This Is What It's Like To Live With Anxiety

Anxiety disorders are the most common mental illness in the US, affecting 40 million adults. This is what it feels like to be one of them.

By Christine Coppa November 10, 2016

 

I had my first real panic attack when I was 19 and a sophomore in college. I thought I was having a heart attack. I couldn't catch my breath, I was dizzy, my fingers tingled, and I felt hot and clammy—all out of nowhere. I made it to a university bathroom and splashed cold water on my face, then slid down the tiled wall, knees to my chest, and waited for that terrible feeling of dread to go away.
I didn't go to class for a few days and stayed in bed, under the safety of my blanket, feeling stiff and like something bad was going to happen. I couldn't think straight or eat. Everything seemed unreal. Truth is, I'd always been a worrywart and perfectionist, but as a kid, my parents chalked it up to nervousness and wanting to succeed. These days I know it was panic manifesting and waiting to hit me like a truck in my 20s.

I'm not alone: According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental illness in the US, affecting 40 million adults in the United States age 18 and older, or 18 percent of the population. Anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life events, and women are twice as likely to be affected as men. 

Feeling out of control

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The panic attacks began to come frequently, and I wanted answers. I'd be walking down Walnut Street in Philadelphia on a sunny day, and all of a sudden I'd start to hyperventilate. For me, a panic attack goes through its stages in about 10 minutes. A dreadful feeling creeps in, a whirl of nasty butterflies infiltrates my stomach, and I can't take a deep breath. Then it escalates to me feeling completely out of control, tears staining my cheeks. When the panic attack passes, I feel like I've been up all night. I want to nap for days in a safe, quiet space.
A panic attack physically feels like a clenched fist, popping white knuckles, or being startled by a prank. Sometimes it feels so extreme that it's like there's a refrigerator on your chest. Your head is spinning and clouded with dread. You feel like you might puke and urgently want to use the bathroom. Your appetite is gone.
Experiencing a panic attack in the flesh leaves a big scar. You never want it to happen again, but you know it will—or that's your thinking. So you start obsessing about it, over and over and over. You wait. For me, a panic attack can come out of nowhere or be caused by a trigger. An email from someone I wasn't expecting to hear from (I've blocked some people to avoid this). A memory of something traumatizing, like when my grandmother died in my arms. Reading about another school shooting, then speeding right to the worst-possible-case scenario—my child is at school. Is he safe? Is he?

What's the deal?

Anxiety symptoms are activated by a part of the brain stem called the locus ceruleus, which is involved with the physiologic responses to stress and panic. When something stressful is sensed, neurons in the locus ceruleus start firing more intensely than usual. Next, norepinephrine, a neurotransmitter, transports neural messages from the locus ceruleus to the spinal cord and other parts of the brain. Norepinephrine is similar to adrenaline. It works by narrowing the blood vessels and increasing blood pressure and blood glucose levels, which causes the physical feelings like rapid heartbeat and quick breathing and contributes to hyperventilation, dizziness, and tingling fingers. A panic attack is physical, mental, and very emotional.

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Getting well

I made an appointment with a general practice doctor who first ran a blood panel to test my thyroid. She told me if too much thyroid hormone is produced, it can cause anxiety due to hyperthyroidism. Fantastic, I thought. An answer. Finally. But the blood tests confirmed I did not have a thyroid problem. So I decided to go on anti-anxiety medication, though it wasn't an easy choice. Going on meds would solidify that I was crazy, right? Wrong. For some people—a lot of people, really—meds are a lifesaver. According to a 2011 report, more than one in five Americans now takes a drug to manage a mental health condition.
My doctor put me on 0.25 milligrams of Xanax, a benzodiazepine that acts on the brain and nerves to produce a calming effect. It works by enhancing the effects of a certain natural chemical in the body, called GABA for short. She compared the Xanax to an asthmatic's rescue inhaler because it kicks in really quickly. If I felt very panicky or couldn't turn my brain off at night, take a Xanax.
I was also started on 10 milligrams of Paxil, an antidepressant I take every day. “SSRIs like Paxil inhibit the reuptake of serotonin and work by regulating its production and actual role in the brain,” explains Sanam Hafeez, MD, founder and clinical director of Comprehensive Consultation Psychological Services.
Sixteen years later, at 35, I am still on Paxil. I also still have the Xanax, which I barely use, but I feel better knowing I have a rescue medication at the ready. I’m OK with my Monday-through-Sunday pillbox, because it makes me a better person. To avoid reaching for Xanax like a crutch, I also use coping skills such as going to the gym, walking my dog, playing Legos with my son, and watching the clock when I feel an anxiety attack coming.
The “clock trick” is something I learned in therapy. I was told to find a clock and watch the time pass. Most panic attacks end within 20 to 30 minutes, and they rarely last more than an hour. Knowing this and watching the proverbial sand through the hourglass always helps me calm down because I know the feeling is fleeting.
Anxiety is a part of my life, but it certainly doesn't define it like it used to. I've used all the tools I can to be healthy and stay in the right frame of mind, and that's my wish for anyone struggling with panic attacks: to know it's not just you, or all in your head. You are not crazy, and it's so very treatable.