When Taking Anxiety Medication Is A Revolutionary Act
I had to learn how to love myself enough to take care of myself. It wasn’t easy.
If I had to describe what having anxiety feels like, I’d say that it’s kind of like walking through the world beneath tornadic skies without an umbrella, unsure if you’ll be able to find shelter if things get bad. When friends invite you out, you politely decline because while you’d like to enjoy their company, the sky could open up and wash you out to sea at any minute so it’s probably safer for you to stay at home. In the background of anything you do is the gentle hum of your nervous system as it tosses and turns, wondering when the deluge will hit, thinking about how unfortunate will be if you don’t survive it. And what kind of storm will it be? Something huge? Just enough raindrops to ruin your hair? Will the people you love be OK? Can you handle it? If you can’t, will people be able to witness you failing to handle it? How will you handle that?
Anxiety can be as exhausting physically as it is mentally — the tears that come from nowhere, the knotted stomach, the squeezing in the chest, the muscles that feel like they’ll snap if they get any tauter. As you move through the day, the only thing you can think of is getting to a safe space where all that doesn’t exist, where you can breathe and finally take your eyes off the sky and pay attention to something else.
This is why I spent so much of my time alone before I was diagnosed with generalized anxiety disorder; alone was the only safe place that I knew. My apartment and my designated classrooms (and later the office where I worked) were the only places I would go, directly from one to the other. I ordered my groceries even though there was a store steps from my apartment. I wanted to get in shape but I couldn’t bring myself to do so in a gym with people to judge me and complicated machines to make me look like an idiot.
One day in 2008, when I was a 26-year-old grad school dropout living in Philadelphia (having moved there from Louisville, Kentucky), I looked at my bank account and looked in the mirror and decided that I was too cute and had too much money to burn to continue living the way I was. I also thought that the reason I was spending so much time alone in my apartment, hiding from people, was simply because I couldn’t get over my ex-boyfriend. So I found a therapist named Gail, a delightfully round, tiny sixtysomething lady who said her most important things in passionate whispers so you knew that she was serious.
After I spent 30 minutes trying to explain the feeling in the center of my chest that felt like a stone when I swallowed, Gail changed my life with seven words:
It sounds like you’re having some anxiety.
I felt a jolt in the pit of my stomach. I had no idea that there was a word that so perfectly encompassed the random, faceless worries I carried with me every day. I knew what the word meant, of course, but I never thought to ascribe it to my problems. I immediately became obsessed with it. As soon as I got home, I looked up the word’s exact definition and was in tears before I even got to the end of it:
An abnormal and overwhelming sense of apprehension and fear often marked by physiological signs (as sweating, tension, and increased pulse), by doubt concerning the reality and nature of the threat, and by self-doubt about one’s capacity to cope with it.
That was it. That was me. I read it over and over again, tears soaking the neck of my shirt.
Before I was formally introduced to my anxiety, I called it by a bunch of other names — nervousness, weakness, timidity. Employers called it laziness, distractedness, and “not being a team player.” My ex called it clinginess. My mother called it oversensitivity and immaturity. But we were all wrong, and learning that we were all wrong, that there was an actual medical thing going on, overwhelmed me because it meant that it wasn’t a tornado of character flaws that landed me where I was.
The problem was not that I simply chose not to be “normal,” that I allowed my fears, baseless as they may have been, to conquer and dictate so much of my life. The problem was my brain. It was a chemical imbalance, something physical, not imagined. My amygdala, the part of the brain that controls anxiety and fear, is essentially running in circles screaming “THE SKY IS FALLING!!” all the time. Knowing this, I stopped blaming myself for my shortcomings, because it felt to me like the equivalent of blaming yourself for having the flu. When you get sick, you don’t just will yourself to get better. You go see a doctor. You do what you need to do to feel better.
I buckled down and did every behavior-modifying exercise that Gail told me to do. I stopped ordering my groceries and actually went to the store. I actually went inside that gym I had my eye on (I didn’t work out, I just walked inside, which was actually a huge accomplishment). I pushed myself to go out with friends at least once a week. On top of that, I did everything the internet told me I needed to do to beat anxiety. I did yoga, tried to meditate, practiced Buddhism for a while (and by “practiced Buddhism” I mean I read three-quarters of Buddhism for Dummies). I took a multivitamin. I kept a journal. I eventually hit a good stride, and by the time I decided to move back home to Louisville, I felt very proud of the person I’d become. She was cockier, louder now that the boulder had been moved at least partly away.
And then I turned around and she was gone.
There is no bigger foe in my world than change. I obsess over making the wrong decision. I have an active phobia of being asked where I want to go have dinner. No matter how stable I am at any point in my life, big life changes cause an explosion of anxiety for me, and I end up right back where I started, on the phone tearily missing my mother. When I moved back to Louisville from Philadelphia, it seemed that I’d left everything I learned from Gail right there in the chair I always sat in in her office (the one pressed against the wall facing the door, because sitting with my back to an open room makes me tremendously nervous). I tried to remember and employ some of the things she’d taught me and had some modicum of success, but once again, I found myself spending much of my time alone at home, the only place I felt safe, leaving only to eat and go to work.
I had to do something, and the next logical step seemed to be medicine. I had successfully overcome the stigma of going to see a therapist, but somehow the idea of seeing a psychiatrist and taking a pill for a mood disorder felt different. I asked my best friend if he’d think it weak of me to look into seeing a psychiatrist and getting a medicine to treat my anxiety, if it somehow meant that I have failed at being “normal.” He told me that the opposite was true: that it takes great bravery to admit that you need help.
This realization kind of blew me away because it went against the ingrained idea I had that medicine was for crazy people. In movies and on television shows, psychiatrists treated babbling, unwashed, self-harming, occasionally murderous lunatics who had psychotic breaks if they missed even a single pill. Since I was itty-bitty, my friends would ask “did you take your crazy pills today?” when we said silly things or got lost in a fit of giggles. Church taught me that if my spirit was unsettled or I was unhappy or something in my life just wasn’t right, then I wasn’t praying hard enough or tithing often enough. And my ex told me in so many words that someone who sought help for emotional troubles was weak and just not trying hard enough. I had to rearrange everything I knew to allow myself to look up the number for a psychiatrist, and rearrange even more to actually make the call. It takes courage and strength to look the stigma of being medicated in the face and push through it, to persist because you care about feeling whole and happy and calm more than you care about what other people think. Loving yourself enough to take care of yourself when it is easier not to is a revolutionary act.
And so I became a revolutionary. I was given a prescription for Celexa, an antidepressant also used to treat anxiety, and took one before work the next day. It worked. It worked too well. I didn’t feel anxious, but that was because I didn’t feel anything at all. At lunch I told my boss that I was leaving because I didn’t feel well. I had plenty of tasks that needed to be done and I knew that my boss was disappointed in me, but I didn’t care. I went home, sat on my couch, and stared at nothing until my best friend came to pick me up for dinner. He’s a stand-up comic and the funniest person I know, but I couldn’t laugh at anything he said. He’d tell a joke and I could only mechanically recognize and acknowledge its existence as an entity that fulfilled my predetermined requirements for “humor.”
“I want to cry,” I said. “I hate the way this feels and I want to cry, but I can’t cry and it makes me want to cry more. I don’t want to never cry again. This isn’t what I wanted.”
Nothing makes you feel more deliberately alive than feeling. Crying with someone you love because you can’t stand to see them hurt; swimming in the unbearable nirvana of eating your favorite meal; drowning in the hot wave that rushes over you when someone special holds your gaze a little too long — with all your senses rioting, you’re hyperaware of everything around you. Your pupils widen to let in as much light as they can and you can count the pebbles beneath the soles of your shoes and feel every fiber in your shirt and the blood in your ears pulses and crashes and in those moments you are so alive. I did not want to trade that for “normalcy.” There at the dinner table, I decided to flush each of those pills as soon as I got home that night, but my best friend eventually convinced me to wait at least a week.
I seemed a new person, literally overnight. I was surprised at how instant this change was, and I later learned that this is not at all typical of antidepressants or antianxiety medicines. Most take anywhere from a week to several months before the patient sees a change, but the very next morning I bounded out of the tangle of sheets on my bed rather than lying there trying to convince myself that I wouldn’t die if I got out of it. I went to work at a job that I absolutely hated without feeling like I was dragging seven burlap sacks full of dread and regret. I made it through the day without having to leave my desk to go catch my breath or cry in the bathroom and I didn’t walk in the opposite direction or quickly jump on the phone to pretend I was taking a call when a co-worker approached.
The best thing was that medicine didn’t turn me into a brand-new person; it didn’t give me any confidence, wit, or charm that wasn’t already there. It just moved the anxiety and constant worry out of the way so that everyone else could see what I always knew was in there, so that I could interact with it unimpeded. It’s also really important to note that it did not make my anxious feelings go away. There is no magic pill that instantly erases them all. I still walked through that same landscape with storms ever teetering on the horizon, but now I had an umbrella. I still thought that something terrible could happen at any minute, but that thought didn’t paralyze me. The need to control every single thing around me was lessened. I felt light enough to accept invitations to go out, to peel myself from my bed to run errands, to actually answer my phone to chat with friends when they’d call. I was given the room I needed to be my full, fantastic self.
I’m often mistaken for an outgoing, type A personality. It gets a laugh out of me every time.
After a stretch of time on mood-balancing medication, many people feel happy, stable, productive, and “normal.” But rather than think to ourselves, Wow, I’m glad I have found a medicine that helps me to be an active participant in the good of my life, we think, Oh my god, I’m cured! I don’t need this medicine anymore! And so, being “cured,” we stop taking our medicines — often cold turkey, which is not a smart or healthy thing to do — and arm ourselves to the teeth with our newfound normalcy, ready to punch life squarely in the face. It may work for a day or two or even a couple of weeks or months. I’ve been here often enough to know that two weeks is typically my limit; after that, my body turns into lead and I’m back on my couch in a paralyzed frenzy, dealing with all the old feelings of frustration now coupled with the shame of having failed, of acknowledging a life chained to a pill, of never having been “normal” after all.
This is a space that I have been in at least four times since being diagnosed, and though I know that “normal” is a mirage, it doesn’t deter me from wanting to try again and again. I know that there is absolutely no shame in taking a medicine for my anxiety. It makes just as much sense as getting an allergy shot during allergy season. I know this in my heart, but I’d be lying if I said I never hunger to feel “normal” and not need my medicine. The pang lessens, but it never, ever goes completely away for me.
I moved to New York City in May 2014, and a month before that I decided it was time to try a life without medicine for the fifth time. My best friend, who knows my strength and stubbornness more than anyone else, myself included, sweetly told me that it was a horrible idea, but he’d support me however he could as I did this thing I felt like I had to do. The timing was horrendous. Shuffling through my stressors felt like running through the ocean against the tide. I wasn’t just preparing to leave my friends and family. I wasn’t just dealing with figuring out how to continue paying off my student loans while living in such an insanely expensive city. I was in mourning. I had lost two uncles on the same day a month before, and my mother and I were preparing to put my grandmother in a nursing home. I felt a tremendous load of guilt for leaving my mother after she had lost so much so quickly. I was in the middle of a storm that was definitely survivable with my medicine. To cast away my umbrella in the middle of it seemed and felt insane, but I was nearly powerless to decide otherwise.
I needed to know that I could do this on my own. Something that always worried me is pregnancy. If I ever do have the occasion to have children, I wouldn’t want to take an SSRI (selective serotonin reuptake inhibitor) while pregnant or breast-feeding. I needed this pill to not be a crutch; if there was going to be a day that I’d be without it, I needed to know that I would be OK. But I also felt like I needed to control something in this space of death and unstoppable change, where seemingly everything was out of my hands. I don’t recommend doing it this way for lots of reasons, mostly medical. Stopping an SSRI cold turkey and without talking to a doctor isn’t the safest thing in the world, and you run the risk of withdrawal syndrome, which can include flulike symptoms, headache, and stomach problems.
Luckily, I was spared the worst of it. Though I could and should have been smarter about stopping my medicine, I don’t regret it, in spite of how tough it got.
But making the move without the medicine was, of course, very, very difficult. Aside from the predictable stresses of uprooting your entire life and moving 700 miles away from everyone you love, I also felt waves of very baseless anxiety. I avoided doing big, necessary things (like packing) until the very last minute (literally the day before my move) because they stressed me out and I didn’t have the energy to do them, mentally or physically.
I resorted to some of my unproductive manners of coping when things got particularly hard. I’m a notorious stress napper, and when I get very overwhelmed the only thing I want to do is go to sleep to escape the anxiety of it all. I’m also an emotional eater, and with so many feelings to eat I’m sure I flirted with high blood pressure. I was also back to craving solitude, which I recognized as an immediate red flag, a sign that I was barrelling toward calling the whole thing off.
When I got to New York and was officially settled in my new apartment, my anxiety definitely swelled, but it didn’t shut me down the way it did when I moved to Philadelphia or when I moved back to Louisville. Knowing what a life with less anxiety looks like, knowing that it is even possible at all, gave me incentive to stay as positive as I could (which was not always very positive) and push through. Still, most of my energy was tied up in not drowning. I’d go out with friends but often would have preferred to stay home, alone, and rest. Negative self-talk increased and presented a huge hurdle to loving my new city, one that I wasn’t sure I could clear (I lamented to my best friend that this city just isn’t for me, that I should have listened to my gut and stayed at home. “I hear you,” he said, gently, “…but it’s only the first day”). My biggest worries surrounded my job performance, which I felt was absolutely abysmal, and I spent more time than I’d like to admit fantasizing about all the terrible poetry I’d write when I finally got fired.
But through all this, I noticed some amazing things too: I didn’t call the whole thing off. When I felt myself wanting to be alone, I made it a point to call friends or visit my mother. I cried when I needed to, but when I felt like breaking down I took a moment to tell myself that it was just the anxiety; it wasn’t weakness or fear, just the hiccuping alarm section of my brain. I reminded myself that in the course of trying not to feel anxious, being anxious is not a failure. I rewarded myself for things that “normal” people would find laughable, like getting out of bed and not napping when I have things to do and going to the grocery store, because I vividly remember a time when things like that were a struggle, if they were possible at all.
When I got to New York, I managed to stay on my feet. I went out with friends because I needed to, even when I didn’t want to. I didn’t call out of work and hide under my bed. I didn’t beat myself up for feeling scared or worried. It was exhausting, but I pushed, and I pushed because taking that pill showed me that a life without crippling anxiety is possible, something that I genuinely never knew or believed before, and something that I deserved to have. In my craziest moments, I know that there is an opposite because I lived that opposite, and what I have done once, I can do again. I can be OK.
After moving to New York, I decided to go back to my medicine because choosing “OK” when “fucking awesome” is an option just didn’t make a lot of sense. It is the difference between unavoidable stress and needless suffering (something I learned about during my month as a Buddhist). Sure, I could stay in that ocean and spend all my energy running through water to get to where I need to be. Or I could hop out, shake myself dry, and walk. Or run. Or skip or cartwheel or walk on my hands or twerk or whatever. I didn’t feel like a failure for popping that bottle open again. I felt like a woman with options who chose not to settle for a life limited by an overactive section of her brain and opted instead to be the bright and shining addition to this world that she has the potential to be when not locked inside of herself. I began to see the difference immediately. With the help of a tiny white pill, I wake up in a better mood. I am calmer, more focused. I actively crave the company of others, and when I notice it, I let it wash over me, rolling around in the way it feels to live after years and years of simply being alive.
Without the medicine, I live a life of “I can’t do this, but I’m somehow doing it anyway.” With it, it’s more “this is sometimes difficult, but I got it.”