Trigger warning: Article discusses mental illness, panic attacks, and self-harming behaviors.
Mental illness is not a new or unusual concept. Human beings’ brains are wired in such a way that allows for specific errors to occur. While these errors are problematic, they’re not a sign of personal failure or inferiority. They are simply an unfortunate side effect of being human. That being said, though, there’s a lot of misconceptions surrounding mental illness. This is particularly true of anxiety disorders.
Anxiety disorders are some of the most common mental illnesses, so it makes sense that they get a lot of attention. However, more attention also means more potential for misunderstandings. As a person who deals with severe anxiety on a daily basis, I think it’s important to clear up some of these issues.
Anxiety: The Facts
What is Anxiety?
First, let’s get some basic facts straight about anxiety disorders. Let’s get one thing clear right off the bat: anxiety disorders are more than just feeling “anxious.” I can see how people would make that mistake since in our cultural lexicon “anxiety” is frequently used as a general description.
But while feeling anxious is a normal part of being a human, anxiety disorders go beyond just general feelings of nervousness. A neurotypical person might get anxious before giving a speech, or a big test. That’s normal.
What’s not normal is when these nervous feelings linger or begin to interfere with a person’s day to day life. Once normal functioning starts to be affected, that’s when you likely have an anxiety disorder. Why do I keep using the term anxiety disorder?
Well, that’s another misconception. Even when they acknowledge it as a mental illness, most people think of anxiety in one specific way. But there is not one defined way to have anxiety. In fact, there are many subcategorical disorders.
Types of Anxiety
What most people think of is likely Generalized Anxiety Disorder (GAD). This is the general excessive worrying that is taken to an unhealthy extreme. People with GAD may find it difficult to control their thoughts or to address their fears face-on. However, another thing many people think of when they think of anxiety is a panic attack. While people with GAD may have panic attacks, people who deal with them are more likely to have Panic Disorder.
One of the defining characteristics of Panic Disorder that sets it apart from GAD is the fear of panic attacks. People with Panic Disorder will legitimately live in fear of having another panic attack. This greatly impacts their standard of living. Panic Disorder often goes hand in hand with Agoraphobia. Agoraphobia is the fear of the outdoors, but in this context means that people with panic disorder are afraid to leave their house for fear of having a panic attack in public.
GAD and Panic Disorder are the most common subsets of anxiety disorders, but there are many more. One familiar subset is social anxiety, which happens when a person gets incredibly anxious about social settings. Think about going to a party where you won’t know anyone, or speaking to a roomful of strangers. These are situations that a neurotypical person might find nerve-wracking. But again, what sets this apart from normal nerves is the extent to which it impacts a person’s life.
Other mental illnesses may often have components of anxiety. Obsessive Compulsive Disorder (OCD), for example, is often related to feelings of anxiety. Obsessive thoughts are often related to something that makes the thinker anxious, and compulsions are used to offset these feelings. Post-Traumatic Stress Disorder frequently includes panic attacks when confronted with specific triggers.
Anxiety Symptoms
Obviously, many of the symptoms of anxiety disorders are mental or emotional. Think of extreme nervousness, fear, and panic. But what makes anxiety disorders so dangerous is that they are frequently accompanied by physical symptoms as well. This isn’t that radical a concept, of course. Anyone who has ever been nervous before a big speech can sympathize. Who hasn’t dealt with sweaty palms, an increased heart rate, or similar feelings?
But again, what makes these symptoms problematic is when they fail to dissipate or negatively impact a person’s life. That person with sweaty palms who just gave a speech will likely calm down after their speech is over. But a person with GAD, for example, will likely continue to present these physical symptoms for a good while. This person may also be experiencing the physical symptoms of anxiety without a specific cause, which of course makes it difficult for the symptoms to dissipate because there is no trigger to move beyond.
The combination of symptoms is especially difficult for people with Panic Disorder. Panic attacks are a terrible combination of mental and physical symptoms. Oppressive fear joins in with racing heart rate, inability to breathe, headaches, even fainting. This explains why people with Panic Disorder are often agoraphobic; no one wants to have a panic attack in public if you know you might pass out.
Who Gets Anxiety?
Anxiety is one of the most common types of mental illness. According to the Anxiety and Depression Association of America, as many as 40 million adults in the United States experience an anxiety disorder in a given year. Anyone can deal with an anxiety disorder, though there are risk factors that make a person more likely to deal with one. Women are more likely than men to suffer from anxiety disorders. A person with a family history of anxiety or other mental illness is more likely to have an anxiety disorder.
Co-morbidity is also a risk factor. Co-morbidity refers to when a person deals with two or more illnesses at the same time. Mental illness has a high rate of co-morbidity, both with other mental illnesses and with physical illness. Co-morbidity is extremely prevalent in anxiety patients. One study found that almost half of all patients with a mental illness had at least one other presenting mental illness. In GAD and panic disorder, there is a high rate of co-morbid depression.
Young people are increasingly likely to develop an anxiety disorder. The ADAA estimates that one in eight children has an anxiety disorder. This is an extremely important point because younger generations often have a reputation — a distinctly negative reputation — for being oversensitive and weak. Terms like “special snowflake” and “participation trophy” seem designed to mock young people for their perceived weaknesses. But they aren’t weak. They are ill. These stereotypes are extremely harmful because they discourage young people from seeking treatment and undermine their health.
My Anxiety: A Journey
This might all seem pedantic and unnecessary to those who have never dealt with anxiety or never have a loved one suffering from an anxiety disorder. But for me, it’s incredibly personal. I deal with anxiety on a daily basis, and it affects my life. This has been a long, difficult journey, and my life is vastly different from what I thought it would be when I was younger.
Co-Morbidity
I didn’t always have anxiety. In fact, when I was younger, I was distinctly un-anxious. I dealt with the layman’s anxiety, the nerves before a big speech type (I didn’t even use to get anxious over tests. I miss those days). What I did deal with were other mental illnesses. I was diagnosed with bipolar disorder at 18, but that wasn’t the start of my journey. For me, it began when I was 14 and had my first depressive episode.
I was away on a school trip; it was my first big trip away from home on my own. I was having a blast until suddenly I wasn’t. It was as simple as that like someone had flipped a switch. At 14, I had no idea what was happening to me. I went from having the time of my life, having light-hearted good times with friends, to hiding under a table in an abandoned room and crying. That might sound over-dramatic and exaggerated, but honestly, that’s what it was like for me.
I went through the rest of high school with no treatment. Similar episodes happened from time to time, but I never sought treatment. I attempted suicide and began to self-harm. I was as lost as I can imagine. On paper, my life seemed pretty good. I wasn’t well-off, but I had a decent home life, I was very successful academically, and I had great friends.
So why was I always sad? Unfortunately, that’s not an uncommon story for many young people dealing with mental illness. A person can have an outwardly perfect life and still deal with mental illness — because mental illness has nothing to do with a person’s circumstances and everything to do with brain chemistry.
Turning Point
When I was 18, I attempted suicide again. This time, I ended up in the hospital. I was put on academic probation at my college, and I would only be allowed to return if a psychologist deemed me stable enough. What could have completely derailed my life ended up being the best thing for me. Because I was forced to see a doctor, I was eventually able to be diagnosed with Bipolar II Disorder.
That doctor was terrific because he listened to me. I had often felt like no one could understand what I was going through. And while he may not have personally gone through everything, this doctor trusted me to be honest and open with him. I was initially being treated for depression, including taking anti-depressants (which, for the record, is incredibly dangerous if you have bipolar disorder). But when things weren’t adding up for me, I raised the topic of bipolar disorder.
Rather than dismissing my thoughts or decrying internet research, the doctor believed me and agreed to run some tests. Because he was willing to trust me, I was correctly diagnosed. But more than the diagnosis was the peace I felt at that trust.
When you deal with mental illness, you often feel incredibly alone and isolated, which of course only makes things worse. This doctor reinforced to me that I can trust in other people, and not assume that everyone has it out for me. Seven years later I still thank that doctor for saving my life.
That is not to say everything magically got better. In fact, it got much worse.
Relapse
When I returned to school, I faced several hiccups in accessing mental health care. I stopped taking my anti-depressants because I didn’t like the way they made me feel. While I may have been right, it is never a good idea to change your own medicine without medical supervision. Worse, I did not begin taking anything else to help tackle the mood swings of my bipolar disorder. And on top of that, I stopped seeing the psychologist and did not restart therapy.
There were mitigating factors, of course. The Counseling and Substance Abuse Services at my school was not set up to treat long-term issues, but rather, minor issues like homesickness, stress, or alcohol infractions. So although they tried to accommodate me, they eventually ended up pushing me out to see a community doctor.
The problem with that is that it is incredibly difficult to access mental health care in our country. At the time, I was 19 years old, with crappy insurance and almost no income. I couldn’t afford to see a doctor consistently and frequently, and I couldn’t provide medication when my insurance would regularly refuse to cover it.
The lack of treatment, combined with increased stress at school, eventually led to a relapse. After another bout of suicidal ideation, I was back to being treated. Except for this time, I ended up getting the right treatment. I was finally put on mood stabilizers, three years after my initial bipolar diagnosis. I saw a therapist weekly, which was very important when I developed PTSD after a very distressing incident.
This PTSD was my first brush with anxiety. It was incredibly difficult for me because, despite my long-running issues with depression, suicidal ideation, and mood swings, I still had not truly experienced anxiety. While PTSD isn’t quite the same thing, it was still a challenging experience. I started to have panic attacks and trouble sleeping. Soon, though, it would get worse.
Anxiety
What led to this? I made a rookie mistake — I graduated college and thought I was ready to be an adult (spoiler alert: I wasn’t). I moved away to go to law school, which ultimately derailed my life. For the first time, I was incredibly anxious about school. The overwhelming stress I felt impacted my ability to be successful, and I eventually dropped out.
On top of the academic success was a growing agoraphobia. I moved to a bad neighborhood because it was all I could afford in the city where I moved. I was afraid to leave the house by myself because I did not feel safe. At one point, while a friend was visiting, we were attacked on the metro. Although no one was seriously injured, it only added to my fears of the outdoors.
After dropping out of law school, I moved back to the city where I went to college. I was able to get into a low-cost community clinic, where I began seeing an excellent therapist and an excellent psychiatrist. The psychiatrist diagnosed me with panic disorder, and it was an appropriate diagnosis. I had panic attacks, then panicking about having panic attacks. I was afraid to leave the house, which was impacting my daily life.
My therapist was a true angel as I dealt with this. I had to take the bus to get to my appointments, which was nerve-wracking. She encouraged and praised me for my efforts. Eventually, we would meet in public for my therapy, and I was enjoying being out of the house. The time I spent with her did miracles for helping me accept, if not truly overcome, my anxiety diagnosis.
Living with Anxiety… and Hope
Things are not perfect in my life by any means. Since my anxiety diagnosis, a lot of other things have gone wrong. But, thanks in no small part to the support I found, I am still here.
I live with my anxiety every day. I take several different medications, both for the bipolar disorder and the panic disorder. A large chunk of my money goes to prescription costs, not to mention the cost of doctor’s visits. But I do my best to keep up with my medicine because I have seen what happens if you don’t.
HYPERBOLE AND A HALF: How NOT To Talk To Someone With Depression
My anxiety still negatively affects my life. I am not able to do all the things I want to. I can’t watch certain TV shows or movies because they might trigger an episode. Minor things that most people might not even think about are huge undertakings. I struggle inordinately with talking on the phone or asking people for favors. But I am also taking steps to deal with these issues. I started watching GAME OF THRONES… just with an anxiety pill handy, just in case. I had begun learning to drive, something I put off for many years after an unfortunate car accident when I was younger.
Most importantly, I try to take things as they come. A lot of terrible things happen every day, to people all over the world. While my anxiety puts me a step behind others at dealing with these issues, I can still overcome them. I take my medicine; I talk to people, I let my loved ones know what to expect so that we are all prepared. My anxiety won’t get the best of me, not if I have anything to say about it.
There is Hope for You Too
If nothing else, let my experience be a lesson to everyone reading. Anxiety is a terrible experience, to be sure, but it’s not life-ending. When so many people are dealing with it, it’s important to be understanding, empathetic, and kind.
And most importantly, be kind to yourself. Anxiety disorders don’t make you lesser than anyone else. It’s important to be cognizant of your symptoms and to take careful care of yourself. But you do not have to let anxiety keep you down.
Support groups are available online. Many communities may have support groups, and look for low-cost clinics if reaching treatment is difficult. If you or a loved one is experiencing severe distress or thoughts of self-harm, you can find help online at crisischat.org and by phone at (775) 784-8090.
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