Adventures in Anxiety: How do I know if I’m (just) worried or anxious?
Before we get started, a disclaimer: If you think that you might have an anxiety disorder (or any challenge with your mental health) please see your healthcare provider to get a diagnosis. I am not a healthcare provider. I am not able to give a diagnosis. I’m just sharing my experience of how I knew I had gone beyond “just worried.”
Next week I’ll talk about how I formed my team of medical professionals and what I wish I would have done differently in those early months post-diagnosis with regards to my care.
Now, to the post!
It’s been a tough few weeks in the world, between mail bombs and shootings and midterm elections in the US… but, depending on your perspective, maybe it’s been a slog for awhile. If you’re like me, that fills you with unease and discomfort from time to time.
Or maybe the broader events haven’t impacted you as much, but there are other stresses in your life. Whether it’s trying to finish a project, run your family’s daily life, maintain your relationships, or just get through another day, there’s always something.
And then you start to wonder — am I just worried? Or is it something bigger, deeper, or more persistent? Could it be that I am struggling with an anxiety disorder?
Maybe you, like me, will have some sort of breakdown (“spiritual awakening”), something that shakes you awake to let you know that something is wrong.
But maybe you won’t. Maybe you just feel off in some way, and you can’t quite figure out why.
And that’s when you have to ask yourself — is it just a bit of a dip, or is about to be a crash?
How do I personally distinguish the two? When I worry, I can tie it to a specific cause. Whether it is physical danger (driving on ice), mental anguish (will I pass my coaching exam?) or my emotions (I feel afraid of how my friend will reach to this), I can identify its source and use logic and coping techniques to easily move past it.
But anxiety? Clinical anxiety is like being stalked by an invisible tiger all. the. time. You’re always looking over your shoulder to find the tiger, but the damn thing is never there. You take a different route to work to avoid the tiger. You avoid certain friends because you don’t want the tiger to follow you. You sleep extra long or not at all, but exhausted by the tiger either way.You dress differently, eat differently, and behave differently. In short? This tiger changes your life and your way of functioning.
There is a big difference between worrying a presentation and coming up with ways to avoid this invisible tiger.
And let’s be honest — avoiding this tiger is freaking exhausting. No one is living their best life when they’re in a constant threat-state.
The question I get most often might surprise you. It’s actually some variation of “How do I know if my parent/child/partner/friend/coworker/other human has anxiety?”
Diagnosis is a tricky thing, and even the pros get it wrong (case-in-point: I was misdiagnosed by my primary-care physician of 8 years… but more on that next week). We live in a time where media dramatizes mental health and we casually toss around diagnoses as descriptions of emotions or behaviors (“They are obsessed with X” or “She is manic when Y happens.”).
Furthermore, it is difficult to understand someone’s experience from the outside. While we can look back on my experience and see the anxiety signs, Google Husband didn’t even really see this train coming. And even in the early years when I was incredibly impacted by my anxiety, it was invisible to most of my coworkers (hello masking and/or self-management).
In short, diagnosing a mental illness is hard for us laypeople.
Were I to have any inklings that I might struggle with anxiety, what would I do?
If I had a sense that I was anxious or things were not right, I might start by doing some informed self-diagnosis. The Zung Self-Rating Scale is an easily accessible tool that you might consider. I also like the paper version in my Anxiety Bible, The Anxiety and Phobia Workbook (which is based off of the DSM-IV, but I assume the new version of the book is based on the DSM-V).
Does this mean you are diagnosed? Of course not! It simply sends you a signal that something might be going on for you, and it’s time to schedule an appointment with your general practitioner and probably a specialist or two (again, more next week). This means that you’re picking up on some signs and would benefit from professional evaluation.
If you worry that a friend or family member is struggling with anxiety, you might encourage them to take the test. But again, we are interpreting their behaviors with our own lenses — using our assumptions and beliefs instead of theirs.
If you truly fear for their safety, look up the local hotline numbers for immediate help — in the US, visit How to Get Mental Health Help on the us.gov website.
What else should I keep in mind as I’m considering this invisible tiger?
There are two big caveats that I want to highlight about what I’ve just said because human brains are amazing but also tricky.
First, sometimes we evaluate ourselves as we want to be, not as we are. Take type and temperament assessments, like the MBTI or Insights Discovery. I can’t tell you how many times I’ve facilitated a type and temperament session where someone’s self-assessment is wildly different than how others, including me, perceive them. It could be that they are not showing all sides of themselves or that we are not seeing those parts. It could also be that they are responding to what they think they should be. If I think that being an extrovert is helpful in my role, I might look for weak signals that point me towards extroversion. I might also want to be more like that, so I step into that identity.
This is true of mental illness. I don’t know many people who desire to be mentally-ill. I mean, it’s got ill in the name, for goodness sake. I’ll choose mental wellness every single time, if I can. That doesn’t mean that I’m worrying and not anxious. It means as humans our brains might make us default to the aspirational instead of the actual.
So, watch out for aspirational beliefs and reality — and remember that diagnosis and treatment might bring you closer to your aspirations.
Second, anxiety (and by extension, I assume mental illness in general) doesn’t always present like a list of symptoms. I know folks who had physical symptoms present themselves long before any of the traditional “mental” symptoms. In my case, I’ve had a slew of other health problems that have followed the anxiety. Not understanding the varying ways that mental illness presents itself means that it is often undiagnosed or misdiagnosed.
This is what we’ll explore in my next post. How did my anxiety first present itself? And I gained understanding about this invisible tiger, how did I assemble a team of medical and health professionals to help treat my mental illness?
Be well, everyone!