(Here’s an article my cousin sent me I’m reprinting so all of you can benefit from the honesty and wisdom in it):
I have clinical anxiety. If the coronavirus scares you, this might help
I’m not a doctor, but what I’ve come to learn over 20 years is that you really can master your anxiety.
Editor’s Note: This story is part of a Globe Magazine special report, appearing in print on Sunday, March 29.
You might think that this is a terrible moment for someone with a clinical anxiety disorder. But here’s the thing: It’s like the rest of you have finally caught up with me. Hyper-vigilance? Insomnia? Catastrophizing? Extreme fear of uncertainty? Welcome to my Isle of Dread. Care for a cocktail?
I’m kidding, sort of. Panic disorder and extreme health anxiety have alternatively propelled and paralyzed me for two decades. For the most part, I exist as a fully functional human being thanks to 10 milligrams of Lexapro, an insightful therapist (now available on video chat), and long-practiced behaviors that keep me even-keeled.
But many friends, thankfully never touched by the cold paws of anxiety, are now asking me how to deal. They don’t know what it’s like to awaken each morning wondering what kind of mood they’ll be in, or to contemplate whether today will be the day that mortality — in the form of a rash, a lump, a tremor — descends. They have never gasped for breath, ridden the acidic wave of heart palpitations and clammy sweats, and clawed for reassurance like a feral cat only to retreat into a mind that offers no solace, only more questions.
Most people move through the world assuming it has a veneer of predictability, or what psychologist Luana Marques calls a “thin veil of certainty.” We are not wired to deal with open-endedness; under normal circumstances, for example, we can feel fairly certain when we go to the grocery store that we’re not going to contract a virus. That has changed.
“But uncertainty is there all the time, and we just don’t feel it,” says Marques, an associate professor of psychiatry at Harvard Medical School and president of the Anxiety and Depression Association of America. Anxiety sufferers know this intimately. You might be realizing it for the first time.
Please know that it will be OK. What I’ve come to learn over the course of 20 years is that you really can master your anxiety. I’m not a New Age guru or a doctor; I’m just a person who’s ridden it out. Here’s the trick: Don’t deny it. Accept that you are absolutely, 100 percent going to feel awful sometimes. I know, I know — the world is rife with mindfulness apps, breathing strategies, glamping retreats, and drugs aplenty to keep your unease at bay. These have their place. We cannot live in a state of heightened vigilance at all times.
But engaging with discomfort is its own therapy, too. It’s the most un-American thing ever, yet: You must sometimes feel bad. So accept the anxiety. Don’t blunt it; summon it. This sounds counterintuitive, I know, but anxiety isn’t a mark of shame to hide from people whom you assume are far more resilient than you. (They’re not.) It will continue to bounce on your shoulders like a thorny goblin until you grab it, stare it in the face, and have a firm chat.
“The first thing I’ve been making people understand is that anxiety is a normal response to a threat,” Marques says. “We want to run away from discomfort, but pushing anxiety away makes it worse. We’re living in times when most of us are comfortably uncomfortable at a minimum. Understand that by embracing our emotions and labeling them, we can ride the wave a little more smoothly.” It’s like surfing. You’ll be jostled by the ocean, tossed around, and eventually tumbled back onto the shore.
Of course, this is all academic until you’re hiding under a weighted blanket scrolling Twitter, wondering about that tickle in your throat. A behavioral way to cope is by doing something action-oriented, Marques says: cooking dinner with your kids, going for a walk. You’re forcing your brain to deal with what’s right in front of you.
Yet those of us with anxiety disorders also know that the only way out is by sitting with the discomfort until it dissipates. It’s like stepping into a hot tub and staying there until the water grows lukewarm. Acknowledge that you’re scared, and then tell yourself that you’ll sit, and you’ll breathe, and you’ll exist — yes, you will exist, minute by minute — until the feeling goes away. And, of course, reach out for professional help if you feel you need it.
Frame it as what we’re being asked to do in quarantine, on a smaller scale. Your mind is your own private bunker. You can’t just get up to leave, but when the door finally opens, think how much stronger you’ll be.
Most of us like to think that usually things happen to us because we’ve made an overt decision – we enroll in a class, then we take the class, we buy certain foods, then eat them later, we drive in a certain direction and end up at our destination. Our mindset is that when these things go awry, its misfortune or an overtly bad decision or mistake on our own part or someone else’s part. And that can be true, but how about the choices we make by not doing certain things or avoiding and denying certain things? How about the role of procrastination in shaping our outcomes?
I worked with a couple awhile ago who were in a war about these other types of choices I call “passive choices.” The husband years earlier had been diagnosed with very high blood pressure and high cholesterol. About 10 years ago he was hospitalized for a burst aortic aneurism, survived it and had a stent put in. He was advised to eat a heart healthy diet and exercise regularly to avoid further cardiovascular problems. According to his wife he initially paid some lip service to those instructions, then proceeded to eat whatever he wanted, drink alcohol liberally, and almost never do any cardio exercise. So it was no surprise to her when last year he needed another stent elsewhere and a repair of the aortic stent, a serious, painful operation requiring extensive recovery and involving lots of caregiving assistance. Needless to say the wife was rips**t! It was clear to her that this was the life he had passively chosen, he wasn’t a victim of bad luck. He couldn’t understand why she had so little empathy for his plight, why so cold? Her retort repeatedly was “You CHOSE this! Your inaction, your avoidance, your denial set the stage for this! What did you think would happen, living the way you did? You CHOSE this life!”
(In this case, the husband’s most recent health crisis sat on top of his history of 40 years of smoking, not heeding warnings from his doctors and dentist, and not stopping until most of his teeth had to be extracted, followed by a disfiguring cancer of the jaw, so the wife’s bandwidth for empathy now was almost nil. It all felt totally predictable to her while he continued to feel like a victim of fate). Predictably, they didn’t have a good outcome in therapy, as she continued to feel like a scolding mother to a childlike man who refused to look at how he was making decisions with his attitude and behaviors every single day.
So, what’s the moral of this sad story? Pay attention to not only what you do in an obvious, concrete way, but also to what you do through inaction or denial.
- Do you routinely put off paying bills until you get charged late fees? If so, you are choosing to create bad credit and financial complications.
- Do you neglect to return calls or emails from family or friends? If so, you are choosing alienation or conflict in those relationships.
- Do you wait for a health crisis to follow your doctor’s advise? If so, you are choosing poor health.
- Do you procrastinate meeting deadlines for tasks at your job? If so, you are choosing to get a lousy review, maybe even be earmarked for the next layoff.
- Do you avoid hot topic conversations with your spouse or partner? If so, you are choosing to create a reservoir of resentment and distance between you two.
- Focus less on your benign intentions and more on how you play them out behaviorally. Good intentions mean very little if your actions aren’t lined up with them.
- Realize that you can be a good person, making some bad passive choices.
- Pay attention to the “handwriting on the wall – early markers of negative outcomes so you can steer in a different, more desirable direction.
- Recognize that you make choices every day, both actively and passively, and that both kinds can create very powerful outcomes.
Most of us have talked about wanting to do or achieve certain things in our lifetime – learn to speak Spanish, remodel the house, write a book of poems, volunteer for a humanitarian cause, take a trip to India, etc. There’s also often a sense of what needs to happen first to make that possible – quit my job, earn six figures, retire, get married, etc. – some future point in time when the stars will align perfectly to facilitate the doing of the thing we claim is important. In the psychotherapy world we call this “destination addiction.”
My “thing” was to be regularly playing our beautiful Mason & Hamlin grand piano with ease and competence. Early in our marriage my husband and I had been fortunate enough to buy the piano for a small sum after it made its way here, supposedly from a castle in Ireland. It was a magical event!
I used to take lessons, and MaryJoyce, my teacher, would exclaim about my large hands and how I was perfectly equipped to play Franz Liszt. It seemed that the piano and I were meant to be a team. Sadly, a few years later, MaryJoyce died and I was so pregnant that it was uncomfortable to sit at the bench, especially now with no accountability to anyone who could witness my musical strivings and ability. So, I stopped playing, and there the sad, majestic piano still sits, unused, reminding me daily of my unfulfilled “commitment.” I look at it regularly with longing from my desk in the “piano room” (which also functions as my home office). I’m reminded daily of my “piano folly.”
I now realize that playing the piano competently has been a sweet story I’ve told myself – a lovely idea, without any renewed infrastructure or resources to back it up, especially since I’ve been taking guitar lessons this last year, honoring a precious gift my family gave me long ago. With my full time private practice and the other realities of my life there aren’t enough hours in the day to dedicate myself right now to both instruments. So, realizing that we make choices in life about where to put our energy and time, I’ve accepted that for now, playing Franz Liszt with facility is part of my “piano folly.” Unlike my commitment to play the guitar, I’ve not hired a teacher, dug up the sheet music, or scheduled in regular tunings and the time to play the piano. A passion without a plan to make room for it, is just a dream.
So, if you’ve also dreamed about doing or achieving certain things in your life, make sure you avoid self delusion, (“piano folly”), by creating some accountability, first to someone else who will take you seriously and hold you to your dream when you get discouraged, but most importantly, accountability to yourself – an action plan, tools, markers of stagnation or change, so you make your dream come alive.
In my case, it’s not the end of the road for the piano and me. When I’m ready to fully commit with not just longing, but with action, Mason & Hamlin and I will make lovely music again together.
Next 20 Minute BlogTalk Radio Podcast Sunday, 11/24 8:30 PM EST: “Take the Dread Out of the Holidays with Some Simple Strategies”
Don’t miss this next BlogTalk Radio podcast!
In this 20 minute episode I’ll share my insights about some of the common sources of holiday related anxiety and stress, and how being proactive and intentional can transform the season.
If you have a history of some really negative experiences related to the holidays, and struggle with how to make it all more manageable, even magical, then this episode is for you! I’ll help you see how some simple planning, realism, and clear boundaries can make all the difference. You’ll see how you alone, or you and your spouse may have the power to turn it all around to meaning, connection and joy.
Call in live with questions or comments at 877-497-9046. If you can’t make this (first ever) Sunday night podcast while it’s happening, you can stream it at your convenience anytime at www.BlogTalkRadio.com/SusanLag
Hope one way or the other you can join me!