Colorful watercolor painting of the hipster girl with glasses

Overthink everything.

Sweat.

Suffocate.

Cry.

Let it take over.

Have a panic attack.

Lie down.

Stand up.

Hold an ice cube till it melts.

Kind of breathe.

Take a walk.

Feel anxious on the walk.

Go back inside.

Write.

Sit and stare at a fixed point.

Call a friend.

Hang up before they answer.

Cry a little more.

Try the walk again.

Walk for longer.

Break into a jog.

Tire after four blocks.

Walk back inside.

Take a shower.

Feel a little better.

Get on with the day.

Wait for it to come back.

This post originally appeared on Medium. You can follow Amanda Rosenberg on Twitter @AmandaRosenberg.

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Dear Shelly,

Today I had a panic attack. It was a real rocker. You know the type. I sweated, felt like I would puke, worried I would kill myself, worried I would hurt someone else, worried about work, worried it would never end — all in the span of 20 minutes. It wasn’t fun. It sucked. I know it sucks. I know it’s hard, but I want you to know you do not understand anything right now. Your thoughts are lies anxiety tells you. Even when there is some truth, it is always a catastrophic version of what might be. Sure, the shit might hit the fan, but you cannot predict the future.

I know you’re hurting right now. You might feel like you’re not good enough. You have a lot of fears. I’m sorry you have to go through that. It makes me sad to think of you going through this anxiety, whether it’s for a few minutes or a few months. I love you, though. We’ve done all of this before. I know all the thoughts you have, and I love you! You should know that.

I want to address the things you might be thinking. I know you overthink shit big time. I’m not sure addressing your fears will help, but we try everything else, why not this?

1. The moment you need your meds to get calm, you are going to start thinking you’re an addict. It’s not true, but it’s what you do. Even if you think “I haven’t had them in forever. I don’t crave them,” you will follow it up with, “Yeah, but this could be the time.” Listen honey, this is the thought you have every time. Remember when you couldn’t sleep with your medication near you? You have anxiety about medicine, kid. So what if this is the time? Are you struggling with anxiety right now? Take care of yourself with the tools you have. Let me take care of what’s left of you when you’re done. I can handle it. I swear. I’m way stronger than you think I am.

2. You’re going to think the anxiety is never going away, or at least stick around long enough to mess up your work. The first is impossible. The second is rare, but it could happen. So what? The reputation you think you need — you’re imagining it. Even if all of your clients cut you off because you were out of work for a month, you would bounce back up, but I’m not here to reassure you. I’m here to tell it like it is. This shit will happen to you. You are sick. You’re also fine.

3. You’re going to worry about taking your life because you have intrusive thoughts about it. I’m not going to bother telling you they are just intrusive thoughts. I know what it feels like. You wouldn’t listen to me anyway. I will say this, though. I really want a chance to come back to my life. I would appreciate it if you would take care of us and just endure this until you get back to me, OK? If you have to cling to a book for a month, drinking Ensure and playing video games, do it please. I need you. No pressure, though, eh?

4. You’re going to worry about puking. I’m baffled we’re so scared of being sick, but it happens. So what if you puke? Which brings me to . . .

5. You’re going to worry your meds will stop working. I know why you worry about this. Sometimes, our meds are not as effective as they can be. It’s because sometimes we have really prominent symptoms. A pill may not knock a panic attack on its ass (though one just did). They will help make your anxiety manageable enough so you can knock back an Ensure, read a book and walk until you find me again. It might take time, Shell, but you will find me. I promise. It’s OK to cry and be sad that I’m gone right now.

6. Do what you would have done anyway. If you sit still and cater to the horrible sensations of your anxiety, it is all you will feel. You might as well feel like shit and do something at the same time. You might enjoy the walk less or zone out during family time, but at least you won’t just be sitting there feeling like shit, right? Live your life. When it’s going rough, it’s going to suck whether you lay around or get up and risk puking in the grocery store, which still has yet to happen. I can just imagine us if it ever does. “OMG, I was right!” Ugh. Whatever.

My point is, get through it. Do what you have to do. I promise you that I, your calm self, will be happily waiting for you on the other side. I always am. Even if it’s just for a minute that slowly grows over time to be hours, I am always waiting for anxious me to get to the other side of anxiety. This is not reassurance. This is just a fact. I can’t wait to see you again. It feels so good to be alive. I can’t wait to tell you that.

Love, Shelly

Follow this journey on Living With Intrusive Thoughts.

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Anxiety is tricky. It likes to lie to us, play games with our heads and most of all finds ways to stick around. So for example, when it’s time to answer a stressful school related email — and oh my gosh thinking about it makes me feel stressed, and now my thoughts are racing. Is it getting warm in here? And ah, I don’t want to look at it, because this is making me feel anxious, so really what I should do is just…

Click. Close the page. Don’t look at it. Don’t think about it. Don’t do it. Ah, now don’t I feel better?

Avoiding: one of anxiety and obsessive compulsive disorder’s most well-mastered tricks. Sure we feel better for a few seconds, maybe even a few minutes if we are lucky, but all too soon the anxiety comes back stronger and we still haven’t done or addressed what is stressing us out. So what do we do to stop avoiding? How do we stop this spiral of continuing to avoid and the anxiety just growing larger?

It’s time for: The 24-Hour Challenge!

What you need: you (a brave person), a stressful thing you are avoiding, and a clock/watch/sundial (some way of knowing what time it is). Have your stressful thing picked out? It can be making a phone call, doing an exposure you discussed with your therapist, taking to that cute boy in class, or for me, answering school related emails.

Now, look at what time it is. Got it memorized? Great. OK — now make a commitment to yourself. Starting right now you have 24 hours to do the stressful thing. And now you have 23 hours, 59 minutes, 30 seconds… (This is a strict deadline!) This is my absolute favorite technique to use when I have been avoiding something. It definitely requires self-discipline (or you can ask someone else to hold you accountable) but for me it almost always works. In fact, just before starting writing this blog post I finally answered a stressful school email because the clock was ticking and it had almost been 24 hours since I committed to answering the email. But it’s done now. I did it and I feel much better!

Here are some final tips for the 24-Hour Challenge:

1. Pick your strategy. There are two ways to go about doing this. You can either just get it over with so you don’t have to think about it anymore. Or, you can keep stalling and feel stressed about it for almost the full 24 hours, finally doing your task toward the end of the deadline. I don’t always succeed at doing this myself, but I highly recommend the first option. Much more pleasant!

2. Give yourself a reward! This can be candy, getting to watch your favorite show, getting to write, etc. Positive reinforcement is a powerful tool and provides great incentive to stop avoiding. You are reteaching your brain to stop avoiding, after all.

3. Choose your own time limit. Some tasks work well with 24 hours, but other tasks work well with a 10-minute challenge or a one week challenge. Adjust the time limit to your specific task, but the main idea stays the same.

I hope this has been helpful. I’d love to hear if anyone tries the 24-Hour Challenge and how it goes!

Click here for more information about avoidance.

Follow this journey on My OCD Voice.

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High-functioning anxiety looks like…

Achievement. Busyness. Perfectionism.

When it sneaks out, it transforms into nervous habits. Nail biting. Foot tapping. Running my fingers through my hair.

If you look close enough, you can see it in unanswered text messages. Flakiness. Nervous laughter. The panic that flashes through my eyes when a plan changes. When anything changes.

High-functioning anxiety feels like…

A snake slithering up my back, clamping its jaws shut where my shoulders meet my neck. Punch-in-the-gut stomach aches, like my body is confusing answering an email with being attacked by a lion.

High-functioning anxiety sounds like…

You’re not good enough. You’re a bad friend. You’re not good at your job. You’re wasting time. You’re a waste of time. Your boyfriend doesn’t love you. You’re so needy. What are you doing with yourself? Why would you say that? What if they hate it? Why can’t you have your shit together? You’re going to get anxious and because you’re going to get anxious, you’re going to mess everything up. You’re a fraud. Just good at faking it. You’re letting everybody down. No one here likes you.

All the while, it appears perfectly calm.

It’s always looking for the next outlet, something to channel the never-ending energy. Writing. Running. List-making. Mindless tasks (whatever keeps you busy). Doing jumping jacks in the kitchen. Dancing in the living room, pretending it’s for fun, when really it’s a choreographed routine of desperation, trying to tire out the thoughts stuck in your head. 

It’s silent anxiety attacks, hidden by smiles.

It’s always being busy but also always avoiding, so important things don’t get done. It’s letting things pile up rather than admitting you’re overwhelmed or in need of help.

It’s that sharp pang of saying the wrong thing, the one that starts the cycles of thoughts. Because you said too much, and nobody cares, and it makes you never want to speak up again.

It’s going back and forth between everyone else has it together but you, and so many people have it tougher than you.

Get your act together.

Suck it up.

You’re not OK, you’re messing everything up.

You’re totally OK, stop being such a baby.

It’s waking up in the middle of the night sobbing because the worst-case-scenario that just went through your head at high speed seems so real, so vivid, that even when it’s proven to be untrue, it takes hours for your heart to slow down, to feel calm again.

Because how “OK” are you when a day without a plan is enough to make you crumble? When empty spaces make you spiral at the very anticipation of being alone with your thoughts? When you need to make a list to get through a Sunday: watch a show, clean your kitchen, exercise, answer five emails, read 10 pages, watch a show… ?

It’s feeling unqualified to write this piece because I’m getting by. It’s when you’re social enough to get invited to things, but so often find yourself standing in a room where it feels like no one knows you. It’s being good at conversation and bad at making close friends because you only show up when you feel “well” enough. Only text back when you feel ready. Because you’re afraid they’d hate you if they really knew you. That the energy would overwhelm them, and you’d lose them.

So you learn to rein it in. Channel it. Even though sometimes you do everything right (exercise, sleep, one TV show, five emails, 10 pages…) and you’re still left with racing thoughts, the panic. The not good enoughs.

When will it be enough?

Having anxiety means constantly managing motion that can be productive or self-destructive, depending on how much sleep you got. Depending on the day. Depending on the Earth’s alignment with Mars. Depending on…

It’s when “living with it” means learning how to sit with it. Practicing staying in bed a little longer. Challenging the mean, unrelenting voices that say you’re only worth what you produced that day.

It means learning how to say, “I need help.” Trying to take care of yourself without the guilt. It means every once in a while, confiding in a friend. It means sometimes showing up even when you’re scared.

It’s when answering a text impulsively and thoughtlessly is an act of bravery.

It’s fighting against your own need to constantly prove your right to exist in this world.

It’s learning how to validate your own feelings. That even though you don’t feel like you’re enough, and you’ll never be enough, it’s knowing you’re at least anxious enough to benefit from help. That admitting you need it doesn’t confirm voices’ lies. That taking a break doesn’t mean you’re a failure.

It’s finding your own humanity in the anxiety, in your weaknesses. It’s trying to let the energy inspire you, instead of bring you down. It’s forgiving yourself when it wins.

It’s a way to live, with this constant companion. Your bullying twin. Collapsible luggage you can bury away at a moment’s notice. Shove it under the bed. Pretend it’s not there until you can’t fit anymore. Until you can no longer ignore it. Until you have to face it.

A first good step is staring at it straight on and calling it by its name.

High anxiety can be a natural consequence of a busy lifestyle, but its existence is akin to the chicken and the egg. Which came first, the anxiety or the busyness? Am I always moving because I’m anxious or am I anxious because I’m always moving?

Either way, it’s not a noble way to suffer. It’s not a “better” way to be anxious. Just because you’re “functioning” doesn’t always mean you’re happy. And just because you’re functioning doesn’t mean you shouldn’t slow down, breathe and take one damn second to be happy the way things are.

In this very moment.

This quiet, short moment.

To remember the peace you found in that second of silence, until the electricity starts again, and you’re forced to move.

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What It's Like To Have High Functioning Anxiety



A few weeks ago, I had my last therapy session. It is wild to me that this is where I am. For so long, especially when I first started, I didn’t see myself ever stopping. Therapy is just so awesome. I’ve never experienced anything like it. It was helpful in ways I probably haven’t even begun to realize yet.

When I started therapy, I felt so completely bewildered and disconnected from myself. I had the firm, ingrained belief anxiety was a thing I should be able to control. If I couldn’t control it, then something was wrong with me. I walked around carrying the pressure, the tension and the feeling of not knowing myself anymore. It was really hard. Asking for help was hard, too, because in my family you do everything yourself. You’re never not capable and you always keep it together.

In the last few years, we’ve all, my parents, my sister and me, been working really hard to give each other the safe space to not be OK. I’m so proud of us for that. I’m proud of us for encouraging each other, for being open about our struggles and for really digging into our separate issues. It’s made this process a lot easier for me.

Therapy did so much for me it’s hard to put it all into words, but I want to try. I feel so grateful I’ve been able to go through this process with someone who has such a wonderful balance of empathy and questioning. My therapist was consistent about encouraging me in my efforts to manage anxiety. She was really good about asking me questions and giving me challenges in order to help me really get to the roots of why this was happening.

Therapy is, by and large, one of the best things I have ever done. There are multiple reasons for this. I could write about it forever, but instead of boring you guys, I’ll just make a list of all the pros to therapy:

1. Therapy gave me a place to be lost.

It was always unequivocally OK to be lost, overwhelmed and hopeless. Those feelings subsided over time but that was a lot of what I felt the first six months. It was always OK. More than OK, it was welcome.

2. Therapy let me go at my own pace.

My therapist never rushed me or made me feel like she had an agenda to accomplish. She let me talk about whatever I wanted to talk about in my own time, and for however long I wanted. This doesn’t mean she let me be all over the place. Sometimes I was, but she would gently nudge me back to center with a question or an observation.

3. Therapy held me accountable.

Because of how I am, I would have felt super ashamed of walking into therapy and not doing anything to fix my own problems. My therapist knows this about me (as she should) and she was really great about checking in with me about what strategies I was trying and how they were going. She never made me feel like a failure, and she always encouraged me to keep trying. Just by asking, she helped me stay accountable and get to know my particular brand of anxiety inside and out. I also had to show up. I had to be physically present in order to get the help I needed. Committing to this week after week helped me to follow though in other areas of my life.

4. Therapy challenged me.

If you’re really working at it, therapy is hard. There were so many times when our conversation necessitated me talking about something from my past I didn’t really want to talk about or realizing some things about myself that were tough to admit. Some things, like how stubborn I am, I will be the first person to tell you about. Other things, like the fact that I cry every time I feel almost any strong emotion or am in conflict with someone, made me feel ashamed and were really hard to talk about. Therapy let me work through that. Now, I know I’m not crying because I’m weak or too sensitive. I’m neither of those things. I cry because that’s how my body reacts to stress and that’s OK.

5. Therapy helped me accept my “flaws.”

First of all, Leslie Knope said it best, “One man’s nightmare is every other man’s total package.” Aside from that, therapy helped me realize anxiety is not a flaw. It’s biology. It’s not something that’s wrong with me. When I realized this and started trying to manage it, I learned how to make room for anxiety and accept it as part of my life. I assumed, and still assume, it will always be something that happens to me and so I’ve made space for it. It has a little corner of my heart where it lives. It’s always going to have a home there and that’s a good thing.

6. Therapy made me give zero f*cks.

Seriously, once I got through all of the crazy “WTF is happening to me!” times and realized anxiety isn’t a flaw but just a thing that happens to me, I stopped caring about what people think about it. I just do not care. Again, anxiety is not a personality trait and it is not a flaw. It is biology. It’s genetic.

It is not something you can chose to have. So f*ck anybody who thinks about it like it’s a choice and who looks down on those who are dealing with it. Screw those people who choose to judge you and us on something we can’t control. Anxiety doesn’t negate that I’m a capable, hard-working and a conscientious human being. Anybody who thinks poorly of me simply because I struggle with this, in the same way that someone struggles with other conditions, can get out of my life.

7. Therapy allowed me to find myself again.

OK, so that sounds kind of corny, but it’s true. Anxiety is so isolating sometimes you start to wonder if you were always this “crazy” person and you just didn’t know it. It can be so disorienting and it can make you feel a big disconnect with who you thought you were and this “anxious person” you seem to be now.

In particular, I had a lot of trouble maintaining my sense of self in different environments. In work, I was really outspoken and confident. With my friends I was funny and entertaining, but with my family, I was quiet and barely talked at all. Therapy has helped me rediscover the cornerstone of who I am so that I don’t feel like I’m five different people and scattered in a million directions. It has helped to ground me and to feel like I’m myself even when I’m anxious.

If you’ve started therapy, good for you. I hope it’s going well and you’ve found a therapist who helps you meet your goals and who you have a good connection with. If you haven’t started therapy yet but want to, then that’s awesome. Go you. You can look on Psychology Today as a starting point. If you’re in NYC, you can message me privately as I know a few awesome therapists and would be glad to put you in touch with them.

If you feel like something is wrong but you’re not really sure what it is and you’re not really sure you want to go to therapy, that’s OK too. I encourage you to go. I know without a doubt my relationship would not be as joyful, fulfilling and resilient as it is without the work I’ve done in therapy (and also my boyfriend’s magical, unicorn presence). I wouldn’t be as close with my family, and honestly, I wouldn’t be happy.

I’ve learned to manage and accept all of my emotions, not just the good ones.  I’ve learned not to think poorly of myself when I’m not happy. Please, consider therapy if you are at all feeling like something is off. It make take some time and you may have to meet with more than one person to find the right fit, but it can change your life.


As we wound down our work together, my therapist and I talked about the whole process and what it’s been like. She brought up the fact that I’ve been very proactive about it, calling my approach to anxiety “methodical.” I started laughing when she said that because yes, I absolutely was. I had to really break down the whole thing and do as much research as I could, and I needed to make sure I was trying everything that was supposed to help even if I didn’t enjoy it.

But we’re not all like that, and it’s important to recognize we each need to deal with anxiety in our own way. The way I manage it may be completely different than someone else, and that’s OK. Just because something has been proven to work doesn’t mean it’s going to work for you. That doesn’t mean there’s anything wrong with you or there’s nothing that can help you. It just means that particular thing doesn’t do what you need it to. And that’s OK.

It took me a long time to figure out what works for me. Sometimes, I just needed to tweak something I was already doing, and sometimes, it was a gigantic life change.

Here are eight things I tried that worked for me:

1. Therapy.

Therapy is amazing for me. I got really lucky and clicked with my therapist during our first meeting, but sometimes it takes a few tries. That’s OK. Read here and here for more of my thoughts on therapy.

2. Read anxiety books.

This was important for me because it gave me a sense of ownership and responsibility over my own healing. There were some books I wanted to throw against the wall, but I read a few that were really helpful. They are: “Panic Attacks Workbook” by David Carbonell, “Don’t Panic” by Reid Wilson, “The Highly Sensitive Person” by Elaine Aron, and “Daring Greatly” and “Rising Strong” by Brené Brown.

These five are my canon. I go back to them again and again, especially the Brown books. They are full of techniques, but they also explain what happens in your brain during a panic attack, and Brown especially talks about the emotional aspects of letting go and accepting what’s happening, no matter what that is. These six books normalize anxiety for me and help me feel less alone.

3. Start a blog.

I’m not going to lie to you guys. I was so scared to start a blog. I really didn’t want to put any of this out on the internet where my parents, my boss or, God forbid, my students could read it. But I got to a certain point where I had been dealing with it for so long and had started to accept its place in my life that I was like, you know what? F*ck it, and published the first entry. And then another one. And then eventually I specifically wrote an entry to my friends explaining what was going on and shared it on Facebook (I hadn’t been sharing the blog before then).

I can’t tell you how liberating it was to talk about my challenges. The only way I could break down the stigma was to talk about what’s going on with me. And I felt better.

4. Depersonalize anxiety.

This one was huge for me and is probably one of the single best things I did. I stopped talking about “my” anxiety and started talking about “the” anxiety. This seems like such a minute change, but its ramifications have been extraordinary. Talking about anxiety this way has helped me see that, while it is a part of my life, it isn’t who I am. I am not an “anxious person.” I am a person who feels heightened anxiety. I am not a “worrier.” I am a person with a tendency to ruminate.

Thinking and talking about anxiety like this has helped me to make space for it in the same way you make space for work or friendships. It’s a thing I have to devote time and energy to, but it’s not taking over my life or my personality. It doesn’t define me. It’s not actually me, it’s my biology. Once I started doing this, it was so much easier to accept it and to not have feelings of shame and guilt around it.

5. Exercise.

I never did sports in high school unless my gym teacher told me I would fail if I didn’t participate. The only exercise I did in college was walking to class and maybe going to a couple of yoga classes with a friend. This has been the biggest and most difficult life change, but it has also been one of the best. It was a real challenge for a long time to a) find a consistent workout schedule and b) find the right type of exercise.

There was a lot of trial and error, but the biggest issue for me wasn’t the exercise itself, it was the accountability.

I use the Strong app to track my weightlifting and cardio, which helps keep me accountable because I can see all of the times I’ve worked out on the calendar. For me, the schedule that works best is a non-negotiable Wednesday/Friday/Sunday routine of weightlifting — my arms are starting to look super awesome — and high intensity interval training on the bike.

I just feel so much better when I exercise, which in itself blows my mind on a regular basis.

6. Keep a panic diary.

Cataloguing my symptoms in a panic diary was really helpful because I started to see patterns emerge, and from there I could begin to identify triggers and underlying causes. This, in turn, helped me to not only make room for anxiety but also to start expecting it in certain situations.

No longer do I travel with the mindset that I’m not going to feel any anxiety. Now, I expect to feel some, and that makes it a lot easier to handle when I inevitably do. There are other situations where I’ve learned to expect it, and that has actually lessened the symptoms because I’m not fighting them. I’m just letting them be.

7. Create an anxiety check list.

I’ve talked about this before, but this has also been really helpful. Through a lot of trial and error, I have a list of go-to, sequential steps to take when I start to feel anxious. I haven’t had to go past grounding myself and breathing for a long time, and that’s awesome. This list also reminds me of all of the work I’ve done and how I made it through.

8. Advocate.

I’ve really started speaking out about mental health issues, both in person and my various social media platforms. I want the people in my life (and all people, really) to understand this is an important issue, and it’s our responsibility to educate ourselves and each other about it.

I get it if you don’t feel comfortable talking about your own experience. If that’s the case, maybe there’s a way you can advocate for mental health in general or help raise awareness. The stigma will remain unless we do something.

And here are four things that didn’t work for me (but could work for you):

1. Create an anxiety playlist.

Guys, I really thought this one would be a winner. Seriously. I love music, and I really thought if I had a playlist I associated with calming down that it would help me when I felt panicked. Nope. My thoughts just kept right on going, and I had to stop using it pretty quickly, so I wouldn’t start connecting some of my favorite songs with feelings of anxiety.

That being said, I did fall in love with John Mayer all over again through this process, and you can read about why here.

2. Keep it private from everyone except my boyfriend and my sister.

For a time, this is exactly what I needed. But I kept things quiet long after I should have, and it actually started impeding my work with anxiety. This started to get better in leaps and bounds when I started writing a blog and sharing my experiences with people. It made me feel so much less alone, and it made me feel like I can handle this. And if I can’t, there are a ton of people out there who have my back.

3. Meditate.

I started meditating because I’d read a lot of studies about how helpful it is. And once I found something that suited me (the Headspace app), it was helpful. But only up to a point. I found the anxiety pack on Headspace to be really effective in terms of accepting the anxiety as it comes and not giving it my attention and escalating it. That was great.

But to be honest, I don’t really like meditating, and continuing to do it after I finished the anxiety-specific ones just felt monotonous and obligatory. Maybe if I did it at a different time of day or under different circumstances, I might enjoy it, so I’m going to try again while school’s out this summer. (But yoga kind of serves the meditative purpose for me and sometimes sitting to meditate feels redundant.)

4. Track symptoms.

This one took me a while to figure out, and I think it may have surpassed the point of its usefulness. At first I tried the SAM app, but it just didn’t work for me, although I can see how it would be awesome for others.

After that, I tried Symple, which helped some more in identifying patterns. I’ve written about it before, but I do I think I’ve moved beyond its helpfulness for me personally. I love this app and its concept, but I just don’t really need it anymore.

You might have already figured out what works best for you, or you may feel totally bewildered and don’t know where to start. If that’s where you are in your journey, my suggestion is to start with therapy. Yes, it’s daunting. Yes, it’s scary. Yes, it can be expensive. But I think it’s worth it because a person can guide you through everything else and you won’t have to do it alone. If you’re already in therapy, then I suggest working on depersonalizing anxiety and exercise.

We’re in this together.

Follow this journey on It’s Only Fear.

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