Politics, professional life and study: my pathway to an anxiety disorder

It came to my attention in the last year or so that how my body responds to stressful events—or even events that shouldn’t be stressful—was outside the bounds of what would be considered clinically normal to the detriment of my quality of life.

I had assumed that much of what is classed as a treatable anxiety disorder—a mental illness—was just me being more caring than others, and that my responses to issues that arose in my political or professional life, such as taking on more work than I could reasonably handle in fear it would not be completed, were merely a result of other people being lazy or not caring as much.

It therefore perhaps comes as no surprise that perfectionist tendencies have a habit of making anxiety disorders worse. Also, it is entirely possible that your feelings—for example, that other people are not pulling their weight—are absolutely spot on, while your response to that is a result of anxiety.

This article explores my discovery that I have an anxiety disorder, how this disorder manifests in my day-to-day life, and how I went about treating it.

Once upon a time in Sweden

At the beginning of 2015, I went to study in Sweden for a semester. Within the first week, I contracted pneumonia. “Fuck,” you say; fuck indeed. Luckily, the doctors were happy to quickly run tests and found it to be bacterial, so due to a quick prescription of antibiotics, I got past the worst of it within about a week.

Unfortunately, as pneumonia likes to do, I contracted a bunch of secondary infections, one of which was sinusitis.

The stress of all of this, while trying to work, study in a foreign country, and manage a political party from the other side of the world (I was the President of Pirate Party Australia while in Sweden!), the stress all got a bit much. It took a lot of energy and willpower to commit myself to start saying “no” to more work, and to just let some things fall apart.

The consequences of not doing this as I felt myself drifting into insanity, while being physically ill and unaware that I have an anxiety disorder, finally forced me into making decisions I should have been comfortable making a long time ago. By April 2015, I had dropped about half of my responsibilities like a brick and immediately felt slightly better. It was very difficult to do, as I felt it was my duty to fulfil the obligations I imposed upon myself.

Upon reflection, nobody else felt those feelings that I did—everyone was simply thankful for the amount of work I’ve done and amazed at what I had accomplished. I wish I could have felt the same, and indeed, even as of now, I don’t feel like I’ve done enough.

At the end of March 2016, back in Australia, I finally had an operation to resolve the sinusitis and related symptoms. Twelve months of suffering chronic sinusitis is very unfortunate and unpleasant, but the resolution is finally upon the horizon.

From blocked noses to finding out you have an anxiety disorder

I was seen by about ten doctors in Sweden, to no avail. Upon returning to Australia, I saw three ENT specialists before one decided there was an actual problem to solve.

The first ENT I saw wanted to rule out idiopathic pain—which can simply be explained as pain created possibly entirely in your mind with no known physiological cause—and other potential causes of sinusitis by prescribing me a low dose of amitriptyline, a first generation anti-depressant that is known to have idiopathic pain-killing abilities.

The pain didn’t go away. But I noticed something else entirely: I could relax, or at least, the closest thing to relaxation I can remember in my entire life.

The luxury of feeling relaxation

I hadn’t realised that I couldn’t relax; that I quite literally had no capacity to wind down. I didn’t know that I had completely forgotten what it feels like to be excited, to feel joy, to not worry.

And it’s not that as a result of the medication that I stopped caring about the things that had value, I was just finally able to recognise those things as priorities, and not obsessing over details that simply didn’t matter to other people.

This was the point that I realised not only that I had an anxiety disorder of some kind, but that I had a treatable disorder. This was so many things, but shocking, surprising and relieving all at once is the easiest way of putting it.

It was also the absence of physical pain in my body that I wasn’t aware was even there until it was gone that was apparent. My IBS entirely dissipated. Gone, just like that. I used to get extreme tension pains in my arms. Gone. My chest hurts from holding my breath without knowing I’m doing it. Also gone.

And amazingly, the worst of my perfectionist tendencies were gone. I still have an extreme attention to detail, and I would not give that up for the world. But attention to pointless factors like how a group behaves, people not completing meeting minutes to my standard, and other factors that simply don’t matter do not stress me or dictate my priorities. I was finally recovering from burnout.

Anxiety, as I felt it

Sometimes, just receiving an email would cause me to get that gut feeling you get when you’re about to panic. Every email was assumed to be a bad thing happening. Unfortunately, when you’re in politics, often emails are simply bad things happening. It makes it difficult to recognise a rational response to a situation versus having an anxiety disorder. The panic went away while I was on medication.

Much of 2011–2012 is a blur, as I would drink about two bottles of rum per month (I might be understating it, I can’t remember). I wasn’t aware of how much I was drinking, nor that I was even self-medicating. I was so focused on “getting the job done” I lost some of my self-awareness.

The worst of the anxiety began in the form of having these mini panic-like attacks. Effectively, for no reason and without any real trigger, my body would simply lock up. I would begin breathing heavily and feel overwhelmed with all of the things, yet there’d be nothing pertinent on my mind, and I would be otherwise relaxed and straight thinking.

My body would simply ache and my breathing would be at a high rate for several hours, sometimes for the rest of the day. I suspect being in a high-stress environment since 2009 (I was involved in administrative and political roles in the Pirate Party since then) has measurable long term effects on your behaviour.

This significantly affects your productivity. It becomes impossible to focus, so for hours at a time, I would be unable to complete any work or do any study, but otherwise be fully alert. I could talk to people, form sentences, and generally do things, but anything that had any level of cognitive overhead would just make the symptoms worse. Time-lapsed burnout. It sucks.

The dance of finding an antidepressant that works

Unfortunately, amitriptyline is—as I said—a first generation antidepressant. The side effect profile of this drug is intense. With me, it induced tachycardia—which at its worst was around 120 beats per minute but usually stayed around 100 bpm—so I had to go off the medication within a month of starting it.

Next drug: escitalopram, a common first-line treatment for depression, and an SSRI. Within a month of taking it, no effect, just side effects such as insomnia, which I’ve never had before, nor since.

So we move onto the stronger pool: venlafaxine, an SNRI drug. This worked quite well, similar to the amitriptyline, but the side effects were quite bad. I was clenching my jaw a lot, causing me to have major headaches. I sometimes had tachycardia. And unfortunately, the weird symptoms of anxiety started to creep back into my life after three months of usage. Raising the dose only made things worse, so I had to kick that drug.

One day I will write an entire post about venlafaxine withdrawal, but suffice to say, it is said to be similar to kicking an opiate addiction. I was trapped in bed sweating like I’ve never sweated, with head spins so bad I needed to throw up and take anti-nausea medication just to keep down water. The price you pay to be in control of your mind.

You might note that at no point do I refer to seeing a psychologist. I did see one for two sessions, but suffice to say we “didn’t make a connection.” He seemed intimidated by me, and I didn’t trust him at all.

Unfortunately, general practitioners, when it comes to mental health issues in my experience, rely entirely on the patient to essentially self-direct their medical care. I saw the psychologist the first time only at my suggestion.

There is also significant lack of understanding of these issues from a GP, particularly around withdrawal consequences when you have to change medications.

I do not want to speculate on how the system could function better in this article, but suffice to say that it’s struggling in its current mode of operation and we could do a lot better on mental health.

And den?

As I write this article, I am currently unmedicated. I’m also working professionally and full time, I am studying part time, and I am still more involved in politics than I probably should be, and of course, have to deal with my personal life as we all do. This is a lot to have on your plate when you’re fully of sound mind, let alone knowingly not.

All of the irrational responses that I have no control over have returned: the pain in my arms, the breath holding, the headaches, the IBS. Medical treatment however is becoming unlikely to work for me at this point.

I have an appointment with a cognitive behavioural therapist in the next couple of weeks for the first time. I had to specifically ask my GP to find a clinical psychologist who follows rigid CBT practices, as I have no desire to debate pseudoscientific feelings based treatment options.

One bad experience with part of the medical field is not a justification to simply give up. If at first you don’t succeed, blame the horrible system and fight it to the end.

Non-CBT psychology hasn’t worked for me in the past, and it hasn’t worked for any person I know who has seen a psychologist. Most of my friends have seen ten or more psychologist before they find one that is helpful, if they ever find one at all. However, CBT has seen similar efficacy to medication, and higher efficacy in parallel to medication. I am hoping this will work for me to cope with my responses to stressful events.

Failing that, next step is to see a psychiatrist to get a full evaluation and diagnosis, so more treatment options may avail themselves.

Conclusion

I am writing this in the hope that people who bite off way more than they can chew like me might recognise some of the behaviours in themselves, and see that they might have a treatable anxiety disorder. It means you can continue to bite off large amounts without being completely drained emotionally and physically.

Nobody ever recognised that I had an anxiety disorder, no matter how close they were to me—in fact, the closer someone was to me, the more surprised they were when they found out.

It seems that I am always perceived to be strong and composed, with a non-quivering voice and strong ability to convey a point no matter how stressful, even if my brain is entire on fire. Even now when I discuss this with people, people are reluctant to believe that this person before them could ever have a mental illness.

The stress weakened my immune system to the point where I contracted illnesses every month since the election in 2013. This is a consequence of unreasonably high levels of stress that many people seem unaware of. Even without an anxiety disorder, unmanaged high levels of stress are harmful to your physical health as well.

People responding badly to the premise that you might have a mental illness should not be a cause for you disregard this as something to follow up with a medical professional. My mother was receptive to the premise that I have an anxiety disorder, though largely still doesn’t understand it, while my father was entirely dismissive of the premise.

Fortunately, shitty people behaving in a shitty way has no impact on the efficacy of medical science. Seek help, ignore the assholes.

Hopefully, if you recognise any similarities with your own situation, you know that these feelings might not be normal and that not only can you seek help, but you should seek help. It can only help you on your path to become the stronger person you want to be.

If you liked this article, please don’t forget to click the recommendation heart!