to compassion and intentionality.
I wanted for years to be cured. I prayed for a miracle (when I still believed); I researched tirelessly for therapies and treatments that might make me better. In the end, I’ve come to the conclusion that I have to manage this, just as if it were diabetes or multiple sclerosis. I am responsible for me and my own happiness, but the difficulty curve in achieving this is much higher than a person who does not manage a condition like this. But you know what? I really can’t do it alone. And there’s no shame in that.