Introducing New Editor Mohammedi Khan

Something new we will be incorporating into Beautiful Voyager is an Advice Column. Weekly, I will be asking for YOUR advice in something another Voyager or I am struggling with. This will give everyone a chance to practice the art and beauty of advice-giving and receiving.

There are many reasons individuals experience anxiety. It can range from chronic anxiety, self-esteem and assertiveness, to sociopolitical reasons such as the salient identities we identify with. 
(race, gender, social class, religion, and educational level being just a few)
We will cover it all!

Hello Beautiful Voyagers!

I am excited and humbled to be joining your journey of understanding, acceptance, and coping with ‘generalized anxiety disorder’. As an editor of this publication, I will continue to ensure the integrity of your submissions and create an integrative platform between us Voyagers.

To paint a picture for you visualizers — I graduated from Loyola University of Chicago with a B.S. in Psychology in May. I am currently working as a group psychotherapy assistant in rehabilitation centers around the Chicagoland area. I first connected the dots of over-thinking and stress with anxiety my freshman year of college, after experiencing my first anxiety attack (and boy was it not pretty…)

In my spare time I love reading and writing, so feel free to suggest any thrillers or psychology books you have read recently!

If you feel as though you are struggling and are in need of advice from like-minded individuals; feel free to post your situation as a response or email me. I will be sure to address it in a prompt for the upcoming weeks.

This will be an opportunity for us all to affirm our giving and healing traits, 
so be on the lookout for my first prompt in the coming days.
Get ready!

Bon voyage, 
Mohammedi

Are You Bugged By Other People's Behavior?

In Nordic folklore, the nisse, or goblin, is short-tempered, but there for protection.

You know how it’s easier for the people around us to see us our patterns than for us to recognize them ourselves? Well, I’d been married for years before my husband recognized the repetition of my complaints about the world around me.

“You’re always talking about how people aren’t examining their behavior enough. Did you know that?”

He was right. My recurring frustration is that other people don’t do what I do: They don’t tirelessly, exhaustively work to “get to the bottom of things.”

“It’s your bugbear,” he said.

In D&D, or Dungeons and Dragons, the bugbear is "chaotic evil."

As I talked about the idea of bugbears with close friends, I came to realize I’m not alone. Whether it’s “people aren’t responsible enough” or “people aren’t working to be more logical,” many of the people around me have their own bugbears. As I heard other people’s bugbears, Icame to understand the bugbear itself has some very specific, very common qualities:

• It’s stronger and more pervasive than a pet peeve.
• It comes from a deep-seated personality trait. 
• It suggests I want the world to be more like ME.

Do you have a bugbear or theme to your “other people” complaints? What do those complaints say about your strengths? Please share your thoughts below! (I am genuinely curious to hear them!)

Migraines Are a Body-wide Disorder

"While the focus has long been on head pain, migraines are not just pains in the head. They are a body-wide disorder that recent research shows results from 'an abnormal state of the nervous system involving multiple parts of the brain.'" — Dr. Charles, U.C.L.A. Goldberg Migraine Program

How Does My Brain Affect My Nervous System?

I've reread this New York Times article about a newly released migraine study again and again. The growing awareness that migraines are a "body-wide" disorder involving chemical reactions in the brain feels like a newly revealed puzzle piece. 

My annual jigsaw puzzle. I'm only allowed to do one in December cause addict.

Sadly, it's just another puzzle piece in a sea of puzzle pieces. 

It can be so hard to make sense of something that even doctors don't understand.

• My brain triggers my nervous system in ways that people without migraines don't experience.
• If I take neurotransmitter-boosting medicine every day, I can nearly entirely avoid migraines. 
• My neurologist said to me just last week, "There are chemicals at play with migraines that no one fully understands yet."

It's hard not to ask: How would understanding the intricacies of the brain and the nervous system help with the pain? 

It might not make any difference. As of now, the knowledge I have hasn't helped me with the pain. Meds have helped. I yearn to complete the puzzle because I'm impatient. I want the world to understand and accept that people's brains and nervous systems vary wildly, and that there is nothing embarrassing or shameful about it. 

Completing a puzzle the day before my daughter was born. December, 2009.

I also believe a deeper understanding of how the brain triggers the nervous system might help with mental health acceptance. This, in turn, feels like it could be a virtuous cycle that leads toward improved mental health for all. This is my idealism speaking.

Thank you for reading this. It's giving me the chance, in my own small world, to be the change I want to see. If I can help demystify the brain's relationship to migraines, I'm doing the work I'm meant to be doing at the Beautiful Voyager. Though the nervous system may be a complex, fragmented, misunderstood mystery right now, I don't believe that it will always be. In the meantime, let's share knowledge and experience, and help each other feel as good as we possibly can.

A version of this post was originally published on the Beautiful Voyager newsletter. Subscribe here.

The Anvil, or Why I Was Anxious In Court

Two days ago, I was in court all day. I was also battling intense anxiety all day. I tried to stay aware of my feelings, and today, I attempted to revisit those sensations to make sense out of the experience.

Anxiety is weird. We all experience micro-doses of it throughout our week. Small urgent matters, to do lists, and regrets about how little time is left in our day: these are little, bite-sized, and usually manageable forms of anxiety. We all handle these each day, and they often don’t even warrant a mention to our loved ones for their specialty.

But for me there is a fixed point where anxiety ceases being a trivial nuisance and takes up residence in my body, so that I can literally feel it. From the reading I’ve done, this happens to a lot of people. For me, I get a tightness around the upper left part of my chest: right over my heart. When trying to convey what’s going on, I often say, “My heart is heavy”, and I mean it in every way it can be meant. When I experience anxiety, it feels like an anvil is sitting on my heart. So, that’s what I have termed the sensation: the Anvil.

One of the more diabolical features of the Anvil is how it behaves like a black hole, sucking all the energy from the other parts of my body and mind, and focuses it all right on top of my chest. It’s laser-like in its precision to disrupt normal bodily functions. My motor skills diminish when the Anvil is present. My thoughts slow down, and my spatial perception takes a hit. Simple tasks like driving or navigating the corners in my office become more difficult. I’m aware of my body at all times, and this makes fluid, normal interactions with reality a challenge. I stammer a bit, and sentences don’t come out right. No expert dancer thinks through each and every step, throughout their routine, and feels the weight of each and every move. And yet that is what the Anvil does: it makes me feel the weight not only of its presence, but of each of my thousands of individual actions throughout the day. It eliminates the flow state.

The Anvil also alters my perception of time. Think about it: we coast through most days. Our routines ease us from dawn till dusk, and time flows from one moment to the next. Even the bad news that greets us falls in line behind Time’s eternal drummer, and we soon forget the impact of the previous moment. Not so for me when the Anvil is around. Each moment becomes heavy, burdensome. I greet every new experience as if emerging from a bog or the La Brea tar pits, with mud still clinging to my garments. Everything is weighty. I feel this bog-bodied sensation of moving from the present over and over and over again. The horror is on a loop. I feel like the patient in surgery who is awake though under anesthesia: powerless to stop the forces that contribute to the pain I’m feeling.

While the Anvil makes entry into the future a thing to be dreaded, it also eradicates any memory of the bounty of the present. This stinks, because when I experience the Anvil, I often break my day down into bite sized chunks. I make it my goal to move through the day like someone in Alcoholics Anonymous — one moment at a time — and cross off the tasks I complete as I go. I do this to gain steam, to get some control back in my body. But because each moment is so weighty and so strangely unbearable, it’s impossible to feel the thrill of accomplishment of a good deed just done. Doing tasks or accomplishing endeavors doesn’t release the same good feeling in my body. I catch myself shaking my head in disbelief often, noting that after doing a certain task which required mammoth effort or focus, I often feel no different than when I started. It makes the relevance of everything questionable.

This most recent occurrence of the Anvil leveled me, because I felt that in the weeks and months prior I was just starting to kick ass. My fiancé Catherine and I have been doing well. The wedding we have planned for later this year is coming along nicely. I’m spending more time reading, writing, thinking about life, business, and how to help others. And I’m hanging in there with diet and exercise. And then: BOOM. Cessation. Well, my progress might not stop, but it sure feels like it. All of those feelings of kicking ass. Of inertia. Of progress. Of nimbly navigating life. Gone. Though I can remember at recently as two weeks ago feeling the wind behind me. I was going somewhere with life! Now all I can remember is The Anvil and what it does.

In this way, the Anvil alters my identity. I can even see myself acting like someone I’m not, and I’m powerless in the moment to change it. It happens in conversations with Catherine all the time. I know I’m not being as nice or friendly or bubbly as I can be: but I don’t have the ability to change either my visage or how I’m experiencing the moment. I often feel like an imposter.

I feel alien sensations. I’m jumpy. I’m scared. Since when am I scared on a random Tuesday in August? And yet I find myself afraid. I’m afraid the anxiety will never leave me. I’m afraid I will never regain the form I felt a few weeks ago. I’m afraid my faculties will not return, or that I’ll always move from present to future as if trudging through quicksand. Most of all, I’m afraid that I’m a fraud. I’m afraid that my progress over the past weeks and months has been an anomaly. Something that never happened. A mirage. And this is the Real Andy: Anvil Andy. The one who will need supervision and allowances made to him in his personal and professional life. I don’t want anxiety to do this to me. I’m Andy, for crying out loud! I do things, care for people, write, help, and have energy left over for leg presses on Fridays! But no, The Anvil hollows me out and makes me a shell of the self I was beginning to love.

It is strange how quickly The Anvil takes charge in realms I used to be able to control easily. Deep breathing would give me peace. So too would closing my eyes for a spell, or turning the lights off. Now, these are all last ditch attempts to regain a semblance of stasis.

Through this past manifestation, which started about 10 days ago, I have tried to study when it hits hardest. When it’s there, it’s always THERE. But sometimes I feel it more strongly than others. For example, the Anvil is heavy in the mornings. This could be because I wake up, hope it’s gone for good, only to realize with horror that it’s still there. When I discover it’s still sitting on my heart, I get a bit morose. As I get ready for work, arrive at the office, and interact with co-workers, I notice the feeling wanes a bit. Sometimes a good bit. Noon and beyond gets tough: these often feel like the Doldrum Hours, as I yearn for evening to come with its promise of rest. And the evening is usually a sanctuary: everyone in the world is getting ready for bed, and I can join in with their ceremony and call it a day.

There are things I can do which I know are good for me in the midst of the anxiety. Working out vigorously makes me feel good. Drinking alcohol does not. It’s funny: you know that feeling you get when you have had a long day at the office and need a drink to celebrate it, or memorialize it, or take the edge off? That’s how the Anvil feels from 8AM onward. But, as alcohol is a depressant, it doesn’t help, disturbs sleep patterns, and generally makes me more off-center. So, I try to not have a glass of wine or a beer when I get home. But sometimes I have a glass of red wine. I’m not perfect. Too much coffee after 9AM keeps me up at night. And alone at midnight is a bad place to be in this state.

I don’t have a solution for the Anvil. I try to accept its presence. To breathe into it. To welcome the feelings and all of their displeasure. Trying to uproot the Anvil, or wish it gone only seems to make me more distraught over its presence. I also try to be very purposeful with self-talk, and being gentle with myself. I got this tactic from author Kamal Ravikant, who has a practice where he tells himself with each passing breath, “I love you.” I do a variation. I tell myself to be gentle with myself. I consciously accept the uncomfortable reality and don’t place blame for its presence. It’s here. Unless I’m going to try to manually uproot a physical sensation (not sure how that would look), the only course of action seems to me to be one of acceptance. Allowing the Anvil to exist, and not judging its presence. It’s no one’s fault it’s there. It’s just there. I’ll be honest, I describe this practice better than I live it. Every breath is a struggle. I’m barely holding on, through much of the day.

You know what’s strange though? Anxiety makes you feel alone, and yet many of our co-workers, classmates, friends and loved ones are going through the exact same struggle you are, right now. During some down time in court, I asked another attorney if they ever struggle with anxiety. This attorney told me that not only did they suffer from it, but they had struggled with it so severely for the past month that they had to seek medical attention to be sure they weren’t suffering a heart attack. Wow.

This gave me pause. I think we suffer from our own personal battles and act as if we are the only ones who know what it feels like to be in the heat of the moment. But, obviously with anxiety this isn’t the case, because books about anxiety fly off the shelves, millions go to therapists every month, and still more take anti-depressants. Secretly, a lot of people are going through this awful dance, each and every day. Day in. Day out.

I wish I could do something to help. I share my experience. I try to provide resources (like Kamal’s books) that have helped me. I encourage people and law students to be comfortable talking about anxiety and depression. Even if that means being comfortable admitting to yourself that you are hurting, and then seeking help. There is no reason for anyone to suffer in silence anymore. The internet is full of resources and people ready to help. So is your law school. So am I. Email me through the site and I’ll do my best to help.

Continue sharing your experience. Continue being curious about it. Learn all you can about yourself and your struggles. Be kind to yourself through anxiety. It’s so tough: I know. But nothing has changed. You are still you. And you are awesome. You are not anxious because you are a wimp, or not as strong as others, or because you are a sinner. (That hearkens back to my upbringing in fundamentalist Christianity. Another article for sure.) Anxiety is just your body reacting as it moves through time, from one stressful circumstance to another. It’s a mystery even to me, and I’ve been going through it since I was in 3rd grade.

You are going to get through anxiety. It often takes time, and very often, longer than we would like or think we can hold on for. That’s the nature of life. Take some deep breaths. Google how others deal with their anxiety. And learn all you can about yourself and your condition. The more you know, the more you can be on the watch for flare-ups in the future.

Have a wonderful day, and remember (stealing from author Seth Godin): you are much more powerful than you think or give yourself credit for. Truly.

You can reach me on Twitter @andrewbrink or email me at brinkad@gmail.com.

What They Wrote When We Married

"New Knot: The bridal couple Meredith and Michael Skrzypek dressed in white and glowing at the little turf church Silfrastad which sits in a field in Arbaer."

On the occasion of our 10th anniversary, I uncovered the original article written in Icelandic about my wedding with Michael. I thought it would be nice to have the translation typed (it was originally written in longhand by a friend of the family). Some things that struck me: how poetic and gentle the language is, and how hilariously wrong our meeting story is. I suppose trying to understand food media back then was a challenge... 

This page's title: "A Dream Life."

Repeated the performance of her parents in turf church

"Look, Michael, isn't the little church cute. I am so thrilled, " said Meredith Arthur to her fiance when she saw the turf church in Arbaer district last Tuesday after a long and hard journey all the way from San Francisco in California, where the couple lives and works. Meredith has always wanted to follow the example of her parents when she found the right man by marrying in Silfrastad church, a turf church which sits on a field in Arbaer.

The story repeats itself in Iceland

So it says the story repeated itself last Thursday, when Meredith and Michael Skrzypek met, both dressed in white and glowing in the little turf church to get married with their family present, who had flown over the ocean to rejoice with the couple.

The parents of Meredith, Rodney and Nancy Arthur from Toledo, Ohio, who are now retired, were married in the same church Aug 7, 1969 At the wedding ceremony with their nearest relatives in front of Silfrastad church. Furthest to the left are the parents of the bride, Nancy and Rodney Arthur who were married in the same church 38 years ago. Rodney had graduated as a lawyer and lived here in Iceland for 8 weeks with 4 other young men on scholarship from Rotary. Rodney wrote daily to his fiancee and told her of his fascination with Iceland. Their plans for their wedding were still up in the air and they had not a date or place and it happened that Rodney sent for his fiancee and they married in Silfrastad church.

This is Erlendur Einarsson next to my dad. He and my father would play chess late into the night (drinking, too, I'm sure).

Erlendur Einarsson (deceased) former president of SIF looked after the wedding, was best man, and held the wedding reception at this home. Erlender was the first host to Rodney on his tours around Iceland. Rev Oskar J Porlaksson performed the wedding service.

Rodney and Nancy visited Iceland on their 20th wedding anniversarsy with their 3 children --Meredith, 14, and twins Matthew and John, 10, who have followed in their father's footsteps and are lawyers. They rented the same suite at Hotel Saga where they spent their wedding night and they invited all their Icelandic friends who had made their day unforgettable to a reception in Hotel Saga. The voyage to Iceland was to show their children the beautiful land which they had talked about and they spoke with Morgunbladid in 1989 that their children were equally thrilled and decided that they too would marry there.

Leading to the Meeting Place

"And now I'm keeping my word and I'm so lucky that Michael was more than willing and now Iceland is on the map as a wonderful and friendly place to visit. I did not have to urge him about this dream of mine for all these years," Meredith said. When asked how they met they looked at each other with a smile. They said a year ago they had met at a business friend of Meredith's. Michael, besides his law career, was a model for a picture where she was working in a restaurant. It was after the 3rd meeting they felt a love and it increased since then.

Beatles songs & the honeymoon

Meredith's parents, twin brothers & girlfriend were present and the groom's parents also. His mother saw to it that the ceremony was a liberal one as they were not of deep faith. The bridal couple were both dressed in white like Yoko and John Lennon according to the groom and the songs that were sung at the ceremony were those of the Beatles including the tune "Blackbird" from the White Album and "In My Life" from Revolver. "I love the Beatles and songs of John Lennon and Meredith was in agreement." At the end of the ceremony the couple with their families went to Sjavarkjallarann and the newlyweds were taking a honeymoon for a week in Iceland before going home to a reception with friends and relatives.

"Then we will come back to Iceland on a wedding anniversary and maybe with many children," said the newlyweds laughingly. 

How I Confronted an Awkward, Stressful Customer Service Situation

And lived to tell about it.

Note: This story was originally published on Feb 10 on Medium. I'm updating and transferring it over from there. It is a useful little tale!

When I first started thinking about selling a first-ever, limited-edition t-shirt sale to raise money for a nonprofit I believed in, I was filled with trepidation. I’d be asking people to buy something, and I didn’t control the production. What if the shirts were scratchy?

The day the shirts arrived at my house, I was filled with nervous energy. My husband texted me at work with the first photo saying, “Looks good. It’s a little…small.”

When I saw my own shirt later that night, my heart sank. It was at least 2 sizes too small even though I’d bought a larger size than usual.

“The shirt is slightly tight,” I captioned, nervously.

There was no avoiding this problem, though I desperately wanted to.

I started to get nice messages from shirt-buyers in their kind and bright voices.

“I love the shirt but might have to give it to a smaller friend.”

UGHHHHHHHHH.  No amount of denial was going to allow me to escape the fact that the sizing was off. This could not stand. I wrote Cotton Bureau, makers of the shirt. They replied:

I was confounded and getting angrier by the minute. Why would they send junior-sized shirts? Why would they ask my people to pay for shipping to return those same shirts for a refund, not an exchange?

It was fast decision time.

Was I going lay bare the shirt debacle to everyone, possibly escalating it along the way? Or should I just let it go? After all, a bunch of people told me they liked the shirt and were happy, right?

My stomach told me I didn’t have a choice. I posted the Cotton Bureau “We-thought-we’d-send-you-junior-sizes-and-no-one-would-be-the-wiser” update on Facebook and emailed as many of the 68 people who bought the original shirt as I could.

Then a crazy thing happened.

I started to hear back from everyone who thought something was wrong with them. Many friends mentioned weight gain. My mom and mother-in-law both assumed they were too old to look good in the shirt. Actually, anyone over the age 35 imagined they just weren’t cool enough to look good in “what the kids were wearing.”

Taken in the rev up to the customer service fight.

When I heard that the sizing caused my people--my BVs!--to question themselves, I started to get a lot more aggressive in my communication. How dare a company make my people question themselves with their mistake!

I pushed harder. I got Cotton Bureau to take responsibility and exchange everyone’s shirts at no cost. They offered to do another 2 week run of the shirt immediately to make sure everyone can get exactly what they want, fully armed with information about the sizing. It just started a couple of hours ago.

A happy ending.

Receiving and sharing pictures of everyone’s beautiful voyages buoys me up much more than the tediousness can push me under the waves. I've begun to manage shirt production directly, and now sell the shirt on a Shopify site to help raise money to support the running of this site.

Adorable happy people in shirts that fit.

The 3 Morals of The Story

1. Don’t Blame Yourself if Something is Messed Up. (You’re great.) 

2. Keep Fighting. 

3. Enjoy Wins As They Come.

Can Technology and Mindfulness Get Along?

I started meditating in January. I’ve managed to stick with it daily thanks to the app I use. It teaches a technique for stressful situations called notation. You untangle yourself by answering questions like: Is this a thought or an emotion that I’m experiencing? Can I describe it as pleasant, unpleasant, or neutral?

This is how I discovered that technology and mindfulness don't have to exist in separate silos, and I learned I could create an escape hatch as needed.

This technique helped me us technology for a mindful, Clark-Kent-like escape.

Parenting Example Ahead, But Technique Works Generally. Don't Blow Off As a “Just for Moms” Situation.

Grocery and dress shopping with my 5-year-old daughter was hard on the best of days. On the day I'm describing, I had a migraine, and my girl was in one of her tennis ball machines moods that afternoon. She was full of questions and demands, varying her speeds, unpredictable, throwing up lobs every so often. Her temper tantrum had long ago pushed me into a blank zone beyond coping.

I tried to use my Headspace approach: Is this a thought or emotion that you’re experiencing? It wasn't working. I just felt overwhelmed and frustrated.

Suddenly, I was able to look at the situation as if I wasn't stuck in the middle of it.

This hilarious little girl is suddenly a small crazed human. embodying the Buddha's words, "suffering is attachment." She’s a vision of every person who has ever wanted anything.

I took this quick photo of her that was funny and also incredibly, deeply, true. 

I imagined myself trying to explain the Buddha’s teachings to her in the middle of the store. Well, Alice, as the Buddha so wisely noted, the root of all suffering is attachment. Now please hand me the one with the purple puffy sleeves, because it is a size 5/6. HA.

I had made myself laugh.

Laughing = oxygen.

I had started to come back to life in the smallest way.

"It was the same pretty as the one I got, but it had a rose."

She chose one that looked the most like a wedding dress, and we left the store. But we were far from done with our struggles. We still had the car ahead of us, and the tragedy of saying goodbye to the dress she didn’t get. “But you got a dress!” Alice, I’m sure you remember our conversation about the Buddha, right? Cherishing what we spoke about in the 3rd aisle of Ross’s?

The technology + mindfulness escape hatch was happening through the combo of the photos and the voice in my head.

 I could empathize with my girl while feeling the absurdity of our situation. Here I was, stuck inside a horrifically pounding head, trying to find space to calm down. Here she was, trapped inside her suffering. The pain of decision-making! I knew it, too. The scale of her emotions was so tempestuously, Liberace grand, but the nugget was universal.

The hatch really cracked open when I broke out the Voice Memos recorder on my iphone and interviewed her. The interview freed us both. She’s breathing! It helped me breath, too. I started to explore her story from a new angle. We were in it together. The funny bits are best. I’ll remember that for the next time.

Using a mindfulness technique, I learned to:

• Tune in to an awareness around thoughts and feelings as they hit.
• Get some oxygen to my head when I needed it.
• Find my own funny escape hatch using my smartphone's camera and audio recorder
• Create something tangible to share with others, building a bridge off the island.

Give it a try and see if it works to get you out of your next stressful situation. Worst case, you’ll be creating something new. Ideally, you’ll find yourself laughing.

All the tools you need are right on your phone.

Originally published April 9, 2015 on Medium. Transferred to Bevoya.com Sept 2, 2017.

What's Up with Thyroid Problems and Anxiety?

In the past few years, numerous friends have mentioned that they're facing thyroid issues. Invariably, it seems like my sensitive, thoughtful friends are dealing with everything from hypothyroidism to thyroid dysfunction to thyroid cancer. It's made me want to look at the relationship of the thyroid and endocrine system to the nervous system.

Remember high school biology?

•  The fast-moving sympathetic nervous system sends signals to the adrenal glands, which, along with the thyroid are part of the endocrine system. 
• This sympathetic nervous system manages "flight or fight" responses, affecting those of us with anxiety.
• The adrenals release hormones like pregnenolone, adrenaline, estrogen, progesterone, testosterone, DHEA and cortisol into the bloodsteam. These are for key hormones anxiety sufferers.
• The slower moving parasympathetic nervous system is responsible for the body's "rest and digest" functions.
• The thyroid is strongly influenced by the parasympathetic nervous system. 

Though we understand the above as facts, stress's effect on the everyday functioning of the glands is a cause of much confusion and discussion. Let's trace how that played out in my own journey.

Cortisol, the frenemy that's here to stay.

Cortisol is a strong theme in my writings on anxiety. It's a big part of the hormone wave I've been learning to face in my own life. I first learned about cortisol in the months leading up to my Generalized Anxiety Disorder diagnosis by my neurologist. I was seeing a family nurse practitioner at One Medial Group here in San Francisco. After hearing my list of physical symptoms including nausea, headaches, light-headedness, and bloating, she suggested we test my adrenals and cortisol rhythm over the course of a 24-hour period. I spit into a small test tube over and over at pre-defined times. A few weeks later she received the results of my test. This is what they looked like:

This is where we get into debate territory. It starts with how to interpret the results of a test like this. Naturopaths would point to my low levels of cortisol in the morning (when it's supposed to be high) and high cortisol at night (when it's supposed to be waning down) and say that I was showing signs of adrenal "fatigue." Many endocrinologists would say that there is no such thing as adrenal fatigue. "Your adrenals either work or they don't," they say. Julie Deardorff, Chicago Tribune reporter writes about the controversy, saying:

Adrenal fatigue proponents say the condition can affect anyone but is often triggered by a serious illness or injury, allergies, poor nutrition or intense social, emotional or physical pressure. Perfectionists and those who feel trapped or helpless, don't get enough rest or have a stressful job are especially vulnerable, they say. 

My FNP looked at my cortisol patterns and summarized that something was off in the way that my adrenals were functioning. She drew a Venn diagram I still look at from time to time.

She said, "We need to look at all of these different factors when trying to figure out what's happening with you. We started with adrenals, and now we need to do a thyroid test. Eventually we will do a hormone test over the course of a month to see what's happening there as well."

So I had my blood taken that day and got my thyroid hormones levels tested. Later that month, I spat into a test tube again, this time to get a read on my hormone levels.

I had investigated every circle in the Venn diagram above but neurotransmitters. I went to see my neurologist, and that's when I was diagnosed with Generalized Anxiety Disorder. I began taking the SSRI Lexapro and in the following year, along with important lifestyle changes, I saw my symptoms improve. For me, the neurotransmitter section of the diagram was the one I needed to address to see improvement.

Hey, aren't we here to talk about the thyroid?

Yes. If every person has their own factors affecting their own Venn diagram, and each of the circles can affect each other, how is the thyroid affected by stress, anxiety, and mental illness?

I don't know.

But I am seeing the pattern of thyroid issues in the stressed-out people around me. That, along with this diagram and the testing framework I used a few ago, has me seeking answers to that question. Do you have thoughts about it?

If you're a doctor who has treated patients for co-morbid thyroid and adrenal issues, I would love to hear from you. If you are a patient who has sought answers for your own thyroid issues, I want to hear from you.

Together we can tackle this sea of confusion by sharing findings, learning from each other, and connecting the dots.

Please share a comment below!