woman holding her hands up in front of her face and looking away in front of stone wall

Many of us have a public and private persona. If we are lucky, these two are more closely related than not. We can be ourselves without feeling judged or imperfect or unworthy. We may not feel the need to hide any part of ourselves for fear of judgment. But for me, as someone who struggles with high-functioning anxiety and PTSD, the mask I hide behind has been so carefully cultivated that many people have no idea I am, in fact, struggling with a mental health issue.

I hid behind this mask for the better part of 40 years. My masked self is a perfectionist, an achiever, someone who could put her mind to anything and succeed. She’s a hard worker, runs a successful business, appears to have super human energy, can juggle a million balls in the air at once, is well-liked, has many people who care for her, is happily married and has an optimistic, positive outlook on life. These are all aspects of myself that are true, but they don’t represent all of me.

Underneath this seemingly put-together persona is an incredibly insecure, anxious person. Someone who often feels unworthy of love or admiration. Someone who feels guilty for having any needs, but has no problem taking care of the needs of others. Someone who questions her abilities constantly and who often feels like a “burden” to others when she needs support. She’s anxious to the point of having panic attacks over seemingly silly things. She’s an over-thinker who can’t shut off her mind. She’s an insomniac, and she worries about everything, imagining the worst-case scenarios and rehashing every perceived failure over and over again, wondering what she could have done differently. She craves connection with others, and yet she struggles to trust people. She is often at war with her body, struggling with knowing what amount of exercise and food is healthy, but seeing a false image in the mirror triggered by her body dysmorphic disorder that tempts her to over-exercise, have “good” and “bad” foods, and restrict her intake because she’s terrified of gaining weight and feels out of control.

The truth is, sometimes it’s exhausting being me. I finally got to the point where I was simply too overwhelmed to go on. I needed help. So I started seeing a therapist who I trusted and started peeling back the layers of my mask. Bit by bit, I revealed the source of my angst, of my insecurities, of my control issues and of my need for perfection. As my trust built with her, I was able to acknowledge the pain I had been repressing from childhood sexual abuse and was able to slowly begin my healing journey.

As I continue peeling away these layers and revealing the unmasked me, I often get comments like “Why do you need a therapist?” or “You seem so put together!” It bothers me that people don’t seem to comprehend that mental health issues are not shameful and there is nothing wrong with seeing a therapist or taking medication for anxiety. My mental health struggles don’t diminish my strengths as a person. In fact, in many ways, I feel acknowledging their existence and accepting I need help was the ultimate act of strength and is a sign of a strong character.

Let’s end the stigma around mental health issues. My struggles do not define me, but they are a part of what has shaped who I am, including the good things. On my healing journey, I’m slowly learning to integrate all of me — from what is in front of the mask to what is behind it. My hope is to one day have a whole self that can be all of these things and who no longer has to hide.

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It all started when she asked, “Where is your mother?”

I found myself in the school nurse’s office with extreme stomach pains. Convinced it was appendicitis, I ordered the school secretary to call an ambulance because I had to be dying or I would die should my appendix explode.

She instructed me to calm down in the way mothers tend to do, then walked me to the cot notorious in school nurse’s offices. I lay down in the fetal position and waited.

This has to be my period. What else could it be? I’m ancient not to have gotten my period. 15 is old for that, right? Wait, maybe I am dying? Do you die if you don’t get your period by a certain age? Oh, man, I have to tell what’s her name not to call Dad. How embarrassing if this is just me getting my period! I would die if Dad knew I had my period, and I’m too dense to know that’s what this is. No. What if everyone finds out I haven’t gotten it yet? Shit. That’s more embarrassing than Dad finding out. Shit.

The nurse finally came in. She asked when I last got my period. I lied and explained that couldn’t be it. It had to be appendicitis. That was the only explanation.

“How are things at home?” she asked. I stared blankly at her. “Is there anything going on at home right now that’s stressful?”

No. No. How could she know? Does she know Mom is sick? No, this can’t get out. No, it’s worse than menstruation.

“Nope. Nothing to report,” I said, grimacing through a smile that had become my trademark coping mechanism. “I really think this is appendicitis. Could you just call an ambulance or something and haul me out of here?”

She smiled and did a quick examination. She felt where my appendix was and asked if it hurt when she pushed. It didn’t, but it was hard to tell with the cramping.

“You’ll be fine. Just hang out in here until you feel better,” she said, closing the door behind her. I heard murmurs on the other side of the door. They were talking about my mom. They had to be.

Oh God. Everyone knows. How could everyone know? F*cking small towns. Of course, everyone knows. Goddammit!

I began sobbing silently. I couldn’t remember the last time I cried.

I guess it was when she forgot me. That was months ago. Why am I crying now?

I didn’t know it at the time, but the racing thoughts and the stomach pains wereanxiety. That nurse was trying to get it out of me, but she didn’t explain that’s what it could be because I wouldn’t tell her what was wrong. She probably should have anyway.

The stomach pains started early in my sophomore year of high school and continued through my junior year. My mother, who was diagnosed with early-onset Alzheimer’s when I was 13, didn’t remember me anymore. One particular night, I was helping her eat and she said, “Where is your mother?” Thinking about it now, this was a profound statement. Yet, from there on out, she couldn’t remember my name. The pains began.

My family didn’t discuss problems. The few times I reached out to my father about my stomach, he one-upped me by elaborating on his own ailments and how mine couldn’t be nearly that bad. I shouldn’t complain when others have it worse. I needed parental attention. He needed spousal attention. Neither of us was getting either.

I stopped complaining after that. Well, until that day at school when I reached out to the nurse. However, after that, my “best” feature became my ability to bottle things up and push them out until they exploded all at once in a blaze of glory. I ended up depressed in bed for a week. You know, “healthy.”

My mother died before I finished my junior year of high school. The pains had become so much a part of me that when they finally stopped, I didn’t know the sensation, or, rather, lack thereof. No one asked me how I was (save one teacher) after she died because I continued to wear a smile. I was grateful no one asked. Falling apart in public was the worst of humiliations or so I thought.

I had no idea what I was experiencing was anxiety and depression. No one talked to me about it. No one saw I needed help because I was so “normal,” and that’s just it. Anxiety and depression hide themselves in fake smiles. Smiles that, on the outside, seem genuine. We’re just trying to hold it together.

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My husband and I took a shopping trip to a large store for the first time in eight years. For so long, I had been limited to shopping in three small, local stores due to my anxiety. My husband utilized his knowledge of my anxiety to organize a trip to a large store in a busy mall I longed to visit. Our careful planning and use of strategies made the seemingly impossible possible for me. 

What did he do that helped? Here are the things my amazing hubby did that helped me reduce my anxiety:

1. He suggested options so I felt in control of the situation as much as possible. My hubby offered to drive or asked if I wanted to drive. Since I chose to let him drive, he let me know frequently that we could turn around and go home if my anxiety got to be too much for me. I also chose the destination, as challenging as it was!

2. He offered reassurance and support. Frequently hearing positive statements along the way helped me. He was specific and clear with his reassuring and positive statements: “We only have four miles to go. You’ve got this.”

3. We tried distracting strategies. Distracting strategies can include listening to music, singing, sharing favorite memories, solving riddles, breathing exercises, and playing road games like “I Spy” or “License Plates.”

4. He was my cheerleader! He reminded me how proud he was of the progress I made at various points of the journey. And when our trip to the mall was accomplished, he told me how proud he was of me for working through my anxiety to accomplish this trip. 

5. When the number of choices at a store provided stress, he helped me reduce the number of choices. He asked me questions like, “What would you wear most often? What do you love?”

6. We were patient with each other. It is difficult for me to cope with anxiety and overcome obstacles. Being patient with ourselves and our partners as we work through this is key to reducing stress. 

7. We talked about what helped make the trip enjoyable. We took time to reflect and review. When we did this, it emphasized for me not only what I did, but what he did as well. I thanked him, and I realized I could ask him to help me by using these strategies in the future.

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We all know what it’s like to be anxious, but unless you’re one of the 40 million adults in the U.S. who has an anxiety disorder, it’s hard to understand how significantly persistent anxiety can affect your daily life. Because anxiety is more than worrying. It creeps up in different ways, and even has varying physical effects.

To understand more about how anxiety affects people in their daily lives, we asked our people in our mental health community to share a subtle sign of their anxiety.

Here’s what they had to say: 

1. “I’ll use a self-scan at the store to avoid having to talk with a cashier or feel like they are judging me for what I’m buying.” — Rachel H.

2. “I seem to become hypersensitive to loud sounds. I jump at sounds that wouldn’t have bothered me that much before, e.g. car door slamming, someone sneezing nearby.” — Chantelle S.

3. “The breathing is the part that always gets me. I’m always super aware of my breathing and when it gets harder I always panic and make it worse. Every waking moment I’m always worried when the breathing and panicking will get worse.” — Liza G.

4. “Unexpected calls, texts or emails can send me in a complete panic and derail my entire day. At work the worst thing a boss can do is ask me to swing by later. I immediately start to feel sick to my stomach, even though I am doing a good job.” — Will D.

5. “Whenever I hear raised voices, or something my brain perceives as that, I immediately get anxious that I’ve done something wrong and someone is angry at me. Even more than usual, this makes me feel like I have to be silent, and take up as little space as possible because that’s the best way to appease them.” — Liselle F.

6. “I avoid taking the elevator at work just to avoid possible interactions with other people. I keep my head down when I pass through the office. Avoid and put off phone calls because I’m too anxious about how the person on the other line will be or what they want to discuss. I jump when phones ring, when doors slam. My daughter misses out on spending time with other kids because I’m too anxious to meet the other parents. My husband misses out on many opportunities because of my anxiety; he backs out of plans or doesn’t make any because he knows it will probably make me anxious to either be alone or meet new people. It impacts my family, my career, myself. I’m trying to get better for all of those reasons.” — Nichole G.

7. “I end up not being able to understand simple concepts and crying over tiny things. I also replay every conversation in my head and convince myself that everyone is laughing at me.” — Vicki B.

8. “It takes me two to four hours to fall asleep every night. Random events play in my head as I try to sleep. Usually it’s something awkward I said or did by accident ages ago (we’re talking years and even decades). I’ll obsess over how I could have reacted differently or fixed it. Usually my only coping mechanism is to read something on my phone to replace the thoughts in my head. Eventually my eyes will be too tired and I’ll go to sleep. Some nights though, I have stress dreams about things I was thinking about before falling asleep. It’s not hard to see why I’ve had severe insomnia since childhood.” — Argy IP

9. “My mood fluctuates so much. I get extremely irritated and angry when things don’t go the way I planned them to go, and I snap at people. I have extreme anxiety about being on time, and will turn into a major witch if someone is making me run late.” — Kelly K.

10. “My chest will tighten for no reason and it’ll become hard to breathe. I will have to convince myself that I am not dying, and that I am getting enough air into my lungs.” — Chantel P.

11. “My anxiety makes me doubtful of my own abilities. Whenever I think about doing something… anything, I always have the thought of ‘what if I cannot do this, I’m not good/smart/strong enough?’” — Christina P.

12. “Unexpected guests stress me out. Changes to plans, too.” — Mel F.

13.Stuttering, shaking hands, unable to remember what word I am trying to say, sensitivity to sound. — Devra Lucas

14. “My interactions with people at work. I actively avoid elevators and take the stairs to avoid being in an awkward small space with strangers. I avoid conversations with people when I walk into the office kitchen, or walk the halls to the copy room. My anxiety also makes it very hard to be motivated or focus on my work. I spend a lot of time procrastinating because of that. Also, I go over what I’m going to do when I get home a million times in my head, stress about what I will eat, how much money I have, any stressful conversations I’ve had with friends/family/partner that day, how much time I will have to relax before sleep if I decide to work out, cook dinner, etc. When it is time for me to sleep, I get anxious that I haven’t accomplished enough in the day or haven’t done all the things I wanted/needed to do, making it hard to actually fall asleep.” — Haylee P.

15. “I’m terrified of phone calls, especially from people I don’t know” – Courtney S.

16. “It makes me feel like I’m not good enough to do anything. Even simple things like brushing my teeth. My brain tells me I didn’t do something perfectly so it was wrong. It makes it hard to do anything because nothing ever feels worth it when you feel like everything you do is bad.” — Sarah S.

17. “Anxiety whispers doubt into every action I take, telling me that nothing I do will be good enough and uses every past action as a reminder that if I was only better the result would have been better, too.” — Kris G.

18. “Being disappointed and angry when not including in plans that my friends make, but also knowing I would probably panic and cancel if I was invited.” — Lexi K.

19. “The anxiety over having anxiety. Small reminders all day long. Feeling anxious over feeling anxious. And it doesn’t manifest itself physically, it just pops in my head and tells me ‘you’re gonna ruminate over this in 5, 4, 3, 2, 1…’” — Cheryl P.

20. “When making any decision, big or small, I spend a great deal of time debating with myself. Oftentimes, despite this being a familiar pattern, it doesn’t occur to me until much later that I’ve been ‘arguing’ with my anxiety, not my own concerns about my choices. Even just writing up this quick response, there’s that ‘little voice’ adding uncertainty and doubt into what I want to share, even though I feel confident in what I have to say.” — Marina F.

21. “Going to work super early every day, just in case something happens on my commute. It is usually only a 15 minute drive, but I leave my house two hours in advance.” — Cassandra T.

22. “Nausea and unsettled stomach… fatigue and brain fog even though my mind is racing and on edge, making it difficult to concentrate.” — Heather W.

23. “It’s like I’m in a fog. I stutter and can’t fully concentrate. My words are slurred and I feel like I’m in a dream. Work is hard. I feel extra slow like I’m moving in slow motion, but at the same time I can’t hold still. My thoughts are scattered, yet I can’t put them into words. My palms get sweaty and hands shake as I try to communicate with people I work with. I get nervous to talk to co-workers because I just know my words will come out faster than my brain can put it together to make sense. I stare at nothing but I think about everything. When someone asks what’s on my mind, I might have a million thoughts racing, but I honestly can’t tell them. The answer is always ‘I don’t know.’” — Marci J.

24. “At work, if I feel like I’ve made a mistake it haunts me all day… or if I feel I’ve said something just wrong. Like if I’ve made a joke about something and it ended the conversation, I wonder if it was inappropriate, too far, or if everyone just thinks I’m not funny. My anxiety makes me lack the confidence I know I should have.” — Milinda M.

25. “Not being able to concentrate on any given thing for more than a few minutes because I always feel like I have a million other things to do and need to address them as well, and my anxiety builds if I don’t. Wash, rinse, repeat.” — Emily K.

26. “When I get invited to something, anything, I am immediately filled with dread. I overanalyze whether or not I should go, then I usually torture myself over that decision leading up to, during and after the event.” — Lindsey P.

27. “The physical pain that my anxiety causes is sometimes overwhelming. For instance my arms, hands and chest have been hurting for the last couple days. It just makes it that much harder to get anything done.” — Natasha A.

28. “I put off everything in any way possible, I stay in bed as long as I can or spend hours pointlessly scrolling through social media because I feel anxious about doing anything for fear of being judged.” — Alex S.

29. “I pick the skin round my fingers compulsively. My hands rarely look nice and sometimes I make my fingers bleed. It can get really painful and awful when my anxiety is at its worst.” — Caro H.

30. “I get anxious when I get notifications on my phone. An unexpected call, text, Facebook message or email can tip my anxiety over the edge. I have to ignore friends who are trying to communicate with me at times and it’s difficult to get others to understand that I’m not trying to be rude; I’m just trying to manage my anxiety.” — Manda W.

31. “I need very specific instructions for so many things or I just stand there looking confused because I don’t want to do something wrong so I’d rather not do anything.” — Jamie H.

32. “Ordering food at a restaurant or fast food place. I’m always so awkward and now my husband knows to just do it for me. I just get so anxious and I forget how to me a normal human.” — Chelsea S.

33. “Being too anxious to leave the house for something important, but worrying about not going. It’s a constant battle in your mind.” — Ammy N.

What would you add?

33 Subtle Ways Anxiety Affects Your Daily Life

People with anxiety share what they want their significant other to understand about their anxiety.

The holiday season is most commonly known as the best time of the year, but for many living with mental illness, getting through the intense shopping craze and extended family dinners is not that easy. From paranoia to personal ticks, the holidays can mean something different to those combating anxiety or depression.

It means a lot of weather watching. Tornado expected six states over? Eh, better not risk it. Blizzard in Greenland? Best stay home today. A single gray cloud in the sky? Sorry Grandma, just save the presents for my birthday. Gust of wind? Looks like Santa can’t make it this year.

It means a lot of staying at home and binging holiday movies while everyone else is socializing. There’s a large amount of people on the roads right now, shopping, frolicking, socializing, that’s a lot of noise and a lot of bodies. However, just because you don’t want to be out in the snow, doesn’t mean you don’t want to get in the holiday spirit! A 24-hour “A Christmas Story” marathon should do the trick.

It means really long bathroom breaks. The only place where you can escape from the loud noises and overflow of family members who love to hug. Also, this is an opportune time to stop by the fridge and chug a couple glasses of water because you’re feeling nauseous.

It means a lot of playing on your phone. Even if there’s no service in the middle of a cornfield at grandma’s house, you’ll find something to do. It’s been awhile since you played Angry Birds. Who knows? Maybe you’ll go pro.

It means a lot of panicking about the future. Every grandpa, grandma, uncle, aunt and weird family member you don’t know how you’re related to will ask what your plans are for the future. Unfortunately, it would be inappropriate to say, “A professional Angry Birder,” so you have to come up with an excuse that’ll make you seem smarter than the rest of your cousins. This lie will haunt you into the next century.

It means a lot of breathing exercises. Breathe in 1-2-3, and out 1-2-3, every time Grandpa uses a racial slur. In one nostril, out the other, each time you flinch at the clattering of forks against plates. Loud noises are the worst.

It means a lot of hand wringing, leg bouncing, foot tapping, and all together, fiddling. Fingers, feet, the hem of your sweater, your split ends, anything that can offer a distraction will suffice.

It means a lot of self-loathing. Why can’t I just go outside? Why can’t I hang out with friends? Why can’t I go shopping on Black Friday or stay out until midnight on New Year’s Eve? What if I don’t have any resolutions?

Instead, you are holed up, staring at the glow-in-the-dark stars on your ceiling because that is what’s most conducive to your mental health. At the end of the day, you’re going to be around a lot longer than a pair of trendy boots or fuzzy socks. You’re here for the long run, and next year, you get to go through it all over again. So you should probably start preparing now before the crowd hits.

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