Cultivating Mental Health Self-Awareness with Generalized Anxiety Disorder Recovery
Listen to Executive Director Gabriel Nathan read this post aloud:
Being an introspective person, analyzing my thoughts and emotions comes naturally to me. For example, I have always been aware of the fluctuations of my mood and I try to understand the source of those changes. It was not apparent to me at first that anxiety had begun to settle within me, causing dysregulation. This realization came to me as a shock since anxiety is not an invisible affliction that affects a minority of people; on the contrary, it is a behemoth that has often been equated with an epidemic. The US Preventive Services Task Force’s recommendation to screen children eight and older for anxiety highlights the overarching impact of anxiety on the US population. In my view, it also brings to the forefront the deficiencies within our society when it comes to educating and empowering our population in the area of mental health. Despite ongoing efforts to destigmatize mental health, exemplified by the dedication of the month of May to raising awareness, we continue to fall short in recognizing our own declining mental well-being.
Why is it that we can recognize mental decline in others, but not in ourselves? Mental illness exists along a continuum, indicating that it does not emerge abruptly and vanishes the next day. Instead, it is a dynamic phenomenon that can be anticipated within a prodromal phase. A prodromal phase is a time period during which early signs appear before an illness actually sets in. During that time, there is a sense that something is not “right,” like a harbinger of a mental or emotional breakdown. For example, I personally believe that when I began to notice a decrease in my quality of sleep, I should have taken immediate action, instead of brushing it off and letting it grow into something worse. Notably, obtaining a restful night’s sleep proved to be challenging for me, as I faced difficulties in both falling asleep and staying asleep throughout the night. I particularly remember waking up consistently at four am, which teased my curiosity and led me to investigate its significance. I discovered that a four am wake-up call is often associated with depression.
Thus the prodromal period is crucial, because it makes it possible to intervene at a stage where the symptoms are still manageable. Anxiety, for example, presents itself as a series of minor annoyances that are not disruptive enough to be noticed, such as unusual irritable moods. Left unchecked, however, they become more frequent, severe, and disruptive, paving the way for a chronic and debilitating condition. When my irritable moods became more frequent and more severe, anything could trigger them. I would lash out at a family member during a mundane conversation, because it was not going my way. Similarly, I frequently put myself in a situation where I could be physically hurt when confronting a stranger in the subway, because they lightly brushed against me when exiting the train. I vividly remembered being concerned by those explosive responses to random people, as they sometimes were directed at unfriendly-looking men that were twice my size.
The challenges inherent with reckoning with one’s mental health are evidenced by the numerous online accounts of individuals who endured prolonged periods of anxiety before seeking help and taking proactive steps. Likewise, many adolescents and young adults are still confused about their symptoms and ask for help online. They experience feelings of fear and helplessness, similar to what I went through a few years ago.
Indeed, a few years ago, I experienced severe anxiety, which made even the simplest tasks, like getting dressed, a source of immense distress. Anxiety permeated my thoughts, causing any random occurrence to trigger a cascade of symptoms such as high heart rates, increased respiratory rate, and especially panic attacks. When symptoms appeared consistently at the beginning of my anxiety attack, I did not tend to them as I should have, because I was convinced that it was physical in nature and that it would dissipate on its own. Particularly, I was convinced that they were related to benign heart issues, since I was oblivious to the chaos that was raging in my brain. Simply put, it did not occur to me that psychological factors were actually manifesting through my body.
One particular instance that stood out the most for me was when I experienced an “out of the blue” panic attack for the very first time. Its peculiar aspect was its occurrence at a spa, during a serene moment when a soothing warm towel was covering my face at the end of a luxurious facial treatment. I was trying very hard to hold it in, but, like a juggernaut, “it” burst out of me, forcing me to stand up and remove the towel from my face. I then began to hyperventilate, feeling hot and lightheaded. My heart was racing so fast that it felt like it could break out of my chest. Once I was able to collect myself and gather my thoughts, my esthetician and I decided to skip the hot towel and move on to massaging my face while sharing some banter about anxiety.
I am an educated woman who pursued a college degree with a specialization in psychology, and yet it did not occur to me that I had actually suffered a panic attack. In hindsight, that was definitely a harbinger of the generalized anxiety disorder that was going to engulf me for a good three years. Along with other minor symptoms, what I had experienced then was my prodromal phase, but I was so occupied with juggling work, school and volunteer work that my mental health was relegated to the background. As long as I continued to function well, I did not see it as a priority.
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Nonetheless, my level of functioning began to gradually decline. I could no longer focus in school and had to drop out of the master’s program. At that time, I was not affected by that decision, because I was expecting that change to be temporary and resume my classes the following semester. It was only after I was able to control my anxiety that I began to develop regrets about the interruption of my academic education. Taking the subway to work also felt impossible without breaking my hour and half trip into two shorter trips to allow me to be outside for a little bit instead of underground. I chose to take those extra steps, because I refused to give in to the anxiety and miss work; I was particularly afraid that if I gave in once, I was not going to be able to go back to work ever again. In addition, thanks to my early wake-up, I managed to avoid arriving late at work despite taking an alternate route. In addition, my social life had to be curbed, because going out with friends required too much effort. It was energy draining to pretend that I was fine when I was not. For example, I remember one instance when I experienced extreme discomfort when my friends and I had dinner at a restaurant that was located underground; I could not enjoy the food or the conversations, because I was focused on keeping myself from having a panic attack due to the confined space and the absence of windows. Physically, I was losing weight due to my decreased appetite; I was fatigued but could not sleep, and worst of all, I could not relax. To me, this inability to relax my body and my brain was the most disturbing symptom, because I could not take a single position that would bring some relief to my internal restlessness, neither sitting nor lying down felt good. I had become an impuissant person.
My helplessness was not due to the fact that my academic education was lacking, it was simply not enough to help me recognize a mental disorder, let alone manage one. In this case, experiential knowledge trumps intellectual knowledge, because experience provides a flurry of detailed information that is not only relatable but also quite memorable. Books and doctors can only relay cold hard facts; they are empirical and authoritative, but dull and easily forgettable. By contrast, personal experiences and anecdotes, which are usually colorful and emotionally charged, often create a strong and lasting impression, and together with medical facts, they create a solid base from which we can build a sound understanding of a mental disorder.
Accordingly, online, I learnt from experts in holistic health, science and, perhaps more impactful, I learnt from my peers. They likewise suffered from similar or worse anxiety symptoms, and they found ways to manage them or overcome them. They were my lighthouse during my journey out of the darkness of anxiety. In addition, they shared tips and resources that had worked for them, and for example, learning from my peers I began to focus on my breathing.
Research indicates that anxiety causes irregular breathing patterns, which for the most part remain undetectable until a panic attack occurs. Therefore, I set out to look up online for ways to reset my breathing on my own. Thankfully, the internet is a treasure trove of resources and tools in self-help, and as a result I was able to learn and practice various breathing and relaxation exercises that improved my well-being.
In fact, doing it alone yielded positive and long-lasting results, because I was able to achieve this elusive state we call mindfulness. Mindfulness, which is defined as a state of heightened consciousness, taught me to become more aware of my symptoms rather than being sensitive to them. That is a very important distinction because being sensitive to my symptoms made me react to them, resulting in more panic and anxiety. By contrast, being aware of them allowed me the opportunity to assess the situation, which in turn reduced the intensity of my symptoms, rendering them less crippling.
So, rather than burdening our already oversaturated mental health system, why don’t we encourage individuals to take charge of their own mental health on a systematic basis; to reckon when something is amiss or not “right”, and to take immediate actions. Adolescents and young adults, especially, could learn how to check in with themselves from time to time and identify signs of mental health issues. Children on the other hand would have to rely on their parent’s insights and pertinent inquiries about their well-being. There are many untapped resources online that we could all use to help us be more in touch with our own mental well-being and recognize when something is not right. After all, we cannot change what we do not acknowledge.
I have grown tremendously from my experience with anxiety, on both an individual and a collective level. Specifically, I have developed a heightened awareness of my mental well-being by consistently evaluating my emotional state and addressing any mental health aspects requiring attention. For example, when I experience troubled sleep, I refrain from dismissing it and instead promptly investigate the underlying causes, often identifying caffeine and sugar as contributors. Furthermore, I’ve extended my growth to a larger context by openly discussing my own anxiety journey and the lessons I’ve gained with my peers. My intention is twofold: to provide solace to those grappling with anxiety and to serve as a guiding beacon, much like I encountered when I was struggling.