Anxiety In a Trying Time

Now is a bad time to have anxiety.

As I write this, I am living through the COVID-19 pandemic. Things are very different from what they were two weeks ago. At that time, the disease was isolated to a few cases in a handful of American states. Now, we have surpassed active cases in China, the country initially hit hardest. Italy was the big outbreak spot until a few days ago when we took over their active case number. They’re still leading in deaths, but it’s only a matter of time. My own tiny state already has nearly 200 cases and six people here are dead. Those local numbers might not sound so bad to most people.

Most people don’t have my level of anxiety.

So, I’ll level with you, appreciated readers, and talk a little bit about one of the personal issues I grapple with daily.

I – like millions of other Americans – suffer from generalized anxiety. Some of it has always been there. Much of it came from a traumatic experience in 2005 as a bonus from PTSD. All of it stems from issues I have regarding human mortality and the fragility of the world that we live in. I think those who know me best would point to a certain morbidity in my outlook. I do write horror after all. It extends far beyond my writing, however. My brain can eat itself alive if I let it.

In 2008 I experienced my first full-blown panic attack. After being discharged pending a four-hour ER encounter in which they managed to pop a faulty IV into my arm, I booked an appointment with my mental health provider. I finally caved at her gentle urging and started taking what are called SSRIs – Selective Serotonin Reuptake Inhibitors. It’s a class of drug that slowly changes how your brain relates to Seratonin, the hormone in your brain that gives you good feels. 

The result of taking SSRI’s is that it’s a little easier to break through low-level to mid-range anxiety, which lets you start to improve executive function. She told me the drugs would take about two weeks to fully work, but I swear to god I felt some relief the first day. It was like having a messy filing system suddenly ordered. Life improved over time. I began to enjoy things again (Depression was something I came to finally admit to years later, but that’s another story). I felt more comfortable in my skin. 

Until recently, it generally does its job. It helps me to cope with a lot of my unreasonable fears and hang-ups. In a world that mostly makes sense, it’s a boon. Things are better when I‘m on them. In the brief times I’ve had to go without, life is not good. These aren’t the kind of meds you just stop taking. The withdrawal effects are full-throated and they last for a long time. The longest I’ve gone without was for about five weeks, and I never want to do that again. 

In times of acute stress, they help form a temporary barrier that holds long enough to weather a bad day. Eventually though, under constant stress, their effectiveness can falter. My average dose is moderate and I take them at night when I am most likely to suffer from panic attacks. I am told higher doses are an option available to me. I either feel the need to suffer (a side effect of being raised Lutheran I suppose) or I simply don’t want to be any more reliant on the SSRIs than I already am. Either way, I have more or less been at my present dosage for quite some time, with only changes to the time of day those SSRIs are taken.

In these times though, I find the anxiety harder and harder to push back. My generation has had few stressors as extreme as this and I’m counting the financial meltdown and 9/11. We’re updated constantly on mortality rates, new information about vectors, incubation times, the importance of physically separating ourselves from our loved ones and coworkers. It’s a lot. In a world where the plague we are all trying to weather is marked by shortness of breath (among other fun symptoms), being susceptible to panic attacks creates a certain kind of hell for those who suffer from anxiety.

As of late, when I am rousing or when I am settling into sleep, I feel shortness of breath. It’s panic breaking through my medication. There is no concomitant fever or dry cough. Just the feeling that the walls are closing in and that I cannot get enough air. Right now I can kick that feeling aside with a little mindfulness, but it takes a few minutes. And, of course, it’s waiting for me just a little while later. It’s the kind of effect that can wear you down over time. It’s not fun.

I know I’m not the only one going through it. I know that I have it good; I was able to secure a sufficient supply of my SSRIs for the next two months. Gods willing, I will have the resources I need to acquire more if this nightmare continues beyond May. Many will not have such recourse. Many don’t have it right now. Hell, some people don’t even have toilet paper. Tyler Durden may have taught us that soap is the yardstick of civilization (and to hear the CDC say it, there’s some truth to that). But, tell you what: go without the ability to shit comfortably for an extended time and you start to feel like you’ve lost about a century worth of progress right there. Toilet paper has a lot going for it.

I’m getting by though. The most important thing I’ve learned about getting through a panic attack is making sure that I’m mindful of my breathing. I have to do that a lot these days. It’s essential to my well being. 

The other thing I have to do is keep busy. I have temporarily lost my day job working at a local bookstore. The time I had before to keep my mind busy with shelving, alphabetizing, and merchandising is gone. Replacing it has been largely successful, though I miss the physicality of my work. Much of the lifting, shifting, and cardio has been replaced with dog walking and playing rather a lot of video games. I’ve taken up a project to get my retro gaming consoles in one place and organized. I have a lot of things lined up to consume in terms of reading, television, and film. It’s been essential in keeping myself just distanced enough from what’s going on outside without becoming fully disengaged. The other option is watching cable news broadcasts constantly and tracking CDC updates. I have never been so happy to have cut cable out of my life.

What I’m getting at I suppose is that we’re all doing things to cope with varying degrees of success. A lot of people have my problems and likely more severe at that. If you know someone who before all of this who had anxiety like mine or worse, check in on them. Let them know they’re not alone. We still have a lot going for us in terms of communication – Zoom and FaceTime are helping a lot of people through tough times. If you’re holding your shit together and have wrestled with anxiety as long as myself, take some time to explain anxiety to people who are just coming into it now. I’m pretty sure there are a lot of people coming around to my levels of anxiety. I’m curious to see the numbers on people seeking assistance from mental health professionals regarding anxiety after this passes – and it will pass.

Regardless of whether or not you’re feeling what I and others feel or are new to the unpleasantness of anxiety, remember these things when you start getting antsy. I’m pretty sure they’ll help because they’re helping me:

  • Breathe. Take deep breaths, in through the nose, out through the mouth. Do it as many times as you have to.
  • Find a routine and try to stick to it. If you’re furloughed like I am, who cares if the time frames are weird? If you’re working from home, you already have a structure. Just make sure you’re keeping fairly consistent.
  • Try to eat well if you can (I’m having trouble with this, but still remembering that veggies exist). A lot of us are cash strapped or have dietary requirements but try to get the recommended three square meals a day. Keep a regular meal schedule. Try not to eat as a reaction to boredom or stress (this is a problem for me) to keep your food supply stocked.
  • Find some exercise time. A lot of places are still allowing people to get out of their homes to exercise so long as you maintain an appropriate distance from other people. Your dog has never had it so good if they love walkies.
  • Take up a project. I guarantee you whatever it is you decide to do beats watching anything coming out of the White House or watching the reactions of people to the misinformation coming out of the White House. The more physical the work is or if it keeps your hands busy, so much the better. At least that’s what’s been working for me.
  • If you’re sick, self-isolate and seek treatment if things start getting bad (lips/face turning blue, feeling like you’re gonna pass out).

Lastly, if you’re like me remember that you are not alone. Reach out for help. There are professionals and friends, and even strangers out there who have the same situation. Talk to them on the phone, by text, use semaphore flags. Whatever it is you have to do, remember that pain is inevitable but suffering is optional. Our connections are what get us through times like this, and you can make things better by reaching out for help. In fact, it’s dangerous to go alone, take this, too:

We’ll get through. Hang in there. You are not alone.

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