My hands tremble as I reach across the counter for my coffee cup and my heart beats so fast it feels like it’s humming in my chest. In my throat, I can feel my stomach churning and for a brief second I feel as though I might get sick, but I am able to take a deep breath and continue packing lunches and book-bags for the kids as they scurry around the kitchen asking me to sign field trip permission slips and progress reports.  I smile as we talk about their plans for the day and although I feel uneasy, the smile is genuine.

This is the face of anxiety. 

It took several years of working in health care and working on my own personal development to get comfortable discussing my struggle with anxiety and post-partum depression (you can read about my post partum depression here). As a medical provider I am often quick to tell other anxious patients that I understand their battle because it is one that I fight alongside them daily.  Unsurprisingly, many of them are baffled that I am no different than they are when it comes to this mental disorder.  As they share their tearful stories, most often looking riddled with shame and embarrassment, I lean forward and confidently say, “me too. I know what you are going through.”

Do you know what they say in response?

“I would never have guessed that you have anxiety.”

Maybe it is my perky greeting as I walk in the exam room or maybe it’s the white coat that makes them think I am immune, but I am going to let you in on a secret. One that took me years in health care to discover:

Some of us are just better at faking “okayness” than others.

To be clear, I don’t mean that I pretend not to have anxiety, but I have learned to control my anxiety so that it cannot control me.  

Even more, my patients don’t see my anxiety because there is nothing to see.  My symptoms are internal.  There is no rash, deformity or hacking cough to suggest my diagnosis and in my opinion it is one of the reasons why society believes anxiety and depression are a personality flaws and those of us who struggle with a mental health disorder need to “just calm down and be happy.”  (Trust me, if that was an option most family practice waiting rooms would be empty and antidepressant medications like Prozac and Lexapro would be obsolete).

So hear me when I tell you, having a mental health disorder is not a reflection of your character. Anxiety and Depression are not a personality flaw; they are caused by a flaw in the chemicals in your brain.  If you have anxiety, if you have depression, you did not choose to have anxiety or depression any more than you chose to be tall, fair skinned and of Irish descent. Having anxiety and/or depression is nota choice and it certainly does not mean you are broken.  

One more time for the people in the back of the room- having anxiety and/or depression is not a choice and it does not mean you are broken.

Could you imagine sitting in a hospital room with a loved one, their body riddled with disease, IV’s in each arm, monitors beeping to alert over-worked nurses and then looking into their sunken eyes and saying “If you would just stop having this disease we could go home. Just relax, be grateful for your life because someone else has it so much worse. Just cheer up and we can go home.”

You wouldn’t because that sounds utterly insane and at best completely unsympathetic.

Instead, you’d listen to the recommendations of the doctors. You’d let the nurses train you on how to change bandages. You’d take prescriptions to the pharmacy. You’d schedule appointments with specialists and hold their hands as they sat waiting in cold exam rooms. You would scour the internet and devour all the information you could find on this terrible disease and suggest every homeopathic remedies and clinical trials you stumble upon.

And yet for many mental health sufferers they are given an unhealthy dose of “just.”

Just calm down.
Just be happy.

Growing up, I didn’t have any experience with mental health disorders (or rather, none that I was aware of). And although I have always been enthralled with words, poetry and stories, I couldn’t seem to put my words together to adequately illustrate my discomfort. Ultimately I struggled in silence for far too long.  Now that I have a good understanding of my anxiety, I can trace my symptoms back to elementary school.  

Being the only girl in the family I was lucky to have my own room, something I cherished during the day hours, but at night as I lay in the dark room and my brothers slept in a shared room just the other side of the hallway, I felt alone and vulnerable.  My mind would race with bizarre scenarios, ‘what-ifs’ and replaying all conversations that happened during the day that I wish I could desperately change.  My mind would race to the point of feeling uncomfortable in my skin and I couldn’t decide if it was worth kicking off the restricting blankets or if doing so would leave me completely susceptible to the scary elements of the room. My heart would pound so hard that I thought it would leap out of my chest and I would dig my nails into the palms of my hands, hopeful that this would distract me from the uneasiness and fear. Some nights I was able to fall asleep, other nights my parents would find me curled up on the floor of my brother’s room because simply being close to someone else substantially decreased my fear.  

Ironically my anxiety decreased throughout middle school and high school (I was probably so wrapped up in my own teenage angst to give it much notice) but during my college years and certainly after my first child was born my anxiety worsened exponentially.  Nowadays my anxiety still peaks at night and it’s when I am most prone to panic attacks.  During the day, my anxiety presents as nervousness, difficulty concentrating, constant cleaning, perfectionism, people pleasing and being short-tempered (sadly this is mostly aimed toward my husband and kids).   My anxiety ebbs and flows over the years- heck, sometimes over the course of a day- and I have learned to recognize when my anxiety is uncontrolled.  

Anxiety is uncontrolled when it cripples you.  

If your anxiety disrupts your marriage, your parenting, your job performance, your household, your joy; then your anxiety is controlling you. 

I’ve gone to counseling.
I’ve been on medication.
I exercise.
I pray.
I meditate.
I journal.
I speak freely and openly about it.

Still, I have anxiety. 

The difference is that over the years I’ve started to become comfortable with the uncomfortable and rather than struggle in silence, I stand confidently with my neurotransmitter imbalance. 

And so if you’re fighting against the tight grasp of anxiety, if a dark cloud of depression weighs you down, please tell your story, share your experience, give a voice to the face of anxiety/depression.  There is so much power and a sense of overwhelming relief when you can tell someone “I know what you are going through. I have been there.”

There is no shame in declaring “this is what anxiety looks like.”