Why Anxiety Is a Physical Illness
This isn't author Kelly Dudzik, but it's a photo of a determined person, and that's what dealing with the physical elements of anxiety is all about.
Apparently, I’ve been to the psychiatric emergency room. I don’t remember it.
My mom picked me up from my college dorm room and took me there. I vaguely remember a waiting room with maroon chairs but that’s it.
I had a hard time adjusting to the thought of college. It had nothing to do with worrying about getting into the school I wanted, but everything to do with my anxiety. I worried about leaving home, even though it would only be a 20-minute drive away. I worried about meeting new people, even though people usually like me. I worried about being lonely, even though I would be surrounded by people.
But going to college is what valedictorians do, so I went. And the first week actually went well. I had prepared myself mentally, running different scenarios in my head and trying to prepare for every possibility before it happened. I was surprised at how well it went. Then I stopped eating.
Food made me sick; my body just couldn’t handle it. My mom came up to eat with me, but it didn’t help. Eventually even the smell of food made me sick, and I avoided it all together. I lived on crackers and water and my frame whittled down to 100 pounds; I could take off my pants without unbuttoning them.
I couldn’t make it through a class without crying. I would be sitting there and everything would be fine, when suddenly I was overcome with fear and I could feel my eyes pricking with tears. I would excuse myself, take my stuff, and sob my way back to my dorm.
Several times I was too distraught to get on the bus and had to have my sister come pick me up. She never understood what the problem was because whenever she came to pick me up, I was always calm and composed. My sister never realized that the reason I looked relaxed was because she was there.
I didn’t know it at the time, but I was having panic attacks. A panic attack is a misnomer: it should be called a fear attack. I wasn’t panicking; I was overwhelmed by fear. My adrenaline rose, my vision narrowed, and I started hyperventilating. I was afraid, but I had no reason for it. There was no one chasing me, no one hurting me. I simply experienced the fear associated with it. I became so overwhelmed that I sobbed as a release.
I had very physical symptoms from my anxiety:
Nausea from the smell of food
Constant diarrhea
Breathing was shallow and insufficient
Crying/meltdown episodes several times throughout the day
Inability to focus and memory loss
Repetitive, obsessive, cyclical thoughts
Unable to function at a basic social level
Restless and light sleep
And so, one night my mom took me to the psychiatric ER. According to her, I called her, but she couldn’t understand me, I was crying so hard. And she couldn’t calm me down like she’d been able to do before.
The ER doctor gave me a Xanax and referred me to the university’s psychological counseling services that are free for students and teachers. My mom took me the next day, but I don’t remember going there either. They gave me the name of a psychiatrist who changed my life.
That psychiatrist gave me a prescription for Xanax and told me to see her in a few days after it started working. I had no qualms about taking a psychotropic drug. If it made me feel better and helped me function, who cared about the social stigma? I knew what was happening to me wasn’t something I could just ‘walk off’ or ‘get over’ and so I refused to feel bad about taking drugs if they helped.
I remember the exact moment the Xanax kicked in. I was walking down my dorm hallway and I looked into the face of a boy. He smiled a little and passed me. I stopped. I realized I hadn’t been looking people in the face since I got to college because I was always looking down. My anxiety was still there; I was a nervous wreck and still had massive intestinal distress, but I no longer felt like I was drowning in it.
Anxiety is like drowning.
Your head is just below the surface of the water and you can’t break free. Your heart squeezes tight and you can’t breathe. You panic and think you’re going to die. What’s remarkable is that no one around you seems to notice you’re drowning. You want to yell out for help but there’s water in your mouth and nose and down your throat. You are dying and no one realizes.
Illustration: Thomas Dudzik
My anxiety was a rolling ocean, but I finally had my head above water. I wasn’t on dry land but at least I could breathe. My psychiatrist said that medication usually helps people realize what they’ve been feeling; it helps people take a step back from themselves. Then therapy can be more effective. Xanax helped hold my head above the water. I wasn’t cured, but I could breathe again.
Once the Xanax kicked in, my psychiatrist gave me homework. She had me write down all the symptoms of my panic attacks in the order they happened. Seeing it written down made me less afraid. I also saw that the panic attack would build up slowly and in a very specific order. I had thought the panic attacks had come on suddenly and without warning. I was constantly afraid of rogue waves. But it turned out, there were no rogue waves; everything followed a very specific order and timeline. Whenever the symptoms started, I was able to identify them and say to myself, “Oh, I’m about to have a panic attack,” instead of suddenly being overwhelmed by it. I was able to identify the symptoms in enough time that I could steer the ship away from the wave, letting the panic attack pass me by completely.
My psychiatrist told me to write down my thoughts with the physical symptoms. It became very obvious what was causing the panic attacks. My psychiatrist explained to me that I get into black and white thinking: everything is either going to be the best thing that ever happened to me or the worst thing that ever happened to me. When something doesn’t live up to the high standards of being the best and is simply, say, just okay, my mind says that the opposite is true and that the most terrible thing is about to happen to me. My psychiatrist had me come up with and repeat a mantra: “Everything could be fine, could be bad. Let life happen.” I repeated that to myself every single time anything happened that I didn’t plan for. I wouldn’t be surprised if I repeated it to myself hundreds of times a day in the beginning. The mantra was a comfort to me, kind of like repeating to yourself there’s nothing scary in the basement as you walk down the steps.
I didn’t really see how any of that was going to cure the massive physical symptoms I had but the psychiatrist had been right so far so I kept at it. And a funny thing happened: it started working. I immediately stopped having crying meltdowns. I would still get overwhelmed but now I had to foresight to take a deep breath and tell myself to calm down, that everything was fine, let life happen, be in the moment, see what happens. My body started to relax and released the death grip it had on my stomach, allowing me to finally eat food. I gorged on all the food I had missed out and quickly gained back the weight I lost.
Finally eating and sleeping better, I realized I had anxiety due to a feeling of lack of control. I would state what kind of day it was going to be and then be a nervous wreck in case it didn’t turn out that way. I was like a party hostess, determined to have everything go perfectly, except I didn’t have waiters to complain to if the shrimp puffs ran out; I only had myself to blame and I did so horribly. I was a bridezilla but only berated myself.
Nothing had to actually go wrong for me to have anxiety. In fact, it didn’t matter what the day was like because I had anxiety. I was constantly worried about everything; I felt like I needed to be in control but couldn’t keep up with all the possible ways the day could turn out. People with anxiety are in a constant state of paranoid hyper-vigilance. They see everything and are very jumpy. Their mind races to sort out all the information while new information continues to come in. They cannot keep up. On top of cataloguing new information, a person with anxiety also comes up with every possible outcome of each situation. It is simply too much information and they cease being able to function.
Slowly, I got better. I was able to head off panic attacks before they started by using the mantra. I never would have been able to do it without the Xanax, but after a month, I was off the meds and just using the mantra. And college got better and I actually enjoyed it because of the tools my psychiatrist gave me.
If you need medication and/or professional help, please get some. And if you’re too far gone to be able to get the help yourself, please ask someone to help you. I was lucky enough my mother is amazing. There would have been no way I would have been able to drive myself to the emergency psych ward; I don’t even remember being there. And my mom navigated the confusing insurance claims for me. Again, I was in no state to deal with those. I was too busy holding on for dear life while the waves threatened to drown me. In this case, I needed someone to take the wheel from me. I needed someone to handle things for me.
If someone fell off a roof and broke every bone in their body, you’d drive them to the hospital or call an ambulance. You wouldn’t plead with them to get help while they laid there, and then get mad when they don’t move. You would physically help them. Mental illness is a physical illness and needs physical help. Sometimes the person will say they are fine while they bleed out. It sucks because in those cases, they can refuse to get in the car. But eventually, they will realize it is out of hand and they need help. And you need to be there ready to go when they finally confess they can’t handle it. You need to know the way to the hospital or a psychiatrist in their insurance plan. Just like you would if the person had broken their leg. Again, it can suck. But if you love the person with mental illness, you will do it. The alternative can literally be death for them.
If you don’t have someone who can help you, find someone. Do it now while you are still able to read this book and remember it. Find a support group who will care if something happens to you. Put the suicide hotline number in your phone. Don’t be afraid to call 911. An emergency is an emergency.
Kelly Dudnik Creator of travel blog lousieandclaire.com.
Kelly Dudnik is the creator of travel blog lousieandclaire.com. Read more of her work on Medium.