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Incident: My three-year-old son was downstairs playing happily with his dinosaurs while I was upstairs playing happily with my ten piles of laundry in various states of clean. As I was folding (read: stuffing into drawers) my husband's collection of 100 tech conference t-shirts, the thought suddenly occurred to me: What if my son got himself a snack, forgot how to chew properly and was silently choking to death just feet below me? My mommy heart leapt in panic and I leapt down the stairs - no mean feat for a woman eight months pregnant. He was fine and I was reassured. I went back to my laundry. So far only slightly irrational, right? But then, like a scene straight out of Groundhog Day, the thought kept recurring and I kept running down the stairs to check on him. After my ninth trip downstairs in ten minutes with no provocation other than my wildly escalating imaginations of choking disaster, it occurred to me: this is not right.
Incident: "I don't think she likes me," I said casually to my husband referring to an acquaintance of mine. "What? Why would you think that?" he asked. "Well..." I took a deep breath and detailed a long list of admittedly ambiguous actions on her part. "She was probably just tired or distracted," he finally interrupted. Normally I'm the kind of girl who you have to hit over the head with rudeness to upset but that day I couldn't let it go. I tried again to explain it to my husband, getting more and more worked up. "Why are you getting so upset over this?" he asked, rightly baffled. I'd been mulling it over all day, rethinking every aspect of our short interaction. "I think I should call her," I said finally. "I think you should not" he answered perfunctorily. I burst into tears, "But she hates me! I know she does!" As I sobbed in his arms, it occurred to me: this is not normal.
Incident: Sleep is precious and despite my advanced stage of pregnancy, I am still able to sleep like a rock. (In other positive preggo news, my hair can do no wrong these days. Seriously, I can sleep on it funny, not wash it for a week and put it in a pony every day and it still looks like a Pantene commercial every time I take it down.) So why was I up past midnight nearly every night last week? I was researching the H1N1 (swine) flu. You are probably thinking, "There are probably only so many articles you can read about the flu before they all start repeating themselves. What on earth were you doing?" See, I was obsessing. It finally culminated on Saturday when I got a phone call from my child's school saying there had been a case reported in the student body. I freaked and subsequently irritated all of my girlfriends for hours during our Girl's Night Out by refusing to talk about anything but the flu, even going so far as to text my husband every hour to see if any of the kids had developed a fever. As one of my friends finally snapped at me, it occurred to me: this is not rational.
Anxious Over Anxiety
It wasn't until this morning that I recognized the connections between all three incidents (plus many more in a similar vein that I won't bore you with the details of). My old nemesis anxiety has returned. I have long had an anxiety disorder. Probably since birth, if you ask my family. For most of my life it went undiagnosed but everyone was well aware of how tightly wound I was. My anxiety has manifested in many different ways over the years: Irritable Bowel Syndrome (IBS), panic attacks, chronic nightmares, Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD) and, natch, Generalized Anxiety Disorder (GAD). I have tried as many different ways of dealing with it: ignorance (is not bliss, it turns out), various eating disorders, especially over-exercising (they work but the cure ends up being worse than the disease), talk therapy (I love me some good talking), medication (with varying degrees of helpfulness), meditation/yoga (useful for preventing anxiety) and Cognitive Behavioral Therapy (CBT) which is probably the most helpful solution of the lot. In addition to my own trials and errors, there are several people very close to me who also struggle deeply with anxiety disorders; I have become somewhat of a de-facto expert on the subject.
The Spectrum - A Brief Overview
All of you have probably at some point experienced something like one of the incidents I described above. Anxiety is a normal emotion and everyone has it to some degree. So what's the difference between someone who worries and someone with an anxiety disorder? Functionality. Anxiety becomes a problem to the degree that it effects your life and your ability to control it. It's one thing to worry about getting the flu and do some reading on it. It's an entirely different story to obsess about it to the point where you can't think or talk about anything else, even when you really want to stop.
Intrusive thoughts - defined as an anxiety-provoking thought that repeatedly intrudes in your consciousness - are the hallmark of anxiety disorders. If you tend to worry nebulously about everything and nothing, your anxiety hanging like a cloud over everything you do, then that is Generalized Anxiety Disorder. If you have a brief, but extreme (most people literally think they are dying), "anxiety attack" then that is a panic attack. If you have repeated panic attacks, usually brought on by an intrusive thought, then that is Panic Disorder. If you tend to obsess over one particular thought or topic, then we call that an obsession and it is Obsessive Compulsive Disorder, "Pure O" (for obsession) type. If you feel compelled to perform a certain action - called a compulsion - to ameliorate the anxiety of the intrusive thought then it becomes classic OCD. There are other types of anxiety disorders but in my experience these are the most common. Please see the National Institute of Mental Health's anxiety resources page for more info.
The Hormone Connection
In a surprise twist worthy of Woody Allen, where most women experience some form of post-partum blues (also called the baby blues) in the weeks after their baby is born, when my hormone levels nosedive I get post-partum anxiety. The good news is that post-partum panic/anxiety disorder is now recognized as occurring in about 4-6% of women. The bad news is that it gets worse with every kid.
After my first son was born, my husband and I slept with the lights on and our baby in our room, waking every hour or so to make sure he was still breathing. Even after pulling over our car several times to check his breathing, we didn't realize that we were a little more anxious than most new parents. After my fourth child, I remember being so overwhelmed by panicky thoughts - mostly related to deathly harm of some kind descending on my children - that I couldn't be left alone near sunset. My anxiety would build gradually over the course of the day until evening when all I was capable of doing was pacing the floor clutching my infant with the other kids following after me like confused baby ducks. Unable to eat or sleep, I was terrified. I thought I was losing my mind. The panic peaked about 2 weeks after the baby was born and then, just like the baby blues, was gone within a month. And I was back to my normal levels of neuroticism.
So you can see why I'm concerned that the anxiety is starting to ramp up even earlier with this kid. My apologies to everyone who has to deal with me in real life. I have 6 weeks until D-Day. Good thing this is our last child.
Any of you deal with anxiety issues? What have you found triggers you? What helps?
