On Anxiety

As the faintly-robotic voice of the GPS navigation tells me my destination will be ahead on the left, the reality starts to settle in. The intermittent discomfort in the pit of my stomach that started hours ago has metastasized to a constant ache throughout my entire abdomen.

I place my hand on my chest. My heart is not only racing, but also pounding. At times, I can even feel the blood coursing through my fingertips with each beat. I turn my attention to taking deep, deliberate breaths, hoping to relax my hyperactive heart.

While waiting at a stoplight with my destination just out of sight, I can’t help but wonder if I’m going to be late. With this thought, the mental floodgates open and other worries start gushing through.

Do I look presentable?

What questions are people going to ask?

Will I be able to provide thoughtful answers and insights?

What will they think of me?

With that kind of reaction, you might think this is a story about a job interview. Truth be told, the stakes were much lower than that: I was merely heading to my first meetup with a group I had heard about on the internet. To be clear, the group sounded fascinating, and I wanted to see what it was all about. That being the case, you might be wondering why I was in fight-or-flight mode, and why I subjected myself to this distress.

Reader, let me welcome you to the world of anxiety.

I don’t really know when it all started. I guess I’ve always been a worrier. My mom tells me it was always a struggle trying to figure out when and how to break bad news to me. She says it was especially difficult with things like immunizations: Tell me about an upcoming shot too early and I’d spend all my time dreading some distant dermal discomfort; tell me too late, and I’d be furious about the unpleasant surprise. There was no safe move!

When I was about 10, out of concern over my constant worrying, my mom took me to see a psychologist. (One contributing factor: I’m told that I protested taking an overseas trip with my family. My objection? We would be flying over Bosnia, which had been the site of a war several years prior. How 10-year-old me knew about that, I have no idea.)

Within several sessions, the psychologist diagnosed me with anxiety. At the time, I doubt I understood what that even meant, but my parents must have felt relieved knowing there was some explanation for all my worries — and more importantly, hope for treatment.

As time went on, under the treatment of attentive professionals (and constant follow-up by concerned parents!), the symptoms of anxiety seemed to dissipate. Whereas at one point, my mom thought my anxieties would prevent me from going to college, I somehow managed to get accepted to a university right out of high school.

In time, I gradually became more independent. After graduating from college, I started my first full-time job, moved into my own place, and adopted a cat. Some might have even called me a responsible adult. But then in early 2014, things started sliding backwards.

Around this time, 3 of my sisters got engaged in quick succession (and the fourth had gotten married about 2 years before). As much as I knew I should be happy for them and wanted to celebrate, I couldn’t help feeling like a failure for still being single. We have similar genetics and an almost-identical upbringing, so how did I manage to mess it up so bad? This sort of thinking launched me into a fit of depression that persisted for over 2 years.

To understand what stopped the depression, I have to digress for a moment. Let’s fast-forward to 2016. One ordinary Thursday at work, I’m sitting down for the usual routine: Eating lunch and reading the latest issue of the ever-insightful The Economist. This issue’s cover story is “Beautiful minds, wasted: How to deal with autism” and true to form, the first editorial is about just that. I dive right in.

The article begins with some statistics and background information on autism. While reading through the abbreviated list of symptoms, I’m struck by how much I can relate to some of them. “Surely I don’t have autism, right?” I wonder. “I’m pretty sure I don’t have any learning disabilities, and I can certainly speak!” But the article points out those symptoms are neither necessary nor sufficient conditions for autism. It’s a condition with “…a wide spectrum of symptoms” and it “…defies simple generalisations.”

By the end of the editorial, I’m intrigued, if not perhaps a bit concerned. A number of the characteristics sound eerily familiar. It was like reading a biography about myself, complete with detailed descriptions of my thought processes — but it was written by someone who had never met me. I resolved to do a little research when I got home. I continued working for the rest of the afternoon, still not quite able to get this nagging thought out of my head: Have I gone all these years completely misdiagnosed?

At home, I spent several hours doing what I always do when something catches my interest: Researching the hell out of it. I read articles from the National Institutes of Health, Cigna, WebMD, and even Wired Magazine, trying to learn all I could. By bed time, I had a reached a conclusion: While I’m certainly incapable of making any diagnosis, I simply can’t rule out the possibility I have Asperger syndrome. Looking at all the evidence, it just seems too coincidental that I would have all these traits without such a condition.

My next step was to get some professional advice. I emailed my former psychiatrist, Dr. K (we hadn’t been in contact for over 6 months at this point) and asked if he would be able to schedule a brief phone consultation. He was delighted to hear from me, and we arranged to speak soon thereafter.

In the days leading up to our phone call, I obsessed about what I should say. Should I present all the things I’ve read that I think support my theory? But wait, doesn’t that risk leading the witness? Then again, he is a doctor; he must be able to think critically and find flaws in a weak argument. Ultimately, I decided to pose an open-ended question to him without much background information: Do you think it’s possible I have Asperger syndrome?

I had expected — maybe even hoped — he would laugh and ask where I got such an idea. Perhaps something along the lines of, “That’s an interesting question, Arthur. What makes you think that?” But much to my surprise, the very first thing he said was yes. A qualified yes, but a yes nonetheless.

Dr. K understandably insisted his response not be construed as a diagnosis, but I still found it shocking. Here’s an expert, specially trained to identify these sorts of things — and by the same token, rule out flimsy theories — and he’s telling me I might be right. That’s gotta be worth something, right? It’s not just my suspicion anymore. I thanked Dr. K for his time and asked for a few days to think about what the next step should be.

It was at this time the depression started to let up. I felt like I could point to something that explained why I have such a hard time connecting with people — and therefore why I was still single. It wasn’t due to personality flaws; it was a mental condition!

I soon decided to consult with a nearby specialist, Dr. R. He had me take the Autism-Spectrum Quotient test and the Ritvo Autism Asperger Diagnostic Scale, two tools developed to aid in diagnosing autism — presumably for preliminary screening purposes. After that, we scheduled an appointment for the following week.

Three consultations, numerous personal questions, and several hundred dollars later, Dr. R had come to a conclusion. He started off saying my scores on the introductory questionnaires were certainly indicative of autism. But then came the twist:

“I just don’t see it in you.”

Dr. R saw a number of characteristics that are largely incompatible with autism spectrum disorder. He observed nothing unusual about my voice, use of language, understanding of what others are thinking, or desire to forge relationships. Dr. R had another theory in mind: I have anxiety.

Now of course, the diagnosis of anxiety came as no surprise. Another doctor had told me that years ago! But to be fair, he got me thinking, and I had an epiphany. All those years, I had been living under the impression I had managed to overcome my anxiety long ago.

That’s not what happened at all.

I learned to avoid things that cause me anxiety. While avoidance is a valid coping mechanism, it’s an extremely limiting one. I realized I was missing out on all the wonderful things that life has to offer, and I didn’t want to keep living in fear of the uncertain or novel. The time to confront and overcome my anxiety was long overdue. This determination finished off the depression that had plagued me for over two years.

The irony is that soon after the depression started in 2014, some family members gave me advice that would have helped me overcome the anxiety I didn’t realize I still had. They recommended looking for local meetups that sound appealing. My sister Rebekah tried to make it easy for me and suggested a handful of groups she thought I might like. She even volunteered to go with me!

Rebekah’s suggestions were fantastic, but I never followed through because the thought of meeting strangers — even when accompanied by a family member — made me too nervous. Like always, I made up excuses to stay in my comfort zone. But in 2016, I knew this time was going to be different! I signed up for a group and pledged to attend an upcoming meeting. And you know what else? I was going without knowing anyone else there!

Now, reader, I wish I could tell you this is where I confronted my fears, quickly realized they’re unfounded, never had to deal with them again, and we all lived happily ever after, The End. The unfortunate truth is that real life doesn’t work that way. This battle is still very much a work-in-progress.

Even today, the prospect of trying something new or not knowing what to expect automatically fills me with a nagging feeling of dread like I described in the introduction to this essay. No amount of rationalizing can will that away. I would be lying if I told you otherwise.

This isn’t meant to be a downer ending. On the contrary, I hope to inspire. Overcoming our insecurities, bad habits, or fears takes repeated exposure to uncomfortable situations. In the moment, and even for a while after, it often feels like you aren’t making any progress. But you can’t let that stop you. The reward is too great to give up, and victory draws ever closer with each struggle.