If I had the chance to visit you, my younger self, a self who was just beginning to struggle with mental illness, what advice could I offer? What wisdom could I impart? I don’t know how long I’ve been struggling, to be honest, but I do know how long I’ve been formally diagnosed with severe depression, anxiety, and adult ADHD and have been seeking help. And if I were to go back to visit Alex before his first doctor’s visit, here are a few pieces of advice I would share.
Worry versus Anxiety
Everyday life presents stress, fear, and worry for everyone, but when you experience anxiety your brain experiences stress in a different way. Although it can be overwhelming, it can be managed and does not have to control your life. In previous articles, I have addressed other mental health issues. This article, written in collaboration with my adult daughter, Kelsey, addresses anxiety.
I will always remember my paternal grandmother as a worrier and there was not much you could say or do to convince her it was okay to let some things go. In her day, resources were limited and she would not have asked her family doctor about her worrying. Now, so much more is known about symptoms and how to treat anxiousness. There is a difference, however, between ordinary worrying and clinical anxiety.
- We tend to experience worry in our heads and anxiety in our bodies.
- Worry tends to be specific while anxiety is more diffuse.
- Worry is verbally focused while anxiety includes verbal thoughts and mental imagery.
- Worry often triggers problem-solving but anxiety does not.
- Worry creates mild emotional distress, anxiety can create severe emotional distress.
- Worry is caused by more realistic concerns than anxiety.
- Worry tends to be controllable, anxiety much less so.
- Worry tends to be a temporary state but anxiety can linger.
- Worry doesn’t impact our professional and personal functioning; anxiety does.
- Worry is considered a normative psychological state while anxiety is not.
I am not alone in my experiences with an anxiety disorder. “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18% of the population.” (Source: National Institute of Mental Health) While Generalized Anxiety Disorder (GAD) is the most common diagnosis of anxiety, many also suffer from Panic Attacks. Panic attacks fall under the umbrella of anxiety disorders. In an article written by Alex Hanna, Founder of Challenge The Storm, Panic Attack: Do’s and Don’ts, more specific details on panic attacks and how they differ from episodes of anxiety are discussed. “Panic disorder affects about 2.4 million adult Americans(~4%.) Panic disorder most often begins during late adolescence and early adulthood. It is twice as common in women as in men.” (Source: Web MD)
Kelsey and I have both dealt with the symptoms of anxiety over our lifetimes. However, just because we both experience symptoms of anxiety, doesn’t mean we experience it in the same way. We can’t diagnose or provide treatment but we can say: if you are experiencing anxiety, you are not alone, there is help, and there is hope. We provide insight into the different ways anxiety and panic manifest in our lives so that you might recognize similarities and reach out for yourselves.
What does anxiety mean to you and when did it become a part of your life?
Anxiety entered my life as a young child. I don’t think my parents were aware of a problem or if they did, lay people were ill-informed about mental illnesses. Some of my most visual memories of childhood involve being anxious, of loud men’s voices and of being left alone. I found comfort sleeping in my bedroom closet.
I continued to experience anxiety through adolescence and in my teens, I started having panic attacks. I was unaware that’s what they were and would have benefited from professional help. As an adult, I have been fearful of feeling out of control, unable to rationalize the things in my life frightening me. I also experience anxiety stemming from a fear of rejection. When someone says something that makes me feel bad or I feel uncomfortable, I think irrationally and become either withdrawn or I strike out, classic fight or flight behavior. Dealing with a mental illness is difficult enough, trying to do so while raising a family can be overwhelming.
To me, anxiety feels like having two brains that are perpetually at odds. My regular brain feels normal amounts of stress and worry, but my anxiety brain asks a thousand questions, ruminates, and does not let things go. I can rationally see a situation as being stressful or experience fear or worry, but it is my anxiety brain that keeps those thoughts moving, buzzing, and poking around. I remember having anxiety as a small child. As a kid, I wanted to enjoy activities that seemed “normal” to me, like sleepovers, staying with extended family, and staying up late for special events. However, I always struggled with bedtime. I endlessly worried about falling asleep and what would happen if I did not fall asleep. My mind would often ruminate for hours on the possible repercussions of not being able to control all of the circumstances around my sleep routine, and sometimes it prevented me from social situations or fully enjoying time with family. Sometimes I would call to get picked up from sleepovers, other times I would lie awake with insomnia hoping for some shut-eye.
I remember having my first clear episodes of anxiety during middle school. Once, I received a low grade on an assignment and when I confronted my teacher about it, I started to panic. I remember visual symptoms like objects suddenly looking neon, flashing lights, shortness of breath, and I instantly started to cry. It took the wind out of me. I had a similar instance a few years later, triggered by a stressful situation that seemed to paralyze me emotionally. In college, I experienced mostly manageable levels of stress and worry about exams, studying, and my future. However, I would sometimes get panic attacks after finals week was over. I remember talking to my dad on the phone walking down Bascom Hill, at UW-Madison, after having completed a week of finals. When I graduated, I became a teacher, which presented new stress and new triggers for anxiety. I once had a panic attack during my prep period, and I felt like I could not face my students or go pick them up without crying. The interference my anxiety had on my daily life and job led me to seek help. As a young adult and professional, now having taught for five years, I understand that I experience cognitive distortions and irrational patterned ways of thinking, at times.
How would you describe a panic attack?
My problem is with breathing. I forget to do it sometimes. Depending on the severity of the panic attacks, they come on differently and have intensity levels. When they are at the worst, I feel so out of control. I am not sure that I feel like I am going to die but I know that sometimes, I will have feelings of suicidal ideation, being better off dead. Or that the pain was going to kill me. When I was not properly treating my anxiety, the episodes were quite severe, but now under treatment, much less.
I experience both physical and mental symptoms during a panic attack. As I mentioned before, sometimes I experience neon, blurry, or spotty vision, increased heartbeat, shortness of breath, crying, dizziness, and a need to sit down. Mentally, my thoughts spiral pretty quickly. Before seeking help, they would be fixated on what if the episode did not end and it feeling like it would last forever. It felt like paralysis….like an inability to process. After seeking help, and experiencing racing and irrational thoughts, I try to use positive self-talk. I remind myself to breathe, find a private space, and to wait it out or ride the wave until the panic and symptoms subside.
How would you describe an episode of anxiety?
I treat my mental health issues as being just important as my physical health issues. I do not need to suffer in silence. I want to lessen the stigma.The constant I experience with anxiety is difficulty breathing. Ever since I was a little girl, I would unconsciously hold my breath when I was afraid, sad or nervous. When I go to the dentist, I am reminded to breathe many times during procedures. When I am having anxious thoughts, I have to tell myself to breathe to control myself and calm myself down. I think of my generalized anxiety as being related to triggers, claustrophobia, large crowds and having to go outside of my comfort zone.
When strategies to lessen anxiety fail, at times, I experience similar symptoms of a panic attack but it is triggered by something specifically (confrontations, important events, large crowds.) As these episodes are triggered by a specific situation, I can try to withdraw from what is triggering me, such as walking out of a crowded grocery store or taking a break during an event with a large crowd.
How do you manage your anxiety?
I have had therapy and learned about irrational thinking v rational thinking, I have come to avoid some situations which I know trigger me. I also realize that there are different levels of anxiety and I try to determine at which level I am experiencing. It was not until adulthood, I received therapy and medications to combat these symptoms. One thin, in particular, that was beneficial was a book given to me by my therapist called The Worry Trap by Dr. Chad LeJeune. “ LeJeune says that it’s important to learn how worry works. Imagine you’re hiking along a cliff, he says. Your brain tells you “I might fall,” and you picture yourself falling. This thought helps you realize that you need to be extra careful about where you’re walking. This is “a helpful thought to have,” he says. However, “when your anxiety is high, you’ll experience that image not as ‘I might fall,’ [but as] ‘I will fall.’” With heightened anxiety, “we are less able to discriminate [between] the thought that might happen” and the reality. This is called “cognitive fusion,” when “a thought becomes fused with what it refers to.” We experience a thought “as a reality, an almost inevitability.”
I pulled my hamstring in high school, and anxiety also reminds me of caring for that injury. At its worst, I sought medical help and treatment (both with my hamstring and my anxiety). After learning to manage it on a daily basis, it sometimes flares up, but I know that I need to take extra care in certain situations. To compare, for my hamstring that looks like stretching before a dance class or after a strength training session. For my anxiety, it means I practice self-care before and after a particularly stressful event. My management of anxiety (and also my pulled muscle) has created an awareness that currently is mostly preventative. I know that if my anxiety worsens or interferes more with my daily life, I can and will seek more help. I currently practice deep breathing and relaxation, as well as engage in activities that I enjoy, such as working out, playing guitar, or spending quality time with friends and family. I also reflect on my own thinking. A therapist taught me about cognitive distortions and how at times, my brain is reinforcing my negative thinking and anxiety by distorting what I am experiencing. ( https://psychcentral.com/lib/15-common-cognitive-distortions/ )
I self-evaluated which cognitive distortions my brain was often doing, reflected deeply on what aspects of my life trigger my anxiety. To combat the cognitive distortions I experience, I use positive self-talk to help evaluate how I’m doing in terms of experiencing stress and life as it is, without letting my “anxiety brain” take over. For example, a colleague at work once made a comment about my age, and assumed that I had less experience than I did. My anxiety brain and distorted thought pattern experiences this comment as: This person thinks I am young. They do not value my experience. If this one person thinks this, many people at work probably think this. Perhaps everyone thinks that I am young and inexperienced, and I am not valued. I’m working on flipping comments from disempowering to empowering. It can be difficult, but in this situation I could think it was possible that I do look young, objectively, and that perhaps I seem eager to learn and try new strategies, a quality that some might attribute to being young. It’s a work in progress.
ON A FINAL NOTE
Amy and Kelsey have both worked with qualified professionals to help determine and reflect on the root of their anxiety. We would encourage others to seek help from a therapist or psychologist to provide insight into your particular situation. It is helpful when those around you have an understanding of what I experience as an anxiety sufferer.
- Just because you don’t understand it doesn’t mean it doesn’t exist.
- I am embarrassed and ashamed that I cannot do the things you can do.
- I don’t like feeling this way.
- I don’t use anxiety as an excuse.
- Stress can make my anxiety much worse.
- I know many of my fears are irrational.
- It’s okay if you don’t know what to do.
Other sources used:
- Feature image sourced from www.pickthebrain.com
One more thing to worry about
As a mother of three and now grandmother of one, I worry what has passed on genetically to my offspring. We don’t have a family history of bipolar disease and as far as I know, no particular gene is identified for the condition in any case. However, I did grow up knowing that my maternal grandmother was clinically depressed. Losing a child to Leukemia took its toll on her. I was quite young and obviously have no memories of Grandma from that time. I do know she additionally suffered the loss of her father during her teen years along with living through wars the Great Depression. I have often wondered whether I received hereditary mental health predispositions. How much of her bout(s) with depression were passed on to her children, grandchildren, great and now great, great grandchildren is unknown. I am unsettled by this lack of information. What does all this mean for my family? What does your family history of mental illness look like?
Recently, I submitted a story of my own struggles with anxiety and depression to makeitok.org in hopes of having my story shared with another outlet. I’m proud to say that they accepted the story and it is now published here. But for your convenience, here is my story.
What kind of stigma did you experience/observe?
Mental illness is no joke. It sucks. Suffering with anxiety, depression, and ADHD has made “adult life” rather challenging. Not to say it was easy as a child either. For me, an always-busy childhood helped keep everything in check. I would spend the school year going 100 miles per hour between school, sports, and other extracurricular activities. Then the summer, I would work six days a week, work out seven days a week, and do all of the AP class preparations and college preparations needed to continue the high octane life I had built. Then when I had the opportunity, I would utterly crash. Zero miles per hour, clutch disengaged, rolling wherever gravity would take me.
After college, I joined a high octane consulting firm to keep up the heat. 15 hour days? On the road 250 days a year? You bet! I still didn’t realize what was going on. Work became my outlet for two years, affecting nobody but myself (or so I thought). Marriage changed that quite quickly. It became very apparent (very quickly) that my all-over-the-place-ness, which I regularly combated with bouts of extreme cleaning and organization or full-on, days long “me” time, was not just affecting me. It affected my wife. And I couldn’t stand to see her hurting like she was. It is easy to have your dress shirts hanging the “right” way, ordered by color, immediately removed from the dry-cleaning plastic when you are alone. It is easy to not have a single dirty dish in the sink when you live alone. No one else is affected by this.
It is so easy to be blinded by naivety when you are only looking at yourself. When others are affected, especially other who you love, that’s when the light of reality shines the brightest. The pain in their eyes is the most haunting sight anyone can envision. When I saw that pain, I knew it was time to act. She kindly and lovingly supported me throughout the process of finding a doctor (even booking me appointments when I was resistant).
She owed (and still owes) me nothing. Her help getting me help saved me. Her undying, and unyielding love saved me.
Years later, she remains my rock. We’ve hit bumps along the way, but she has never doubted what we have, she had never doubted my love for her, and she has never doubted the future we are committed to sharing together. Even through the most challenging of times, she reminds me who I am. She helps me understand who I am. She never lets me forget who I truly am.
Anxiety, depression, and ADHD: they are a part of who I am. I live day in and day out with these illnesses. But they do not define me. I am me. And while they occasionally have more say over my life than I prefer, I will not let them win. Even if I fail today, there is always tomorrow. There is always tomorrow.
How did you overcome this experience?
To overcome is to completely extinguish. I am, and will forever be overcoming mental illness, every single day. Share your story and do not be ashamed that you have a mental illness. There are more of us out there than we know, but who are afraid to talk about it. Your words make a bigger impact than you think. You never know who may be reading, and whose life you may save.
Help others by sharing a brief, positive message.
No matter what happens in this crazy world, there is always a brighter day ahead. There is always tomorrow.
The sunlight shines –
Shines so bright.
After the darkest –
Darkest of nights.
Your tired or fighting –
Fighting this fight.
But tomorrow brings hope –
Hope of new light.
Panic Attacks…they suck
If you’ve ever seen someone have a panic attack, you may not have known what to do (turns out most people do not). That’s completely normal. Witnessing a panic attack will most likely catch you off guard, completely unprepared, feeling as if there is nothing you can do to help. But there is.
Defining panic attacks
So what exactly is a panic attack? Is a panic attack different from an anxiety attack? The short answer is that it is an anxiety attack is an extreme reaction to a stressor, and its duration is often tied to the stressor as well (once the stressor is gone, the attack subsides). A panic attack, on the other hand, does not need a stressor to be induced, and because of that, it may not be as short-lived as an anxiety attack (since there is no stressor to get rid of). They carry similar physical symptoms, racing heart, shortness of breath, extreme fear or terror, etc. so they may look similar on the outset, but it is important to know the difference.
Example: If being in a grocery store is causing someone to have an anxiety attack (they get nauseous, can’t breathe, …), you may be able to help them out of the grocery store, removing the stressor. If you are at a friend’s house and someone starts breathing heavily, body getting tense, feels extremely hot (or cold, depending on the person), they may be having a panic attack and there may be no way to easily “snap them out of it”. This is where I want to focus. Here are some quick “do’s and don’ts” if you find yourself in that situation. You may think something as harmless as a calming touch on the shoulder is helpful, but you may be in for a surprise. Then, I want to share with you what a panic attack looks like in the word of Alex (that’s me).
Do’s and Don’ts
First, let me share a list of some “do’s and don’ts”. These are general guidelines, and will not apply to every situation. Everyone is different.
|For Starters||Be patient, sensitive, and soft. It’s a scary thing to go through a panic attack. But being a soothing presence, we have the chance to feel that warmth.||Don’t freak out. It is likely that this person has experienced panic attacks before. While it doesn’t make it any easier to work through, necessarily, the person likely knows it will pass. Gently remind them of this, in a calm and soothing voice.|
|Breathe||Breathe with the person – keeping a steady, consistent pace. Help them remember that this will pass; that they should keep breathing and that they will get through it.||Don’t tell the person to “just relax” without being willing to work them through the attack. It seems easy enough to realize that the perceived terror is irrational, but that’s where you’d be wrong. It isn’t an intellectual challenge, it’s an emotional (and chemical) one. So be patient and be willing to help your friend slow down his or her breathing.|
|Ask about Touch||Ask if you have permission to touch their shoulder/back/hand. If you are able to establish touch, this is a huge step in the calming process.||Don’t assume physical contact will calm them down right away. Often, the person is so over-sensitized that touch can feel like a serious threat, when the personal already may feel extreme fear or apprehension. So don’t go in for the “hand on the shoulder” until you have permission to do so.|
|Listen||Be cognizant of the person’s needs. They may change. They may be freezing cold one second, then burning up the next. Be flexible and work with them. Listen.||Don’t assume that you have any clue what they are going through. Everyone experiences panic attacks differently. My panic attacks won’t be exactly like yours. And that means everyone needs something unique. Don’t assume you know what that person needs. Listen to them, instead.|
|Be Present||Ask if we’re ok and if you can get us anything, a glass of water, perhaps. Ask if we want you to stick around for a little or not.||Don’t judge the person, not during, not after. More often than not, there is a severe sense of shame associated with having a panic attack. Don’t make us feel worse than we already do. Don’t try to immediately dig into the root cause of what may have been at the genesis of the attack. Now isn’t the time. It’s most important that we have a period to recover. It’s exhausting.|
A panic attack in the world of Alex
So this is where we get personal. I have panic attacks. I don’t always know what sets them off. Things like being in an overcrowded mall will make me anxious, sure, but they won’t toss me into an attack (that would be an anxiety attack). Most of my attacks happen when I am safe at home and often times don’t seem to have any stressor (panic attack). One of the scary things about panic attacks is that you feel them coming on. This can actually lead to an attack, itself, which sucks. This is called “anticipatory anxiety”, anxiety related to the fear of having an attack.
I experience a number of the common symptoms of a panic attack, but not others. When I have a panic attack, I feel:
- Heart racing
- Extreme tension in my muscles (typically my left bicep and triceps and my quads)
- Shaking, due to the tension
- Curling up in a tight little ball
- Rapid breathing, which can lead to hyperventilation
Not fun. I am usually very cognitively “with it” when I have an attack, however. Normally, I am just upset with myself for being in this situation as if I have magical control over my body’s chemicals (which I usually don’t). I say things like, “Come on Alex, this is ridiculous,” (I know I said not to judge), or “Why can’t I just get rid of the tension?” Safety isn’t the concern. I know that I’m safe and that I have no reason to panic, but my body believes otherwise, and my body wins out over my rational mind. I don’t feel that I’m going to die, or that I’m going to have a heart attack. No. I feel an utter loss of bodily control, with what appears to be a sound mind. How frustrating.
Mine tend to last anywhere between 12 and 20 minutes. It feels like they last forever, but that clearly isn’t the case. In a previous article, I talk about some of the things that help me when I’m having a panic attack. But again, everyone is different. My goal is for you to walk away from this article knowing just a little bit more about panic attacks, and some things you can do if you happen to witness someone experiencing one.
Do you feel like we’ve achieved that goal today? Send me a note and let me know.
I’m back, and today I chose to write about the road to recovery from my eating disorder (ED). Who’s with me?!
Negative coping skills related to ED’s are in one word, exhausting. The behaviors, rituals, and all the thinking about food and my body consumed a large part of every single day of my life for the better part of an entire DECADE. Over time, I realized that I wanted to live life again – in the present. I wanted meaningful relationships and experiences – I wanted to laugh and remember the days where I just listened to myself, not my ED voice – I wanted to live life for me. And most of all, above anything, I wanted to be free. Liberated.