Picture a younger version of yourself on one end of a seesaw. Now pretend there is a baby elephant on the other side. Let’s assume you are about the same size (you guessed it, the seesaw represents your state of mental health). The seesaw can go back and forth because you are relatively balanced. As you grew, so did the elephant, and things were pretty equal for some time, for 25 years to be exact. And then WHAM! The elephant hits a growth spurt and overnight, you’re stuck at the top of the seesaw with this giant elephant weighing the other side down, totally out of balance.
Michael Buble’ s Feeling Good.
“…It’s a new dawn
It’s a new day
It’s a new life
And I’m feeling good
I’m feeling good …”
Ralph Waldo Emerson famously said:
“Finish each day and be done with it. You have done what you could.
Some blunders and absurdities no doubt crept in; forget them as soon as you can.
Tomorrow is a new day. You shall begin it serenely
and with too high a spirit to be encumbered with your old nonsense.”
…And what happened in the following months and years.
In 2015, my life looked textbook-charmed. I’d lived in San Francisco for 12 years — long enough to understand its ups and downs — and worked in tech nearly as long. I had a thoughtful, handsome husband and a wise, funny, five-year-old daughter.
This is what life felt like:
Nearly daily migraines, crippling neck and shoulder pain, and a nauseated stomach that sometimes forced me off the bus to keep me from fainting.
I’d given up much earlier on the hope of finding a cause for these pains, so in July 2015 I went to my annual neurologist appointment ready for dose of confused irresolution. Instead, in response to my hyper-focused research and fast speaking, she diagnosed me with generalized anxiety disorder. My life changed on the spot.
Why had this diagnosis been so elusive?
Generalized anxiety is an umbrella term, meaning that there are lots of different types of people to be found under there when it rains.
The statistics shared on ADAA suggest that 6.8 million Americans, or a little over 3% of the population, has generalized anxiety disorder. (I think that’s massively understated, incidentally).
I believe that the description of GAD caused me to miss the symptoms I was experiencing. “Excessive worry,” the disorder’s most common descriptor, was problematic for me. For 39 years, I didn’t consider myself a worrier.
I was an overthinker with migraines
Since I never used the words or mindset that the health industry used, I found very few examples that rang true when I searched for information about generalized anxiety. Even after my diagnosis, and acceptance of diagnosis (which was lightning fast, btw. As soon as my neurologist said the words, I knew she was right), I had a terrible time finding relevant information about GAD. In person and online, though, I met tons of people who were, in fact, just like me: men and women experiencing physical pain resulting from perfectionism, fear of failure, and overthinking.
The disconnect between how people talk about anxiety and what anxiety actually feels like is what drives me to write and talk about anxiety. Thanks to my diagnosis, what was once invisible now has shape, and I understand the world around me differently.
Was My Experience Unusual?
A few months after going on anti-anxiety medication, I went back to my neurologist at UCSF and explained that my once-daily headaches were now down to one per month. I was grateful. I was also curious to know if my experience was unusual. From what I could tell, it seemed surprisingly common.
But—cue the overthinking—maybe I was overestimating it. Like every good student of anxiety, I had memorized my list of cognitive biases. Was I overgeneralizing? Was my sense that people around me were experiencing physical pain as a result of perfectionism simply projecting my problem onto others?
Was I hearing only what fit my story?
My neurologist listened to my concerns and then replied, “This problem — the problem of perfectionism and anxiety — is getting bigger and bigger every day.”
She described seeing an average of three people a day suffering from some form of chronic physical pain who had one thing in common: perfectionism.
“It’s extremely common in the tech industry,” she said. “These people are very successful. They want to do everything right.” She then said something haunting: “One of the groups that has the hardest time seeing GAD in themselves is psychiatrists and psychologists.”
Diagnosis is hard
In the past, if you had a physical problem, you’d visit a doctor.
If you were having a mental problem, you’d visit an office like this:
Treating symptoms meant sitting in a room with an expert, looking for answers together.
If your physical symptoms spring from your intense pursuit of perfectionism, however, this method is problematic. You can visit doctors of all stripes, and they won’t find anything physically wrong with you. Therapists may enjoy your confessional insights and wit as much as you enjoy sharing them—but they won’t help you when your back gives out again.
It’s Up to You to Connect the Dots
Anxiety, though chemically and genetically influenced, is, at its most fundamental, a system of messages the body is trying to send the mind. It’s similar to an allergic reaction where the body overreacts to stimuli. In this case, the fear of losing control causes an adrenalin and cortisol rush in the body. Our minds work to avoid negative feelings (or the stimuli that caused it). Yet the effort of avoidance ends up creating more fear—and more overreaction. Doctors have long seen a connection between the physical pain that people feel and the emotions they are repressing.
For perfectionists, the mind is trying to tell itself the truth: “I can’t live up to my own expectations.” But inherent in the perfectionist problem is an inability to accept this reality. The mind deflects the message of impossible expectations and literally pushes it into the body.
My neighbor is an example of this. Let’s call him Shane. Shane is an artist and teacher who spends a lot of time worried about what other people think about him. His standards for work are extremely high.
He also has a lot of neck and back pain, sudden bouts of sweating, and dizziness. He takes 3–4 ibuprofen a night for “sore muscles.” He needs a whiskey to help him fall asleep.
He knows that he has anxiety, but hasn’t yet figured out how to listen to what his body is telling him, or how to address the pain.
When I learned about my generalized anxiety disorder, I started with the treatment path of medication (Lexapro, 10 mg every day), meditation (Headspace, 20 min every day), and communication (writing, talking, all the ways). Treating perfectionism meant I’ve been forced to stop comparing myself to other people, especially on social media. I’ve had to learn how to turn up the volume on my own voice of confidence and creativity. I did this by creating a project that looks at perfectionism from a bird’s eye view.
Beautiful Voyager was born
Since late 2015, I’ve been working to create a place for perfectionists to meet and learn stress relieving techniques from each other. It’s called The Beautiful Voyager.
My goal with the site was to create a space where it was OK to be imperfect. I threw my real, far-from-perfect self, out into the world for everyone to see, hoping that other people like me might find comfort and common cause in my struggle. It’s like training wheels for social interactions. As confidence builds, pain subsides.
The Only Map is Buried Deep
I used to think, “There’s no map to understanding anxiety.” But that’s not true. There is a map. It’s just that each person’s is unique and buried deep inside of them. It takes a long time to navigate your own internal terrain. I created the site because it helps to have other navigators around during the map-hunting process.
If you or someone you love is experiencing symptoms like those on this list from my neurologist, take a closer look at how anxiety isn’t always what it seems.
- back pain
- neck pain
- chest pressure
This is one epidemic we can do something about, but we have to work together. So as you go out into the world, or deep into the world within, in search of the map you need, know that you’re not alone.
I’ll meet you there.
Disclaimer: This article is not written by a certified health professional. I am not qualified in any way to give advice on whether or not to take any type of medication for symptoms of mental illness. The reason I am writing about my own experience with medications is to further emphasize that my mental conditions are of equal importance to my health as my other medical concerns. I have struggled over the last twenty years with decisions on what medications, if any, to take. I hope to shed more light on this challenge and to let others know they are not alone. Similarly, Challenge the Storm and its representatives are not certified mental health professionals. For any questions regarding medication, please seek the counsel of your health care provider. See our Disclaimer page for more information.
What you will get from this piece
I would like to accomplish at least these three things with this article: share some of my own history with prescription medication, give you some pros and cons from my own experience, and talk about what all of us can do to further break down barriers between the people who need help and the professionals who give their help. The goal is to work past the stigma and to challenge ourselves to believe we are worthy of help and helping others by spreading our message. When discussing this piece with my therapist, I explained that my number one goal in writing about my struggles with mental health issues is for normalization of mental illness to any other illness.
“Relationships can be wonderful but challenging under the best of circumstances. When one partner has a serious mental illness, the situation can become even more complex. Many times, the partner without a diagnosed disorder will assume more responsibilities, at least for the short term. For a person who is already worried about what is happening with his or her partner, having to spend more time maintaining the household or taking care of the children can be especially hard.
It is important for the couple to keep in mind that most people diagnosed with a serious mental illness improve over time, and that a partner’s attitude and behavior can make an important contribution to recovery. It helps to maintain an accepting and positive attitude, while holding realistic expectations for the partner with serious mental illness.” Source: http://www.apa.org/helpcenter/serious-mental-illness.aspx
“Because of the stigma and misunderstandings surrounding mental illness, many people are reluctant to tell their partners. You may think that ‘what they don’t know won’t hurt them.’ If you’re in a long-term relationship, it’s better to disclose your health condition when you are well than conceal it until an acute episode…To talk to your partner, choose a time when you aren’t actively experiencing mania, anxiety, depression or psychosis.” Source: NAMI