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15 Survival Tips for Anyone Living With a Mixture of Anxiety and Depression

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This piece was written by Sarah Hughes, a Thought Catalog contributor.

I just finished my fifth year of high school (barely) and I am beyond excited for the next chapter of my life. This, however, hasn’t always been the case. You see, I used to be afraid of the future. This fear was merciless, suffocating me from the inside out, and it dictated my entire life. Later, after many visits to doctors, therapists and a psychiatrist, I learned this kind of fear has a name.

“Sarah, meet Anxiety,” the world of medical personnel declared. At first I was intrigued, happy to be able to finally call this intruder by name. Maybe we could get to know each other better. Maybe we could learn to coincide instead of constantly indulging in disputes over whether or not people liked me or how I failed to meet my ridiculous expectations of perfection once again.

Anxiety, unfortunately, had other plans in mind. Continuously coming over uninvited and completely ignorant to social cues, Anxiety became infamous for overstaying its welcome. Neglecting all duties of an acceptable hostess, I tried to make it obvious I wanted this houseguest to leave. This made Anxiety lonely. Vengeful. It had to do something. It needed back up.

“Sarah, meet Depression.” I tried to tell the world of medicine I didn’t need any more friends. I told them I already had plenty. This, however, was obviously a lie as I had become a recluse, refusing to leave the familiar four walls of my bedroom. Many saw right through the twisted web of lies I had carelessly woven. I’m not going out anymore, because I’m sick. I’m not trying in school, because I don’t care. I’m honestly fine. I think I knew these were not believable, but one of my other acquaintances, Apathy, reminded me it didn’t really matter if I lied. It didn’t really matter if anyone believed me. Nothing really mattered.

I never got along with Anxiety, but my relationship with Depression was a whole different story. We despised each other. It was a deep loathing I had never felt before. We had formed a brutal rivalry, the only casualties on my side. It was every man for himself. Depression was a lot worse to me than Anxiety ever was. I think it’s because Depression had me brainwashed, kind of like the older guy you date in high school who you’re madly in love with, but he has you believing the entirety of your self-worth is dependent upon what he says.

I was hopeless, worn out and at times suicidal. This dynamic duo was relentless. I began to fail classes, lose friends and become fixated on self-sabotage. I even went as far as taking an overdose that landed me a two-week hospital stay in the mental health unit at the local hospital, but that’s a story for another time.

My point is, I didn’t just finish five years of high school. I just finished five years of high school with an all-consuming mental illness. As mental illness affects everyone at some point, I’m sure many of you already know how big of an accomplishment this is. I am proud of myself, and to everyone who has also graduated or who is currently attending school with a mental illness, you should be proud of yourself as well.

Fortunately, I am currently in a safe and stable spot in my recovery and would like to share some wisdom. Mental illness needs to be talked about. If I was in the hospital for some kind of physical ailment, you would all know. So, I think it is only fair that you know about this as well. I hope by sharing these pieces of advice someone will feel a little less lonely and a little more hopeful.

1. You do not have to be at rock bottom or have something horrible happen to you to receive help.

Mental illness affects many people for different reasons and how you feel doesn’t always have to have an accompanied explanation. In fact, you don’t even need to have a diagnosed mental illness to justify wanting to talk to someone or needing help. Remaining silent is how mental illnesses fester and turn into something unmanageable. Life is hard. Everyone needs help. Heck, even therapists have therapists.

2. Do not procrastinate getting help.

Yes, it is possible to recover from a mental illness on your own, but it is extremely unlikely. It usually doesn’t get better without help. Please reach out before things continue to get worse.

3. If the first person you reach out to doesn’t give you the response you want or need, don’t give up.

Friends and family can be a great support system, but you have to remember they are not professionally trained. I would encourage you to speak with a professional as they will be able to provide you with the tools and resources needed to begin your recovery.

4. Educate yourself.

You should talk to as many professionals as you can and do as much research as possible. The more you understand about your mental illness and how it affects you, the easier it will be for you to recover.

5. Mental health services can be extremely expensive, but please don’t let that discourage you.

Many places will offer a sliding scale where you can talk to people who are still trained, but do not have the exact same credentials as a seasoned therapist. They can still be helpful and be able to provide you with similar tools and resources.

6. Nobody will ever be able to understand exactly what you are going through.

Mental illness is extremely individualized, so sometimes you have to take what people say with a grain of salt. What helps them may not help you. It is also important to note, however, that even if someone doesn’t completely understand, they may be able to relate to some of your symptoms or experiences, which can make them a great form of support.

7. Do not feel bad for communicating your mental health needs.

If you break your arm and are unable to physically write a test, you receive extensions or are given the opportunity to illustrate what you have learned in a different way. Therefore, if you need extensions on assignments, or need to write your test in a different room to help direct your concentration, just ask. Guidance Counselors are often great advocates when it comes to your mental health and its corresponding educational needs.

8. You often have to indulge in a game of trial and error, and that’s OK.

If you opt to be on medication, it will often take a few tries to find the right kind and dosage that best suits you. This also applies to finding a counselor. Sometimes you may have to see a couple before you find one you’re comfortable with. Always keep going until you are content with your treatment plan. You will find what works for you. It may just take time.

9. Although mental illness can be fueled by external factors, it often is more internal than you think.

You often cannot completely cure a mental illness by moving to a different environment or changing who you hangout with. If these changes are positive, they definitely can help you along your recovery path, but they may not fix everything like you had hoped for, so don’t be discouraged.

10. Talk about your mental illness openly if you can.

You’ll be surprised by how many people you are secretly helping to feel less alone. You may even be surprised about how much talking about it helps you.

11. There is still a massive stigma surrounding mental health.

With this in mind, you have to recognize that many people will talk about mental health ignorantly and inappropriately and will not be empathetic or understanding to what you are going through. These people have not been provided with enough information (or the correct information). Don’t let this stop you from continuing to get help. You have to recover for yourself not for other people.

12. You are the only person who can save yourself.

Don’t get me wrong, there are so many people that can help you along the way, but you have to want to get better and you have to be willing to put in the effort.

13. Try and find something to believe in that is greater than yourself.

This doesn’t always have to be a religion. For example, I am not religious, but I believe that everything happens for a reason, and with this in mind, I find it easier to remain hopeful.

14. Create a crisis plan.

It is easier than you think to reach rock bottom, and when you are at rock bottom, rationality is not often present. With any mental illness, thinking is distorted and when you are at your lowest point this is magnified even further. It is helpful to have a plan you can refer to when you’re in this state so you can reach out to the right people and remain safe. There are many people you can talk to who can help you to create this, and you can even find outlines of these online.

15. It gets better.

It really, really does. Four years ago, or even last month, when I heard people say this I thought it was ridiculous. I thought my situation was different, and that there was absolutely no way it would get better for me. I always wondered how other people could say this not knowing my situation. How do you really know it will get better for me if you don’t even know me? How do you know I’m not the one person that it won’t get better for? You can always rework how you think, or find a solution to improve how you feel. Sometimes this takes a long time. It may even feel like it is taking forever. You must know though, the mind is a very, very powerful thing, and it is capable of so much more than you even realize.

Keep going.

This story is brought to you by Thought Catalog and Quote Catalog.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255.

We want to hear your story. Become a Mighty contributor here.

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I Am Done Apologizing for My Anxiety

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When I was younger, I didn’t know I was having anxiety attacks. I would wake up in the middle of the night unable to breathe properly, sweat all over my body. I would tell myself it was just a nightmare. But then it started to happen when I wasn’t sleeping. It usually happened late at night, when the world got silent and I was left with nothing but my thoughts. Maybe it’s the nighttime I fear, the darkness and the unknown. I made my parents buy me a nightlight, and I would read until my eyes literally could not stay open anymore, anything to keep me busy. Then I would wake up in the morning and go about my day like everything was fine.

I was the girl with the smile on her face, and I liked it. There’s something so satisfying about being the person who can make other people laugh as soon as she walks in to the room. I was that girl. The one who saw the world as the beautiful place it is.

In fact, I still am that girl.

I promise I am.

The only difference is now I know my anxiety attacks are anxiety attacks, and they aren’t picky anymore. They find me at any time of day.

People tell me I used to be optimistic, I worry too much, it’s going to OK, the world isn’t that bad. I don’t think they mean to upset me. They just want that girl back who didn’t have a care in the world and could make light of any situation. They think their words are full of reassurance, but to me they feel like accusations.

What they don’t understand is that I still think the world is beautiful, and I am optimistic. My anxiety does not define me. It’s a part of me. It’s a part of me that comes without knocking and overstays its welcome. It’s the part of me that feels like I have frostbite on my heart. It’s the part of me that can’t help but think “What if?

I don’t go about my day with the intention of bringing other people down and taking a fun conversation and turning it dark. It’s out of my control. My anxiety is the shadow that walks in front of me. I can see it, but I can’t grab it.

I used to feel bad when someone would tell me to lighten up. Not only would I feel bad, but I would feel even more anxious. There I go again screwing it up for everyone. Good job, you have made everyone uncomfortable. Way to go. I would mumble an embarrassed “I’m sorry” and hope that everyone’s nods and shoulder shrugs were sincere.

But the thing is, I’m not sorry. I’m not sorry my anxiety doesn’t come with a pause button. I’m not sorry I’m struggling with daily panic attacks that take double my effort to try and hide. I’m not sorry my optimism can’t always be found under the weight of my worries. I’m not sorry I have anxiety.

I am who I am. Smiles and anxiety and optimism and fear.

And I am done apologizing for it.

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When I Finally Checked the Box Next to Anxiety

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The first time a doctor prescribed me pills for my mental problems, I didn’t take them. I didn’t even take the bottle out of the pharmacy bag. Instead, I tucked it into the basket of all my other misfit medications and half-used ointment tubes and shoved the whole thing to the back of my linen closet.

I don’t even know what it was, an antidepressant I suppose. All I know was I wasn’t sure I needed it. I wasn’t sure there was something wrong with me. Except some part of me knew there was, but for some reason, I needed someone else to verify that.

Looking back, I can see I’ve always had anxiety. I faked sick a lot in elementary school. I freaked out about being alone in the house as a teenager. I stressed uncontrollably the night before I had to take the university campus bus for the first time, but I managed.

I got through school, dated, got married, got a job, the whole business. I was fine. Kind of. That all changed when my son was born. When you’re pregnant with your first child, every parent you meet will give you the same look and tell you,“Your life is about to change.” They weren’t wrong in my case. They just didn’t know how right they were.

The thing I remember most about the day I brought my son home from the hospital was everything there seemed fake. It was like my living room was the set of a sitcom I used to watch. I felt out of place. My life wasn’t anything I recognized. I couldn’t eat. I couldn’t sleep. I worried all the time. All the time. When my husband’s relatives came to visit, I actually hid in the bathroom because I couldn’t stand to look anyone in the face.

I know at some point, I called my OBGYN and she told me, “Everyone feels this way at first.” I wasn’t sure about that. If everyone felt like this, then no one would ever have more than one child. Yet, I couldn’t find the words to explain what was wrong with me.

Yes, I could still get out of bed. Yes, I felt love and interest toward my baby. No, I didn’t have thoughts of harming myself or my child, but everything was still horribly wrong. She called in a prescription for me and told me if I didn’t feel better in a few days, then I should start taking it. My husband went and got it for me, but her comment had dug itself into my head.

“Everyone feels this way.”

To me that meant I was making something out of nothing. So I set out to toughen up and the medicine, whatever it was, stayed in the closet.

The next six months were bleak. Two feelings stand out to me now from that period: I wanted to run away, and I was desperate for someone to help me. At every doctor’s visit, I hoped for the pediatrician to ask me how I was doing. She never did, and I could never find the words to speak up about it.

I typed it into Google a million times instead. Lord, yes, I Googled post-partum depression and post-partum anxiety several times a week, hoping a miracle would leap through my computer screen and into my head, vanishing all my problems. Instead, I saw lists titled, “When to See a Doctor.” I never met the criteria of those lists.

I was upset, irritable, plagued with worry and doubt and filled with the sense that I hated being a mother. Yet, those were never on the list. I could still get up, nurse my child, fix my hair, go to work, make dinner, give my boy a bath and revel in how amazing he was before putting him to sleep in his crib. So by the lists I saw and my own misguided logic, I didn’t have a disorder.

Yet, still I felt like I was drowning in air. I sometimes Googled therapists in my area, but I never called. In my imagination, I could hear them thinking, “Everyone feels this way.” I didn’t even think about taking those pills that were still in the bag. They were for people with much worse problems than me.

Over time, things got better, and then, they got worse. And then better. And then worse. Eventually, I came across some helpful websites like Anxiety BC, and I bought a book on mindfulness and anxiety. I taught myself coping skills and meditation. I exercised to keep my demons at bay. I managed.  

Yet, sometimes I didn’t. Once, I almost made it to a doctor. I had forgotten to get Valentine’s cards for my son to give out to the kids in his preschool class. He came home that day with a bag of goodies from all the other kids. I cried silently to myself while I made dinner that night and spent the next week battling unending thoughts that I was failing as a parent.

Realizing that was over the edge of reason, I finally tried to call a local psychiatric group to make an appointment. However, all I got was a recorded message said I needed a doctor’s referral. The only doctor I saw regularly was my OBGYN. I didn’t go.

Then, something fortuitous happened. I moved, and at the appointed yearly time, I went to a new gynecologist for my annual exam. While I was filling out the new patient forms, there was a sheet to check off prior or current health issues, and sitting there at the bottom of the paper was a category for mental health. I looked at the little box next to anxiety, and in a moment of bravery, I checked it. I told myself the doctor wouldn’t even notice.

He did. He sat down with me and asked me about it. I told him I was basically fine, and I just had occasional problems (I was thinking of the Valentine’s incident in particular). He nodded his head, but said with anxiety, you live with it your whole life. So sometimes you don’t realize it’s there all the time.

He suggested I try taking a certain type of medication. I admit. I was still scared. Yet, he explained it to me, told me about other patients he had who were on it and what their experiences were like. He said he would call in the prescription, and I should try it.

I headed over to the pharmacy after the appointment. As I stood in line, I felt like there was a spotlight over my head, like everyone could tell what I was there for. Of course, they didn’t. I tried to laugh at the fact that I was anxious about having anxiety.

I got the script and left without a problem, but when I got back in my car I cried. I cried out of relief, and I cried out of fear. I worried somehow I was my anxiety and my anxiety was me. Because despite telling myself for six years I was fine, I knew I wasn’t. Who would I be if it all went away?

I went home and read the package details as if it would ease my fears. It didn’t. Instead, I read all the horrible things that could go wrong. On that night, I was still feeling brave, and I took one. The next day, I took another. Then, I wanted to stop taking them because they made me nauseous and restless, but I kept taking them. Once I had gotten past the fear, I was determined to find out what was on the other side.

I am happy to report the other side is a lovely place. A place where I don’t hate myself for everything I think I do wrong. A place where I don’t panic if I make a mistake. A place where a fear can cross my mind, and I let it keep going until it’s gone. And I can’t help but wonder, does everybody feel this way? I hope so. It’s a wonderful way to feel.

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8 Things I Want My Family and Friends to Know About My Anxiety

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I have anxiety. Not the kind where you hear people say, “Oh, I have a test today. I’m super anxious!” Then, it goes away. No, my anxiety is severe, debilitating and at its worst, crippling. I try my best to mask it on social media and in life so no one knows I’m secretly losing a battle with my own mind. I think I even try to fool myself too, to make myself think it’s not so bad but it is.

Anxiety ruins my life, every single day. There’s not one day that passes where I’m not thinking about how I would do anything to make this go away, to end this war going on inside my head. It’s so hard to go to sleep at night, knowing the demons and beasts I dealt with all day today will be waiting to greet me in the morning. I have anxiety, and this is what I want my friends and family to know.

1. I cannot control the irrational thoughts.

I know when I ask you for reassurance constantly, it gets annoying. I know I really don’t have a life-threatening disease when I feel a headache coming on. I know my irrational fear of not being able to drive anywhere by myself isn’t normal. Here’s the thing: all of those irrational fears and thoughts I have aren’t my own. They are the thoughts of my anxiety. Even though I know all of the irrational things I think aren’t true, I can never convince myself it’s false, that it’s all in my head. So please, bear with me as I fight this battle with my own mind.

2. I don’t cancel plans to avoid you.

When we make plans, I really do have the best intentions of showing up, visiting with you and having a fun day full of laughter and smiles. However, you need to understand the amount of fear I get as the time gets closer for us to meet up. You’re at your house, and all you’re doing in getting ready and probably thinking about what you’ll make for dinner after you get home.

Me? I’m on the floor in my bathroom sobbing and rocking back and forth because I can’t physically bring myself to do my hair, to do my makeup or to make it to the front door to drive to see you. When I do cancel our plans, please believe me when I say how hard it is for me. I don’t spend the time we would have spent together binge-watching Netflix or eating my favorite junk food. No, I’m in my safe place, curled up in a ball on the floor of my shower, crying because that’s the only place that drowns out the sounds of my anxious and fearful thoughts. Believe me, I feel bad about canceling for several days after.

3. I’m afraid of my own mind.

I know, people say this a lot, “I’m going crazy! Oh my mind is going to turn against me one day.” To me, mine already has. To me, my mind isn’t my friend. I’m my own worst enemy and my own worst friend all at the same time. I never tell myself I look good. I never tell myself I’m a good artist. I never tell myself anything good. It’s all negative.

You could be skinnier. You really could be smarter. You are so silly for being an artist. Don’t you know you aren’t good enough to make a name for yourself?

Every day, I fight a constant battle with my mind which is always, always trying to tear me down. Not only does it tear me down, but I always convince myself I’ve done something wrong or someone is mad at me because they took too long to call me back. I know that sounds illogical, believe me I do. Yet, to my anxious mind, that fear is completely rational.

 

4. Some days are better than others.

I know it may seem weird, that one day I can go out to the store with you and walk off by myself to go pick out my favorite snack. Then, the next day, I have to wait in the car because I had a panic attack on the way to the store or to the restaurant, and I can’t stop myself from hyperventilating or uncontrollably crying. I wish there were more of the better days than the bad ones. Unfortunately, this doesn’t seem to be the case, but I promise, I still love you just the same on both days.

5. I really do feel like I’m dying when I have a panic attack.

I know from an outsider’s view, a panic attack must not make any sense and seem pretty scary. I appreciate that you take the time to tell me to calm down or to just breathe. I need you to understand just how scary and real a panic attack is to me. My panic attacks come out of nowhere. They are usually noise triggered or when my nervous system is just overloaded.

When I have a panic attack, it feels as if I’m locked inside a small glass cube, and all of my friends and family are sitting there staring at me, as water is rapidly rising. So I start to hyperventilate, and it feels like I’m actually suffocating. So I start gasping for air, although my oxygen levels are perfectly fine.

My throat starts to tighten as well as my chest. My hands, feet and face start to tingle, and then, my hands go into temporary paralysis and are locked into two claw forms, begging to be released. All the while, you’re still sitting there, outside of my little glass box, telling me to calm down, while you don’t see the water slowing getting up to the top.

I start rocking back and forth and sobbing because I know this is the end. My heart is going 100 miles a second and sweat starts rolling down my face, and I can feel the end coming. I let out a scream because everything just hurts so bad. Then, I can breathe again. Suddenly, the water starts to drop, and the box is slowly opening. I start to get feeling back into my extremities, and I’m able to say, “I’m OK.” In that moment, yes, I am OK. Yet, I’m also terrified of when my next panic attack will show it’s ugly face because with every attack I have, I grow more and more fearful of them happening again.

6. I’m not rude or being anti-social, I promise.

When I’m having a really bad anxiety day, I get stuck in my head. I hardly notice the world that is going on around me, and I have tunnel vision. All that seems to exist are the constant worries and fears dancing around in my head.

Do I feel OK today? I just got a random pain in my foot. Do I have foot cancer? I shouldn’t have said that thing last month. That was not smart. What if no one likes my artwork I posted on Instagram?

I promise you, when you talk to me and I come off as distant, I don’t even notice I’m doing it. I’m too focused on my mind and making sure to cover all of the worries and fears to make sure I didn’t miss one.

7. I miss me.

I know. I’m still here physically, but mentally, it doesn’t feel like I am. I don’t feel like the same old girl who was carefree, spontaneous or adventurous, who you used to know. Now, I just feel scared, worried and anxious, every single day of my life. There hasn’t been one day that hasn’t gone by where I haven’t cried because of how miserable I am and how desperate I am for this all to go away. I hate this part of me, and I hate that you have to deal with it too.

8. I’m still here.

Yes, anxiety has taken over my life. I can’t go fill up on gas when my gas light comes on by myself. I can’t drive myself to get a haircut. I need you to drive me because I’m worried about driving on the highway. I have to run out of the movie theater when I have a panic attack triggered by loud noise, and we can’t finish the movie we paid $12 to see. I seem disinterested in our conversations, or I just seem like I’m not in the mood to talk. I can’t work up the nerve to go to a networking event that could greatly benefit me as a thriving artist. I can’t go out to eat with you without needing to get out my medication to calm me down before I break out into a panic attack.

I can’t do a lot of things the way I used to anymore, but I’m still here inside. The girl you knew that was so full of life and loved to make everyday adventures. She’s still here. I know it doesn’t seem like it, but I am. I try so desperately to break free out of this web of anxiety that is robbing me of my happy life.

So this is me, and I have anxiety. But you know what? Anxiety does not have me. I know I will overcome this, and I know I will come out strong. This may be the toughest battle I have ever had to fight, and it may be a long and excruciatingly painful one, but I will win this. My anxiety doesn’t define me. It’s just a part of me, but I refuse to let it take me down. I refuse to let it make me sink.

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When You're Afraid to Admit You Need Medication for Your Anxiety

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My journey with mental health, especially anxiety, hasn’t been a smooth ride. It took me a long time to come to accept my issues and the use of medication, and that wasn’t an easy thing to admit to.

I was offered but declined antidepressants when I was in my early teens, not wanting to go down the route of pills. I was first prescribed anti-anxiety medication when I was about 19, but not for the same reasons. After I took and failed my first driving test, my instructor suggested I talk to my GP, as he thought I had high anxiety. I managed to pass the theory with flying colors, but the practical was another matter. I declined, thinking I didn’t need pills to get me through anything. I tried and failed again. After a few attempts I realized I wasn’t just nervous. It wasn’t worry over passing that was getting to me. It was the shaking, the desperate itch, the repetitive thoughts, the twitch in my leg that meant I couldn’t keep my foot on the clutch. My instructor had said later on that I could have passed first time if I had sorted out the physical aspects of my anxiety, as my driving skills weren’t the problem.

When I saw my GP and explained what I was going through and the symptoms I was experiencing, and had experienced for a while, added to what a psychologist had already diagnosed years previously, I had to face up to it. I had high anxiety, and I could either keep putting my head in the sand and failing all of my tests, or try medication and see what happened. After fail number six, I accepted. Test number seven went smoothly, though nothing had changed other than taking the medication, which stilled my leg, stopped the shaking and calmed the itch of the anxiety.

Since then, it’s been a bit of an uphill struggle with medication. I have hated to admit that it helps me. Knowing it makes a positive difference battles with the other part of me that doesn’t want to be on pills. I don’t want to admit I need them or have a use for them. I don’t want to feel powerless over my mind or my body in this way. I don’t want to seem weak or inadequate or be labelled as having “mental health issues.” High anxiety was something I was embarrassed about for a long time, but back then it wasn’t as widely acknowledged either. And so it went, with me being on/off them for several years, struggling to accept and admit to having an issue and taking medication for it.

I’m the first to admit I’m a bit of a hypocrite. I’m someone to whom the phrase “Doctor heal thyself” applies. I can say all of the right things to someone else; I know what to do, the advice to give, the way to treat someone with compassion. I just can’t apply the same thoughts and knowledge and advice to myself.

It’s silly, also, that I know the underpinnings of anxiety medication through a psychology degree and my personal interest in mental health. I know the biochemical aspects of SSRIs and how they work. I can appreciate the factors that cause and contribute to anxiety, depression and other mental and behavioral activities. I know, I know, that anxiety is real, that there are things going on in your head and in your physical make-up that form part of the cause and effect. I understand CBT and reframing thoughts but also how this doesn’t always impact and improve issues such as anxiety, that sometimes the neurological and biological elements can override them to some extent. I therefore should be able to accept that, as a human being, these factors apply to myself too. I’m no different to anyone else. These things can affect me, I can’t always change how I feel by changing my behaviors and thoughts. Sometimes there’s something bigger at play, something medication can reach when you cannot.

The psychological and physical impact of anxiety, and indeed depression, has been quite forceful as it affects day-to-day life from minute to minute. It’s not just worrying and stressing. It’s overthinking. An obsessive need for control that gives way to nervous worry and painstaking indecision over the smallest of things. Repetitive thoughts. Dizziness and heart palpitations. Panic attacks that make you feel as though you’re suffocating. Shaking. Poor sleep and concentration. A metaphorical itch you can’t scratch.

Just because you can’t see the anxiety inside your head doesn’t mean it’s not there. You may not be able to show someone the imbalance of brain chemicals, the firing of neurons, the regulation or serotonin and noradrenaline. You may not be able to give a reason for having anxiety. It may or may not form part of another issue; it may be generalized anxiety, or it may be part of post-traumatic stress or a result of social anxiety disorder. It may just be, just because it is.

I can’t truly pinpoint mine. I had a degree of OCD when I was much younger, though it was never known back then what it was. I was simply rather frustrating at times and a little odd. I still remember now the painstaking time it would take some mornings to get my shoes on in the morning before school, with my mum having to keep taking my shoes off as one was slightly tighter than the other, and then one sock was slightly off-center, and then because she had touched my left foot she had to repeat the exact same action with my right foot except it wasn’t quite right so shoes and socks had to come off to start all over again. While some remnants of this remained, the OCD style behaviors transformed in to more repetitive thoughts as I got older. I had social anxiety when I was younger, the kind that was terrifying when you’re entering high school and can’t even cough in public. Depression and anxiety took over from there and still affect me to this day to differing extents.

But what has changed over this period of time is society. Conditions such as anxiety and depression and OCD are now more widely known and accepted, more talked about. On top of that, more famous faces are speaking out about mental health. Amanda Seyfried has recently commented on how she has been taking anti-anxiety medication for the past 11 years and believes mental health, as an invisible illness, should be taken as seriously as physical health.

It’s a shame that despite the increased awareness and therapies, both psychological and pharmaceutical, available, that stigma and judgment still abound. As with other invisible illnesses, mental health conditions can’t be seen until they affect overt behaviors, and most of us can get pretty good at covering them up and plastering over the cracks. I think we need to challenge how we look at medication too. Everyone is different; some will benefit from the likes of CBT, some will benefit from exercise and dietary changes, and others will benefit from medication for the biochemical and neurological elements.

One thing I have found really difficult to come to grips with is the sense of being out of control, that I can’t fully control the anxiety myself through the things I do or the way I think. But taking medication isn’t giving over your control. It’s not admitting there’s nothing you can do and now need to be reliant on taking pills. Quite the opposite. It’s about realizing mental health conditions can be viewed and treated akin to physical conditions. There are times when medication can work in conjunction with other forms of therapy or self-care. It doesn’t make you weak, you are not simply at the mercy of your brain chemistry. You are taking control of your life by admitting there’s an issue and doing something to help yourself. And that is something to be proud of.

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When You Can't Outrun the Pain of Anxiety and Grief

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For years, I ran and ran. I ran because I thought it’d fix my problems. I ran because I felt if I stopped, I’d have to deal with the pain, anxiety, the grief and the deep, raw feelings. I was afraid I’d have to finally accept things I wasn’t ready to accept about myself and my story. I spent years running in circles, determined not to let these things catch up to me. I believed running was easier, that repressing the scary things in my brain and not accepting them or dealing with them was easier. But I couldn’t run forever. I was exhausted; I finally found that out when suddenly everything I didn’t want to deal with was now weighing down on my shoulders, and everything I didn’t want to face made me crash into the pavement.

I thought I was a pillar of strength for being a kid who made it through tough times and had carried on with a smile, but really I was just running from my problems and my past. I never realized what strength was until I was dealing with all these emotions, the grief and the trauma, all at once. I knew what pain felt like, but I was unable to express it because numbing myself from the pain was so much simpler.

Once I finally was able to express my pain, I learned it’s tough and it’s so incredibly hard. The tears fall and fall, and sometimes I feel like I’ve cried enough tears to fill the Atlantic Ocean. And there are times when I just want to crawl up in my bed and isolate myself from the world. It’s not going to be easy and I know that, but I keep telling myself one day it might get easier.

I’m not going to tell you what works and what doesn’t. Because honestly I still don’t know what works for me. I’m a work in progress. What I do know is the work I’m doing on myself is harder than any academic class I’ve taken in college or graduate school. It’s more rigorous than anything I’ve ever done.

But every day is a new day, and every day my anxiety comes in different forms. I battle with thoughts of not feeling enough, not feeling worthy, and I wonder if I’ll ever get to a place where I love and accept myself exactly as I am. The eating disorder I developed at 14 years old has warped my brain. The scale is in complete control of me and has created a monster of irrational and self-loathing thoughts.

I often wonder if I’ll ever heal from the trauma of my dad dying by suicide when I was a child. The ripple effect it’s caused throughout my life turned into a tidal wave. The trust issues, separation anxiety, fear of the worst and just fear in general have become a large component of my life. I wonder if I’ll ever be able to trust someone, if I’ll ever be able to let anyone in. I’m so terrified of being hurt that it’s often easier to rely on myself and only myself, because I know I won’t hurt myself or let myself down.

I often wonder if I’ll always live in fear and be terrified of the unknown. If I’ll continue to think the worst of every situation — not because I’m a pessimist, but because I’ve been through the worst.

I got tired of running, and here I am. The past has caught up to me, the feelings and emotions stronger and more powerful than ever. I finally acknowledged the fact that I have severe anxiety and that it’s OK. I finally accepted everything and all I’ve been through, and I realized nothing I ever do will change my story. It’s all part of my journey.

I know running from your pain may seem like the easiest solution, but I’m here to tell you it’s not. Eventually your legs get tired and you may not be able to hold yourself up any longer. That’s what happened to me, and I crashed into the pavement.

Luckily, I was able to clean the scrapes off my knees, rise from the ground and begin to do the hardest work of my life.

Working on yourself is a marathon, not a sprint.

Image via Thinkstock.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255. You can reach the Crisis Text Line by texting “START” to 741-741.

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