I'm Not Anxious. I Have Anxiety.

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Thanks for asking, but I am not anxious about any specific thing. I don’t have anything specific that is worrying me. There is no real and pressing immanent doom. Not really. I am not anxious. I have anxiety.

Instead, I have a liar that lives in my head. The liar was planted in my head many years ago and is part of my complex post-traumatic stress disorder (PTSD).

The liar tells me I am incapable. It tells me I am ugly. It tells me I am not worthwhile, and it’s probably not worth trying. It tells me I am foolish. It tells me my life isn’t worth living. It’s a draining soul-eating voice, and it rules my life sometimes. There are times the liar immobilizes me.

I also have low self-esteem based on failures the liar has caused me and based on my history with the liar. Together, the low esteem and the liar can create a psychic pain that is palpable physically. The pain starts in my chest and travels along my arms. At those times, I sometimes want to die to get rid of the pain. I feel worthless, hopeless and useless. At times like that, the act of holding on and continuing to breathe and even to exist takes all of my will and courage. And I do.

Medications help some people. I don’t take any medications. They don’t work for me. I just hold on and do my best. I really do.

I remember the times I used to have hope, and I hold onto those times. I force myself to do things, to get out of bed, to shave and to shower and to work out. In horrible pain, I push myself to go and write daily. I push myself to go perform comedy at night. Still, the liar is subtle and remains with me

The liar tells me people don’t like me. The liar tells me I am not good enough. It will allow me to make my way, all the way to a comedy performance and then just when I think I am safe, the liar keeps me from entering the establishment to perform. I have taken public transit, which is a soul sucker of another sort, and just as I am about to defeat the liar, it wins!

And yet there are some ways to, if not completely defeat the liar, make his power over me smaller. There are small victories that over time can build into successes.

I work out daily. I walk on the treadmill for a minimum of 45 minutes a day. I watch my diet. I meditate on a regular basis. Meditation has allowed me to separate the voice of the liar from the other voices. I make myself get dressed and leave where I am staying every day. I write this blog.

I keep myself occupied.

I try not to compare myself with others. I have learned comparing who I am with what others have is a way the liar likes to beat me up. I try hard not to do that.

I no longer use alcohol or pot to try and defeat the liar. I was in trouble the first time I had a drink because, for a time, alcohol silenced the liar completely. Pot made me friends with the liar. For a time the liar and I coexisted, I thought happily, with the aid of alcohol and pot. Then the liar became demanding. It wanted more and more and more of me and more and more and more pot and alcohol. And more. There were times I was high all day long. Then, over time, alcohol and pot stopped working. It took more and worked not at all. That’s why, today, I choose, for myself, to stay sober. Some people claim pot helps them and it probably does. For me, I have to stay clean and sober.

I wish I knew where my life was headed. I wish I knew what was going to happen next. Right now, I am on disability and I am technically homeless. I try and stay optimistic. Maybe my writing will work out to be a job of some sort? Maybe I will become well enough to work. Maybe I will be stuck here for the rest of my life. I try to not despair. Despair is what the liar uses to defeat me.

I do what I can, one day at a time.

This post originally appeared on Medium.

If you or someone you know needs help, please visit the National Suicide Prevention Lifeline. You can also reach the Crisis Text Line by texting “START” to 741-741. Head here for a list of crisis centers around the world.

The Crisis Text Line is looking for volunteers! If you’re interesting in becoming a Crisis Counselor, you can learn more information here.

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So, You Think Anxiety Isn't Real

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The picture is my psychiatric service dog with me during an anxiety attack
The picture is my psychiatric service dog with me during an anxiety attack.

After a year and a half of hospitalizations, misdiagnoses, countless medication changes and many unanswered questions, I was fortunate enough to get an evaluation appointment with one of the best mental health specialists in the country. My parents and I drove six hours south to meet this doctor to hear his opinions on my diagnosis and future treatment.

The evaluation process took more than five hours. At the end of the day, the doctor said, “There is no need for her to be on antipsychotic medication because she actually has a severe anxiety disorder.”

My parents were so happy to hear this prognosis, and everything the doctor explained about the onset, symptoms and reactions I had to medications made sense. At the time, I couldn’t wrap my head around the idea that I had an anxiety disorder because I didn’t understand how the severity of what I was going through was a term I heard people say every day. Many times people use the word “anxiety” when they are describing feeling stressed or nervous about something. When I heard the doctor say “anxiety disorder,” I thought he meant I was just a nervous person. After learning more about anxiety disorders, I realized they are real psychiatric disorders that can consume and change someone’s life and future.

An issue I’ve seen many times for people with anxiety disorders is others’ belief that anxiety isn’t real. When people are dealing with anxiety, one of the most damaging statements they can hear is that they are making it up or exaggerating their feelings. Some common examples are phrases like:

“Everyone gets stressed.”

“All students go through this at the end of the semester.”

“You just need more sleep.”

“She’s just trying to get attention.”

As a woman with an anxiety disorder who also has friends and family with anxiety, I’ve heard countless versions of these statements. I usually don’t dwell on the limitations I’ve had to deal with due to my disorder, but what I’ve faced over the past few years illustrates that anxiety is real and should not be taken lightly. For those who think I’m “doing it for attention,” consider this:

I gave up my privilege to drive at night because I became afraid of driving in the dark. I had to change the career path I’d wanted since the seventh grade because I knew the job environment would trigger my anxiety. Why would I want to leave the part time job I’d loved for five years? Why would I throw away three years of college after being so close to
getting my teaching degree? Why would I want to spend three months in the hospital away from my friends, family and brand new kitten? Why would I spend Thanksgiving in a hospital three hours away from my family? Why would I want to take medications after living my whole life drug and alcohol free? Why would I stay home from my best friend’s bachelorette party in Atlantic City? Why would I want to face mental health stigma? I have to see people graduate college, get their dream jobs, buy their first houses and take spontaneous trips just because they want to. Why wouldn’t I want to experience those things too?

This is how anxiety has had an impact on my life. I’m not using anxiety as an excuse to skip school, get out of a test I forgot to study for, get extra time on a paper I put off doing, leave work early or avoid my adult responsibilities. When people use the word “anxiety” as an excuse, it essentially tells the world that people with diagnosed anxiety disorders can turn it on and off and are just exaggerating their symptoms. Nobody would want to go through a battle with mental illness if they had the choice. We are not doing it for attention.

Anxiety is a disorder, not a decision.

Follow this journey on Redefine Mental Health.

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The Social Anxiety Window

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This post is part 2 of a 3 part social anxiety series. Please click here if you’d like to read part 1 before continuing. Otherwise, read on.

There is something I call the “Social Anxiety Window.” This is the amount of space and leeway where people feel comfortable when having a social conversation. For example, some people feel they can engage in light small talk and prefer to keep the conversation focused on the other person. This keeps the topics on the surface and avoids bringing oneself (or even both) into the conversation. This is representative of a fairly tight window.

For a socially anxious person, having a tight window for acceptable conversation tends to reinforce the anxiety because once the other person has said their part, it leads to conversation jumping. Searching for different topics in a conversation tends to be a more difficult mental exercise, as opposed to expanding a topic into broader conversation. What often happens with social anxiety is there is more focus on thinking of the next question to ask to keep the other person talking, rather than trying to find a way in to engage with what is present.

A tight window makes the fluidity of the conversation quite difficult, and also impedes the conversation from being able to take its own shape between the two people. It becomes heavily constricted by the limits of the window. Meaning — if you don’t feel comfortable bringing yourself into the conversation, the conversation weighs completely on the ability for you to generate questions the other person can continue to respond to; and if there are only certain topics you feel are safe to discuss, then the conversation can only go as far as the topics you feel safe with (for some — this may be just the weather, or surface conversation about family or work).

On the flip side, a more open window indicates a person is more willing to take risks by bringing themselves into the conversation (risks of judgment or rejection by allowing themselves to be more known), and also allowing more room for comfort with topics. Rather than simply small talk, a person may bring up an issue they are having at home or work, or otherwise, that seems to fit in the conversation; or may bring up something passionate to see if the other person can relate: sports, TV shows, dating, hobbies, etc. Not only is there more room to be yourself in an open-window conversation, but it allows more possibility of connection by finding common ground in emotional areas.

Listening for cues for where you can bring yourself into the conversation, as well as where you can deepen the conversation, helps open both of your windows for more fluid and connected conversation. It can take topics deeper and can bring in a variety of topics. The closed window is more constricted and reinforces anxiety, whereas the open window allows room to breath and relaxes anxiety.

Obviously, the whole conversation isn’t completely up to you alone, as there are two people involved. Hopefully the other person will ask you questions as well, and hopefully they will have an open enough window that can assist in you opening yours a bit more. But it’s how one approaches a conversation in this area that can make a significant difference in the level of comfort/discomfort one experiences.

Why is it important to understand your own Social Anxiety Window?

If you can understand the limitations with which you approach a social environment and where you may actually reinforce the anxiety, you can take steps to open the window in these areas. Don’t expect it to be an overnight change, but as you become more comfortable with the adjustments, you’ll see it start to pay off. Next time you’re in a social conversation, try some different things to help open your social anxiety window:

  • Branch off what the other person is saying and include something about yourself on the same topic (“I so understand what you’re saying.. .that happened to me last week… ).
  • Branch off what the other is saying, and introduce a new topic (“Oh yeah… that reminds me of this time when… “).
  • Ask about something that interests you to see if they can connect. If they can’t connect to it, ask what they like to do. (“….I like to get out and run when I have a moment of free time… that’s not your thing, huh?… What do you prefer, what’s your thing?”
  • If the other person is talking about something emotional or passionate, ask more questions (use the active listening skills from part 1). It’s OK for the conversation to stay on the other person when it seems they could use support.
  • If you’re passionate about what you’re talking about and the other person seems interested in it, don’t be afraid to say more. It’s OK for the conversation to stay on you for a bit. Just remember to eventually bring the conversation back to the other person, if they don’t do so first. (If you’re both passionately into what you’re talking about, you won’t have to think so much).

Essentially, what we’re going for with the Social Anxiety Window is the ability to create a balance between bringing the other person in and bringing yourself in to connect, while allowing room for more depth to more topics that go beyond the general small talk. There is more emotional risk with this, but just like with relationships and love, one can’t have the rewards without taking the risks along the way.

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When I Had My First Panic Attack, Nobody Knew What It Was

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It’s not easy having it at a young age, especially when you don’t realize what it is until you’re almost an adult.

Growing up, I never realized the issues I had (anxiety disorder and depression) were mental illnesses or something uncommon. My family only knew the symptoms of schizophrenia and a bit about depression, seeing that we had family members who had those.

The first time I ever had an anxiety attack was at the age of 8. Life at home wasn’t really great and I was always worried about my mother (who dealt with a lot of harsh things). I don’t exactly remember why or what I was over thinking about. All I can remember is going to the doctor’s afterwards.

I was crying at home telling my mom I couldn’t breathe and panicking. So of course, my worried mother took me to the hospital assuming I was having an asthma attack (my brother and father has asthma, so it wouldn’t be a surprise if I had it, too). I went to the doctor’s and he tested me for asthma and did other tests. He concluded I didn’t have asthma, and that I was possibly lying about my symptoms. He told an 8-year-old who was crying and unable to breathe that she was lying and making it all up.

After that, I stopped telling the doctors about the breathing issues I had, thinking nothing was wrong. So for another eight years I coped with it, along with depression that came soon after, whether it was in the middle of the day, after I woke up, or even in the middle of the night when it would wake me up. Even in the middle of dinner I would have a full-blown episode. I was so anxious all the time and couldn’t even focus on my school work or daily routines. I began to fear every waking and sleeping moment, worried I would lose my breath. It started to control my life.

Finally, sophomore year of high school, I told my friends about my situation and issues. Most suggested it could be anxiety and that I was having anxiety attacks. So I researched for days to see if my symptoms matched up. Which they did — down to the T. It was weird for me. I denied it instantly. I didn’t want anything to be wrong with me and become a burden to my mother. Still, I endured it, and it brought on a lot of issues — unable to wake up and face the day, living in fear, skipping school to where I almost failed and couldn’t do much anymore.

However, with more issues at home, I never brought it up. It wasn’t until I turned 18 and had another horrid episode at home while a friend was sleeping over that my mother realized how bad it was. (Actually, she realized it was bad when I collapsed to the floor crying and on the verge of passing out). She left work early when I called her the next day and took me to the hospital. I couldn’t take it anymore, and after dealing with it for 10 years I finally caved in.

I was scared to tell the doctor the symptoms I was having in fear of being rejected (this doctor also had no clue what was wrong), but I caved in and told her everything. And after listing all the symptoms, I told her it might be anxiety. After that, she nodded and gave me a prescription for some medication to try, telling me to come back a month or two later to check in.

I’ve been on the medications for about three months now, and I haven’t had a major panic/anxiety attack since. And when I do have one, it’s minor and doesn’t disturb my sleep.

If you believe you have something and show all the symptoms, consult your doctor and ask them. It took mine 10 years to finally realize what was wrong and give me the proper medications. It is worth it, especially when things start to get better, you begin to function properly and suddenly, you’re able to face the day.

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The One Word That Still Haunts Me After Getting Prescribed With Anti-Anxiety Medication

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How did I get here, crying in my bathroom at three in the morning?

The answer is, one little word from my doctor during a med check: “Good.”

It was a simple enough question during the visit that led to the prescription my first ever anti-anxiety medication. “You’re not planning on having kids any time soon?”

“No,” I answered, still sniffling from breaking down and confessing how awful my quality of life currently was.

“Good. We’ll try Lexapro, 10 milligrams once a day.”

At the time, that “good” didn’t set off any alarm bells. And I genuinely meant what I said about not planning to have kids any time soon. I was such a mess at that point in my life, the idea of taking on the responsibility of growing and raising a tiny human was enough to set off yet another anxiety attack. I was so exhausted from trying to pretend everything was OK I was on the verge of a true breakdown. Kids were the last thing on my mind. I started taking medication, tolerated it shockingly well, had no side effects, quickly found a few coping skills that worked and never looked back.

It’s now six months later. I feel like a brand new person. On most days, I engage in zero compulsive behaviors and am able to turn off most obsessive thoughts. On worse days, I can turn the thoughts down and manage not to perseverate on them using cognitive behavioral therapy techniques. I am not picking my skin more than once a week, and have gotten at least six hours of sleep every night. My thoughts and emotions are mostly under control, and I feel like my life is back on track.

Until last night, when all of a sudden, I heard my doctor’s voice in my head say, “Good.”

And I couldn’t turn it off or push it back down. And I couldn’t fall asleep.

So I did the thing I tell all of my clients and their families not to do under any circumstances, which I am not at all proud of.

I rolled over, picked up my phone, went into the bathroom and shut the door… and Googled, “What anti-anxiety medications can you take while pregnant and breast feeding?”

At three in the morning, after four and a half hours of clicking on link after link after related link, I started to cry. Because the consensus of Internet-land is you really shouldn’t take any. Unless it’s a matter of life or death, and your obsessive compulsive disorder (OCD) or anxiety is so severe it cannot be managed without medication. And if you do take it, you will most likely be labeled a high-risk pregnancy. And in the third trimester especially, you can do unknown damage to your unborn child.

And then the obsessive thoughts began: Is my OCD and anxiety that severe? Do I want to be labeled high-risk? Will that limit my choice of doctors? Will this mean for sure I won’t be able to have a midwife and deliver in a birthing center and be stuck in a germ-infested hospital?

Because here’s the thing; having a child is something I do want. And I’m very much in favor of a natural pregnancy and delivery, vaginal birth and no epidural. Preferably in a nice clean birthing center with a midwife. And breastfeeding. And cloth diapers. And homemade baby food. You get the picture. Before I started taking Lexapro, I didn’t like to take medication at all. It had to be the worst migraine ever for me to even take Ibuprofin. My husband and I had said 30 was when we’d start trying to get pregnant. That’s in July for him, November for me.

But then life happened, and a lot of stressful events piled up on me at once.

One of my clients broke my foot in September. And we put in a bid on a house.

In October, my grandfather, who we lived with to help care for, was suddenly diagnosed with cancer and passed away two weeks later. He begged me to bring him home to die, which I did, and we started round the clock hospice care. My grandmother and mother were devastated and since my mom is an only child, I planned the funeral and did all of the hosting, etc.

In November, we closed on our house and adopted a kitten. And my brother and sister-in-law split up, and she took my nephew and moved back home to Florida. And I accepted a new client which added 10 hours to my caseload. I was burning the candle at both ends with moving, nesting and working. I drank more coffee and slept less. And started picking my skin again.

In December, I stopped sleeping abruptly. I was already unable to sit still for longer than 15 minutes without compulsively straightening and organizing. I paced all night to try to wear myself out and keep the obsessive thoughts at bay, anything from what if I got sick and died to what if the hot water heater breaks. I became forgetful and short-tempered. And we rescued another kitten. And one of the kids I worked with was constantly in crisis. And my psoriasis went from covering five percent of my body to 30. I tried to push back the little voice in the back of my head that said, “If a parent was describing these symptoms to you, you would recommend an evaluation.” I work with most of the psychologists in my area dealing with the kids I work with, and I was reluctant to mix business with personal.

All of this led to me sobbing in my primary care physician’s office. He’s known me since I was born, and has always checked in during routine appointments about my OCD.

And so, “You’re not planning on having kids any time soon? Good.

I know I should give him a call and talk to him about this. Maybe call my OBGYN, too. But the truth is, I’m terrified they’ll say, “Well we can cut back the medication slowly and see what happens.” Or, “We really recommend coming off of it all together as soon as you start trying.” Because, since I’m already being so honest, I don’t just feel better than I did six months ago; I feel better than I have since sophomore year of college.

I have an appointment at the end of July, and I’m working up the courage to bring this all up. Maybe I’ll show him this article. Or if I can’t sleep again tonight, maybe I’ll call tomorrow.

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Why Anxious Introverts Are the Worst (and Best) Friends You'll Ever Have

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I did not make many close friends during my five years at university. Friendly acquaintances, sure, but very few who I actively spent time with. It turns out, making friends is hard. I kept thinking things would fall into place and I’d find my group, but it never really happened. Why? Because making real friends takes hard work in areas I am terrible in.

I am an introvert living with anxiety. Individually, either of these can make making friends difficult. But combined, they make it a nightmare.

As an introvert I’m at a disadvantage from step one.

We’re awful at small talk, you see. No, that’s a lie. We can make small talk. We just hate doing it. Small talk is exhausting and such a waste of time. It sounds terrible, but I really don’t care what your plans are for the weekend. For people like me, small talk is what you do to avoid awkward silences with strangers when you make the mistake of going out into the world alone without headphones. It is shallow and pointless, but it fills the silence.

But when I’m trying to make friends I want to find out what you’re passionate about. I want to talk about your favorite books and why you related so strongly to a particular character. I want to know what your dreams are and what you are most afraid of. Basically, I prefer to skip the tedious polite acquaintance phase and jump right to the deep existential conversation phase. It’s an introvert thing, and it can be off putting for some and that’s fine. But the real problem is that when you pair this with an anxiety-ridden mind that constantly tells me I’m annoying everyone around me, I end up being too scared to start up any of the conversations I actually want to have. Which means I get bored. And I also come off as really boring.

On the odd chance I survive phase one, you might think things would get easier from there. If only.

I rarely make the effort to reach out to people, which probably makes a lot of people think I don’t care enough about our friendship to be bothered. Most of the time I badly want to talk to someone more, but I avoid reaching out because I worry I’m bothering them. Then (and here’s the real hypocritical kicker), when people don’t reach out to me, I assume I was right and they don’t actually care about me or like me. If they had any interest in me, they would have texted, right? Obviously.

On some level I of course realize this goes both ways. I cannot expect others to make an effort when I won’t, but the voice in my mind insists that no, they just don’t like me. They are just being polite when we’re together. I did them a favor by never trying to talk or hang out.

If I am too anxious to text someone, it maybe goes without saying I’m also terrible about making plans. I probably come off as either a boring introvert who never leaves her house or someone who can’t be bothered to try and therefore isn’t worth the time. The truth is  I avoid making plans with people because I’m terrified that if I try, nobody will show up and I’ll look like an idiot. For someone without anxiety it might just be a bit disappointing, but for someone like me it is utterly humiliating. And it has happened before (file under: reasons I no longer do anything for my birthday). It might sound ridiculous, but trying to make plans with people has a high risk factor in my mind. Best not to bother, the voice insists.

People like me are terrible friends. When we’re first getting to know each other we will want you to reach out to us and make an effort to invite us places, while rarely doing the same for you. We will sometimes back out on plans because we’re having a bad anxiety day. We’re the worst for spontaneous nights out because we get overwhelmed when our plans suddenly change, and we’re probably already in bed with our sweats on anyway. We will need constant reassurance you actually like having us around, and it will take you months to convince us to stop apologizing for literally everything.

But if you are patient with us…

 …we are also the best friends you could ever ask for. The more time we spend with you, the less high-maintenance we’ll become. We will realize you don’t secretly hate us, and we will start reaching out to you. We’ll send you pictures and videos we know will make you laugh and tag you in every adorable puppy picture we find on Instagram when you’re having a bad day.

Our introversion and our anxiety means we are always tuned into to our environments and the people around us, so we will always know when something is bothering you. We will let you vent for hours while we just sit and listen. We will trust you with our deepest secrets, and we will never share yours. We will never be angry with you when you wake us up in the middle of the night, because we know better than anyone how terrible it is to be hurting and alone.

We will never judge you for what you love. We’ll watch your favorite shows with you even if we think they’re silly, because we know how important they are. We will remember every single inside joke, partially because we are so embarrassingly excited to have inside jokes with someone. We will value you more than you could ever possibly know, because we know exactly how difficult we are to be friends with. And because we will never forget how much you made our day the first time you asked us if we wanted to hang out.

I am working hard to become a better friend.

I am trying to make a point to reach out to people, to try making plans, to let them know I would actually really like to have them in my life. But it’s a process. And even knowing how much I have to improve on, it is really discouraging to feel like no one cares enough to shoot me a text, and that gives my anxiety just that much more fuel when it is trying to convince me not to say hi to someone.

I know I am not the only one who feels like this. So, if you were kind enough to take the time to read this whole post, I encourage you to reach out to someone today. You never know; you might make their whole day with just one quick text. And if you know you have introverted friends with anxiety (or any friends with anxiety, really), be patient with them. Take the time to reassure them they are valued. Remember that it is highly unlikely they are ignoring you or blowing you off. In reality, they are probably terrified of annoying you, and are hoping you’ll decide to text them.

And when you do, it really will mean more than you could ever possibly know.

Follow this journey on Katsyxo.

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