Seattle, Washington, USA (Winter 2018)
|The unnerving level of vigilance that anxiety patients maintain|
For the past six years, I have not been myself. Then again, the memory of my former self has grown a bit foggy over the years. Perhaps things were always this bad. Perhaps I have not changed much at all.
Around six years ago, at the age of seventeen, my world was brimming with possibilities. I was offered a full scholarship to college and guaranteed admission to an Ivy League medical school. I had loyal friends, fantastic teachers, and a supportive family. On the surface, I had it all. But few would come to know or understand the turmoil brewing underneath. Or the gnawing feelings of guilt and self-doubt that often consumed me.
I watched myself deteriorate that year in a way that will haunt me forever. It was painful and numbing. It was vicious and unhurried. It was anxiety and obsessive-compulsive disorder (OCD).
Anxiety and OCD are diseases of “what ifs?” What if my comment offends someone? What if that bump in the road wasn’t just a bump in the road? What if unpaid merchandise fell into my purse while I was shopping? What if I unknowingly pass on an infectious disease?
Each of these worries stems from my biggest fears. If I offend someone, they will think I am an awful person and my reputation will be ruined. If I accidentally injure someone, I will have caused pain to others, and I do not want to live with that. I worry that I will hurt myself or others in a way that cannot be reversed. Since I cannot fathom the idea of these worries coming to life, I always take extreme precautionary measures. I check and double check. I clean until my hands are raw. I do whatever it takes. But sometimes, I miss the deadline for preemptive action.
Sometimes I worry about a mistake I made long ago, or a situation that I cannot possibly revisit. In these cases, I must replay the moment in question in excruciating detail to confirm that I have not done anything wrong, and that is the best-case scenario. The worst-case scenario is that I am unable to convince myself that I am in the clear. And so, I harbor feelings of guilt and begin the torturous path of determining how I can make amends. I do not always get this far. Before I can complete one cycle, I am usually forced to divert my attention to a more imminent threat.
At seventeen, I was already beginning to lose myself. I quit driving, volunteering at the hospital, etc. These activities used to be effortless and bring me joy. But every time I put myself in these scenarios, anxious thoughts infiltrated my mind, and I was already buckling under the load of my “essential” tasks. I simply could not take it anymore. The constant fear of consequences was paralyzing. Everything became a chore. My productivity plummeted, my relationships were strained, and yet I could not stop myself from feeling this way. I often resigned myself early to bed because it was the closest thing I could find to an “off” switch. Before seventeen, I was likeable, ambitious, and free. After seventeen? I was living a shell of my previous existence. But when I dig deeper, I can identify the red flags from my childhood.
One summer I feared I had a cavity, so I routinely flushed it with milk using a straw. When I was a kid, I thought it was illegal to visit the same store twice in one day. Once I discovered an abnormal lump on my head, feared the worst, and hid it from everyone. And before we left the house, I would often confirm that the appliances were indeed turned off. These may seem like the trivial worries of a child who does not know any better, but I wonder if they were warning signs. My childhood imagination engineered risky situations, so from an early age I attempted to prevent, diagnose, and treat my worst fears. I have been in a constant state of hypervigilance for perhaps my whole life.
I carry the weight of my past along with the woes of today and my dread for tomorrow. Every direction spells danger. What can you do with that? I have been given every blessing on this earth, but my anxiety has restricted the use of most of them. And so, I wonder, will I ever excel at anything again? Will I ever be fully functional again? In my college application I described myself as an ice cream sundae – a novice, yet promising delight. Upon graduation, that sundae should have turned into a banana split. But I never evolved. I regressed into a soupy mess instead.
My journey with anxiety has been debilitating, but I am afraid that may not be the worst part. That there are people who turned me away when I needed help is what hurts the most.
Mental illness is perhaps the most guilt-ridden of diseases. I cannot think of another class of disorders where the onus is on the patient to heal themselves. Any successful therapy requires patient compliance – this is true. But I have lost track of how many times people have suggested that I am somehow obstructing my own healing process. If only I could change my outlook on life, meditate more, and quit being stubborn, I would have been better by now. If it were so simple, wouldn’t I be cured by now? Or are they implying that I desire to prolong this hellish existence? We need to change the way we think about mental health.
Medicine is the practice of treating the whole person. A doctor cannot perform a life-altering operation and then abandon the patient’s struggle during rehabilitation. Similarly, it would be a great disservice to heal a patient’s wounds without considering the psychological effects of the trauma that caused them. For the same reasons, mental illnesses require a holistic treatment approach.
Unfortunately, mental illness is complicated by the fact that the source of the disease is invisible. Since there is no physical ailment that we can trace the symptoms back to, people may assume that the suffering is somehow less credible. But we cannot treat mental health patients as if the physical manifestations of their illness are isolated behavioral problems. If we only attempt to treat what we can see, mental health will never become more than an afterthought. But mental health is not some sort of elective or luxury tier of wellness – it is fundamental, and we should start treating it as such. Any person, school, or institution that we entrust with our wellbeing must also operate under this understanding.
I have known warmth in my times of weakness (both related and unrelated to my anxiety): the counselor who made weekly visits to my high school; the residents who detected my fear and offered to eat lunch with me during a hospital stay; the caregiver who nurtured me with warm blankets and IV fluids during an unforgiving streak of migraines. Those people were my saving grace. In my moments of weakness, they showed me compassion and a genuine concern for my wellbeing. They believed I was suffering. But for every unsung hero, I can recall one of the agents of my agony: the friend at a party who suggested my anxiety episode was a cry for attention; the school administration that treated my anxiety as a disciplinary issue; the countless people who brought tears to my eyes when I struggled to explain why I could not be “normal.” I suffer from an illness that makes me tell myself “you’re not good enough.” So, to have others reinforce that sentiment is to pour salt into an already throbbing wound.
I have been in and out of therapy for the past several years. I have tried talk therapy, exposure therapy, and various prescriptions. It is difficult to hide my frustration at this point. I have jumped through all the hoops with seemingly nothing to show for it. Six years later and I am still not better. But then, I remember, I am still standing. I have been through hell and I am still here. Those therapy sessions were not useless; the ability to unload my worries to a sympathetic ear was essential to keeping me afloat. The people who considered my issues to be secondary to the person I am mean more to me than they will ever know. Had it not been for such compassionate individuals, I am not sure where I would be today. And I do not say that lightly. Medicine often connotes syringes, stitches, and pills – but that is not all it is. Medicine is the holistic approach to treating a person, and I am lucky to say that I have been on the receiving end.
LIBANOS REDDA is a recent biomedical engineering graduate of the University of Southern California. After receiving her bachelor’s degree in 2016, she began her career in the pharmaceutical industry. She has experience in both traditional & computational biomedical research, and a passion for community outreach. Her ultimate aspirations are to apply her technical background to social causes and live a life of purpose.