Elephant in the room

Every day I wake up and try to keep my mornings as routine as possible. Brush my teeth, have my coffee and go to work. Come home, have dinner, watch mindless television until it is time to (hopefully) go to bed. Anxiety keeps me up, nervous about the fact I may not get enough sleep to make it through my following day. This is a normal day.

My anxiety elephant sits on my chest and follows me throughout my day. Sometimes he is heavier than normal, but he is always there. I try to ignore him or talk him into lessening his weight on me, but it doesn’t seem to be a choice of mine. If it’s really bad I turn to my prescription medication.

Nights are the scariest. As soon as the sun sets I feel that elephant pushing and squeezing in between by ribs on my heart and throughout my chest. Like a wild and restless beast. This is when I begin to feel overwhelming sadness. I’m irritated, and I’m frustrated with myself and with the only people around me, my parents — the ones who have been my biggest supporters. I snap and I’m mean, or I cry and I scream out of frustration, confusion and such heavy sadness.

The elephant wins another night.

Once I have stopped crying and am able to regulate my breath, the elephant sits softer or maybe I am too tired to bear his full weight or to even notice. I reflect on the attack of emotion I had: Was it anxiety? Was it panic? Was it just sadness? Do people just cry and scream on a regular basis? I feel strange, out of body. Who was that? And what was that? I’m embarrassed people were witness to that, even if it was just family. I say things I don’t mean and am always asking to go home… although I’m already home.

My elephant sits with me tonight again.

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Thinkstock photo by Brian A Jackson


I have dedicated so much time and energy to focusing on the physical symptoms of my chronic illnesses that I was completely caught off guard when I started experiencing pretty severe anxiety and post-traumatic stress disorder (PTSD) symptoms.

My anxiety snuck up on me, but it didn’t slowly creep up behind me. Instead, it seemed to smash me in the back of the head so I couldn’t miss it. It’s not the kind of nervousness you get before you take a final exam or speak in front of people. It’s the kind of anxiety that my typical coping mechanisms of writing, adult coloring books and guided meditation couldn’t handle. This couldn’t be ignored. This is agonizing anxiety. It’s an intense and constant state of worry, where you can’t turn your brain off from the rapid fire irrational thoughts. It’s the kind of anxiety where your thoughts consume you to the point where you are physically debilitated. I will play out every scenario to every situation in my head, even meaningless tasks. Sometimes I will fall so far down the rabbit hole of nightmare I forget what I was thinking about didn’t even happen or isn’t real.

At first, I wasn’t going to seek help. I didn’t want someone to perceive my mental illness symptoms minimized the physical symptoms that stem from my very real chronic illnesses. I didn’t want to deal with the stigma associated with having mental health problems or seeing a therapist. I didn’t want to be called “crazy.” However, it got to the point where I was desperate for help. I was in a battle with my own mind and was my own worst enemy. Almost every single waking and sleeping moment was spent in a constant state of worry.  

It was almost a relief when the therapist confirmed I struggle with anxiety and PTSD. It was almost a relief when I was prescribed medication to relieve my symptoms and began therapy sessions.    

Therapy isn’t easy and is truly a lot of work, but it is worth it. I think of my therapy sessions like Thanksgiving leftovers. I have so many things running through my mind at any given time. Therapy or counseling sessions help me put each of those thoughts into separate boxes, much like the food containers that house slices of turkey, dressing and cranberry sauce the day following the holiday. I don’t have to deal with everything at once and things can be put away in the refrigerator to handle at a later date. Each therapy session, I can take a new container out of the fridge and process those thoughts one at a time. It makes all of the leftovers seem less overwhelming.

As a public health professional, I think mental health is just as important as physical health. It has such an impact on almost every aspect of your well-being. Be nice to your body and mind. Take care of yourself.  

Although I was at the point where I probably wouldn’t be alive without my psychiatrist’s help, you don’t need to be at that low of a point to attend therapy. You don’t need a catastrophic event in your life to benefit from counseling sessions. I honestly recommend it to everyone, just to deal with the regular stuff life throws at you.

Most people want to live to their fullest potential and therapy can help you achieve that.  It’s beneficial to talk to someone who gets paid to have a unbiased opinion, who won’t judge you and doesn’t give you unsolicited advice like your friends and family members may do.

Your body is like a car. You have to bring it into the shop for maintenance and fine tuning to make sure it continues to run smoothly. This is like therapy. Although I am out of the depths of my anxious thoughts, it doesn’t mean I don’t need to continue to maintain in order to sustain.

I have heard every excuse for people not wanting to go to therapy. One of the major ones is cost, but there are many free or low cost options, as well as options for students on college campuses. It just takes some research. Those interested can visit the National Alliance on Mental Illness for more resources.

I have no shame in telling people I have sought mental health help, although it took me a while to get to this point. There is no shame in seeking help when you need it. You go to the doctor when you’re sick, right? What makes this any different?  

Honestly, I think seeking mental health help or attending therapy sessions is one of the bravest things a person can do. Opening yourself up to a stranger can be terrifying and can leave you vulnerable with a lot of raw emotions left on the table. However, I believe it is the ultimate form of self-care and is truly worth it. I wouldn’t be here today if I didn’t take that step.   

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

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to 741-741.

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Thinkstock photo via vadimguzhva.

My sister and I had been planning a trip for a few months. It would be a road trip during her school’s spring break that would take us on a loop of four states, two of which included friends we were excited to visit. We had the details settled and were excited to see the days on the calendar start to fly by, inching us closer and closer to our departure date.

A week and a half before we left, we got an offer to join a few friends on a side trip for a few days before our planned road trip. It would more or less lead into where we were already headed and could be a fun addition. It could be an added adventure. Sure, it would cost a little extra money, but what else had we been saving for besides adventures like these? It would be good, it would be fun, it would be spontaneous and easy.

Except it wasn’t.

Immediately upon hearing about this side trip offer, my sister’s mind was turning. This would be great! It would be so fun! She was ready to pack up, change the plan and leave the next day. But I clammed up. My eyes shied away from her and my mind began to race. The conversation we had been having shut down. I was a brick wall.

Having lived with me her whole life, my sister knows me. She can tell when I’m gone. So immediately after expressing excitement and anticipation for the trip, she began to back track. She saw the anxiety all over my face and did her best to counteract it.

“It would be fun,” she said, “but we don’t have to.”

Shortly after, she excused herself upstairs, saying she was tired and ready to get to bed. She knew I just needed to be alone. To think. To process. But what she didn’t know — what nobody can really know unless they’ve been there — is where my mind went after she left.

We can’t go. It said.

We had a plan and this wasn’t part of it. The change is too much. It’s too overwhelming. I can’t handle this. I have to say no. But, why can’t I just say yes? Why can’t I be more spontaneous like everybody else? Me saying “no” ruins this for my sister. I’m preventing her from doing something she really wants to do. Why can’t I handle things better? What is overwhelming about this? It’s just a few days, get over yourself. I’m 26, I’m supposed to take trips like this. I’m supposed to live in the moment. I’m supposed to be more fun. Why aren’t I better than this? Maybe I just shouldn’t go at all. They would probably have more fun without me, especially if something as small as this is “overwhelming.” I’m pathetic. This is ridiculous. Breathe!

I leaned into my hands, looking at myself in the mirror. My mind was a mess, but the voice of reason was fighting its way to the front.

Just breathe. It said.

We’ve been through this before. Breathe. You don’t have to decide right now. You don’t have to change everything right now. Take it in steps. Break it down into pieces. Breathe. You are not pathetic. You are not weak. You are not ridiculous. Breathe. You shouldn’t be someone else. You shouldn’t act a different way. You shouldn’t think different things. Breathe. You are perfect the way you are. You are OK. You are going to be OK. Just breathe.

My sister had gone to bed by this point, leaving the house dark and quiet. I breathed in and I breathed out. Maybe I wanted to go on this trip, maybe I didn’t. But I didn’t have to decide in that exact moment, it could wait until morning. I breathed in and breathed out. And whatever I decided, even if it ended up being me saying “no,” it would be OK. There would be other trips. There would be other days. So just breathe, I told myself. Right now, all you have to do is breathe.

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Thinkstock photo via welcomia. 

One of the hurdles I face and strive to overcome on a regular basis is my anticipatory anxiety. This kind of anxiety builds up prior to my commitments, sometimes days and other times weeks and months in advance. When my anticipatory anxiety is particularly strong, it can be extremely difficult to leave the house and follow through with my day as planned.

The night before any commitment is when I especially struggle with my anticipatory anxiety. I try not to focus on the accumulating worry, but it makes itself known through the coldness of my hands, the tight pressure in my head, the fluctuating temperature of my body and the uneasiness of my stomach. I try to sleep, but I only manage to do so in an interrupted manner. I tend to wake up at one-hour intervals, my thoughts consumed with the next day’s event, wondering if I will be able to uphold my commitment or if I will need to cancel because of the way my anxiousness makes me feel.

I composed the following letter, addressing it to my anticipatory anxiety in recognition of the strong hold it has upon my life and my wish for it to work with me, not against me, as I go about my daily routine.

Dear Anticipatory Anxiety,

Why do you accompany every decision I make? Why do you cause me to second-guess myself? Why do you make it uncomfortable for me to go about my every day?

When I plan to spend time with a friend, you grow in intensity as the days approach our get-together. I so look forward to seeing my friend, but when I’m feeling nervous and tense because of you, I consider canceling my plans. I don’t want to miss out on shared moments with my friends. I know you are just looking out for me, but my friends are here for me too. My friends are an important part of my support system, and they make me feel safe and comforted by reminding me how much they care about me and how much they believe in me. Please believe in me too.

We are in this together and need to trust each other as you accompany me throughout my life. I want to be a team, where you help me to be perceptive of others’ needs and my own, and where I grow in acceptance of you, recognizing you are a part of me that contributes to who I am — a part I don’t need to be ashamed of anymore. I am humbly asking you to not be a hurdle I need to jump over. Help me keep running in the race, because I know I have the strength to do so and I don’t want to give up on myself.

Yearning to better understand you,


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Thinkstock photo via KatarzynaBialasiewicz

It starts with a slightly empty-stomach, nauseated feeling. I might not notice it at first, probably because I’m more focused on why there seems to be a pain point behind my left eye. These are small things that can easily be brushed off as being hungry, thirsty or needing some caffeine in most people. But for me, they are the first warning signs my anxiety is starting to spike. If I can seize control before a full blown anxiety attack, I can limit the physical symptoms to ones that people won’t notice. I can ease them out through tics like bouncing my knee, tapping my fingers or chewing my nails. Little stuff that is so common most people don’t notice.

But after that first indicator, my hands start to tremble ever so slightly and the vicious cycle of negative thoughts encouraged by my own fears — rational or not — start looping in my mind. At that point I get restless. I have to move, I need space to breathe because it feels like there is a weight on my chest and lungs. I have to get outside or into a bigger room or a quieter room to be able to figure out if I’m actually suffocating or if my mind has told my body it is, even when it isn’t.

Then the gut wrenching stomachaches start and the nausea grows worse. I can’t tell if I need to throw up or not and I wind up so dizzy that standing is hard. So I press my back against the wall and try to breath, try to stem the tears the lump in my throat and the burning in my eyelids tell me are going to fall. The symptoms spike quickly once I’m past a controllable stage and spread to weakness in my knees and legs, uncontrolled crying and desperate gasping for air.

Anxiety isn’t just an excuse to try and slide out of obligations, it’s a real illness with real symptoms that manifest both psychologically and physically. No two people with anxiety will display the same symptoms when they are feeling anxious, so I wanted to caveat my article with explaining these are the physical symptoms of my anxiety.

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Thinkstock photo via Silmairel.

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