I’ve spent a lot of time on this blog addressing what it’s like to have an eating disorder and what it’s like to self harm. I’ve done a fair amount of talking about depression as well as BPD symptoms. But one thing I have not addressed is my third diagnosis: generalized anxiety disorder. In general, I think this is a fairly overlooked and forgotten diagnosis. In my personal life, I haven’t spent a great deal of time thinking about anxiety, but I recently ran across a post that tried to describe what it’s like to have anxiety and it hit me that anxiety is one of the driving motivators for many of my other behaviors. I also realized that many people don’t really have any idea what it’s like to have clinical anxiety. Many of you (including those I know personally) probably don’t know that I have this diagnosis. But I’d like to try to separate out what pieces of my life are anxiety, to help you all have a better understanding of what it’s like.
For a long time I didn’t realize I had anxiety: I thought that it was just part and parcel of my depression, or just how people act when they’re stressed out. My therapist didn’t tell me when he gave me the diagnosis, and originally I was put on Prozac as an anti-depressant, only to find out that it ratcheted up my anxiety to no end. I didn’t realize that they hadn’t taken into account my anxiety. I thought that was just part of how depression worked. When I got on anti-anxiety meds, I began to realize that not everyone felt like the whole world was on hyperdrive all around them and they couldn’t keep up. Yet even though I peripherally knew that I was on an anti-anxiety medication, I still didn’t really think about the implications for my mental health. I think about my depression, about my self-harm, about my eating disorder, but I forget that the panic of a to-do list is not something that other people experience. So now I want to give myself the time to actually identify what my anxiety is, and how it differs from the experiences of others.
My current therapist tends to think that anxiety and depression are simply two sides of the same coin, but I feel them as a war inside my own mind. My depression is like a weight pulling me down. Sometimes it feels like someone has stuck a giant fishhook into my chest and is trying to rip it through my body. It pulls, it drags, it’s heavy, and it’s momentum is all downwards. I get lethargic when depression kicks in, and most of my thoughts in depression land circulate around hopelessness, pointlessness, and emptiness. Anxiety is the complete opposite. It’s as if there’s a constant fire directly under my ass, as if my body can’t contain all the things that are happening in it, as if my mind is running and running and running and can’t quite ever catch up to the ideas and the tasks that it needs to understand. My brain won’t focus, Depression holds me still and anxiety fuels me to move.
In my day to day life, anxiety tends to manifest itself as perfectionism and fear. Perfectionism is the most apparent. In school, I completed all of my assignments a week ahead of time and still felt that I was behind. When I feel that I’m not accomplishing enough, I load my schedule with more and more until I start to crack under the pressure. I’m always worried that I’m not doing enough, or that I’m failing, or that I’ve embarrassed myself and screwed up. These feelings are nearly constant, and they’re like a little gnawing worry going at the back of my brain taking up my energy and making me desperate to do better.
Part of the perfectionism is fear that things won’t go the way I intend them to, or that I can’t control things. It shows up in the fact that I am a compulsive lister- I cannot make it through a day without trying to plan what I will be doing, in what order, and for how long. I start to panic when I have long stretches of time without any plan: who knows what might happen? And although lists have been a life-saver in many ways, they also intensify the anxiety. Some people might look at a neatly drawn up list with clear and reasonable time frames and think that it makes things more manageable. I look at it and wonder why I can’t do it all at once, my brain jumps from place to place trying to solve every problem, I can’t focus, and I start to feel as if no matter what I do, it will never be enough or never be good enough.
In conjunction with this fear is the fact that I cannot handle boredom. Probably in part due to a fairly major surgery as a young child, I have some really strong emotions about boredom. I don’t experience boredom as an annoyance: I experience it as worthlessness, meaninglessness, and a kind of pain. When I get bored I feel trapped, I feel lonely, I feel like I need to smash my head against a wall just to do something. And so I operate in a constant state of anxiety that I need to be doing more and that if I stop moving for one moment, then boredom will get me. With boredom comes depression and pain.
A huge part of anxiety for me is my inability to let go of thoughts. I think there’s a fair amount of overlap with some of the OCD characteristics I tend to exhibit. Once something anxiety-provoking is stuck in my mind, I can’t get rid of it. Oftentimes when I feel I have too much to do I will make a list and burn through it, completing everything I need to do in a haze of anxiety and fear, certain that I’ll never complete everything in time. Usually I finish quite quickly, and then spend the rest of my day feeling as if I have more to do, unable to calm myself because even though I can keep checking the facts and seeing that nothing else needs to be done, part of my brain is still left in the dust, worrying over the original tasks.
The interaction of some of my BPD symptoms and my anxiety is that I take everything personally, and thus can’t disengage from anxiety-provoking situations. I have a lot of fear that people are attacking me or don’t want me around, and so I spend a good deal of time rehearsing scenarios in my mind: possible explanations for why people around me are doing what they’re doing, things that I could do to improve my relationships, or simply how I will handle future anxiety-provoking situations. As an example, I dislike talking on the phone. Before I pick up the phone to call someone, I will review in my mind at least five times how I intend to initiate the conversation and the potential ways that the conversation will go, working through my potential responses to what they might say. Very rarely does this help me actually prepare for the conversation, but I feel extremely vulnerable in that situation and so my anxiety tells me I need to be afraid and protect myself from embarrassment. Whenever I go into an unknown situation I spend a great deal of time imagining it and emotionally and mentally preparing myself, otherwise my anxiety will shoot through the roof. It’s a waste of my time and it interferes with my ability to engage in other tasks beforehand, as well as escalates my irritability and fear, but I can’t stop myself.
Anxiety also manifests for me in thoughts of the future. I have always had a tendency to exaggerate failure and problems in my own mind. To take an extreme example, when I was in Jr. High I got a B on a mid-sized project. My brain extrapolated from that that I wouldn’t make it in to the correct high school, thus not the correct college, and I’d end up a crack whore living on the streets (un PC language is from my 13 year old self). I have a fairly quick moving brain to begin with, so I can move through all those steps in the space of about 5 seconds, and I spend most of my life trying to stop my brain from drawing out all the possible conclusions of a situation. Most of them are not good. This can leave me crying, anxious, desperate to please, or any number of other bad things.
The size of the future drives me crazy, as does my inability to control it. I am terrified that if I don’t have complete control over everything, it will all fall apart, but I’m also afraid that I will miss out on everything. I love the potential and the size of the future. It excites me. I love all the possible things that I could do. And I absolutely want to do everything. Unfortunately, that means that I hate it when I can’t do something. And so when I have to choose between things and cut off one avenue of my life, I freeze up. I can’t make decisions. My college decision process got so bad that the day I had to declare my dad walked into my room and said “Answer the first one that pops into your head, St Olaf or the U of M,” and I confusedly burst out “St Olaf!” because the logical methods of decision making had failed me. I always am left wondering what my life would have been like if I had chosen differently, and that makes me feel as if my current choices are bad and wrong. This leaves my mind spinning in circles over possibilities and what I could have done and where I am now and comparing where I am to others until I’m absolutely flooded and overwhelmed.
Oftentimes I forget that other people don’t experience the world the way I do. Other people tell me about procrastinating, about getting anxious about things and then putting them off because they don’t want to deal with them. Other people are capable of forgetting about their work or their homework when they’re away from it. Other people aren’t always feeling the huge weight of the future, or the burden of a thousand small failures they always need to make up for. Other people are capable of choosing to do something fun before they finish their work. These things all seem like complete impossibilities to me. This may be the biggest sign of my anxiety: certain actions that could involve lower anxiety or putting off anxiety-producing things, or stepping away from anxiety don’t even exist in my life.
Many people don’t totally know how to recognize my anxiety, or don’t even know it’s there. I’m not entirely sure my family is aware of the diagnosis. They know that I’m “sensitive”: I cry easily, often out of frustration. But very few people think of “anxiety” as a diagnosis, or as something on par with depression. Everyone feels anxious, right? Perhaps this is because my coping mechanism for anxiety is to shut down. I get very quiet, I begin playing with something or getting little tics like picking at my fingers, my voice falls into monotone. Because the feelings of anxiety are so large, I often feel afraid of actually expressing them: I have to keep them under control, and so I tamp down on them as hard as I can. I think this often leads to me looking zombie-like or dissociating. There is almost always the constant buzz of some anxiety in my life, but when the buzz becomes a roar I stop moving. I become paralyzed.
The odd thing about anxiety is how invisible it seems to be to others. In my family we talk about my depression and we talk about my eating disorder. For some reason anxiety doesn’t really come into it, even though it’s intimately tied to both of the others. There’s a reason that the sight of food can send me into a panic, and it’s because my panic button is a very delicate thing. I think that even I forget that my sensitivity and my extreme susceptibility to stress are not just character traits: they are in fact a mental illness as serious as my depression. I forget that I don’t simply self-harm out of feeling helpless. In fact I rarely do it for that reason. I do it to calm myself, to bring my mind back to the present, to remind myself that I am not actually in all the million places my mind is at once, I am not being ripped in a million directions. I am here, in my body. Anxiety leaves me feeling very ungrounded, but I often forget it’s the culprit and so I fight depression and eating disorder instead of anxiety.
My anxiety tends to stem from feeling inadequate, and so whenever I get the smallest reminder that I might have screwed up, not done everything I could have, might not be as far ahead as I could be, or might have more I could do, my brain simply goes haywire. It’s as if my brain has a filter that looks only for “evidence you suck” and then constantly feeds all the results to me. And so my baseline of emotion is nearly always higher than other people’s.
My anxiety takes all of my worries and all of my fears and finds them constantly in my everyday life. Then it tells me that I’m in danger, I need to be on alert, and I need all my senses to be on high, while also completing every possible task to protect myself from danger. My anxiety asks me to fix the world so that it is no longer dangerous to me. And so I spend most of my days trying desperately to keep up with what my anxiety expects of me and panicking when I cannot. Meds have been extremely helpful in toning down some of this feeling, in giving me back some sense of an emotional skin. But many times the best I can do is to practice skills that calm me down when anxiety begins to hit. I’m still practicing at that. I hope that soon I won’t have to always worry when I’ll fall apart.