When the Natural Toolbox is No Longer Enough, You Do What You Have to Do
Anxiety and I, well, we go back. I do recall a sepia-toned time when I didn’t have anxiety as my copilot but it’s been a while, as they say.
After a pretty idyllic early childhood, anxiety started to seep its way into my body over time, like dark ink from a well slowly being drawn up into a fountain pen, until it was just a part of my blood. Whether it was from my alcoholic household, the legacy of intergenerational trauma, years of severe bullying in middle school, simply how I am wired or a combination of all these factors and more (ding-ding-ding!), the net effect is that I am someone who has become more and more anxious over time, especially the past five years or so.
There have been valid reasons for amplified anxiety — my mother’s long illness and subsequent death, my husband’s cancer, my beloved dog’s sudden, shocking death — but the causes began to matter less and less as it blew out like a mushroom cloud into a worsening and chronic state, shadowing everything. Working with a therapist on specific traumatic events seems to have made the generalized anxiety, which had been at a constant but manageable buzz for years, become much more turbulent and interruptive. My anxiety, which I came to think of like Mya N. Ziety, a name fit for the terrible roommate I never asked to have and couldn’t kick out, became so cacophonous and pervasive, it drowned out virtually everything. I couldn’t enjoy good news and opportunities because of how insistent the anxiety was; when positive things would happen, it was like I was on the outside, watching it unfold for someone else from a smudged, dirty window.
I don’t want to make it sound like the suffering has been severe day-in and day-out, because it has not been. I have had a fulfilling life with enriching relationships and experiences despite the anxiety. The anxiety in the pit of my stomach has been with me like a burning coal I swallowed since at least sixth grade, though; it burns like a red hot poker at times and at other times, it is just warm to the touch but the coal is always there, always lit. In more recent years, it has burned brighter and more consistently, with or without new kindling.
What you should know about anxiety, or at least my anxiety, is that there is most often a root of past experience or even just common sense that justifies it but it flames and flares out beyond all that is rational or reasonable. Let’s say, for example, that you are caring for an elderly parent with Alzheimer’s disease, as my husband and I did for a number of years. It is reasonable to be worried about this parent endangering themself and it’s responsible to take precautions on their behalf to minimize risks, but it is not healthy to be constantly doom-scrolling in your mind, to get into a panic multiple times a day, to become so hyper-vigilant you can’t turn it off.
Those reactions are bad enough, but when the anxiety spills over to all areas of your life where you are almost constantly worried and on edge, sleep-deprived from insomnia and trying to micromanage everything you can to reduce the likelihood of perceived danger, you are not really living a life, at least not one you can enjoy: Your life is dictated by anticipatory fear and threat management. Your anxiety is driving the vehicle, white knuckles gripping the steering wheel; you are strapped into the passenger’s seat, not quite trusting anxiety to do the driving but convinced you’d be dead without it. When you’re at this stage of anxiousness, not only are you not living in the moment, you are pre-living a scary imaginary future and you believe that your anxiety, this response that is causing so much personal suffering and damage, is all you think you have to avoid the worst outcomes.
It needs to be said that telling someone with an anxiety disorder to not worry or calm down is about as helpful as telling someone with depression to not be sad or someone with insomnia to get more sleep. It is also akin to telling someone with a physical disability to just be able-bodied. We can do the things to help mitigate the condition and its manifestations, but it is still a dysfunction that is real and complex and when it becomes acute, it is something that no amount of chamomile tea and Rescue Remedy could quell. We know most of our fears are irrational. You pointing it out does not make us feel less scared. It just makes us feel more isolated and more, well, crazy.
As I write this, I am no longer in the throes of anxiety. It’s not because I altered my diet, chanted or bought a book. I am not free thanks to breathing exercises alone. If I could show you every herb, every tincture and capsule blend I have taken over the years to soothe my anxiety, each time desperately hoping that this could be the magic cure, you might believe me. If you could understand that when my husband was sick with leukemia, recovering from a bone marrow transplant and then the pandemic started, that even during this time as the only caregiver of an immune-compromised person I dearly loved, I still did yoga every single morning, maybe you’d stop suggesting it to someone like me like it’s a panacea.
Other things I did and still do that are wonderful but not magic bullets: I walk every day for miles for pleasure and to clear my mind. I meditate. I continue to believe in the power of deep, intentional breaths and mindfulness practices, gratitude journaling, noticing my daily delights, calling friends and emphasizing a wide range of produce in my vegan diet. I did those for years to help improve my quality of life and I do them now. They are still part of my toolbox.
In late June, though, with July casting a huge shadow over me with the anniversary of my dog’s death, I reached into my mental health toolbox — the one that reminds me to call a friend, take a walk, go to the beach, research new supplements, stay hydrated, limit social media, watch my favorite comfort food show, etc., etc., etc. — and I had nothing left to turn to for relief. I sifted through this toolbox I’d curated for years and I knew it wasn’t enough. Nothing could put a dent in this thing that had basically taken me hostage. All of these tools and strategies that had served to reduce my anxiety reliably for years were no longer enough, separate or in the aggregate, I realized as I still clung to them for life like buoys in choppy waters, desperately scanning as far as I could see for something, anything, that would effectively and substantially reduce my anxiety.
Upcoming meetings or appointments had become things to obsess and worry over for days before they happened, to toss and turn over in bed about until I would finally crash, dropping into dystopian dreamscapes directed by Mya N. Ziety. Ruminating over things I might have said or done wrong became a compulsion. Catastrophizing became normal. It felt like I had a mechanism inside me that I couldn’t turn off, and its job was to constantly scan for things to worry about and urgently bring to my attention.
This year, I was finally and legitimately concerned about how I would survive June. I didn’t want to just power through and come up for air in August as I had for the past couple of years and I didn’t think I had the strength anymore for the ensuing panic attacks and around-the-clock anxiety. More than once, I cried and cried to my husband, tears of absolute desperation, pleading, “I. Just. Need. Help.” He was present with me, he listened, he tried to help but there was really very little he could do.
In early July, I reached out to my primary care physician. Thankfully, she was able to see me quickly and on our televisit, I sobbed and shook as I tried to speak the words, which had been so much easier over email. She is an empathetic woman and could see how much I was suffering. She expressed her sadness at my state and she talked about options. I was able to pick up and start prescriptions that night. (I don’t feel it’s right to discuss the ones I was prescribed here because that should be a conversation with a medical professional to figure out what might work best for you.) After years and years of refining and using my options to make myself more functional despite the anxiety, it was bad enough that I was finally ready to supplement my natural toolbox.
I was finally ready.
A month after starting medications — one for sleep, one for anxiety — I am dramatically better. After a couple of weeks of brain fog and sleepiness, I feel embodied again, just without the anxiety. I am sleeping through the night. I am calm, rested and productive. I can recognize things that would have been very difficult and stressful even a month before and know that it would have really bothered me before my meds, but now I am fine. The anniversary of my dog’s passing came and went, and instead of spending the day shaking from panic attacks, I celebrated his spirit and the time we had together. I’m not a robot, though. I still feel emotions; it is just as if 75% of my anxiety was flushed out and what remains is a reasonable, healthy amount. Some unexpected side benefits: I am able to concentrate much better because I’m not consumed with repetitive thoughts or trying to stop spinning out. I’m able to appreciate things more because I’m not consumed with pre-living disappointing outcomes. I have so much less attached to everything; if new pursuits pan out or they don’t, that is life. Essentially, I know that everything is going to be okay, a phrase I repeated over and over like an anguished mantra I didn’t believe back when I was wracked with anxiety, except now I know that it’s true. Everything is going to be okay.
It saddens me to think of how many people feel like failures and quitters for extending their toolbox to medications that could legitimately help them be more functional, happy people. There is no personal virtue, real or imagined, to managing to avoid pharmaceuticals. Those who pride themselves on not having medical interventions sound more and more to me like smug eugenists with something to prove about their worth these days.
Does taking medication to reduce my anxiety mean I run to the doctor for every little issue now? Absolutely not. I cannot stand that kind of false dichotomy where there is no middle ground or nuance. I still love my herbs, teas and the calendula oil I make every summer; I still do yoga every day and take long walks. Simple, DIY remedies are still what I turn to first when I have a physical or emotional challenge and they have been, for the most part, very effective for me. But for an acute condition that is absolutely harming my quality of life as well as the lives of those with whom I share a household? One I have lived with for years and it is only worsening? A condition that is no longer responsive to the interventions from my “natural” toolbox? I wish I’d swallowed my pride and some anti-anxiety pills sooner.
As a social justice activist and a vegan, of course I have issues with the pharmaceutical industry with its greed and cruelty to animals; until there are alternatives that work when other things don’t, this is what we have in this imperfect world, though. In the meantime, we should keep encouraging transparency, modernization and progress for the industry.
When I was 12 or 13, my neighbor and best friend’s mother talked to me about my treasured grandfather, who was suffering from Alzheimer’s and would say and do hurtful things because of it sometimes. I was sitting outside, tearful after a difficult visit with him. My neighbor sat down next to me and said, so kindly, so wisely, “You have to think about your grandfather’s illness like you would a disease, because it is. It’s easy to forget that he’s sick because he doesn’t look sick. But he can’t help what he does because of his disease. He doesn’t do it on purpose.”
This has always stuck with me. This was a woman who lost her husband in his 30s to cancer and she knew how serious a disease something that seizes our brains can be.
Virginia Wolfe. Sylvia Plath. Sinéad O’Connor. It is obvious that mental illness is a serious medical condition that can lead to death. Anyone judging you for pursuing effective relief likely does not understand your suffering.
I also have a form of mental illness. It is called Generalized Anxiety Disorder, which sounds so innocuous for a condition where you’re basically scared of everything. I deserve to have a decent quality of life, though, and so do you. If medications are a path to improved well-being, so be it. Please forgive yourself for being a fallible human and get the care you need and deserve.
Marla Rose is co-founder of VeganStreet.com.
