What no one tells you when they tell you they have anxiety.

Or: when you’re diagnosed with anxiety. I know that when my therapist and I first talked about the diagnosis, we talked only about the symptoms I was dealing with at the time. We didn’t talk about others that were possible, or likely, or what might trigger them, mostly because we were so focused on what was currently happening. I only gave her about a month’s heads up before I stopped, and I do wish I had kept going for a few more sessions beyond that and really made a plan about how to handle symptoms I had already experienced and talk about any new ones that might spring up. That’s my bad.

For those of us who deal with anxiety, we know all too well what it feels like. There are a myriad of symptoms encompassed in the anxiety diagnosis, and no two people have quite the same experience. When someone tells you they have anxiety, chances are that they don’t go on to enumerate all of the different things that means. And even if you see it firsthand – maybe your partner has it, or a close friend – you’re still only seeing part of it. There is so much that’s invisible and hard to articulate, or that we actively try to hide/downplay. There’s also the danger that because someone knows what one or a few of the symptoms feel like, they think they know everything else when actually that’s not it at all. What the dude said a few years ago has stuck with me: it’s important to remember that while you may know some things, that doesn’t mean you know it all.

I’m going to try to talk about some of the things that we almost never talk about. It’s possible I’ll speak pretty bluntly. If that doesn’t work for you, maybe try to remember that this is a frustrating experience and that this stuff happens. But I encourage you to try to read it, especially if your person has trouble explaining what anxiety is like for them. I’ve talked about this before, and before, and yet again, because this is important.

Here’s what’s happening in your body when you feel stressed, nervous, or anxious: something – a weird twinge, a thought, a gross smell – tells your brain that it better wise up because there’s danger somewhere. The brain stem(the oldest, most primitive structure in your brain), is like oh fuck, let’s bounce, and sends a whole bunch of messages to your sympathetic nervous system. Your SNS is basically your survival instinct, and it prepares your body to fight or flee: it speeds up your heart and breathing, messes with your digestive tract, raises blood pressure, circulates adrenaline, makes you sweat, dilates your pupils, I could go on. Before your logical mind (your frontal lobes) can tell the rest of your brain that there’s nothing to see here, your SNS is already off to the races and getting you ready to either kick some ass or to get the hell away from wherever you are. 10,000 years ago when there were many things that could kill us that we could actually physically run from – instead of things like cars or cancer or guns – this was super useful. There’s a lion that looks hungry and maybe wants to eat me? Yes please I’d like to feel some adrenaline and have my heart and lungs work more efficiently so that I can run away. Now, though, we’re living with a nervous system that isn’t adapted for the world we live in; it hasn’t had time to catch up, and so people with anxiety often have a more sensitive SNS. This is why breathing, meditation, and certain meds are so helpful: because, depending on the thing, they either suppress the reaction by the SNS or help you to activate your parasympathetic nervous system, which calms you down.

Here are some of the things that we might experience, but don’t talk about:

There are stomach things. If I had a dollar for every time I felt nauseous or had diarrhea because of anxiety, I’d quit my job and go live in Rome or Santorini. Because, people. This happens all. the. time. Would you like to hear about the time I took waaaaaay more Imodium than you’re supposed to just so I could make it through an evening with our friends? Or how about the time I had to text one of my coworkers in the middle of class to come to my room and stay with my students so that I could go throw up in the bathroom? Or about the time I threw up on the Q train for no apparent reason(thanks for getting me safely home, KC)? Or the week I lived on coffee and Tums because I couldn’t keep anything down after the boy I was dating had gone M.I.A.? (He was fine, just a jerk. A stupid, Ryan Gosling-looking jerk.) There have been multiple times when I thought I would shit my pants. I don’t even want to try to estimate the amount of times I’ve thought I would throw up on the subway; for a while there I carried around one of the dog’s poop bags with me, just in case. This is probably my number one complaint with anxiety stuff; I really wouldn’t mind dealing with anxiety so much if nausea didn’t come with it. I would rather feel excruciating pain than be nauseous. I would rather get my heart broken than be nauseous(though historically getting my heart broken equals me getting nauseous so that’s up in the air). IT IS THE WORST.

There are breathing issues. Sometimes this may be what actually sets off an attack: we may not be able to take a complete breath for some reason, and then we start to panic that we can’t breathe and something is wrong and oh my god do we have a tumor? and then we actually can’t really breathe because we’re hyperventilating. This can cause us to feel lightheaded, dizzy, or even to faint. When I was in middle school, we moved from a city of ~75,000 to a town of 900. I came home from school in tears every day because my classmates had all been together since kindergarten and there was clearly no room for a new weird girl who liked to read and went to New York sometimes. I would wake up in the middle of the night gasping for breath, unable to do anything but clutch at my throat until it stopped, seemingly on its own. It had been happening for a few months when I went to my cousin’s wedding; I was staying with my grandma, and it scared her so much that she prayed over me and anointed me with oil. It got better, but it wasn’t until I started going to therapy that I realized those experiences were actually panic attacks.

Some of us cry. A lot. For me, this is just one of the ways that my body reacts to stress. It makes sense when you think about it: crying is cathartic. It’s your body trying to release the trapped stress or emotions that have contributed to the feeling of anxiety. Sometimes I feel like I’m crying for no reason: last week at work I was actually feeling pretty on top of things, and yet suddenly I was crying in my classroom at lunch. Sometimes it feels like an overreaction; many times when the dude and I have been having a disagreement about something, I’ve had to specifically say “I know that I’m crying, but I’m not actually that upset. My body is just reacting to the tension. Please ignore my tears and don’t allow them to color this discussion.” Sometimes I am actually sad or angry or scared enough to warrant tears, but most of the time I feel like I’ve sprung a leak unexpectedly.

Our brains don’t function normally during an attack. I straight up have the mental capacities of a toddler when I’m in the middle of an attack. It’s hard to remember things; I don’t really remember the attack because my brain has trouble making new memories during it, I can’t make decisions, and I basically just want my mommy. Luckily, the dude knows this. When he can see that I’m feeling anxious, all he says is “Is there anything I can do?” and any next steps are mine. He knows that I can’t make decisions and that he needs to just let me ride it out instead of asking me a million questions about what would be helpfuly. I’m sure it takes a toll on him to watch me be in distress and not be able to help, or be specifically asked not to. But I honestly couldn’t tell him what to do. There’s a whole scientific explanation for what happens in the brain when we feel anxiety: basically, anxiety impairs your working memory(short term) but enhances your long-term memory. This is why decisions are so hard during an attack – we may not remember the options – but why even one attack can produce such a strong, lasting anxiety response.

We are very easily irritated. The other night I was feeling anxious and having trouble sleeping. Mostly this is because I spent five whole days of my break doing no work at all(the luxury!) and thoughts about my to-do list started, and, well, there you have it. Normally in that situation I would get up and get my weighted blanket, but I was feeling hot and didn’t want the extra trapped heat. Often I’ll wake up with the dog curled into the space behind my knees or against my hip, and I love it. The other night? It was driving me crazy. And I normally love it when the dude snuggles up to me during the night because we normally sleep pretty separate, but his closeness made me feel like I was trapped. He wasn’t even that close, really. I lay there for a while feeling irritated and trapped and contemplating waking him up and telling him to move over. I realized as I was stewing that it wasn’t his fault – he was asleep, after all – and I needed to deal with my own feelings of anxiety. This happens to a lot of us when we feel anxious, because anxiety is a sense of being on edge. Every little things grates, and sometimes that gets in the way of us actually helping ourselves feel better. I knew exactly what I needed to do: take my weighted blanket and go sleep on the couch, or wake the dude up and ask him nicely to move over so that I had room for the blanket, get it, then turn the fan on. But instead I just let myself get more and more irritated and blamed him for my feelings of discomfort. Not a good look. If your person is lashing out a bit more that usual or is quicker to anger, this might be what’s happening for them.

We might feel physically weak. I often don’t describe this when I’m talking to people about what anxiety feels like, but sometimes I feel like my muscles have lost all of the strength or my bones can’t support my body. Sometimes it feels like my chest is going to cave in or like I can’t hold my head up. This is a rarity for me; typically, if I feel any whole-body sensations, it’s a little tingling or maybe I need to twitch every now and again, but some people get the shakes or have trouble with simple motor functions. In the past I’ve noticed when I’m feeling anxious and trying to reach out to my Emotional Support SWAT that I have trouble texting accurately.

The physical symptoms can be bad, but they’re nothing compared to what’s going on in our heads. Listen. I hate all of the physical stuff that I go through when I feel anxiety. I don’t like feeling uncomfortable in my own body(who does?) But I can manage that. I carry around a little emergency kit with ginger pills, advil, pain reliever, imodium, and a couple of other things that help me with the physical side of anxiety. But all of that pales in comparison to what happens in my head when I’m feeling anxious. It can start with something small: the other night as I was falling asleep, all I thought was I should probably work for a few hours tomorrow. For most people, this is a typical thought and one that they’ll register but not necessarily need to engage with right at that moment. I didn’t even make the choice to consciously engage, but as soon as I thought that, my brain went I have so much to do. Where do I start? Did I remember to put this thing on my to-do list? I’ve been messing around for five days. I should have started working sooner. Oh, and I need to do this thing. And what if I don’t get everything done? What if I’m feeling stressed and I say that wrong thing to a student? Ugh, remember that time… and on and on. The physical stuff can be uncomfortable, painful, irritating; but the thought stuff? Downright torturous. Because you can’t control it. You can’t stop it. You can’t just decide you’re not going to think about something. And for me, that’s the hardest thing to manage because there is simply no managing it. The most you can do is train yourself through meditation or yoga or whatever mindfulness exercise you use to accept your thoughts as they come and go.

What physical symptoms do you experience? How do you deal with it?

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2 thoughts on “What no one tells you when they tell you they have anxiety.

  1. Pingback: Lenny, or: my relationship with anxiety – it's only fear

  2. Pingback: Finding a vocabulary for anxiety | it's only fear

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